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Home My WebLink AboutPermit Plumbing 2007-7-12 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2007-00691 ISSUED: 05/18/2007 APPLIED: 05/15/2007 EXPIRES: 01112/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4128 Camellia St Springfield ASSESSOR'S PARCEL NO.: JACOBS PART CAMELI TYPE OF WORK: Plumbing Only TYPE OF USE: New PROJECT DESCRIPTION: Install Sanitary and Storm Sewer lines for land partition approval Residential Owner: TIM AND MICHELLE JACOBS Address: PO BOX 734 PLEASANT HILL OR 97455 Phone Number: 541-741-1940 I CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone BUILDING INFORMATION I # of Units: 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: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a 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 IMPROVEMENTM A' NTI~tJ.Drft9Qn taw requires you to Street Impr<N(w~: ~now rul~~d:cJ8p'teW8f:the Oregon Utility Storm Sewe.rN~if.l6RMIT SHALL EXPIRE IF THE WORK NotlflcatiorOO6m~u~rMlf!S are set forth Special InstvWift<<DRIZED UNDER THIS PERMIT IS NOT In OAR 952-o01-OO10thro~gh OAR 952-001- COMMENCED OR - 0090 You may obtain copies of the rules by Notes: IS ABANDONED FOR catilng the center. (Note: the telepho~e ANY 180 DAY PERIOD. number for the Oregon Utility Notification venun 10 ,.g~.:,-3:;f. Ea 11). I Valuation DescriPtion' Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtll00' Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Fixture Storm Sewer Each AddtlIOO' Amount Paid Date Paid $11.80 $5.90 $9.44 $45.00 $14.00 $45.00 $14.00 $2.80 $1.40 $2.24 $14.00 $14.00 5/18/07 5/18/07 5/18/07 5/18/07 5/18/07 5/18/07 5/18/07 7/12/07 7/12/07 7/12/07 7/12/07 7/12/07 Total Amount Paid $179.58 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2007-00691 ISSUED: 05/18/2007 APPLIED: 05/15/2007 EXPIRES: 01112/2008 VALUE: Receipt Number 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000001117 2200700000000001117 2200700000000001117 2200700000000001117 2200700000000001117 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. ~eolJiredJnsnections . Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: cOM2007-00691 ISSUED: 05/18/2007 APPLIED: 05/15/2007 EXPIRES: 0111212008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 ~~. '1-I;).--C;7 Owne;or ~~actors Signature Date Page 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00691 CO M2007 -00691 COM2007-00691 COM2007-00691 COM2007-00691 Payments: Type of Payment CreditCard cReceint I RECEIPT #: Description Fixture Storm Sewer Each Addtl 100' + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By TIM JACOBS City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001117 Date: 07/12/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received Jlh 170375 In Person Payment Total: Page 1 of 1 1:17:15PM Amount Due 14.00 14.00 1.40 2.24 2.80 $34.44 Amount Paid $34.44 $34.44 7/12/2007