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HomeMy WebLinkAboutPermit Plumbing 2001-9-27 -. / .- SPRINQFIELD ~- . I Job# 01-01060-01 . Page 1 of 2 TRANS#:Ol-0006830 DATE:SEP 27 2001 AMT RECD:1 $ 52.00 CHANGE:$ 0.25 CASHIER:061 CITY OF SPRINGFIELD, OREGON 225 North Fifth Street Springfield, OR 97477 Location Of Proposed Site: 3444 Assessors Map#: 17023131 Lot: Block: Owner: Address: Thomsens Market 3444 Main Slreet Scope Of Work: Plumbing Thomsen's Market Sign Storm sewer repair Contractor Type Plumbing Conlr COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-01060-01 Main Sl Spr Office: 726-3759 Inspection Line: 726_376~. Tax Lot #: 00800 ~ Subdivision: Addition: Phone Number: City/State/Zip: Springfield, OR 97478 New Value: $0 Contractor Mr Rooler PO Box 50154, Eugene, OR 97405 Phone 541-343-4404 Registration # Expiration Date 147076 2/1/2003 Office Use uta N requireS yo .. Land Use: ilON:oregon \a~ oregon#_Of.IB~lldmgs: Zoning~Cb'd~~ les ac;oiltad bY tM \'S aie Occupancy Group: ._II~'II/ ru -rhose ru ~ ,n ~"1_ Bedrooms: t'on center. \" gh OAR 'Heat Source: .. tH\ca \ 010 tnrol.! ""\fi" t'I" Water Heater: Rang'~::"!l.f\ 952-001-0~._,,, ~ooies at t\1:~~:.~gotage: ";"'nQO- 'Iou fl'GlY ....::-.. (Note: tne lC:I:'~i';?tion To requesl an inspection call1he 24 hour recording.?,\\?i?J>,3769!n~~~n~p.e.s~.on.streq'ueslea before 7:00 a.m. will be made lhe same working day, inspecliohs requesle(j(after'7:00,a:m~will\be made lhe following working day. nun'''"'6~n(3riS 1-11Uv-,,v-- Quad Area: # Of Units: Constr. Type: Required Inspections I Plumbinll - Prior to filling lrench, Storm Sewer Line Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ,Area (Sq. Feet) I Main: Accessory: Fee Minimum Plumbing Permit Fee %Oi\CE: XPIRE If '\'\-IE WOR\<. ,\-lIS ?ERM\1 S\-I/l.LL; 1\-\IS PERM\'\' IS NO'\' # Of Storie~:,"'LlOo\ZEO UNOEHeight.{feet)i.l fOR Il.u'" " '" ~H",NuU:'- Current Units, : ."",Mc;E.D OR I'Proposed Units: f.\l"'\t..1I.\lJ1_1'i,I Census Cotte: Does not'iapI1IY,IC'D. lit-I\! 1.RGUM. .- I j.... Total: Paid On Receipt# Plumbin!! 09/27/2001 6830 Value/Quantity Fee Amount $.00 ....... -I Job# 01-01060-01 - Page 2 of 2 /' Fee Paid On Receipt# Plumbing 09/27/2001 6830 09/27/2001 6830 09/27/2001 6830 Value/Quantity Fee Amount Slale Surcharge - Plumbing Storm Sewer Foolage Administralive Fee - Plumbing Total Plumbing Grand Total By signalure, I state and agree lhat I have carefully examined the completed applicalion and do hereby certify lhat all information herein is lrue and correcl, and I further certify lhal any and all work performed shall be done in accordance wilh the Ordinances of lhe City of Springfield and lhe Laws of the State of Oregon. I further stale thai only contraclors and employees who are in compliance wilh ORS 701.055 will be used on this project. I further agree to ensure lhat all required inspections are /?~~e projecl address is readable from lhe street. ;::? tf.; ~ 27 t.Slgnatq Date 45 $3.15 $45.00 $3.60 $51.75 $51.75