HomeMy WebLinkAboutPermit Plumbing 2001-8-7
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I Job# 01-00841-01 I
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Page 1 of2
TRANS#:01-0006366
DA TE : AUG 07 2001
ANT RECD:1 $ 52.00
CHANGE:$ 0.25
CASHIER:061
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SPRINGFIELD
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Ready Rooter 1 chapman plumb 'l'lGf!:li-744-7991
88608 ermi bee rd, springfield, OR 97478 'X- ,\,\'i:. ~'O'
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,'I" \,\O~\1.>;; O~c~upancy Group:
f>.\l' ~'i:.~C'i:.\) r.'t-l!!lrSource:
COW:. ,0.(\ D~'{? Sq. Footage:
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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, 'loll \0
,,\i\I~fo 1\.-"1\'1
Required Inspections 1'I I"".".~ Ole\r ~ ,~\ w;:--
, I ,012\\0 \\\3 -zp J" QQ\-
Plumbmg_. ~~', \ed \)'1 IIlI<:S p.. g<::,?' '0'1
:lltol..... . '300~ . '~OSO :<> OJ>( illeS
~ \IO~ IvleScel'l\ei. ~~ '((\IO\J~~S 0\ ~(\5 I~O(\a
\0" \iO(\ '1.CI). GV?\v \Ella?, ~IO(\
~O\I\\C'3 g<::,?""O 0'0\'3\(\ o\e'. \'(\a t-lo\i\\C'O:
i(\ O~p.. '{oil tl\'3'1 e(\\el, \~ 1'I \.l\iXI\'1.y.A)'
0090, , 9 \'(\e C e 0le90 IJ'~?;'..'?
G'3\\I(\ \01\'(\ '~'1''OO
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(\Iltl\ I!eight (feet):
Proposed Units:
225 North Fifth Street
Springfield, OR 97477
Location Of Proposed Site: 3253 Pheasant Blvd Spr
Assessors Map#: 17032213
Lot: Block: Addition:
Owner:
Address:
Jay Ellison
3253 Pheasant Blvd
Scope Of Work: Plumbing
Water service
Contractor Type
Plumbing Contr
Contractor
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
Sanitary Sewer Line
I
-Prior to filling trench.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. Feet)
I Main: Accessory:
Job Number: 01-00841-01
Office: 726-3759
Inspection Line: 726-3769
Tax Lot #: 00500
Subdivision:
Phone Number:
City/State/Zip: Springfield, OR 97478
New Value: $0
Reg istration #
Expiration Date
Phone
# Of Stories:
Current Units:
Census Code: Does not apply
Paid On Receipt# Value/Quantity
Plumbing 1
08/07/2001 6366
Total:
Fee
Minimum Plumbing Permit Fee
Fee Amount
$.00
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;r' ~
Fee
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
Grand Total
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Job# 01-00841-01 I
Paid On Receipt#
Plumbing
08/07/2001 6366
08/07/2001 6366
08/07/2001 6366
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Page 2 of2
ValuelQuantity Fee Amount
I
30
$3.15
$45.00
$3,60
$51.75
$51,75
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 used on this project. I further agree to ensure that all required inspections are
requested at ~roper time and that the project address is readable from the street.
.;Qe YIA H
Signature
fj /;10/
Date