HomeMy WebLinkAboutPermit Plumbing 2008-8-27 (2)
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01297
ISSUED: 08/27/2008
APPLIED: 08/28/2008
EXPIRES: 02/27/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-376Hnspection Line
SITE ADDRESS: 2140 5TH ST
ASSESSOR'S PARCEL NO.: 1703262105900
Springfield TYPE OF WORK: Plnmbing Only
TYPE OF USE: Repair
PROJECT DESCRIPTION: Replace Existing Water Line approx 75' Feet
Resid'ential
Owner: ULLMANN ELAINA MARIA & A J
Address: 2140 5TH ST .
SPRINGFIELD OR 97477
Phone Nnmber: 541,359-7501
Contractor Type
Plumbing
Contractor
OWNER
I CONTRACTOR INFORMATION I
License . Expiration Date Phone
BUILDING INFORMATION I
# of Units:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
SprinKled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
. Occupant Load:
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Frontyard MOO!ON' Oreg I I Overlay Dist:
S. . on aw requ res you In,
tde 1 Set~ rules adopted by th 0 U ,v.""treet Trees Rqd:
Side 2 Se~~If1cation Center. Those r~le;~1~~et ~rred Drive Rqd:
Rearyardilii@l1lRlS62,OOI,OOlO through OAR 952-0~1 ~f Lot Coverage:.
Solar Set~;;_Y.?~_ may obtain copies of the rules bv
~J -..- ""...",..... ,'VVlv. tilt:::' It:::''....1n~::''"\
number for the Oregon Utility NdtllA!PMf- IMPROVEMENTS'
Center is 1-800-332-2'344) , ""
Street Improvements: .
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Notes:
NOTICE:
THIS PERMIT SH . .
AUTHORIZED UN~LL EXPIRE IF THE WORK
r.nAnn'''''n~_ _ ER THIS PFRMIT It' "S.
I fllVY 1 R -g"~. u ':In /1:> AI:iANDONED FOR .
Valuation Descrintl J)'IY PERIOD.
DownspoutslDrains:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 01'2
Status 'Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - 1st 50 Feet
Water Line - Each AddtllOO' .
Total Amount Paid
Amouni Paid
. $6.90
$8.28
$3.45
$52.00
$17.00
$87.63
Total Value of Project
Fees Paid J
Date. Paid
8/28/08
8/28/08
8/28/08
8128108
8128/08
I Plan Reviews I
CITY OF SPRII'llJ1<lELD
Building/Combination Permit
PERMIT NO: COM2008-01297
ISSUED: 08/27/2008
APPLIED: 08/28/2008
EXPIRES: 02/27/2009
VALUE:
Receipt Number
2200800000000001298
2200800000000001298.
. 2200800000000001298
2200800000000001298
220080000000000t298
To Request an inspection call the 24 hour recording at 726-3769. 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
work day. "
I ~,~ol~,jred ~\':oections I
Water Line: Prior to tilling trench and including required testing.
By signature, I state and agree, that I have caref~lIy,examined the completed application and do hereby certify that all
information hereml is true and correct, and f'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 aud 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
street, 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 during consh",uction.
AJ (;0<---
Owner or Contractors Signature
Page 2 of2
'8h~/z.()(J8
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Plione
Job/Journal.Nul11ber
COM2008-0 1297
COM2008-0 1297
COM2008-0 1297
COM2008-0 1297
COM2008-0 1297
Payments:
Type of Payment
CreditCard
...
cReceintl
RECEIPT #:
. Description
Water Line - 1st 50 Feet
Water bine - Each Addtl 100'
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
AJU;;MANN
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000001298
Date: 08/28/2008
8:42:06AM
Item Total:
Check Number- Authorization
Received By Batch Number Number How Received
Amount Due
52.00
17.00
3.45
8.28
6.90
I $87.63 .
Amount Paid
IIh
07792b In Person
Payment Total:
$87.63
$87.63
.'
Page 1 ofl
8/28/2008