HomeMy WebLinkAboutPermit Plumbing 2009-12-21
12/17(2e~9 13:43
72..5.3.5.75-
CITY OF SPRIJfGFIE:LD
PAGE: El
Pluc.m}j'hlg'PeT~it A.nnlkatiGD
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1:25Fmo Street ._Sp:rl!ll!o(;"rd".:Ql{. ~7n7" Pti(S41}-126-1753 ;;. Fl..x{~.n}1*,J~9
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This permit. is 'is~ued 'under OAR'~lS~7St}.:.095lK-PtTmib'D-J'-t. 'l>>ue;~ onlY, tQ.th~:.?~).,b9 ?![' ~t:mtnctuTdumi-~c,'('(Q1"k;- Pe-r.roii:, ,
expire.ir:';Of'k.is"no'rstat't~d within iSOd-a"y1t afi5~uaiiCt or jf-work is $f,l$pellded fnr 180 d~yS: ,.. . - .'.. ' :.
I . .., .:COCADiGO\'l::~JMENX](P,"R9VAl<.f"r:<:Y";"'!;;'1- "F"?'<,':::':?~::~~':"'~~P:S:~D?j;Eii;":;:!};;~~""'~N~'{\<;'.~,
I Zomng .approval "enfied7..... lSayes' 0 ~.,..a . . L .hL~...;,..e<+.:on.!~..W;':<;':'i,\...S,.j;.:\IQ1;y;. :".k.:.~S..~i,;,!\.:;T~.OI~LI.'
I Sanit'iionnpproval verifted? . ~ 've, 0 No rl"~:~;;;i~t:!i~;':'"';''''''''''' ,.,L.:., ~""",.u,...\
i~__ . CATEG~DY:':>F.'CO>>STRUC\TION';' .;.,. ;'1" f';n~~~~~'::;~:'~?i!=:t,{t,il. I....
Q RcsulentulI,.: t ,.,,\>Yemtrllg'L~ .:.DcommerclOl . 01",. ~ mtili,..u^duJlou'/ow,POinl' $2:Ig,~6 S
t,'.i;,.;:',JOB;.srrEINFORMA'tjON::ANP/l;QCATION,:,~;.f';. ,;, "' '.d";;;,..i,;"tI"..,,incd,ain:jjiii14ii3.).. .1.. ....\
'job site address: ./ z./ob:C >,. ..:' 2 balhroomsii kitchc";37~.OG 1"$
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'lUCcIq .se,tVl(~k 1'.Olo1.0OU"lU~'..f"e'-", . '''1. 1""5&9.00\,.5
. U.OO1t'h"l,€QQ,quaref=. I; $1i.Oa ~.
. . _u ; 'PROi>ER'fY..OWNEtt"Ytt3.60110?;200'Q""'@' . [,., "$174;001 S
"Name; WA'ftle.. -z., ~f,,;d"'M\JZoea.l fsIa:K. .J.:r,701 S.1..-fmtnd~, ...t. sw..f!lll i
fr4i!1nufla.fotufed dwctli'ngor pre~fab (,jrc!e oee\- '---..,.
Address: 2-'-II~ IV. It.. ~ .j.c,........."J!<>. b\!;}4"'g"'W<f~"4' I .1' >sa'\ $.
City'?!>" II.',ftek:l. I Siiiic: OL I ZIP: q 1 'tl1 .watenupp!}"'.'''' .. F. .00.
I ' __t;;.?n'I~~i:!.r, .indu-.tfilll,tind-dwtliiags. other than ont~. Of
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. Bern.iI: . __ Minimum fe< I nUQ i $
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- .liism,t;;I""?" i, being m.de <in ,..id.nliaror farm properly'-' . j .' ....' .:,
, . 9wnei'i,by me.or:,irrrremher'ofm}':Unm~diate fa~Yrarn1~is;._..~:. .-- Mi,c;:tjll,feou'5'rE'e3"~""-. ~.~'- ....
r:~cmDt from H!:,Ensing,t€_q~~re.l!'ent~:under.O~918"f695~~fr20;'. --- ,,'.ij:':}OO""S~m:-t!ewefi:~aiti~ine';n/.. ~.f ~1,e~oo'I:'~$
_ Sigrioturo; LEach fixlllr<, .ppyrtepanc,. and pipinB I S19.00... $.
I CONTRACTOR lNSTAtjoATION. ",'.., .tl~Stonnw"ei'rct~ntionldcteniicnfaciJtty-':i'" sw.tinj, s
i Business nA"'e:pf!..f4s~r\ P!.tv<b,fl" 1 U,,;g,'j~HY$lt1'!1!.. . i" ..$19.DD: $
tJ '. '~I.:;P-iPifrQOf:Pfi;".a[e:stcrrrm1mrn:8.~:".- .. f'
Addr(ss~'. .0".6,* ~ lfO~ -J~. SVSfem! el(Cl;l;dinq U'ie fiTJi 100 rect $19.00 .S
Ci':;t:&'1'U.L tsmlc;oe.... IzlP,'T7'lO'2-[".l.SjOWiJljiflitut"'.;.,....... j' m:OO$
Phone?lJl.-m.93q,~. IF1!iX,'5':iV!;8-3.'if'{,~ }. _~,;nsp:clion(;;~.Qfhi,."f'ePerb'.) I 5SM~ $
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Status
Issued
225 Fifth Street, Springfield, OR
541-726~3753.Phone
541-726-3676 Fax
541-726-3769' Inspection Line
SITE ADDRESS: 1266 r ST
ASSESSOR'S PARCEL NO.: 1703351101200
,
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01808
ISSUED: 12/18/2009
APPLIED: .12/18/2009
EXPIRES: 06/1812010
VALUE: .
