HomeMy WebLinkAboutPermit Plumbing 2009-1-13
--,~'''ir!!i~~~;l~" ,,; ~
~,,', '-d':,' .~, ,.",'t i<";"'j<'
.,
<
Status
Issued
CITY.OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00054
ISSUED: 01113/2009
APPLIED: 01-/13/2009
EXPIRES: 07/13/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5792 FORSYTHIA ST 5794
ASSESSOR'S PARCEL NO,: 1802041100124
SPRINGFIETYPE OF WORK: Plum~i1lg Only
TYPE OF USE: Repair
.PROJECT DESCRIPTION: Replace two water lines, each approx 40' each
Residential
Owner: NICHOLS DAVID & KRISTINE
Address: 88608 ERMI BEE RD
.sPRINGFIELD OR 97478
Phone Number: 541-744-7991
I CONTRACTOR INFORMATI?N 1
Contractor Type
Plumbing
Contractor License
READY ROOTER DRAIN CLEANING & R SI192524
I BUILDING INFORMATION I
Expiration Date
02118/2009
Phone
541-744-7991
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Coustruction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
_. ,oJ
Lot Size:,
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Ba~ement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION 1
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
<;ompact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Sidewalk Type:
Storm Sewer Available: DownspoutslDrains:
Special Instruction: . ou to
O n law reqUires Y
ATTENTION: rego the Oregon Utility
Notes:follow rules adoPte~hb~e rules are set forth
..~tif,,..~tion center.. 0 .,'_ '" ^ 0 Q<';9-001-
In OAR 952-001-UU 1\:' "~;pi~~ of the rl-';"o'~i I
0090., You may obtal(Note: the tele~t-~Maluation Descriotion
calling the centoer. n Utility Notiflcalloll ..
, !l"mber f~the rego ~",0"'44) $ Per Sq Ft' squaretm""""E" ,,""I".UlnQ~
Descno 0'0" Ce YlI/'i!!f-j:lloStililiu9ll' ' , It' I' B'd I ru. HYfllu~P IRE \fijullll:Ulfll1ll ed
o. mu 'p ler or I QJlIUERM\1 S ALL!:^ IT IS NO
THI::> \" NDER THIS PERM I
, AUTHORIZED U IS ABANDONED fOR
COMME.NCED OR
Paee I of 2 ANY 180 DAY PERIOO. ,
- G!l!"'!lt',9!il'l!I~~: ..,.~
'1
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00054
ISSUED: 01/1312009
APPLIED: 01/13/2009
EXPIRES: 07i13/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Pair! I.
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - 1st 100'
Amount Paid
Date Paid
Receipi:Number
$18,24
$7,60
$152,00
1/13/09
1/13/09
1/13/09
2200900000000000043
2200900000000000043
2200900000000000043
Total Amount Paid
$177.84
Plan Reviews I
To Reque'st an inspection call the 24 hour recording at 726-3769, All inspectio,ns 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 Reoll;,'ed InSlJections 1
I rill"
Water 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 contract~~ and employees who are in compliance with ORS 701.005 will be used on this project,
I further agree to ensure that all iequii-edin~pections are requested at the proper time, that each address is readable from the
street,.that the permit card is located at the fronjf the property, and the approved set of plans will remain on the site at all
,I d" , {/
times ~urmg construc~on, .
l /,1_/( _' ^-1 1--- (}.-C) /'
Owner orto tractors Signature Date
Paee 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone'
~
Job/Journal Number
COM2009-00054
COM2009-00054
COM2009-00054
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Water Line - 1st 100'
+. 5% Technology Fee
+ 12% State Surcharge
Paid By
DAVID NICHOLS
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000043
Date: 01/13/2009
1:19:29PM
Item Total:
Check Number Authorizatio~
Received By. Batch Number Number How Received
Amount Due
152.00
7.60
18.24
$177,84
Amount Paid
LLH
015830 In Person
Payment Total:
$177.84
$177.84
Page I of I
1/13/2009