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HomeMy WebLinkAboutPermit Plumbing 2000-10-24 -. .,~ ~.- . ... ~ . I Job# 00-01575-01 I Page 1 of2 TRANSU:01-0003583 DATE:OCT 24 2000 AMT RECD:1 $ 45.00 CHANGE: $ 1. 00 CASHIER: 061 CITY OF SPRINGFIELD, OREGON 225 North Fifth Street Springfield, OR 97477 COMMERCIAL PERMIT. City Of Springfield Community Services Division Building Safety Job Number: 00-01575-01 Office: 726-3759 Inspection Line: 726-3769 * Location Of Proposed Site: 1673 Main St Spr Assessors Map#: 17033631 Lot: Block: Addition: Owner: Jack Dearth 1673 Main St Address: Scope Of Work: Plumbing Tax Lot #: 05000 Subdivision: Phone Number: 541-746-9669 City/State/Zip: Springfield. OR 97477 New Value: $0 replace sewer and connection T Contractor Aardvark Excavation 5335 Daisy Sp 119, Springfield, OR 97478 Contractor Type General Contr Registration # 101850 Expiration Date 6/1/2001 Phone 541-741-2041 Office Use Land Use: # Of Buildings: Zoning Code: Occupancy Group: Bedrooms: Heat Source: Range: Sq. Footage: "'O?'\( _.,C\I'II ~. oRt=.\l..... 0\ To request an inspection call the 24 hour recording at 726-3769. AII~iisp~'ctioriS{eq\!estga<b~fOr;!l(H)O\ \S ~ a.m. will be made the same working day, inspections requested aft~~oo:a':m'!'Wiii'be.made't~e followingO?' working day. ~~~O?I1.E.O \.l;~ fl-\3fl-NOOI'lt-v R . d I t' f>' ._01("1='0 - equlre nspec lonsr,OIIIIW'-' :{ 1"E.\-\IUv' Plumbing !~N'{ ieO 0P; . Quad Area: # Of Units: Constr. Type: Water Heater: Sanitary Sewer Line I - Prior to filling trench. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ,Area (Sq. Feet) I Main: Accessory: Fee Minimum Plumbing Permit Fee 'loutc N leQuila'" U\llit'l ,OtegOtlla~ eOlegon et,o(\n ;f\"E.N\IO~'dO?\ed b'i .: luleS ate \2000'\' # Of Stories: H1jght.,(feet):~ ",\et .\OOSo""n Op.~e9 _uIOS '0'1 \G.'V " _-l.e" iO\nl "" ~ tn ' Current Units: Proposed.Units:.OO coni9S0 ,,,,,notle \'lu."" S'/.:\Jv' 'n'" to'''''' 'n Census Code: Does not apply 'n Ofl-~ 9 n\e.'l obtaI \.NO\EI',\~e Noti\iCat\O 10090.~0\\necentel, Ol'Ut\\lty.y.4). Total: I ca\\lng \O,tne?l~~Oo.'33'2.-Z ._r?,'oOl._..:-:""" i Value/Quantity Paid On Receipt# Plumbing 10/24/2000 3583 Fee Amount $.00 ~ .--' . . Fee Job# 00-01575-01 Paid On Receipt# Plumbing 10/24/2000 3583 10/24/2000 3583 10/24/2000 3583 Page 2 of 2 Value/Quantity Fee Amount State Surcharge For Plumbing Permit Sanitary Sewer Footage Plumbing Administrative Fee Total Plumbing Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the p"ime and that the project address is readable from the street. ":K'A"l~. .., ..,A _ /0' 2S?-o-i) si9naUv ,:. Date 150 $2.80 $40.00 $1.20 $44,00 $44.00