HomeMy WebLinkAboutPermit Plumbing 2005-12-05Building/C ombination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2005-01688
ISSUED:
APPLIEDz 1210512005EXPIRES: 06/0512006
VALUE:
SITEADDRESS: 406S42ndPl
ASSESSOR'S PARCEL NO.: 1702323300601
' PROJECT DESCRIPTION: site work, 60lf sanitary sewer, 0ffifgfine
Springfield TYPE OF WORK: Site Work Only
TYPE OF USE: New
Expiration Date
03t26t2007
Residential
r-741-1707
Phone
541-895-4517
Owner:
Address:
Contractor Type
Plumbing
SPFD EUGENE HABITAT
PO BOX 488
SPRINGFIELD OR 97477
FORHUMANITY AUTHORIZED UNDER THI
OMMENCED OR IS ABANDONED FORC
lNY
Contractor
TOM CHARPENTIER PLUMBING INC
License
112138
.ORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Yo ofLot Coverage:
n/a
Sidewalk Type:
Downspouts/Drains:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Description Type of Construction
Page I of2
Value Date Calculated
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Valuation Description I
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield' OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Fee Description
+ l0o Administrative Fee
+ 77o State Surcharge
Sanitary Sewer - lst 50 Feet
Sanitary Sewer Each Addtl 100'
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
Total Amount Paid
Total Value of Project
Date PaidAmount Paid
$rr.80
$8.26
$4s.00
$14.00
$4s.00
$14.00
$138.06
Receipt Number
2200s00000000001667
2200500000000001667
2200500000000001667
2200500000000001667
220050000000000r667
2200s00000000001667
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Fees Paid
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection 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 work
day.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
stree! that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times construction.
Owner or
Pase2 of2
Date
/2- 72{
PERMIT NO: COM2005-01688
ISSUED:
APPLIEDz 1210512005
EXPIRBS: 06/0512006
VALUE:
Kequrreo ltrsDecuons I
2fi Fifth Street
- Springfield, Oregon 97 477
541-726-3759 Phone
^ity of Springfield Official Receipt
_.lvelopment Services Department
Public Works Department
RECEIPT #: 2200500000000001667 Date: 1210712005 12:03:20PM
Job/Journal Number
coM2005-01688
coM200s-01688
coM200s-01688
coM200s-0r688
coM2005-01688
coM2005-01688
Description
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
Sanitary Sewer - lst 50 Feet
Sanitary Sewer Each Addtl 100'
+ 7Yo State Surcharge
+ lOYo Administrative Fee
Amount Due
4s.00
14.00
45.00
14.00
8.26
I1.80
Item Total:$138.06
Payments:
Type of Payment Paid By Received By Batch Number Number How Received Amount Paid
CheckNumber Authorization
Check SPRINGFIELD EUGENE
HABITAT FORHUMANITY
ddk 24071 In Person
Payment Total:
$138.06
$r38.06
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