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Home My WebLink AboutPermit Plumbing 2004-6-4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00658 ISSUED: 06/04/2004 APPLIED: 06/0412004 EXPIRES: 12/04/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 11611ST ST ASSESSOR'S PARCEL NO.: 1703263301300 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace approx 12lfsanitary sewer Owner: ELLIS MATTHEW T & TAWNY A R Address: 10001 SW SILETZ PORTLAND OR 97062 I CONTRACTOR INFORMATION. Contractor Type Plumbing Contractor HOFFMAN NORTHWEST INC License 71162 Expiration Date 01116/2005 Phone 949-380-4161 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat:. Sq Ft 2nd Floor: waje :~ ~T10N: Oregon law ret11u' ment: Ran ,.le: I dopted by the 0, i \ Ie/carport Ener lIYIP.J es a '. S . lFi\~fd\li~nter. ThoNJl rules , oad: p a.r OAR 952:qb"1 !.Q01 0 throuQh 01\ ~~ · I DEVELON\\l~"1vINF.~kFroN"rl~ of the rules bY , , ~11l1I\:pfIO ~,!!J.~,~~~~",na!a: the telepho~QUlRED PARKING .number for the Oregon Utility NotifICation Overfay UISf:r.Aoter, i$1.~0-332.2344). Total: # Street Trees'"'R"qil: '. " . Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: R-3 Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Notes: NOTlCE: Do..w!l~IlD,u.ts.lIN~ins: THIS PERMIT SHALL EXPIRE k 'HtVVUIiI AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR u.... ;~11: r~p,mq I V al~~tion Description 1 Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pal!e 1 of 2 liF.!RtNGE'JiEL:D; -__,~,_~; r "~,"1l\~'~~ ,~".i.}' -_~."~"$r "",..."~.~-"1" )...~ ~ ,. ~ g: ..' f" Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2004-00658 ISSUED: 06/04/2004 APPLIED: 06/04/2004 EXPIRES: 12/04/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Sanitary Sewer - Ist 50 Feet Amount Paid Date Paid $4.50 $3.15 $45.00 6/4/04 6/4/04 6/4/04 Receipt Number 2200400000000000713 2200400000000000713 2200400000000000713 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 Reouired Insoections I 1 Sanitary Sewer Line: Prior to filling 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, 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 ,~:s.eE;--IMO kl? (pI?! h&/ ~m con.:t" Signa'.e.. Dat. ( ! ( Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00658 COM2004-00658 COM2004-00658 Payments: Type of Payment Check 6/4/2004 RECEIPT #: -.ity of Springfield Official Receipt vevelopment Services Department Public Works Department 2200400000000000713 Date: 06/04/2004 Description Encroachment Permit - 1.0000 @ $120.0000 + 7% State Surcharge + 10% Administrative Fee Sanitary Sewer - 1st 50 Feet Paid By HOFFMAN NORTHWEST Item Total: Check Number Authorization Received By Batch Number Number How Received djb 332638 In Person Payment Total: Page 1 of 1 1:22:07PM Amount Due 120.00 3.15 4.50 45.00 $172.65 Amount Paid $172.65 $172.65