HomeMy WebLinkAboutPermit Plumbing 2005-1-12
Status
Issued
, CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01575
ISSUED: 01112/2005
APPLIED: 12/23/2004
EXPIRES: 07/12/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6463 Thurston Rd
ASSESSOR'S PARCEL NO.: 1702341200700
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
PROJECT DESCRIPTION: 420 feet of private water line utility and common driveway storm sewer
Residential
Owner: WIRFS THOMAS G & DIANE M
Address: PO BOX 237 SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Sewer
Contractor
EMMANUEL EARTHWORKS INC
License
Expiration Date Phone
541-746-5630
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
BUILDING INFORMAmIOJN,II law requires you to
, :"', .)IP" adopted by the Oreaon "tility
# o~Stone_S;IOi'l venter. Those rules 'L3t ~zf: r,
HeJghj,.oJ-~!~~ftY'E~ -0010 through o:.ft%W. 1~ Flfuor: .
Tm~gf~f8t may obtain copies oft~~f2~QFloor.
Wate~c1i~n~:the center. (Note: the t~~1J 'FlEffi.gement:
Ran~u?rr&e; for the Or U . . 9~PP~rage/Carport
Energy Pat~ . egon ttltty N~qijt<OOter:
Sprinkled Buii3Jltel: IS 1-800-;1Y\f-2344bccupant Load:
I DEVELOPMENT INFORMATION I
Front yard 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:
Street Improvements:
Storm Sewer Available:
Special Instruction:
~MJ11HClE:
PUBLIC IMPRO~M;EiNiS LL E:XPIKt n- I Ht vvunr\
AU I unlL .DER T~IS PERMIT IS NOT
COMMENCED OR IS ~6~~~JJlfOR
ANY 180 DAY PERIO[)I)ownspouts/Drains:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01575
ISSUED: 01112/2005
APPLIED: 12/23/2004
EXPIRES: 07/12/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Fixture
Storm Sewer - ht 50 Feet
Storm Sewer Each Addtll00'
Water Line - 1st 50 Feet
Water Line - Each Addtll00'
Amount Paid
Date Paid
Receipt Number
$17.40
$12.18
$14.00
$45.00
$14.00
$45.00
$56.00
1/12/05
1/12/05
1/12/05
1/12/05
1/12/05
1/12/05
1/12/05
1200500000000000051
1200500000000000051
1200500000000000051
1200500000000000051
1200500000000000051
1200500000000000051
1200500000000000051
Total Amount Paid
$203.58
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
Water Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
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 cnnst~ ~ ~ '2- / i> )
j I'
Owner or Contractors Signature Date
Paee 2 of2
225 Fifth Street
Sprirtgfield;Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-01575
COM2004-01575
COM2004-01575
COM2004-01575
COM2004-01575
COM2004-01575
COM2004-01575
Payments: '
Type of Payment
Check
1/12/2005
RECEIPT #:
Description
Water Line - 1st 50 Feet
Water Line - Each Addtl 100'
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl 100'
Fixture
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
COZY HOMES
r.ty of Springfield Official Receipt
,velopment Services Department
Public Works Department
Item Total:
Check Number Authorization
Batch Number Number How Received
1200500000000000051
Received By
djb
37300
Page 1 of 1
Date: 01/12/2005
1:59:26PM
Amount Due
45.00
56.00
45.00
14.00
14.00
12.18
17.40
$203.58
Amount Paid
In Person
Payment Total:
$203.58
$203.58