HomeMy WebLinkAboutPermit Plumbing 2009-12-31
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01855
ISSUED: 12/31/2009
APPLIED: 12/31/2009
EXPIRES: 06/30/201.0
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 345 S 35TH ST
ASSESSOR'S PARCEL NO.: 1702314302300
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace water line approx 60lf
Owner: LAND DEBBY L
Address: 345 S 35TH ST
SPRINGFIELD OR 97478
Phone Number: 541-554-1087
I CONTRACTOR INFORMA nON I
Contractor Type
Plumbing
Contractor License
JENCOURT ENVIRONMENTAL SERVICES 1182531
Expiration Date
06/11/2010
Phone
541-689-1711
I BUILDI~G;!NFn~MA TION I
. co'.. ~~~".
# of Units: /'..i.i' -, ~~l~\l\ ,'t;'
Primar}' Occupancy Group: R-3 t'/-.<:(\'?-,t~I!fIf\?\ .ru~.g~f:.e
Se~ondary Occupa~cy Gr~~~.. ",~,:': \'f.-\"v B,'\;.l/1~ t:.,"'..
Primary ConstructIOR~PC' '?-,\1\\\-\V~t'?-, ~~ I1'erl)pe:
Secondary Constructi~~\l2rP~: \1-t.\) 'U :r- \0 ~'O Range'Type:
# of Bedrooms: ')j\'f.-\)<:(; ,,'Ct.\) \l '?-,\'iJ\). Energy Path:
~ "\1\\1\t\, n~ V't:: Sprinkled Building: nla
r.'U ,('0(\ v ,
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~~'\ ' IDEVELOP!'1ENT INFORMATION'
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKlNG
Front yard Setback:
Side .1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
.' # Street Tre~~~~ .
pav~ dll \)\\ .....
l\ I \0""
0\'-1'. Ole~'d'\{ ~e$<a~&.e;..()O\.
f>,i\C~~e!; 0.d~~; "'("os~.~~" O~ ~Il\e'i~
~~~~\\~~:~~~~~:i"':J.. -r~ ..
il\ 01'0 'lOll ~0.!.n\et.~~\\'L""). Sidewalk Type:
oog ., \"e v~ Otego;. ",-",'l.-~
00.\\\1\9 ,at \"e ,.&au-- Downspouts/Drains:
(\\I~t cet\\et \9 ..
Total:
Handicapped:
Compact:
Street. Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
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,....
I Valu.ation Descrintion ,
Dcscdption
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01855
ISSUED: 12/31/2009
APPLIED: 12/31/2009
EXPIRES: 06/3012010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 I nspection Line
Total Value of Project
I . Fl'es Pairl I
II. I ~. ,II ;
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - ist 100'
Amount Paid
Date Paid
Receipt Number
$9.12
$3.80
$76.00
12/31/09
12/31109
12/31109
1200900000000001377
1200900000000001377
1200900000000001377
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 Re9ui~~d I~~pedin?~ I
Water Line: prior to filling trench and including required testing.
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By signature; 1 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 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 Commnnity Services Division, Building Safety.
Ifurther 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 located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
VILLI; ;?~A'
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. Owner or Contractors Signature
I()/ ? II OJ
Date. .
-J.
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. ".
, Paee 2 01"2
225 Fiftli street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1855
COM2009-0 1855
COM2009-0 1855
. Payments:
TYIJe of Payment
Cheek
cReceint\
RECEIPT #:
Description
Water Line - 1st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
JENCOURT
ENVIRONMENTAL SRVCS
1200900000000001377
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/31/2009
2:S3:SIPM
Amount Due
76.00
3.80
.9.12
$88.92
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
Page 1 of 1
1133
Amount Paid
In Person
$88.92
Payment Total:
$88.92
12/3 1/2009