HomeMy WebLinkAboutPermit Plumbing 2009-9-10
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01336
ISSUED: 09/10/2009
APPLIED: 09/10/2009
EXPIRES: 03/10/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1247 HAYDEN BRIDGE RD
ASSESSOR'S PARCEL NO,: 1703261101600
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace approx 301fwater line
Owner: ZARZYCKI DAVID M
Address: ,344 RIVER RD
EUGENE OR 97404
I . C<;'NTRACTOR INFORMA TION ,.
Contractor Type
Plumbing
Contractor License
CARLOS GILBERT MACIAS & RAQUEL TO 110117
I, B~ILDING INFORMATIO~,i
Expiration Date
01/03/20 I 0
Phone
541-607-8740
# of Units: ATTENTION: Ore,#JOfISrorties::'Jires you to
Primary Occupancy Group: follolRJ31les adopt'Heighflor SIii1l'tuteJlility
Secondary Occupancy Group: Notification Center. Type'iiJti'H'eat:1re set forth
Primary Construction Type in OArvjp2-001-001WifterL1;yp~AR 952-001.
Secondary Construction Type: 0090" You may obt<Range"Jitypef the rules by
# of Bedrooms: calling the center'Eh'lirgy:pli'th!elephone
number for the Omsnnn k' ',Hill'('B' Mlnd':f;~ation
I!rIU e UI lUg:
Center is 1-600-332-2344\.
I DEVELOPMENT INFORMA nON I
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq,EtOther:
, Occupant Load:
nla
REQUIRED PARKING
Frontyard Sethack:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
'Total:
Handicapped:
. Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS I
NOT\l,;t: Llr"I!I\~~W'ffi~S,.k Type:
THIS PERMIT SHA lif'\" n\:l HI'" Lc. .fIq'{i
AUTHORIZED UNDER "H\~ ~~\\IV\.\ uoWlispoutslDrains:
COMMENCED OR IS AMNMN@ F~~
ANY 180 DAY PERIOD.
Notes:
I Valuation Descrintion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e I of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01336
ISSUED: 09/1012009
APPLIED: 09/1012009
EXPIRES: 03/1012010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~ee' Pai,IU
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - 1st 100'
Amount Paid
Date Paid
Receipt Numher
$9,12
$3;80
$76.00
9/10/09
9/10/09
9/10/09
1200900000000001046
1200900000000001046
1200900000000001046
Total Amount Paid
$88,92
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 RrOl~k~~ .l~~n.ec.tion,' 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 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 Services 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 located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
,
Date
Cj III? / Oq
. I t
Pa2e 2 01'2
225 Fifth Street
Sprihgfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1336
COM2009-01336
COM2009-01336
Payments:
Type of Payment
CreditCard
cRcceint 1
RECEIPT #:
Description
Water Line - 1st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
DA VlD ZARZYCKI
I
City of Springfield Official Receipt
Development Se\-vices Department
,
Public forks Department
I
Date: 09/10/20~9 II :27:22AM
1200900000000001046
Item Total:
L:heck Number Authorization
Received By Batch Number Number How Reeeh' ~d
Amount Due,
76,00
3,80
9,12
$88,92
Amount Paid
djb
$88,92
$88,92
09717z In Person
Payment To al:
Page I of 1
9/1 0/2009