HomeMy WebLinkAboutPermit Plumbing 2010-7-19
e~l1!lt~.i!I~ll:
I
ii'
V
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00955
ISSUED: 07/19/2010
APPLIED: 07/19/2010
EXPIRES: 01119/2011
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5140 C ST
ASSESSOR'S PARCEL NO.: 1702333200400
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace approx 1061fsanitary sewer
Owner:
Address:
ELLEBRACHT SARA M
5140 C ST
SPRINGFIELD OR 97478
Phone Number: 541-521-9186
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor License
ROYAL FLUSH ENVIRONMENTAL SERVIC 153694
BUILDING INFORMATION.
Expiration Date
12/2312011
Phone
541-895-2072
# of Units: # of Stories:
- Primary Occupancy Group: R3 ""itight of Structure
Secondary Occupancy Group: IllleS ,!Oll~~qe of Heat:
Primary Construction Type la~VBl~le901\ \"\!dI\.\T Type:
Secondary constructio'\-lype:90~ b'! l\"Ie \eS ale se~~" Type:
# of Bedrooms:'I\:.I'\IIO S aclollte I\"IOse (Il \"I Oi'-'?- 9S\~\!~ Path: '
1'\\0'" (\lle eel\\8I"OI\"l101l9 o\I'l\el~~led Building:
\0 .' _nhO\l ,,-I _ ,0\ 1"\ \es e '
\~o~'?-~;~-;~;;.'! ~~~~, \I'\~~ ' OPMENT INFORMATION
oo90, , I'l\e ce 0(e90 -:,-:,'2.-
"a\\I\\9 ( l\"Ie \ \100-
Frontyard SetbacR: (libel \0 tel IS -
Side I Setback: 1''' eel'
Side 2 Setback: ..
Rearyard Setback:
Solar Setbacks:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Fl Other:
Occupant Load:
nla
REQUIRED PARKING
-'
Overlay DiSt:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
........".".., .. ,d'
Total:
Handicapped:
Compact:
,-
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS I ,.,..y'"
.. .. "Side\v~'iU~i~a\l.\C.
.. ~\y,~tv\l!di\Q1
l-\O\\C\\-J\\\ CO\\~\..i~\\\S \'~~t\) ~a\l.
'I "i\\!.IS?'\'SLt\) \}~\) IS f>,~f>,~\)
: Ide \\<:\:\\Q \) a\'. .
Notes:
Description
Type of Construction
$ PerSq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of 2
...1 (
~ ~~ ,.1 .
,,'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
:; LIS
;. , ;. i ~~." ~
~~ 1f"h !" "', .; > ;" . t
. ,.,JAtal Y.~.lueof Project
-~::;~--'1.J. ." ........~ - .
l :';'iees Paid i
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Sanitary Sewer - 1st 100 Feet
Sanitary Sewer Each AddtllOO'
Amount Paid
Date Paid
$11.40
$4.75
$76.00
$19.00.
7/19/10
7/19/10
7/19110
7/19/10
Total Amount Paid
$111.15
. ~ ,,'.
. I . P!an Reviews ~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00955
ISSUED: 07/19/2010
APPLIED: 07/19/2010
EXPIRES: 01/19/2011
VALUE:
Receipt Numher
2201000000000000841
2201000000000000841
2201000000000000841
2201000000000000841
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.
.1 u~ '1.), ,.~,.,,:
Re.~:~~ed ii1~~ec~
.-:..n .....
Sanitary Sewer Line: Prior to filling trench .~Jd 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 he 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 reque.~ted 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.
_~A~~ej}j
: III I
.. c'"
tJ1~e..{<".(eh~
Owner or Contractors Signature Date
1 l..: ' I, ~'.:, .'
..'-.... , . .1
~;:~;1I :'. ;~i~~.~ ~~
..l\:J,~',,,~,,,~' "g~_!,~'I't" ''''
...".:~.",-.' .
.,,(i'.
Page 2 of2
7~/q~/o
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
a1~~~,'~~, "",.:'
1Iti!"
. .~. j
<C," "
"'h",''''';''._'' ..
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000841
Date: 07/19/2010
10:01:06AM
Paid By
SARA ELLEBRACHT
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
76.00
19.00
11.40
4.75
$11 1.15
Job/Journal Number
COM20 1 0-00955
COM20 1 0-00955
COM2010-00955
COM2010-00955
Description
Sanitary Sewer - 1st 100 Feet
Sanitary Sewer Each Addtl'l 00'
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
Check
Amount Paid
djb
1182
In Person
Payment Tota':
$111.15
$11 J.lS
.f.
""
~-:. L(\'~
~J
,,,,;A -,~
i,l
l{l'i:i'i~' ,Hy
r;;
"
'{~;"',~ :',' j <,.
,;1
cRcceintl
Page I of I
7/19/2010