HomeMy WebLinkAboutPermit Plumbing 2009-5-18
Status
Issued
qTY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00684
ISSUED: 05/18/2009
APPLIED: 05/18/2009
EXPIRES: 11/18/2009
VALUE:
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 970 W L ST
ASSESSOR'S PARCEL NO.: 170327340]800
Springfield TYPE OF WORK: Plumbing Only
TYPE OF, USE: New
Commercial
PROJECT DESCRIPTION: Fixture - Hose Bib
Owner: U A I.... - ^ ...\ " \J...n-e..>
Address: ~en , "U~ ~'" '
q,o W \... ~,~\\.d.
~ 00'
~~ i/.:>'Uu-.'"
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
OWNER
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 Patb:
Sprinkled Bnilding:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENTINFORMATION I
REQUIRED PARKING
Notes:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
^"TUf'\DI7CC, "~ln~R nile: Pi=RMIT IS NOT,
Total:
Handicapped:
Compacl:
ATTENTION: Oregon law requires youto
follow rules adopted by the .oregon ~~~~L
'\lotltlCatlOn velll~l. IllU.;lv ....m...""....._ ---.-
I PUBLIC IMPROVEMENTS 1\ OAR 952-001-0010 through OAR 952-001-
0090,S'i(JeWaI"Yrtvte~in copies of the rules by
calling the center. (Note: the telephone
nuITtBmv~JPr.~Js(p.,.,!!ns: Utility Notlflcatton
Center is 1-800-332-2344).
Overlay Dist:
. # Street Trees Rqd: '
Paved Drive Rqd:
% of Lot Coverage:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Description
r,OWv1ENCED OR qi nl)f\I~lf.UI~lY~UI1. I
,-":', cr, f)~Y PERI:~alua IOn eScflotlOn
$ Per Sq Ft Square Footage
or multiplier or Bid Amonnt
Value
Date Calculated
Type of Construction
,
Paee I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00684
ISSUED: 05/18/2009
APPLIED: 05/18/2009
EXPIRES: 11/18/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees P,aid I
"
Fee Description '
+ ]2% State Surcharge
+ 5% Technology Fee
Fixture
Minimum/Adjustment Plumbing
Amount Paid
Date Paid
Receipt Number
$6.96
$2.90
$19.00
$39.00
5/]8/09,
5/18/09
5/18/09
5/18/09
,]200900000000000462
]200900000000000462
1200900000000000462
]200900000000000462
Total Amount Paid
$67.86
I Plan Reyiews 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.
I Re/luired Insnections I
Final Plumbing: When all plumbing work is complete,
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 witb
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to tbe 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.
[ further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, tbat 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 construction.
C;a:eL~)JJ.(~L'
Owner or ContraCtors Signature
Date
Paee 2 op
225 Fifth Street
Springfield, Oregon 97477
541-726~3759 Phone
a~1~QF~~
Ja:,...
City of Springfield Official Receipt
DeyeIopment Services Department
Public Works Department
Job/Journal Number
COM2009-00684
COM2009-00684
COM2009-00684
COM2009-00684
Payments:
Type of Payment
Check
cRcceiotl
RECEIPT #:
1200900000000000462
Date: 05/18/2009
Description
Fixture
Minimum/Adjustment Plumbing
+ 5% Technology Fee
+ 12% Slate Surcharge
Paid By
ADELINE KATSCHEN
Item Total:
t:heck Number Authorization
Received By Batch Number Number How Received
njm'
3044
In Person
Payment Total:
Page I of I
10:08:59AM
Amount Due
19,00
39,00
2,90
6,96
$67.86
Amount Paid
$67,86
$67.86
5118/2009