HomeMy WebLinkAboutPermit Plumbing 2009-12-14
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225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01780
ISSUED: 12/14/2009
APPLIED: 12/14/2009
EXPIRES: 06/14/2010
VALUE:
Status
Issued
SITE ADDRESS: 510 S 5TH ST
ASSESSOR'S PARCEL NO,: 1703353404100
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace approx 651fsanitary sewer
Owner: MAPLE STANLEY A & K
Address: 510 S 5TH ST
SPRINGFIELD OR 97477'
I CONTRACTOR INFORMATION '.
Contractor Type
Plumhing
Contractor '" '. ,..- License
JENCOURT ENVIRON)\1ENTAL SERVICES 1182531
Expiration Date
06/11/2010
Phone
541-689-1711
, ,_,) BUILDING INFORMATION I
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#ofUnits: .- ,,>"- #OfSt~~Va~\wt '
Primary Occupancy Group:, R-3 He'~~~
Secondary Occupancy GrouP:~~llf.lll ~ fl,J:P"
Primary Construction Type VB~. 0""!e6 ~ ~ fjlS ~ee '"
Secondary Construction Type: .-..rt\Oe9 ~6~. ~~~ i~ee~~~
# of Bedrooms: ~'t\l' ~JP"'Se~\~ ~~ &P"""
VJ~ ,~~'!:?JP' o~~~J .~ n/a
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~~.~O~\NFORMATlON I
9"'~\\t\~~1 ,"---
~~ Overlay Dist: ,~",
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Haudicapped:
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I PUBLIC IMPROVEMENTS I " ~ S 'X~ is>'
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I Va,luation Description I
Street Improvements:
Storm Sewer A vaila ble:
Special Instruction:
Notes:
Description
Type of COllsfruction
$ Per Sq Ft.
or multiplier
Square Foutage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-01780
ISSUED: 12/14/2009
APPLIED: 12/14/2009
EXPIRES: 06/14/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541_726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Sanitary Sewer - 1st 100 Feet
Amount I'aid
Date Paid
Receipt Number
$9,12
$3.80
$76,00
12114/09
12114/09
12/14/09
1200900000000001326
1200900000000001326
1200900000000001326
Total Amonnt Paid
$88,92
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 Reollired IJrlsllections I
f ,111,1.( T ,
Sanitary Sewer Line: Prior to filling trench and including required testing,
By signatnre, I stale and agree, that I have carefully examined the compieled application and do hereby certify that all
information hereon is t"ue and correct, and" fnrther certify that nny and all work performed shnll be done in accordnnce with
Ihe Ordinances of the City of Springfield and the Laws of the State of Oregon pertnining to the work'described herein, and
that NO OCCUPANCY will be made of any strncture 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 used 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 10 ated at the front of the property, and the approved set of plans will remain on the site at all
. ';"f}""'''"'';''' / I zJj() ( I) 7
6wner or Contractors Signature Date /. / I '
. '!it.
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Pnee 2 01'2
225 Fifth Street
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Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1780
COM2009-0 1780
COM2009-0 1780
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Sanitary Sewer - 1 st 100 Feet'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
JENCOURT
ENVIRONMENTAL SRVCS
City of Springfield Official Receipt,
Devell!pment Services Department
Public Works Department
1200900000000001326
Date: 12/14/2009
Item Total:
Check Number Authorization.
Received By Batch Number Number How Received
djb 1129 In Person
Payment Total:
"
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Page I of I
9:40:0IAM
Amount Due
76,00
3,80
9,12
$8H.92
Amount Paid
$88,92
$88.92
12/14/2009