HomeMy WebLinkAboutPermit Plumbing 2001-7-19
I~ .
\
....
.
I Job# 01-00742.01 I
.
Page 1 of 2
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: 01-00742-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 5983 Obsidian Ave Spr
Assessors Map#: 18020300
Lot: Block: Addition:
Tax Lot #: 00502
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
Sanitary Sewer line from street 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,
Sanitary Sewer Line
Required Inspections
I Plumbinfl
- Prior to filling trench,
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
[""Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Plumbinfl
07/19/2001 6193
07/19/2001 6193
07/19/2001 6193
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Sanitary Sewer Footage
77
$,00
$2,80
$40,00
.
"
Fee
Administrative Fee - Plumbing
Total Plumbing
Grand Total
.
Job# 01-00742-01
Paid On Receipt#
Plumbinll
07/19/2001 6193
.
Page? of 2
Value/Quantity Fee Amount
$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 will be sed on this project. I further agree to ensure that all required inspections are
re~t the ~nd "e project address is readable from the street.
~.)~
Signature
7;{-?~/
Date f r