HomeMy WebLinkAboutPermit Plumbing 2001-2-15
.~,
..
\ ,~,~
I Job# 01-00133-01 I
Page 1 of 2
TRANS#:Ol-0004455
DATE:FEB 15 2001
AMT RECD:2 $ 44,00
CHANGE:
CASHIER:061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00133-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
\
Location Of Proposed Site: 1170 C St Spr
Assessors Map#: 17033514
Lot: Block: Addition:
Tax Lot #: 12001
Subdivision:
Owner:
Address:
John Overton
1170 C St
Phone Number: 541-741-2041
City/State/Zip: Springfield, OR 97477
New Value: $0
Scope Of Work: Plumbing
sanitary sewer connection
Contractor Type
General Contr
Contractor
Aardvark Excavation
5335 Daisy Sp 119, Springfield, OR
97478
Registration #
101850
"
Expiration Date
6/1/2001
Phone
541-741-2041
i,
Office Use
Land Use: # Of Buildings:
Zoning Code: N'()"e!:!cg?E"YP~!1~Y(.Gr.ou~~O
Bedrooms: A1iENTIO .~' W Heat..Source:)O Utility
, I~~ o.ooptea ""'y ...~ -~, f of",
Range: folloW rL\ ':'.. t' ,Ss:lsEog,ta'giHe set ,on,.
"'1,..+I~i""Hnfl Len ~r. "" ..,. . ..... ^:n nc:t)_no'.,
. , . ~:~"'q952-001-00101mU~YII~;:~'~'-';'~o': \,
To request an inspection call the 24 hour recording at 726-37€)!!l9~II-t9sR~Fg,~ns.r\.~q~~~t~(hbefOreq;00""S bJ
a,m, will be made the same working day, inspections requestet'\d}gft~r:7?O'd ~.l11d~YfW{~\~\\rvaq~rthet{011~Wl~
working day, calling m~~e OrsgO\1 Utility NotificatIon
'R . d I nt.uvt1ber~OI . - - :~,.. o...."_.,,::;?-:~~44).
eqUlre nspec Ions Vl:.imv"-' ~-
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Sanitary Sewer Line
I Plumbing
- Prior to filling trench.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
NOTiCE:
# Of Storie~: THIS p~8i@.,~t~w~~~ ~XPIRE IFTHE WORK
Current Umts: ~J ITHdRI~~cnsO~QJ~~i-lIS PERMIT IS NOT
Census Code: Does not apply ABANDONED FOR
COMMENCED OR IS
Total: ANY 180 DAY PERIOD.
Fee
Paid On Receipt#
Plumbing
02/15/2001 4455
Value/Quantity
I
Fee Amount
Minimum Plumbing Permit Fee
$.00
,.,
I Job# 01-00133-01 I
Paid On Receipt#
'I Plumbing
02/15/2001 4455
02/15/2001 4455
02/15/2001 4455
Page 2 of 2
Value/Quantity Fee Amount
..
Fee
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein is true arid correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701 055 will be used on this project. I further agree to ensure that all required inspections are
requested at the pro~ that the project address is readable from the street.
?"~t4~ 2'/$-"0/
Si~ill Date
99
$2.80
$40.00
$1.20
$44.00
$44.00
v
"', '" ,~.