HomeMy WebLinkAboutPermit Plumbing 2010-1-28
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM20IO-00118
ISSUED: 01/28/2010
APPLIED: 01/28/2010
EXPIRES: 07/28/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1338 D ST
ASSESSOR'S PARCEL NO.: 1703362304400
Springfield TYPE OF WORK: Plumbing Only
PROJECT DESCRIPTION: Replace water line
TYPE OF USE: Repair
Residential
Owner: BLEVINS DONALD C & CHERYL A
Address: 1338 D ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMA TION I
Contractor Type
Plumbing
License
Contractor
QWNER
BUILDING INFORMATION'
# of Units: # of Siories:
Primary Occupancy' Group: R-3 - -. Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type VB Water Type:
Secondary Construction TA'l'fENTlON: Oregon Iawlte~rHIYOu to
# of Bedrooms: follow rules adopted by tili'61000'gonlUtillty
Notification Center. ThoseiJumeldm ilblildilll:: n/a
::-~ aM 3S2 eel 99~~ !~f_8~,r: j~ a,"" 7~_~ :7~
0090. You may otliliilt~il:Jll1tJ1fnJllif~MA TION I
calling the cantlll. r.:UL~ rr,..I(\":I~r.ulll
number for the orego~U ilit)',NO~f!cation
Center Is 1-80 -2'J4ll 1st:
Street rees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available:
Special Instruction:
Phone Number: 541-726-1777
Expiration Date Phone
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basemeut:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKlNG
Total:
Handicapped:
Compact:
Sidewalk Type:
, ". ,;'!. .,;:~,~:.I''' "-"
N01ICE:DowuspoutslDrain\ If THE WORK
THIS PERMIT SHAi~ ~~~ PERMIT IS NOT
AUTHORIZED UND S ABANDONED fOR..: '.
r.nMMENCED OR_I. ., .', .'
,.y 180 UAl rdll~E.
I Valuation DescriDtiot,
'_",'i'
"
Notes:
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Page I of2
Value
Date Calcnlated
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - I st 100'
Total Amount Paid
Amount Paid
$9.12
$3.80
$76.00
$88.92
Total Value of Project
Fees Paid I
Date Paid
I Plan Reviews I
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2010-00118
ISSUED: 01/28/2010
APPLIED: 0112812010
EXPIRES: 07/2812010
VALUE:
Receipt Number
1/28/10
1/28/10
1/28/tO
2201000000000000079
2201000000000000079
2201000000000000079
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.
Reouirerl Insnections I
Water Line: Prior to filling trench and including required testing.
By signature, I state and agree, tbat 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 Oregou 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 contractors and employees who are in compliance with ORS 701.005 will be used on tbis 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.
DCV1 t3~
Owner or Contractors Signature
Paee 2 of2
j l~:y i:;JOIO
Date / f
22;; Fifth Street
Springfi~ld, Oregon 97477
541-726-3759 Phooe
Job/.Journal Number
COM2010-00118
COM20 1 0-00 118
COM20 1 0-00 118
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Water Line - I st 100'
+ 12% State Surcharge
+ 5% Technology Fee
raid By
DONALD BLEVINS
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City of Springfield Official Receipt
Developmeot Services Department
Public Works Department
2201000000000000079
Date: Ol/28/2010
Item Total:
Check NUfIlber Authorization
Received By Batch Number Number I-low Received
djb
05127g In Person
Payment Total:
';"~.
t: ;1..
\:.r
Page I of I
II :39:14AM
Amount Due
76.00
9.12
3.80
$88.92
Amount Paid
$88.92
$88.92
r
]/28/2010