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HomeMy WebLinkAboutPermit Plumbing 2001-2-1 ... -, . - l:;: '- -. I Job# 01-00089-01 I Page 1 of 2 TRANS#=Oi-Q004353 DATE:FEB 01 2001 AMT RECD:2 $ 44.00 CHANGE: CASHlm:061 PUBLIC PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00089-01 . 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 location Of proposed Site: 525 Mill St Spr Assessors Map#: 17033523 lot: Block: Addition: Tax lot #: 04500 Subdivision: Owner: Springfield School District 19 1890 42nd Street Phone Number: 541-744-6375 City/State/Zip: Springfield, OR 97478 New Value: $0 Address: Scope Of Work: Plumbing 60 feet water supply Contractor Type Plumbing Contr Contractor Twin Rivers Plumbing Inc Po Box 40397, Eugene, OR 97404-0064 Registration # 17695 Expiration Date 3/11/01 Phone 541-688-1444 Quad Area: # Of Units: Constr. Type: (VN) Wood Frame Water Heater: Office Use land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Office/Professionc Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. All ins.R>tcti'~crs'Requested before 7:00 a.m. will be made the same working day, inspections requested after 7!do q.m..~i11r~~pj1,~E~l!.M)f~1I0WirngIEWORK working day. . 1HI5:;RI~EDUNDER1HISPERM\1'SNOT . R' d I t' AU1 ._..,.....^tol~I'"\Cf"lQ eqUlre nspec Ions COMMENCEU Uti I\:> M.O,....I',...,~. .-- I Plumbing I ANY 180 DAY PERIOD. Water Line -Prior to filling trench. Construction Types:(VN) Wood Frame Occupancy Groups: Office/Professional/Rest t . . .' ",.....,-,,' "~ "nr-r'!a'lIj "powresyou 0 # Of BUlldmgs: # Of Stones: ATTHelgnt1(feet)::!:' ." ,-, ,l.-. . . . " . _..I",", ..,rl't-tel,.: hVH"teOregon Utility # Of Bedrooms: Current Umts: fo\!m:P~opo~ea:l:J.n!t~:. ,! . I S are setforth H d" A ? D ~ I_A'&:cal'lon l en'\7h fnose ru,e an Icap ccess. Census Code: Does notl~pply ....~ ..... I :00"10 through OAR 952-00'1- - Area (Sq. Feet) In OAR v5~ 001 bt . copies of the rules by . 0090 You may 0 am Mam: Accessory: Total: ('~ilinn the center. {Note: the telepho'~e ~ .a _ r-\....".\-"'Il^"'" . :\YHU\I ;~I ;~~:;lJ~~;5'r: nurnO>-l1 IVI li 10 """ ",...,,~.. - .", -~ . Fee Paid On Recelpt# ('ont~Y~~4~!.gg<tnJll:Yl344). Fee Amount Plumbing Minimum Plumbing Permit Fee 02/01/2001 4353 $.00 ?- Job# 01-00089-01 Page 2 of 2 Fee Paid On Receipt# Plumbing 02/01/2001 4353 02/01/2001 4353 02/01/2001 4353 Value/Quantity Fee Amount State Surcharge - Plumbing Water Service Footage Administrative Fee - Plumbing Total Plumbing Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time and that the project address is readable from the street. 60 $2.80 $40.00 $1.20 $44.00 $44.00 ;v(J .. b~. t ~ 2/; /'Z..6e> I Date I Signature