HomeMy WebLinkAboutPermit Plumbing 2009-9-24
Status
Issued
CITY OF SPRINGFIELD
, Building/Combination Permit
PERMIT NO: COM2009-01424
ISSUED: 09/24/2009
APPLIED: 09/2412009
EXPIRES: 03/24/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 276 17TH ST
ASSESSOR'S PARCEL NO,: 1703362404600
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: 25 ft water line replacement
Owner: FLETES JOSE L & KATHERINE R
Address: 276 N 17TH ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION 1
Contractor Type
Plumbing
Contractor'
JENCOURT ROTO ROOTER
License
182531
Expiration Date
06/11/2010
Phone
541-689-171]
BUILDING INFORMATION.
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Constru~tion Type:
#of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION 1
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
,
Total:
Handicapped:
Compact:
Street Improvements:
I PUBLIC IMPROVEMENTS I t
, " ,~~o
.' Sillewa~ T~p'e:la\N leQUI gon Util\ty
f.l"'ION', le~/~'h" the ore et torth
Jl,T\ DownspoutslDrainS:rl\leS are 552 001-
to\\o\N fU'"'' - nter, \\\OO~ \1 OAR 9 -
\~otitiGat\on C~1_0010 t\1rou9 01 the lules bY
, OAR g52-0 blain copIes telep\1One
iH"irtC:t": _. ,_, _ _ ,_ T' ,r '^' no-> v I~Ogo:,,~~~:eaJe~I::I._ ~~~t~~i;~~ N~ti\iGation
("IV r-t.nIVIII 011r\LL ~ '" "" " ,,,-,. - . v......- - , t1.1\v .....'-.... 3'j"t,.-c....r.')
AUTHORIZED UNDER 1IHVaru::fti~IJ h~~kfj.TDtion Il\Url1ber~~nter is 1-800-
COMMENCED OR IS Ab/-ll,uu"Lu 'V"
T'"'' f' ~" ntW "t.~DIOD $ Per Sq Ft Square Footage
.,v,pelO ~ons ruC! Ion' .. .'
, . or multIplIer or BId Amount
Value.
Date Calculated .
Storm Sewer Available:
Special Instruction:
Notes:
Description
Page 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01424
ISSUED: 09/24/2009
APPLIED: 09/24/2009
EXPIRES: 03/24/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - 1st 100'
Amount' Paid.
Date Paid
Receipt Number
$9,12
$3,80
$76.00
9/24/09
9/24/09
9/24/09
1200900000000001093
1200900000000001093
1200900000000001093
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 Re/lU ired T nsnections .
, 1l1li11 1
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 ofthe 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 ofthe Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed 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 tbe site at all
times during construction.
Owner or Contractors Signature
Date
Paee 2 of2
225 Fifth Street
SprilJgfield; Oregon 97477
541-726-3759 Plioll'e------
RECEIPT #:
Job/Journal Number
COM2009-01424
COM2009-01424
COM2009-01424
Description
,.waterLine - 15(\00'
+ 5% Technology Fee
'. + 12% State Surcharge
Payments:
Type of Payment
Check
Paid By
JENCOURT .
ENVIRONMENTAL:
cReceintl
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001093
Date: 09/24/2009
2:47:57PM
Item Total:
<';heck Number Authorization
Received By Batch Number Number How Received
nJm 1109 In Person
Amount Due
76.00
3.80
9.12
$88.92
Amount Paid
$88.92
Payment Total:
$88.92
Page I of I
9/24/2009