HomeMy WebLinkAboutPermit Plumbing 2005-1-14
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01574
ISSUED: 01114/2005
APPLIED: 12/23/2004
EXPIRES: 07/14/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6451 Thurston Rd
ASSESSOR'S PARCEL NO.: 1702341200700
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: 310 feet of private water line utility
Owner: WIRFS THOMAS G & DIANE M
Address: PO BOX 237
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
JET MECHANICAL LLC
License
158633
Expiration Date
02/10/2006
Phone
503-363-2334
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:
Wat~~~e:
~~ ~'ii~
.~I ~e~libG(" Pa,",,~'(\
~ \a."~ ~r i:~~~ \-
O~eQP '0'1 \'(\e ~~.al ~~<ff(r g:
_\('\~. ~~P,O -'" (~Cf\.~ I"c '0'
.-::~\I OV\" ~~u...
~\\ ~ ~\).\e~ '0.' ~\e'(.: ~ ~~ORMA TION .
\Q\\O'-S'l \0'(\ Ce .00'\. CO e . . u,.
:(\\\G'O-'V. 'f;)?:,00'\ 'X)\a.\'(\ ~\o\e'. \~ N.O\\~~
't\o Op..~ 9 {'(\'O-'i 0 ~e~'~" ~~l)j~ ?i~t:
\'(\ BO.'<O'J. ~e ce'f\ Q{eQP'(\ ~. ~rees Rqd:
00 ~\\'(\9 ~ \O~ \'(\0. VtgOOi aved Drive Rqd:
~u\'C\'Oe~ ce'(\V3~ \$ % of Lot Coverage:
Lot Size:
. Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
REQUIRED PARKING
Total: '
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Description
Type of Construction
Square Footage
or Bid Amount
Value
Date Calculated
Notes:
Pal.!e 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01574
ISSUED: 01112/2005
APPLIED: 12/2312004
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-'
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st 50 Feet
Water Line - Each Addtll00'
Amount Paid
Date Paid
$8.70
$6.09
$45.00
$42.00
1/12/05
1/12/05
1/12/05
1/12/05
Receipt Number
1200500000000000050
1200500000000000050
1200500000000000050
1200500000000000050
Total Amount Paid
$101.79
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 ReQuired Insoections I
Water 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
timC'dUri.gCO~ '/17--/ t!)
Owner or Contractors Signature Date I I
Pal!e 2 of 2
225 Fifth Street
.... y' f
Springfield, Oregon 97477
541-726-3759 Phone
rity of Springfield Official Receipt
.velopment Services Department
Public Works Department
RECEIPT #:
1200500000000000050
Date: 01112/2005
1:59:04PM
Job/Journal Number
COM2004-01574 '
, COM2004-01574
COM2004-01574
COM2004-01574
Description '
Water Line - 1st 50 Feet
Water Line- Each AddtI 100'
-i- 7% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment Paid, By,
Check COZY HOMES
Item Total:
Check Number Authorization'
Received By Batch Number Number How Received
djb 37300 In Person
Payment Total:
Amount Due
.45.00
42.00
6.09
8.70
$101.79
Amount Paid
$101.79
$101.79
'"
1/12/2005
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