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Home My WebLink AboutPermit Plumbing 2004-8-26 ~. .' CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01065 ISSUED: 08/26/2004 APPLIED: 08/26/2004 EXPIRES: 02/26/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1306 PIEDMONT ST ASSESSOR'S PARCEL NO.: 1703264115400 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Approx 401fwater line Owner: LEITZEL LYNDA S Address: 1085 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 Contractor Type Plumbing /}~mO\\l: \,jc,"'.tl..... ~~ I\oiqUII\7l> y..... .v I COlllr,RAGT.oR iJlffi~jf~egon Utility T' · .,." tf rth Wo~ Cc1ltG? ~Vlcml fUl are se 0 Contractor t7I OAR e52-CG1.(1010llimm.J'e OA~ton Date TRENCH LESS PIPE SERNi.I/t~lil\l ctrteIrt._;t$ of the rul09/tsn005 , "", -,me 1818pnunu BU1IJDIllf(iP.)NFORlI'I\\'fmN "\' N tifacation ~~ llJ urJe',.,:j,ev, ity 0 # ofSton~b ~~-~). Lot Size: Heigbt of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Patb: Sq Ft Other: Sprinkled Building: nla Occupant Load: Phone 541-741-1744 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN , 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: 'Janll I PUBLIC IMPRQ.."~ I \'II'.LL f.'f,.PIRf. If \ ~~ IS \'licit 1\'11S P\:~~~6 ~~~~81k-\~B~~~O fOR 1'.1.l1\'1~~\'IICt.O {))h~b,~frtslDrains: , COWl Q 01'.'/ pt.RIQD. 1'.\'11'/18 Notes: Description Type of Construction I Valuation Descriotion I $ Per Sq Ft Square Footage or multiplier or Bid Amount Value Date Calculated Total Value of Project Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01065 ISSUED: 08/26/2004 APPLIED: 08/26/2004 EXPIRES: 02/26/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line , Fp.p.~ P~ill I Fee Description + 10% Administrative Fee + 7% State Surcharge Water Line - 1st SO Feet Amount Paid Date Paid Receipt Number $4,50 $3,15 $45.00 8/26/04 8/26/04 8/26/04 2200400000000001098 2200400000000001098 2200400000000001098 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. L.Rp.ouirp.d Insnp.~tion'lJ Water Line: Prior to fining trench and including 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 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 Community Services Division, BuUdlng 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, tbat 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. ~,'~ Owner or Contractors S~ature 8/z},/o'f I Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0 1065 COM2004-0 1065 COM2004-0 1065 Payments: Type of Payment CreditCard 8/26/2004 . RECEIPT #: Description + 7% State Surcharge + 10% Administrative Fee Water Line - 1 st 50 Feet Paid By TRENCHLESS PIPE ~ ~" ~ of Springfield Official Receipt .velopment Services Department Public Works Department 2200400000000001098 Date: 08/26/2004 Item Total: Check Number Authorization Received By Batcb Number Number How Received djb 223793 In Person Payment Total: Page 1 of 1 I1:12:35AM Amount Due 3.15 4.50 45.00 $52.65 Amount Paid $52.65 $52.65