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HomeMy WebLinkAboutPermit Plumbing 2009-9-15 _~~.~Il\\~~~\",~. ':.,!, . 1.' ."', . . . -":.: . ,;':;Y,l,,\~:;..~ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01360 ISSUED: 09/15/2009 APPLIED: 09/15/2009 EXPIRES: 03/15/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 850 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703264301100 Springfield TYPE OF WORK: Plumbing Only , TVPE OF USE: Repair Residential PROJECT DESCRIRTION: Replace water line Owner: NAAS pAULA L Address: 850 CEN~ENNIAL BLVD SPRINGFIELD OR 97477 Pbone Number: 541-746-4187 I CON~RACTOR INFORMATION I Contractor Type ' Plumbing Contractor BERNARD PETERSEN INC License 93126 Expiration Date 08/2312011 Phone , 541-343-9339 BUIL~ING INFORM~ nON I # of Units: # of Stories: Primary Occupancy Group: ,R-3 Heig~t.o~Stni.1iQre Secondary Occupancy Group: , Olegon la~6pj~!!~aliti\it{h Primary Construction ~yn<>rlE.Nl\O\l'BAonted 'o~ 'Water. Type"t tOol, . rf" leS au r ",IU'~o ~ ~c2. 0 ,- Secondary Construction 'lJXIWJ'I IU centel. lhOS'Kango:rype~ - 'o~ # of Bedrooms: ',' "o'titicatlon2. 00' _00'10 th(<Eb'{'[g)'lp,at1i':JleSe ,. R 95 -, . caD'''- \ n~"n , in 01\ ma~ obtaIn SP.,fig"Jed, BU,i1tlinJ11 11 _,,1"\("\ "YoU . _....... INot..... .. t..\n:hhca\\ , ~- ~a\\ing \~;( \'h,j; DHv-ItLORMENfF JINFORMA TION , numbel cente( ,S . -' " ' , Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: Street Improvements; Storm Sewer Available: Special Instruction: -:f I PUBLIC IMPROVEMENTS Ix. \r "'i\\t. 'N~01 c'j..r'" ,.(\' \S O"'\Ct', ,,\'\[;.\..\.." \" 1't.I'-Side.w."'~ Type: ' ~ 1\ n\'J\\I" c?- 1\'\ oJ, "If\) rU I\\\S I't.D t.\) \)~\)" [;.,,[;.~\)O'lTownspouts/Drains: 1\'\0?-\'1: O?- \S . [;.\) \'J\t.~c,t.\) t.?-\O\). \ c,0\'J\ 'Oil \)[;.'{ I' [;.~'{'\ Notes: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I on Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01360 ISSUED: 09/15/2009 APPLIED: 09/15/2009 EXPIRES: 03/15/2010 VALUE: 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fe~~ Paid. $9.12 $3.80 $76.00 9/15/09 9/15/09 9/15/09 Receipt Number 1200900000000001061 1200900000000001061 1200900000000001061 Fee Description + 12% State Surcharge + 5% Technology Fee Water Line - 1st 100': Amount Paid Date Paid Total Amount Paid $88.92 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 Reouired Insneetions I Water Lirie: Prior to filling trench and including required testing. By signature, I state and agree, that I bave carefully examiued 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 OCCUPANC'v will be made of any structure without permission of the Community Services Division, Building Safety. I furtber certify that ~,nly 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 tbe front of the property, and the approved set of plans wil'l remain on the site at all times during construction. 0--)!/~ Jj~ ---" Owner or Contractors Signature ~ /3 ~1 ." / " . Date Pae:e 2 of2 ' 225 Fi(th,Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1360 COM2009-0 1360 COM2009-0 1360 Payments: Type of Payment Check cReceint I RECEIPT #: Description \vater Line - 1 st 100' .;. 5% Technology Fee -i- 12% State Surcharge Paid By PAULA NAAS 8r1~~ ~ f', ~i'''''';. .~ City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000001061 Date: 09/15/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1722 In Person Payment Total: Page 1 of I 9:59:57AM Amount Due 76.00 3,80 9.12 $88.92 Amount Paid $88,92 $88.92 9115/2009