HomeMy WebLinkAboutPermit Plumbing 2005-12-9
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01710
ISSUED: 12/09/2005
APPLIED: 12/09/2005
EXPIRES: 06/09/2006
VALUE:
'~ Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
~ 541-726-3769 Inspection Line
SITE ADDRESS: 3311 OREGON AVE
,ASSESSOR'S PARCEL NO.: 1702313401900
"
Springfield TYPE OF WORK: Plumbing Only
PROJECT DESCRIPTION: Replace approx 701f sanitary sewer line
TYPE OF USE: Repair Residential
REQUIRED PARKING
Overlay Dist: I W reQ.9.tap. you,t~
# Street Trees Rqd: E.NiIO~1'. Oregon a the <!1.lt~icap'ii'~'dY h
Paved Drive Rqdf-.'TI lee; adopted by Fompact::t tort
% of Lot Coverag€:lIoW r,u 'center. ihose ru h"'OAR 952-00~-
NotifIcatIon -OO~ -OO~ 0 throug 0' tile rules bY
'. flfl..~ 952 , ._',~ rnOl8S '_~nO
I PUBLIC IMPROVEMlii~)T.S'I'{oU m:~e~~~;'- (Note: ,the ~~~i~~~tion
ca'\lng th Q ~oon UtIlity
, ber ~~ewalkrTYP'e~332-2344).
num ~ t r is ~-5DU
C{lb\v8nspoutslDrains:
Owner:
Address:
JUAN M LOPEZ & GRACIELA R LOPEZ REV
2920 EXPOSITION BLVD
SANTA MONICA CA 90404
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
GARY ALAN MUSTIN
i, # of Units:
Primary Occupancy Group:
: Secondary Occupancy Group:
, Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
I, Storm Sewer Available:
., Special Instruction:
Notes:
I Valuation Description I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Pa2e 1 of2
, Expiration Date
06/24/2006
Phone
541-463-7568
\'
n/a
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD:'
Building/Combination Permit'
PERMIT NO: COM2005-01710
ISSUED: 12/09/2005
APPLIED: 12/09/2005
EXPIRES: 06/09/2006
VALUE:
"C
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
LFees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl100'
Amount Paid Date Paid Receipt Number
$5.90 12/9/05 2200500000000001678 r{
$4.13 12/9/05 2200500000000001678
$45.00 12/9/05 2200500000000001678
$14.00 12/9/05 2200500000000001678
Total Amount Paid
$69.03
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.
I Reouired Insoections I
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
tim~~::o:/~
Own~tr~gnature
VeL-- q - cJS--
'b { ,
Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-72"-3759 Phone
Job/Journal Number
COM2005-0171O
COM2005-0171O
COM2005-0 171 0
COM2005-01710
. ~;::~,
Payments:
Type of Payment
Cash
Change
Job/Journal Number
COM2005-0171O
C;OM2005-0 171 0
o-OM2005-0 1710
COM2005-0 1710
Payments:
,Irpe of Payment
d~sh
Grange
.~.":
,;\, ~
::'I:
l
"
, ~~
IT
}
'Ii
yo
~~
",j-
"
~l
'.~
i
"
~~
12/9/2005
RE<=EIPT #:
Description
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
GARYS ROOTER SERVICE
GARYS ROOTER SERVICE
Description
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
GARYS ROOTER SERVICE
GARYS ROOTER SERVICE
-'~y of Springfield Official Receipt
__~velopment Services Department
, Public Works Department
2200500000000001678
Date: 12/0912005
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb In Person
djb In Person
Payment Total:
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb In Person
djb In Person
Payment Total:
Page 1 of 1
2:01:52PM
Amount Due'
45.00
14.00
4.13
5.90
$69.03
Amount Paid
$70,00
($0.97)
$69.03
Amount Due
45.00
14.00
4.13
5.90
$69.03
Amount Paid
$70.00
($0.97)
$69.03