HomeMy WebLinkAboutPermit Plumbing 2009-7-1
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Status
Issued
CITY OF SPRINGFIELD
Building/C~mbination Permit
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PERMIT NO: GOM2009-00966
ISSUED: 07/01l2009
APPLIED: 07/01l2009
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EXPIRES: 01l01/2010
VALUE:
225 Fifth Street, Springfield; OR
541-726-3753 Phone
541-726-3676 Fax
54I-726-3769 Inspection Line
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TYPE OF USE: New
//a./')'7 b (;.. 1
O/7z'::y
Residential
SITE ADDRESS: 980 54TH ST
ASSESSOR'S PARCEL NO.: 1702283403200
Springfield TYPE OF WORK: i'eIlJ~
PROJECT DESCRIPTION: Water Line
Owner: DA VIS SCOTT D
Address: PO BOX 72435
EUGENE OR 97401
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I CONTRACTOR INFORMATiON I
Contractor Type
Plumbing
Contractor
OWNER
License
Expiratipn Date Phone
BUILDiNG INFORMATION I
# 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 l~t Floor:
Sq Ft l'nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
,
Occupant Load:
if
n/a
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
Ii REQUIRED PARKING
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I~ Total:
I' H d' d
ii an Icappe :
, Compact:
I PUBLIC IMPR?VEMENTS I
Street Improvements: . Sidewalk Typ~:. ~s yoU to
O,'~n()n laW re1;\u1r" . utility
Storm Sewer Available: '.TTENTION: 'Downspouts/Drains" , th
,... d pleo "1 ".- . -t lor
Special Instruction: loilow rules a 0 Those rules are s"2 001-
NOTIG'" 'f tion Center. hOAR 95 -
1;: Noli \ca 52_001-0010 throug lthe rules by
Notes: THIS PERMIT SHA in OAR 9 u may obtain caples ~ telephOne
^"T..~_._ . . LL EXPIR>: Ii' TUC "'A~" n090. Yo_,^, INote. th " ..,,__>inn
COM;~EN"'CcCU UI~UtR THIS PEk11//!IIR '~I;"~' v':'::'~::I';~~ the oregon Ul\lllid44)H-
A ED OR IS ABANDONE - \laluation DescriDtionEntei is 1_800-332- , '
NY 180 DAY PERIOD L. 'v" ....~ .
. . '. $ Per Sq Ft Square Footage
Descnphon Tvpe ofConstruchon I' I' B'd A Value Date Calculated
Of mu tip lef Of I mount
Paee I of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line,- 1st 100'
Total Amount Paid
Amount Paid
$9.12
$3.80
$76.00
$88.92
Total Value of Project
Fe'" Paid.
II I III 1
Date Paid
7/1/09
7/1/09
7/1/09
I Plan Reviews ,
CITX OF SPRINGFIELD
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Building/Combination Permit
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PERMIT NO: COM2009-00966
ISSUED: 07/01/2009
APPLIED: 07/01/2009
EXPIRES: 01101/2010
VALUE:
Receipt Number
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3200900000000000505
3200900000000000505
3200900000000000505
To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. wilIi!be made the following
work day.'
I Rellliredln,"ection'J
Water Line: Prior to filling trench and including required testing.
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By signature, I state and agree, that I have carefully examined the completed application and do h~reby certify that all
information hereon is true and correct, and I further certify that any and all work performed shali'be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the w&rk described herein, and
that NO OCCUPANCY will he made of any structure without permission of the Community Servifes 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 aadress 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 construction.
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Owner or Contracto~;Signature
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Paee 2 of 2
7/IO?
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00966
COM2009-00966
COM2009-00966
Payments:
Type of Pa'yment
CreditCard
cRcccintl
RECEIPT #:
Description
Water Line - 1st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
SCOTT D, DAVIS
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City of Sprj,ngfield Official Receipt
Deve1opme:nt Services Department
Public Works Department
,
3200900000000000505
Date: 07/01/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
nJm
o l828c In Person
;1
Payment Total:
,
Page 1 of 1
8: 18:03AM
Amount Due
76,00
3.80
9.12
$88.92
Amount Paid
$88.92
$88.92
7/1/2009