HomeMy WebLinkAboutPermit Plumbing 2003-9-9
CITY OF SPRINGFIELD'
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2003-00871
ISSUED:
APPLIED:
EXPIRES:
VALUE:
09/09/2003
03/09/2004
SITE ADDRESS: 633 4TH ST
ASSESSOR'S PARCEL NO.: 1703352401700
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Repair
Residential
PROJECT DESCRIPTION: Water line repair
Owner: HUDSON DAVID W & DEBRA JEAN
Address: 687 ASPEN ST SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
Contractor Type
Contractor
"License
Expiration Date Phone
BUILDING INFORMATION'
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS'
I DEVELOPMENT INFORMATION.
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements: Sidewalk Type: res you to
OrJ'Ore.9.on laW reqUl ,"
Storm Sewer Available: AnENTI J)'ownsfef8~~~regon UtIlity,
Special Instruction: folloW rules adop Those rules are set fort
NOTICE: Notification cent~~10 through OAR 952-00'
Notes: in OAR 952-001- ain copies of the rules l
THIS PERMIT SHALL EXPIRE IF THE WORK f)non You may obt I I AL." tolonhone
AUTHORIZED UNDER THIS rtntM-llU N-Ul - : cal 'ng the cemer. ,'W'Utiiity Notification
COMMENCED' OR IS ABANDO 'on Descri tIo erforthe,Oregon -2344).
ANY 180 DAY PERIOD. . - Center IS 1-800-332
$ Per Sq Ft Square Footage
Description Type of Construction I' I' BOd A t Value Date Calculated
or mu tip ler or I moun
Total Value of Project
Pal!e 1 of 2
CITY OF SPRINGFIELD -
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: cOM2003-00871
ISSUED:
APPLIED:
EXPIRES:
VALUE:
09/0912003
03/09/2004
I Fees Paid'
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
WaterLine - 1st 50 Feet
Amount Paid
Date Paid
$4.50
$3.15
$45.00
9/9/03
9/9/03
9/9/03
Receipt Number
1200200000000002088
1200200000000002088
1200200000000002088
Total Amount Paid
$52.65
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.
I Reouired Insoections .
1 Water Line: Prior to filling trench and including required testi~g.
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
times during construction.
&i. A
t-J~
1tc53
Owner or Contractors Signature
Date
Pal!e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00871
COM2003-00871
COM2003-00871
Payments:
Type of Payment
Cash
Receipt #: 1200200000000002088
Description
Water Line - 1st 50 Feet
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
DAVID HUDSON
Received By
dIm
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Department.
Date: 09/09/2003
1:29:56PM
Amount Paid
Item Total:
45.00
3.15
4.50
$52.65
How Received
In Person
Payment Total:
Amount Paid
$52.65
$52.65