HomeMy WebLinkAboutPermit Plumbing 2010-6-4
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
54] -726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-007I9
ISSUED: 06/04/2010
APPLIED: 06/04/2010
EXPIRES: 12/04/2010
VALUE:
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Status
Issued
Owner:
Address:
SITE ADDRESS: 562 M ST ' ,',.< . SPRINGFIETYPE OF WORK: Plumbing Only
ASSESSOR'S PARCEL NO.: 1703263400404 ,~,,} 4iU'JI.YOU to
AIJENTION: Ore90n \a~~:6te!\lahlOOlIt'liE: Repair
PROJECT DESCRIPTION: Replace watY611llW rules adopted ~se rules are set forth
Mntification cen~~ 1 ~~r^' .gt> OAR 952-00b1-
in OAR 952-UU ,- . les oHh8lU1eli r
STEW ART SANDRA 0090 You may obtain cop . the telephone
562 M ST '. the center. (Note.. N tlfica>>on
SPRINGFIELD OR 97477 call1bne9r for the Oregon UtllitY23404i
num ._.. W"n.4'1",,_ I.-
,",ell\Ql Ril'''
I CONTRACTOR INFORM~TlON ~
Residential
Contractor Type
Plumbing
Contractor ,~ -' . '''License
BERNARD PETERSEN,INC 93]26
I BUILDING INFORMATION ~
Expiration Date
08/23/2011
Phone
541-343-9339
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
~pf Stories: WORj(Lot Size:
NOTIC~li:r IlfIM_~!X"\.RE IF THE,S NOPq Ft 1st Floor:
TI1IS P~ n i'j~R THIS PERMIT Sq Ft 2nd Floor:
AUI11 p ~IS ABANDONED FOR ,Sq Ft Basement:
COMMI!~II. : D ' " . Sq Ft Garage/Carport
ANY nl~iWf{tIaf!R\O .' Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
I DEVELOPMENT INFORMATION .
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:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
,/
Sidewalk Type:
Downspouts/Drains:
Notes:
Description
Tvpe of Construction
I Valuation Description I
;-';::" ".:." j:~
$ Per' sijiFt ';.t, ~\ l' "Square Footage
or multiplier. ,:'!.J or Bid Amount
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Value
Date Calculated
Pa2e I of2
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone'
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - 1st 100'
Amount Pai~';:'4: l.,"~. ;..>" . ..
".':l:,:" . . ',;,(.
$9.12"1:]' ".':'
$3JW:~;'.l~--ic.
$76.00,
6/4/10
6/4/10
6/4/10
Date Paid
Total Amount Paid
$88.92
I Plan Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00719
ISSUED: 06/04/2010
APPLIED: 06/04/2010
EXPIRES: 12/04/2010
VALUE:
Receipt Number
2201000000000000632
2201000000000000632
2201000000000000632
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.
l Reauired InsDections ~
Water Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Final Electric: When all electrical work is corit.,lete. ,
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By signature, I state and agree, that I have carefullx.examined the completed application and do hereby certify that all
information hereon is true and correct, and I fnrther: 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 Commnnity Services Division, Building Safety,
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 fnrther agree to ensure that all reqnired 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.
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Owner or Contractors Signature
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Paee 2 01'2
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Date
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000632
Date: 06/04/2010
11:14:54AM
Job/Journal Number
COM201O-00719
COM2010.00719
COM2010.00719
Description
Water Line - 1st 100'
+ 12% State Surcharge
+ 5% Technology Fee
",,};;,L Hi::; f";\.!'
Amount Due
76.00
9.12
3.80
$88.92
.' .1."',
Item Total:
Payments:
Type of Payment
CreditCard
cReceintl
Paid By
BERNARD PETERSON
Check Number Authorization
Received By Batch Number 'Number How Received
Amount Paid
cjc
$88.92
$88.92
02714c In Person
Payment Total:
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