HomeMy WebLinkAboutPermit Plumbing 2009-7-7
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00990
ISSUED: 07/07/2009
APPLIED: 07/07/2009
EXPIRES: 01/07/2010
VALUE:
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1086 F ST
ASSESSOR'S PARCEL NO.: 1703351106000
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace water line
Owner: TRENA JAYNE
Address: 1086 F ST
SPRINGFIELD OR 97477
Phone Number: 541-991-0924
Contractor Type
Plumbing
, I CONTRACTOR INFORMA T.IO~r'll \0
, '<'J \O~,- '\.)\\1\\'/
0(\ Ie: 01e90(\ \ 'In
Contractor :(\0\'\'. Ole~ed '0'1 \nUcg'l~ese\ ~,\piration Date
BERNARD PETERSEN'f~b\les ad~~, lnOse \j1f~.YAI'\ 952,'~c '0,/08/23/2011
1~;B'iJillriING~iNF0RM1Ii@N i ~~~e?~O(\e
\0 0f'\\7~ ll\a'l JL.~' ,\-Io\e, ,':'~ \,\o\\\\Ca\\O(\
00911.ofSYof~es:J(\te '890(\ \J\\1\\~'j44). Lot Size:
cH~ig'i\i\of(Stru.Q&reoo-'j'j'2--,;. Sq Ft 1st Floor:
\5H\ IV . \-0
(\lI'ype o[}I-e''''tt \s Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Buildi,ng: n/a Occupant Load:
Phone
541-343-9339
# of Units: .
Primary Occupancy Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms: '
R3
VB
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact: ,
r: \)IJO\'l"
\'IE \f If\.. ~OI
;.~.~"Ir.f.:, ,;,Ir1.' ~?I, ;:.71'" IS
I PUBLIC IMPROV,E~~'\l~ \l~\)t\'lIf\\';:, ~o~t\) fO\'l
, , i'j ~ ' llu ,,"l'.I'>,~u
p,Ij\\"l n:'CE\) QRd~hlJ{ Type:
coWlWltl' nt:P-IO\).
p,~'i '\ 80 \)p,'i Vownspouts/Drains:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction :
Notes:
I V a~uation Descr~Dtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
q"'I\lGI'lIIU.:O',
-""1;~"" "("~d""".A.".v'" ".,-.'
, ,
,
I
Status
Issued
225 Fifth Street, Springtield, 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
Fees P~id I
Date Paid
Plan Reviews I
717/09
717/09
717/09
CITY VI' ~rKll~GFIELD
Building/Combination Permit
PERMIT NO: COM2009-00990
ISSUEQ: 07/07/2009
APPLIED: 07/07/2009
EXPIRES: 01/07/2010
VALUE:
Receipt Number
2200900000000000763
2200900000000000763
2200900000000000763
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 R~?l!ir~~ In~n~.~.ti,,!~s I
Water Line: Prior to tilling 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 ofSpringtield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structnre without permission of the Community Services Division, Building Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 further agree to ensure that all required inspections are requested at the proper time, that each address 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.
C ~ ~WV
Owner or contractortf'igr0Jre
Paee 2 of2
117/v?
Date
225 Fifth &t,:,eet
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00990
COM2009-00990
COM2009-00990
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Water Line - 1st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
TRENAJAYNE
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000763
Date: 07/07/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 322599 In Person
Payment Total:
Page I of I
9:04:14AM
Amount Due
76.00
3.80
9.12
$H8. 92
Amount Paid
$88.92
$HH.92
7/7/2009