Springfield TYPE OF WORK: Plnmbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace water line. less than lOOIf
Owner: JENNIFER DEFAZIO REVOCABLE TRUST
Address: 6518 DEVINE ST
MCLEAN VA 22101'
-. ._. -. ....' ....;::l'~,. .'..... .'-''1....'''-''-' ,........ LV
follr'(';mhRWCTOR;INFOR~1JlONJllility
Not', .. I I. ", 'b If' h
1,\.,;..........'" ....,.....11....,. "'....,IuIJ IUIIJ00IC'';' 'L art
Contractor in OAR 952-001-0010 through l'lib'eM'e2-00'Expiration Date
BERNARD PE9ER~E~I~Y obtain copies ~3ijN; rules by 08123/2011
VVd""I.L '.JL'C l";'IL'o;;' !'.':I.'''O- l'f<iiIJF1Une
nLJ Id..J)INGrlNF..oRMATIQ f'c t' '
\ _ / ! I a lon,
. Center is.1-800-3322344). " _i;'~
W of Stones: - ;;,~'::'::.
Height of Structure . ,..
Type of Heat:
Water Type: .
Range Type:
Energy Path: ',.
Spri'nkled B~ilding:
"'~TI~[!
~M&fP'~WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMM~~IS~BANOONED FOR
ANV18~~5r~~~:~:
% of Lot Coverage:
Contractoli Type
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type ,
Secondary Coustruction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improyements:
Storm Sewer.Available:
Special Instruction:
Notes:
Description
Type of Construction
^"1"'"Tr-J. l"rrr-",_ ,...
Phone
541-343-9339
R-3
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
VB
n/a. '.
.;,1
~r
REQUIRED PARKING
. ,
Total:
Handicapped:
Compact:
I
,
.,
'.,."
.~
~h .
I PUBLIC 1MPROVEMENTS I
Sidewalk Type:
DownspoutslDrains:
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Fo.otage
or Bid Amount
Value
Date Calculated
Paee I of2
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01808
ISSUED: 12/18/2009
APPLIED: 12/18/2009
EXPIRES: 06/18/2010
VALUE:
Springfietd TYPE OF WORK: Plumbin
Downspou IDra}.I].~;..,~;<:i--';.,~~,::,;..
". ", ,~." . ".' .
NOTICE:' .' . PIHE If THE WOR\(
lHIS PERM\1 SHflLL 1 IS PERM\1IS NOT
, "~IJ"QI7>'Q UNDER _ II"M\1=f"l FOR
. ,..,.. hJ. ' ENCED OR I::' I'll) ~.
I Valuation DescriDtioG?V\M180 DI\Y PERIOD.
. . . 1'\1' {
$ Per Sq.Ft Square Footage
or multiplier or Bid Amount
_"~~IN9~1~'i!'
; ~. .,
Status
Issued
225 Fifth Street; Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspectiiin Line
\
\
SITE ADDRESS: ~
ASSESSOR'S pARCEL NO.. 1703264112000
TYPE OF USE:
PROJECT DESCRIPTION: Re lace water line. less than 1000f
Owner:
Address:
~
EUGENE OR 97401
Contractor Type
Plumbing
/
. ['CONTRACTOR INFORMATlON.1
Contractor \ . , Lic...!se
BERNARD PETERSEN I~ 93~w
I BUILDI~G INFORMATWN I
, '.'--- ..
R-3
Front yard Setback:
Side I Setback:'
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
/ I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
i
,
I
/
,
/
Notes:
,.
DescriDtion
/
Type of Construction
, .
I
Paee I of 2
Residential
I
Expiration Date
08/23/20 II
Phone
541-343-9339
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I
. REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
"
CITY VI' ~rR1NGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01808
ISSUED: 12118/2009
APPLIED: 12/18/2009
EXPIRES: 06/18/2010
VALUE:
Status
Issued
TotafValue of Project
Fees Paid I
Fee Description'
+ 12% State Surcharge
+ 5% Technology Fee
Water Liue - 1st 100'
Amount Paid
Date Paid
Receipt Number
$9.12
$3.80
$76.00
12/18/09
12/18109
12/18/09
1200900000000001346
1200900000000001346
1200900000000001346
Total Amount 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 Re(lui~ecll~~pection' I
Water Line: Prior to filling trench and incl~ding 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 aud 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 pertaining to the work described herein, and :
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, ;Building Safety.
I further certify that only coutractors and employees who are in compli:mce with ORS 701.005 will be used on this project.
] 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 located at the front of the property, and the approved setof plans witl remaiu on the site at all
times during construction.
~~\ ~~~ \~vt\
Owner or Contractors Signature
\'Ll1\ \0)
Date
", <"t.
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-7.26-3759 Phone
Job/Journal Number
COM2009-01808
COM2009-0 1808
COM2009-0 t 808
Payments:
Type of Payment
CreditCard
cReceiotl
RECEIPT #:
Description
Water Line - 1 st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
BERNARD PETERSEN
City of Springfield Official Receipt
Development Services Department
Public Works Department
120090000000000]346
Date: 12/18/2009
Item Total:
Check.Number Authorization
Received By Batch Number Number How Received
djb
00682c In Person
Payment Total:
"
.:'"
,- .~
Page I of I
IO:40:50AM
Amount Due
76.00
3.80
9.1:2
$88.~2
Amount Paid
$88.92
$88.92
12118/2009