HomeMy WebLinkAboutPermit Plumbing 2007-7-27
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
, 541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00987
ISSUED: 07/27/2005
APPLIED: 07/26/2005
EXPIRES: 01/27/2006
VALUE:
, Total Value of Project
I Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtll00'
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtll00'
Amount Paid Date Paid Receipt Number
$11.80 7/27/05 1200500000000001087
$8.26 7/27/05 1200500000000001087
$45.00 7/27/05 1200500000000001087
$14.00 7/27/05 1200500000000001087
$45.00 7/27/05 1200500000000001087
$14.00 7/27/05 1200500000000001087
Total Amount
$138.06
I Plan Reviews I
To Request an inspection call theo24 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.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
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
o 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 wiD 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 wiD remain on the site
;~;~~~~h~~ .:/~?~
Owner or Contractors Signatu~ I' Date
2 of 2
225 Fifth Street
Spr}ngfielfl, Oregon 97477
541-726-3759 Phone
J;\b/Journal Number
COM2005-00987
COM2005-00987
COM2005-00987
COM2005-00987
COM2005-00987
, COM2005-00987
P:ayments:
Type of Payment
Check
f!
'.'
"
7/27/2005
RECEIPT #:
Description
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl 100'
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
1200500000000001087
r'ity of Springfield Official Receipt
.welopment Services Department
Public Works Department
Date: 07/27/2005
Item Total:
Check Number Autborizatwn
Batch Number Number How Received
9625 In Person
Payment Total:
Paid By Received By
LB OLSON AND ASSOCIATES llh
I of I
12:15:15PM
Amount Due .
45.00
14.00
45.00
14.00
8.26
11.80
$138.06
Amount Paid
$138.06
$138.06