HomeMy WebLinkAboutPermit SUB Sanitary Sewer 2009-9-10
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01335
ISSUED: 09110/2009
APPLIED: 09/10/2009
EXPIRES: 03/1012010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 740 S 4TH ST
ASSESSOR'S PARCEL NO.: 1703353403100
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Repair Sanitary Sewer Line
Owner: BOYERSMITH JEFFREY A & M C
Address: 740 S 4TH ST
SPRINGFIELD OR 97477
Contractor Type
Contractor
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t,-.,/I",,,, ....1__ -~, - . .. .
NOII,CONTRA,--,. uIU1'O'FORM'A"fIONJllity
in OAR 952-001'..0010 thr~~gh~r.l,~~Co,;;~..,orth, . .
0090. You may obtain copi I';lcense 001-ExPlrahon Date Phone
II' es Oltne rules by
ca Ing the center, I/\Inlo' tho '~IM"___
II"................. ..-- ...~ - ,... . . .'. - --
I Bp-ILDING'INFORM\\:rrI0Nt'cation
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# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R3
# of Stories:
Heigbt of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Fl 2 nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
VB
No
I DEVELOPMENT INFORMA nON 1
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
M~"'BmG'IMPROVEMENTS I
THIS PERMIT SHALL tArlt\t IF T.I;\~ W.oRK ype'
AUTHORIZED UNDER THIS PERlVilf~1~bf '.
COMMENCED OR IS ABANDONE@~pouts/DralDs:
ANY 180 DAY PERIOD.
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e 1 of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection Line
Fee Description
Total Amount Paid
Total Value of Project
Fees Paid I
Amount Paid
Date Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01335
ISSUED: 09/1012009
APPLIED: 09/1012009
EXPIRES: 03/10/2010
VALUE:
Receipt Number
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,
$0.00
I Plan Reviews I
I Rellllire1 Insoections I
Sanitary Sewer 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 onty contractors and employees who are in compliance witb 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 7i~g~"lion. C> ~~{ Q7 -: /6' - c?- u OJ
lJ_ 97/
ow&ntractor~ Signature Date
Pa2e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
8,!J;lI"'-GI'l,ELO ~" ',.
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Job/Journal Number
COM2009-01335
COM2009-0 1335
COM2009-0 1335
Payments:
Type of Payment
CreditCard
cReceint I
RECEIPT #:
3200900000000000642
Description
Sanitary Sewer - I st 100 Feet
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
JEFFREY A BOYERSMlTH
Received By
Check Number
Batch Number
Page I of I
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 09/10/2009
Item Total:
Authorization
Number How Received
04581 B In Person
Payment Total:
8:49:38AM
Amount Due
76,00
3,80
9.12
$88.92
Amount Paid
$88,92
$88.92
9/1 0/2009