HomeMy WebLinkAboutPermit Plumbing 2009-12-4
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01733
ISSUED: 12/04/2009
APPLIED: 12/04/2009
EXPIRES: 06/04/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726,3753 Phone
541-726-3676 Fax
54 I -726-3769 Inspection Line
SITE ADDRESS: 7025 GLACIER DR
ASSESSOR'S PARCEL NO,: 1802022300700
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Residential
PROJECT DESCRIPTION: ~epair waterline to residence.
Owner: BOWDEN GARY L & JUDY P
Address: 42003 MCKENZIE HWY law requIres you to
SPRINGFIELD '<J\l'.I::JI'Il, IPN: oregt Odn by the Oregon Utility
~ " ,_..IA" ..rlQD e " B~"h
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t1ot\flcatlOn -o~~looomrRWafr~l~ nON I
In OAR 952 \ ,({ IV! f.. J~l'"
0090 You may 00 II ". the telephone '
,Contractor Type Conlr&'lt!?ilg the center. (~~t~iility Notificatiorl--icense Expiration Date Phone
number for the. O~e~M <I<lll.2a44\.
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, I BUILDING I~FORMATlON I ;,
# of Units:
Primary Occnpancy Grollp:
Secondary Occupancy Group:
Primary Constrllction Type'
Secondary Construction Type:
# of Bedrooms:
R3
# of Storie~:",..._,..(,..-...._ '7f,
Height o(Si'ructure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Bnilding:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOTICE:
1; ;'0 t'tHIVIIT PPtmLl~F~~M/IIj!,t
~~~~E~~~~ ~Ru,Sn I Ml~ PERMIT IS NOT
,ANY 180 DAY PERIOtB!\NDO~ED FOR
Overlay Dist:
# Street Trees Rqd:
raved Drive Rqd:
'Yo of Lot Co~erage:
,REQUIRED PARKING
Total:
, Handicapped:
Compact:
Front yard Setback:
Side I Setback:
,Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Sidewalk Type:
Downspouts/D,rains:
Notes:
I Valuati~~ Des~,ription I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
': Date Calculated
paee I of 2
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01733
ISSUED: 12/0412009\
APPLIED: 12/04/2009
EXPIRES: 06/04/2010
VALUE:
Status
Issued
225 Fifth Street, Springlield. OR
541-726,3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fe~s 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
1214/09
1214/09
12/4/09
1200900000000001305
1200900000000001305
1200900000000001305
Total Amount Paid
$88.92
Plan Reviews ,I
To Request an ins'pection 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 Relluired InSIlf'ct;lIIIS I
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 of the City of Springlield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any strncture withont permission of the Community Services Division. Building Safety,
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further <lgrce to ensure that all required inspections arc rC<luested at the proper time, that each adcjress is readable from the
street. that the permit curd is located at the front of the property, and the approved set of plans will remain on the site at all
times during constructioll.
Il~- 1JtAA~
Owner or Con~ctors Signature
_6R~
be-c.,
j
a:t7
~/
f
Date
I I
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
f ,.......
541-726-3759 Phone '
Job/Journal Number
COM2009,OI733
COM2009-0 1733
COM2009,01733
Payments:
Type of Payment
CreditCard
(
cReceiotl
RECEIPT #:
Description
Water Line -1st 100'
+ S% Technology Fee
+ 12% State Surcharge
Paid By
GARY'S ROOTER AND
PLUMB
.f~~61i
Itil, ,
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001305
Date: 12/04/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
04336] In Person
Payment Total,
Page] of]
3:05: 15PM
Amount Due
76,00
3,80
9,12
$88.92-
Amount Paid
, $88,92
$88.92-
] 2/4/2009