HomeMy WebLinkAboutPermit Plumbing 2009-8-7
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Status
Issued
CITY OF SPRINGFIELD
Building/C~mbination Permit
PERMIT NO: COM2009-01l54
ISSUED: 08/07/2009
APPLIED: 08/07/2009
EXPIRES: 0210712010
VALUE: '
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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.
SITE ADDRESS: 1664 MAIN ST
ASSESSOR'S PARCEL NO,: 1703363103301
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Water line
Owner:
Address:
GRAZIER DEAN STEW ART
1664 MAIN ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Plnmbing
Contractor
OWNER
License
Expiration Date Phone
VB
BUILDING INFORMATION I, '
NCJtifir.Ati;,~;~ "uOPied by th~eqUlres you to '
in#'ofjStorie,s:,enter, Those OregOn LLot,Size:
-, I I tJQ:.J f1I)-f ru/ ''',tv'
OGHeight of StrnCture) throu I es are setS<j,Ert 1St Floor:
-~. lUll ~~" 9 I OAR .... ~ I
cType(of,Heat: obtain cOPI'e '952,Sg ,Ft 2nd Floor:
''"''''leN. sotth -,,-
nlWater Type:,nter, (Note' th e ruleSq)lit Basement:
..........1 II.{ t11A 0 'e tel- r
Rang~I.Y,p"er regon Utility N ephorSq Ft Garage/Carport
Energy Path:/S l-BOO-332,234t,t,catlsq Ft Qther:
Sprinkled Bnilding: n/Q, Occnpant Load:
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Construction Type -
Secondary Construction Type:
# of Bedrooms:
R-3
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:'
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
, Paved Drive Rqd:
N % of Lot Coverage:
"r,.or'Cf'
. "1,) .',~
AU.THd,~,UBJi,JG,I~~R~VEMENTS' '
COMMEN'-I::D UNDl'Rl/:'XPIRE IF ,Sidewalk Type:
ANY CED 0 "THI THE .
180 DAY R IS A8 S PERMIT W~nspontS/Drains:
PERIOD, 'ANDONED FdZ NOr . '
Total:
: Handicapped:
. Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Tvpe of Constrnction
$ Per Sq Ft
or multiplier
Sqnare Footage
or Bid Amount
Valne
Date Calculated
Paee 1 of2
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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
Total Value of Project
Fe~s Pai~ I
Amount Paid
Date Paid
8/7/09
8/7/09
8/7/09
CITY OF 1'lrKll~vNJ',LD
Building/Cqmbination Permit
PERMIT NO: COM2009-01154
ISSUED: 08/07/2009
APPLIED: 08/07/2009
EXPIRES: 02/07/2010
VALUE:
Receipt Number
,
2200900000000000899
2200900000000000899
2200900000000000899
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. wilfbe made'the following'
work day.
$9,12
$3,80
$76,00
$88,92
I Plan Reviews I
I Re/lllired Tnsneetions I
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 ofthe 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 from the
street, that the permit card is It cated at the front of the property, and the approved set of plans will remain on the site at all
time ring const Ictiol '\
;1, ~ ~ cE-7-()~
O,~r Contractors Signally Date
i I
Page 2, of 2
225 Fifth Street
Springfield; Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01154
COM2009-0 1154
COM2009-01154
Payments:
Type of Payment
Cash
Change
Job/Journal Number
COM2009-0 1154
COM2009-0 1154
COM2009-0 1154
Payments: '
Type of Payment
Cash
Change
cReceintl
RECEIPT #:
Description
Water Line - 1st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
DEAN GRAZIER
DEAN GRAZIER
Description
Water Line - 1st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
DEAN GRAZIER
DEAN GRAZIER
, '
City of Springfield Official Receipt
Development Services Department
Public Works Department
i
2200900000000000899
,
Date: 08/07/2009
Item Total:
Chec~ Number Authorization
Received By Batch'Number Number How Received
djb
djb
In Person
In ~erson
Payment Total:
Item Total:
Check Number Authorization
Received By BatchiNumber Number How ~eceived
djb
djb '
In Person
In Person
Paym~nt Total:
Page 1 of 1
2:44:25PM
Amount Due
76,00
3,80
9,12
$HH,92
Amount Paid
$100,00
($1108)
$HK 92
Amount Due
76,00
3,80
9,12
$HK 92
Amount Paid
$100,00
($1108)
$H8,92-
8/7/2009