HomeMy WebLinkAboutPermit Plumbing 2000-03-24Job# 00-00459-01
RESIDENTIAL PERM!T
City Of Springfield
Community Services Division
Building Safety
Pagel ot2
IITHNUS: UI-UUUIUJJ
DATE:Hf,R 24 :OOO
Al{T RE[D:2 $ ].0.50
IHANEE:
IHSHiER;05?
SPRINGFIELD
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2525 00031st St Spr
AssessorsMap#: 17021934
Lot: BIock: Addition:
Job Number: 00-00459-01
Office:726-3759
!nspection Line: 726-3769
Tax Lot #: 00300
Subdivision:
ctTY oF SPRfiNGFfiEL4 OREGON
Owner: Melvin and Carol Mead
Address: 2525 31st Street
Scope Of Work: Plumbing
backflow permit
Phone Number:
City/State/Zip:
Alteration
541-746-2344
Springfield, OR97477
Value: $O
Contractor Type
Plumbing Contr
Contractor
Meadow Landscape Services
1755 Clearwater Lane, Springfield, OR
97478
Registration #
6695
Expiration Date
411100
Phone
541-726-9903
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Required lnspections
Plumbing
Backflow Device -After device is installed but before backfilling trench
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:Accessory
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee 03t24t2000 1033 $5.00
lr'rGF llLLC)
CAL PERHIT APPLICATION
1
!3u{o b
@DEL
Permits are non-transferabie and expire
if vork is not staf,ted vithin 180 days
of issuat:ce or if vork is suspended for
180 days.
2. COT,ITRASTOR INSTALT,ATION ONIY
Electrical Contractor DEXO.!;} ELE{-
Address
city (-fZ \u*W. . vhone %?,f*$to
Superviscrr License Number ,\llt14 --Expiration Da rc lO - eC -,.
Constr Contr. Number
Expiration Date r-tr
Si ture of Supervisi c t rrclan
225 FIFTE STREET
SPRINGFIELD, OREGON
INSPEGTION REQUEST;
0FPICE: 726'3759
OF
Owne ame
Address ST
Ci ty hone
OIJNER LATION
The installation is being made on
property f ovn vlrich is not intended'for sa1e, Iease or rent.
Orners Signature:
DATE:
b Nunber
SCHEDUIJ BBLOV
llev Residential-Single or
Multi-FamilY Per dvelling unit'
Service rncluded t ,,"r" cost
601 amps
Over 1000
to 1000 amps
l3:fiqH[$F+"11,'i33 $ 85 oo
sqTHBti:'Dlrrllo$ldAbb EXPIRE lF THE WORK
, jlfi rfi $*,lWW i,tWF qLIH I s P ERM rf I S ft 0q0
Mo66Letf t[/e$ Iilft S AHANDON ED FOR
Serr!$qq.',gt, FSpAF+n $ 40.00
Services or Feeders
InstaIlation, A1 rerations
or Relocation:
200 amps or less g,
201 amps to 400 amPs
-_401 amps to 600 amps
-
?t lO >tt
A
Sum
B
amps /
0n1viii,i..,l_
vol ts
,=.00
.00
.00
.00
.00
.00
300
40
$)
$
$
$
$
50
60
100
130
Reco,qnec t
rrJ
c
0ver
D Branch Circui ts
TI
2
tion
rules
ng-
Brr above
Nev, Alteration or Extension Per Panel
One Clrcuit $ 35.00
Each Additional
Circuit or uith Service
or Feeder Permi t dO $ 2.00 </O
I'tiscellaneous ( Service/ f eeder not included)
-Each installation
Pump or irrigation
Sign/Out1ine Lighti
Linri ted Energy/Res
Limited Energy/Comm
$ 40.00
s 40.00
$ 20.00
$ 36.00
5 SUBTOTAL OF ABOVE
5Z State Surcharge
3?{ Administratiwq Fee
TOTA],
nTlrluT\lun ,rrl
,^-lo . oo
Ci ty
a
, .?, C>C)
tt,i f 'l5l : .r l-r
Job# 00-00459-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumb
State Surcharge For Plumbing Permit
Backflow Prevention Device
Plumbing Administrative Fee
Total Plumbing
03t24t2000
0312412000
03t2412000
1 033
1 033
1 033
1
$1.05
$10.00
$.45
$16.50
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein is true and correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the time and that the project address is readable from the street.
S nature Date
$16.s0
CITY OF SPRINGFIELD, OREGON
SPRIiIGFIELO
BACKFLOI{ PREVEMION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTII STREET
SPRINGFIELD OR 97477
OFFICE:
INSPECTION LINE:
726-37s9
726-3769
-)r I 1JOB LOCATION:
.. ASSESSORS MAP *:
^..t(tf t
TAX LOT *:
OVNER:iY)o Lr,1rq:Rr.rt fne;d\>+
ADDRESS:
crrY: Y*r-r NLF it STATE:dR--
PHONE *,'-l.lb- -)34q
zTPz 'i l'l
\S+
l\
BACxFLOll PERMIT IS $15.00 +1.05 (STATE SURCHARGE) + $.45 (ADMIN. rEE) =$16.50
COMRACTOR:/Dt 'jl
ADDRESS: ,-7 t,;'.I r TLt^t*12A2- Ln'rt e PHoNE *: l) b 99o 3
crrr: l'51"F-rxr1ifie?-f\)cl
'11 (
-i
STATE:ZTPz
CONSTRUCTION CONTRACTORS REGISTRATION *:r*EXPTRES: ' V,/ i.t,(;' ,
BY SIGNING THIS PERI.IIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE
BACKFLOV PREVEMION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION
<izo-llog>. r ALSo srATE THAT ALL TNFoRMATToN oN THrs pERMrr/APPLrcATroN rs
conngcT.
\) \-o)
D-TE
FOR OFFICE USE
ra
DATE OF APPLICATION:JOB *:0o-0o45
RECEIPT T: TSSUED BY:
TOTAL N{OTNM COLLBCTED:
1
.)
-