HomeMy WebLinkAboutPermit Plumbing 2004-6-16
Status
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: COM2004-00691
ISSUED: 06/16/2004
APPLIED: 06/11/2004
EXPIRES: 12/16/2004
VALUE:
SITE ADDRESS: 4762 Rocky Rd Springfield TYPE OF WORK: Plumbing Only
ASSESSOR'S PARCEL NO.: ROCKY RD SUB LOT 9
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: ' 8' Storm Sewer, 1 Catch Basin
Owner: PACIFIC WEST ENGINEERING, INC
Address: 3610 GOOD PASTURE LOOP EUGENE OR 97401
Phone Number: 541-344-2215
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
Notes:
I DEVELO~~NT INFORMATION I
u'r- 't~ ('\ ,
:/ ~\'I;'~ S ~\; ,
Front yard Setback: r:x\~'" '\ ~*\'l:)Vr\'\l.ay Dist:
Side 1 Setback: \.. "'~ S x>~ x,~ '$'tteet Trees Rqd:
Side 2 Setbac"': ~. CO\\~~ ~ ,y...'\ ~'V\j~ Paved Drive Rqd:
Rearyard Setb.!\~\~ ",~*v.. 'V>~'V~ S ~<Q~ % of Lot Coverage:
Solar Setbacks~ ,\\CO x> o..\1."'\) \j~ '\ ('\,\).
~ '1;' .. \f\P r('" ,ro.\'v "l ' rl'
\" ~v' ,<,vrQJ ~.
, ~~ C'\**"'~C'\ \)~ I PUBLIC IMPROVEMENTS I \ 1$\ '}0\\J '}o\ ~00..~~~
<:,\.1 \ <Q\J , . O~'1 0~ t~\\ Of;)
Street Improvements;~'\ ' , . .-9~1J~~-:J:j ot~~'Y.Wl.t-.'Oe ~\
r", 91~~u ~ ~ '~0\\j ~,,\\V ~~O
Storm Sewer Available:.:' "~fV,\~~'0\0~ID_~U~,~~\).,o~
Special Instruction: o~-eO\\\).Q 0\ eu." ~o.O'J u.~ ",Of:! \~ \).O~-e ~O\\O~
~ 0\)O,^00~u.\ \p ~~"'o'}~,() .~e~ ~ S0\~ ~v.'4'
, S0\fI~ ~~O ~ ~ 9'O0~~ 0\009 .~O~~
~o.. _ .-1GtO, ~'" s0\'" J" (..0.. '9 .f'C>.~O .
I V aluation D~~t~oWJ, ~~0~r~-e\ v
. 0\\ '
$ Per Sq Ft ~4~a~e Footage '
or multiplier or Bid Amount
REQUIRED PARKING
Total:
Handicapped:
Compact:
Description
Type of Construction
Value
Date Calculated
Total Value of Project
Pafe t.of2
-~;~
~.
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00691
ISSUED: 06/16/2004
APPLIED: 06/11/2004
EXPIRES: 12/16/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
LFees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Fixture
Storm Sewer - 1st 50 Feet
Amount Paid
Date Paid
Receipt Number
$5.90
$4.13
$14.00
$45.00
6/16/04
6/16/04
6/16/04
6/16/04
2200400000000000782
2200400000000000782
2200400000000000782
,2200400000000000782
Total Amount Paid
$69.03
Plan Reviews,
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.
L Reouired Insoections I
Storm Sewer Line: Prior to filling trench.
Special: See Plan Review and/or Inspector Notes.
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.
~~ ~Ld
_/~ v
-6v...." u. Contractors Signature
G..K t0J€::/d2
( -- /6 r 011--
Date
Pal!e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00688
COM2004-00688
COM2004-00688
COM2004-00688
COM2004-00689
COM2004-00689
COM2004-00689
COM2004-00689
COM2004-00689
COM2004-00689
COM2004-00689
COM2004-00690
COM2004-00690
COM2004-00690
COM2004-00690
COM2004-00690
COM2004-0069I
COM2004-00691
COM2004-00691
COM2004-0069I
COM2004-00692
COM2004-00692
COM2004-00692
COM2004-00692
(':tv of Springfield Official Receipt
elopment Services Department
Public Works Department,
RECEIPT #:
2200400000000000782
Date: 06/16/2004
8:55:16AM
Description
Storm Sewer - 1st 50 Feet
Storm Sewer. Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl 100'
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl 100'
Fixture
+ 7% State Surcharge
+ 10% Administrative Fee
Fixture
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl 100'
+ 7% State Surchaq~e
+ 10% Administrative Fee
Fixture
Storm Sewer - 1st 50 Feet
+ 7% State Surcharge
, + 10% Administrative Fee
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Amount Due
45.00
14.00
4.13
5.90
45.00
14.00
45.00
14.00
28.00
10.22
'14.60
14.00
45.00
14.00
5.11
7.30
14.00
45.00
4.13
5.90
45.00
14.00
4.13
5.90
$463.32
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 1462 In Person
,Payment Total:
Payments:
Type of Payment Paid By
Check DAVID NICHOLS
6/16/2004
Amount Paid
$463.32
$463.32
I'
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