HomeMy WebLinkAboutPermit Plumbing 2009-6-9
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Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00818
ISSUED: 06/09/2009
APPLIED: 06/09/2009
EXPIRES: 12/09/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2355 YOLANDA AVE
ASSESSOR'S PARCEL NO.: 1703244402200
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Public
PROJECT DESCRIPTION: Replace water line
,
Owner: SPRINGFIELD SCHOOL DISTRICT 19
Address: 525 MILL ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION ~
Contractor Type
..,.9Jntractor _ I
\\nli'\ ~~'S LH
I BUILDING INFORMATION I
License
'W"ID.oq
Expiration Date
Phone
# of Units:
Primary Occupancy 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 1
"
:: REQUIRED PARKING
Total:
Handicapped:
Compact:
Front yard Setback: Overlay Dist:
Side 1 Setba~!HENTION: Oregon law requires yotliAtreet Trees Rqd:
Side 2 Setb~~0W rules adopted by the Oregon Ulllly,ed Drive Rqd:
Rearyard !:?~!I1~~.k":lion Center. Those rules are set%I()~ Lot Coverage:
Solar Setb:lcks:~R 952-001-0010 through OAR 952-001-
................. ~,___ ,__~_. _1_..._~_ __~:__ _.J'"I-..... ~,.1_..... L-...
- - - -. . - - . ---J -.- I ~
. calling the center. (Note: the IFPUBm(]; IMPROVEMENTS I
number for the'Oregon UtilOtty t\lVllll'-'l;.l.UVII
Street ImpJ'ovemen~ior;ter is 1-800.332-2344). . Sidewalk Type: '
Storm Sewer Available: . Downspouts/Drains:
Special Instruction :
Notes:
NOTICE:
THIS PERMIT SHALL EXPIRE:IF THE WORK
^ lIT) 'rr.l""Il""7!'"'"n 1Ift.ln"-"'" "'rl "..... ....~....~ ft...... ,..... .........
....... "....., ,..-....... ....,~.J...., I ,t "'-' , """ "",,, IV I~J,
Description
Tvpe of Construction
I Valuation Descr1fti~~E'~CED OR IS ABANDONED FOR
"I,r r uu DAY PERIOD.
$ Per Sq Ft Square Footage'
Value Date Calculated
or multiplier or Bid Amount
Pae:e I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00818
ISSUED: 06/09/2009
APPLIED: 06/09/2009
EXPIRES: 12/09/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726'3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fe~s Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
WaleI' Line - 1st 100'
Water Line - Each AddtlIOO'
Amount Paid
Date Paid
$ 13.68
$5.70
$76.00
$38.00
6/9/09
6/9/09
6/9/09
6/9/09
Receipt Number
3200900000000000434
3200900000000000434
3200900000000000434
.3200900000000000434
Total Amount Paid
$133.38
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.
I Reollil'ed Insnections 1
Water Line: Prior to filling trench and including required testing.
By signature, I state aud agree, that I have carefnlly 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 doue 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 Servi"es 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 frum the
street, that lhe permit card is located at the front of the property, and the approved set of plans wIll remain on tbe site at all
times during construction.
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Date! {
OWD.er or Contractors Signature
Pae:e 2 of 2
225,Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00818
COM2009-00818
COM2009-00818
COM2009-00818
Payments:
Type of Payment
Check
cRt':ceintl
. RECEIPT #:
Description
Water Line - 1st 100'
Water Line - Each AddU 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
TWIN RIVERS PLUMBING
City of Spl'ingfield Official Receipt
Development Services Department
Public Works Departmcnt
,.
3200900000000000434
Date: 06/0'9/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
31026
In Person
Payment Total:
Page I of 1
2:09: 13PM
Amount Due
76.00
38.00
5.70
13.68
$133.38
Amount Paid
$133.38
$133.38,
619/2009