HomeMy WebLinkAboutPermit Plumbing 2009-9-15
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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.
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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
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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