HomeMy WebLinkAboutPermit Plumbing 2001-12-28lsPNINGFTELD
Job# 01-01434-01
RESIDENTIAL PERMIT
C:ty Of Springfield
Community Services Division
Buitding Safety
Page 1 ot2
Job Number: 01-01434-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00300
Subdivision:
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 272 00035th St Spr
AssessorsMap#: 17023131
Lot: Block: Addition:
ctTY oF SPRINGFIELD, OREGOTV
Owner: Ron Holland
Address: 1220 Marsh Street
Scope Of Work: Plumbing
New water line (145')
Phone Number:
City/State/Zip:
New
805-543-4071
San Luis Obispo, CA 93401
Value: $O
Contractor Type
Plumbing Contr
Contractor Registration #
Don Lewis Plumbing 33076
500 Greenfield Street, Eugene, OR 97404
Expiration Date
611012003
Phone
541-688-1 931
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 a1726-3769, 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
-Priortofillingtr"#
Construction Types:
Occupancy Groups:
Water Line
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:Accessory:Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
Minimum Plumbing Permit Fee 12128t2001 7634 $.00
{T
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Job# 01-01434-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbinq
State Surcharge - Plumbing
Water Service Footage
Administrative Fee - Plumbing
Total Plumbing
1212812001
12128t2001
1212812001
7634
7634
7634
145
$4.13
$59.00
$4.72
$67.85
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
at ti that the project address is readable from the street.
nature Date
$67.85
-2P--kD