HomeMy WebLinkAboutPermit Plumbing 2001-7-19
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TRANS#:01-0006193
DATE:JUL 19 2001
AMT RECD:2 $ 726.00
1 $ 30.00
CHANGE:$ 2.50
CASHIER: 003
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01.00738.01
225 North Fifth Street
Springfield, OR 97477
Office: 726.3759
Inspection Line: 726.3769
Location Of Proposed Site: 5936 Obsidian Ave Spr
Assessors Map#: 00000000
Lot: Block: Addition:
Tax Lot #: 00000
Subdivision:
Owner: Crossroads Development
Address: 2622 SW Glacier Place, Suite 1
Scope Of Work: Plumbing
Phone Number: 541.923.6607
City/State/Zip: Redmond, OR 97756
New Value: $0
Storm sewer line from S. 59th SI. to P.L.
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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
working day.
Storm Sewer Line
Required Inspections
I PlumbinQ
. Prior to filling trench.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Plumbing
07/19/2001 6193
07/19/2001 6193
07/19/2001 6193
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Storm Sewer Footage
77
$.00
$2.80
$40.00
'.
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Job# 01-00738-01 I
Paid On Receipt#
Plumbing
07/19/2001 6193
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Value/Quantity Fee Amount
I
Fee
Administrative Fee. Plumbing
Total Plumbing
Grand Total
$1.20
$44.00
$44.00
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 '11 be used on is project. I further agree to ensure that all required inspections are
ested a time d that the project address is readable from the street.
7/1t1;b1
Date I
Signature r