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Home My WebLink AboutPermit Plumbing 2008-12-15 (2) Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01774 ISSUED: 12/15/2008 APPLIED: 12/15/2008 EXPIRES: 06122/2009 VALUE: 225 Fifth Street, Springfield, OR ' 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1135 21ST ST ASSESSOR'S PARCEL NO,: 1703254304300 Springfield TY~E OF WORK: Plumbing Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Replace water line and sanitary line Owner: Address: AUDREY B CHURCHILL FAMILY TRUST 2055 BONNIE LN SPRINGFIELD OR 97477 Contractor Type Plumbing I CONTI~.ACTOR INFORMATION' n. . "''''UN: uregon law reg' Contractor '~ow r~les adopted by th~~~~iI~'Wiration Date ' Phone, ROYAL FLUSH E~~~~kI1; SitR1YIlCro~tIJ s.fl.I fnrlh 12/23/2009 541-895-2072 , OlJownOO~R952-001- (!"lfI~g Yhe center. (Note: the tie r~'es by nUmblll'da;~regon Utility N~~hc~~e Lot Size: , HeljfHeoti6lt<OO01332-2344). Ion Sq Ft I st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: ' Sq Ft Garage/Carport E~ergy Patb: Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I, DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: _% of LotCoverage: REQUIRED PARKING ,Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: NOTICE: I pu~~bijffhWewE,l;'r~PIRE IF THE WORK, _, ,,~,\[L W!er.-nHS PERMIT IS NOT COMMENCED OR IS ABAND6NrnaPo1t'pe: ANY 180 DAY PERIOD. Downspouts/Drains:' Notes: I Valuation DescriDtion l Description Tvpe of Construction $PerSq Ft or multiplier Square Footage, or Bid Amount .,. .. Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: C0M2008-01774 ISSUED: 12/1512008 APPLIED: 12/1512008 EXPIRES: 06122/2009 VALUE: 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project fl"'~. P"i11 Fee Description + 10% Administrative Fee + 12% State Surcba~e + 5% Technology Fee Water Line - 1st 50 Feet + 10% Administrative Fee + 12% State Surcharge, + 5% Technology Fee Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each AddtlIOO' Amount Paid Date Paid Receipt Number $5,20 $6,24 $2.60 $52.00 $6,90 $8,28 $3.45 $52,00 $17,00 12/15/08 12/15/08 12/15/08 12/15/08 12/22/08 12/22/08 12/22/08 12/22/08 12/22/08 2200800000000001745 2200800000000001745 2200800000000001745 2200800000000001745 1200800000000001239 12008000000~0001239 1200800000000001239 1200800000000001'239 1200800000000001239 , Total Amount Paid $153,67 I Plan Reviews I 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. ~lff\\tif)n~J 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 carefnlly examined the completed application and do hereby certify that "II information hereon is true and correct, and I fnrther certify tbat any and all work performed shall be done in accordance witb tbe Ordinances of the City of Springfield and the Laws of tbe State of Oregon pertaining to the work described berein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify tbat only contractors and employees who are in compliance with ORS 701.005 will be used on this project I furtber agree to ensure that all required inspections are requested at tbe proper time, that eacb address is readable from the street, that tbe permit card is located at tbe front ofthe property, and tbe approved set of plans will remain on the site at all times during construction. ' /l /J /" j~ I --)'I1P) Sk--' /./ if i - Owner or C6frt1caCtors Si20ature I I Date Paee 2 of2 225 Fifth Street . .' ,... Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number C0M2008-01774 C0M2008-0 1 774 COM2008-01774 C0M2008-01774 COM2008-0 1 774 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description Sanitary Sewer - 1 st 50 Feet Sanitary Sewer Each Addtl 100' + 5% Technology Fee , + 12% State Surcharge + 10% Administrative Fee Paid By JEFFREY BOWERS City of Springfield Official Receipt Development Services Department Public Works Department 1200800000000001239 Date: 12/22/2008 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 00377p In Person Payment Total: Page 1 of! 9:53:57 AM Amount Due 52,00 17,00 3.45 8,28 6,90 $87,63 Amount Paid $87,63 ) $87,63 12/22/2008