HomeMy WebLinkAboutPermit Plumbing 2004-12-29
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. CITY VI' ~PRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01593
ISSUED: 12/29/2004
APPLIED: 12/29/2004
EXPIRES: 06/29/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1230 PIEDMONT ST
ASSESSOR'S PARCEL NO.: 1703264115300
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION: Relocate fixtures in existing bathroom
Owner:
Address:
Contractor Type
General
Plumbing
VIRGIL DUNNICK
1601 RHODODENDRON SPACE 533 FLORENCE OR 97439
ATY1I:r.mn\\l. nn>nn'l tAIAI rAflulres you to
'i>n~"H'.!'''!'. !l1C'ntp.rl.hY thl! orl!~i Utility
Ql'CON:U!Af.J:ORI~:rJf .' set forth
In OAR 952-001-0010 thrOllQ.h OAR 952-001: .
Contractor MAA You may obtain copfslfSf1Me rul&~ratIOn Date
JERRY D DUERK~~liin9 the center. (NotJ.~7elepho~e 10/01/2006
DONN B MERRICK _. ._..__ 8_. ..._ n.onn" 11i~~ntlfl('-"hnn 11/18/2006
Phone
541-521-9741
541-687-1907
, -BlJILOOWllN~JlI.'llIONf44).
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
R-3
nla
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOiICE: _..,' nlOIOr: Ir: TI-\E WORK
I PUBLIC IM~RovEMi'N:i:s;li~ER 11-\15 PERMIT I~ NU I
/'w".. IS "C1~~lnnNEO fOR
COMMENCEDOR SldeWalk'Type:
ANY 180 DAY PERICh~wnspoutsmrains:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pace I of2
-iJ.....~~...p.t..Lq. .
-
.
. CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-01593
ISSUED: 12/29/2004
APPLIED: 12/29/2004
EXPIRES: 06/2912005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Ff'f'S Paw
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Fixture
Minimum/Adjustment Plumbing
Amount Paid
Date Paid
$4.50
$3.15
$28.00
$17.00
,.
,
12/29/04
12/29/04
12/29/04
12/29/04
Receipt Number
1200400000000001802
1200400000000001802
1200400000000001802
1200400000000001802
Total Amount Paid
$52.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
[Jeouired InsDec~ions I
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
By signature, I 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 ofany structure without permission of the 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 located at the front of the property, and the approved set of plans will remain on the site at all
times during construction. /7
d~~,,/ ___ Izh~7'
O~ ~r Co~ors Signature Date /
Pace 2 of2
225 Fifth Street
Springfield, Oregon 97477
541,-726-3759 Phone
,
.
."RING....... 'I
~...............~
Wit,
. ..AI,; !.
....! ~
-...- ..' ~ '."'
~ of Springfield Official Receipt
.elopment Services Department
Public Works Department
Job/Journal Number
COM2004-0 1593
COM2004-0 1593
COM2004-0 1593
COM2004-0 1593
Payments:
Type of Payment
Check
12/29/2004
RECEIPT #:
1200400000000001802
Date: 12/29/2004
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Fixture
Minimum/Adjustment Plumbing
Paid By
JERRY DUERKSEN CONSTR
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 1393 In Person
Payment Total:
Page 1 of I
11 :29:53AM
Amount Due
3.15
4.50
28.00
17.00
$52.65
Amount Paid
$52.65
$52.65