HomeMy WebLinkAboutPermit Plumbing 2001-1-3
I Job# 01-00005-01 I
Page 1 of 2
TRANS#:Ol-0004157
DATE:JAN 03 2001
AMT RECD:2 $ 44.00
CHANGE:
CASHIER:061
~"f~J.'lj'~~:I.:rd
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00005-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 1917 J St Spr
Assessors Map#: 17033612
lot: Block: Addition:
Tax lot #: 02100
Subdivision:
Owner:
Sam Montano
Address:
1917 J St
Phone Number: 541-741-0622
City/State/Zip: Springfield, OR 974~7
New Value: $0
Scope Of Work: Plumbing
sewer replacement
Contractor Type
Plumbing Contr
Contractor
Oregon Excavating Inc
3195 River Rd, Eugene, OR 97404
Registration #
100308
Expiration Date
6/26/01
Phone
541-689-1442
Office Use
Quad Area: land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type: Bedrooms: Heat Source:
Water Heater: Range: Sq. Footage:
To req~est an inspection call the .24 hour ~ecordi~g at 726-3769. AI~n9JJ~cffi~{e~eNedJ>e,tor.~il;Q~EW~liK
a.m. will be made the same working day, inspections requested after: i7'i:.QO a:~~-!vIIPt5e~ma8~ltIiJqolloU:lng .
working day. ,AUTHORIZED UNDER THIS PERMlll$ NO r
R . d I t' f'OfiAfiAJ:'t\Ir.l=n ORIS ARANDONED FOR
eqUlre nspec Ions
Plumbing A~Y180DAYPERIOD.
I
- Prior to filling trench.
Sanitary Sewer Line'
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
Fee
^'TTE"IT'Cr,'.n..s....",.., l"'IAf "I:'cu!res \IOU to
/"'\1' i'., ~ "'\I. ..Jr. ~V:\ . tt;:.;.., -' '1 II' .!
# Of Stories: follow \1d~19ht:(\f~et.)::1 by the Oregon Utility
Current Units: NotificatRr.opose(:frlf~'itsle rules are set fort.h
Census Code: Does n&t. 81UP@ 952-001-001 0 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note:.t~e tel~~ho~e
nllVllhMfnl'the Orallon Utlhtv NotIfIcation
. .____.__"...,_AJI.\
Paid On Receip~fl~m6r ':V~i~~)Q'tvf,mty"""'. Fee Amount
Plumbing
01/03/2001 4157
Total:
Minimum Plumbing Permit Fee
$.00
Fee
Job# 01-00005-01 I
Paid On Receipt#
Plumbing
01/03/2001 4157
01/03/2001 4157,
01/03/2001 4157
Page 2 of 2
Value/Quantity
Fee Amount
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 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
requ~ted at the proper time and that the project address is readable from the street.
i_'/~ /Ut~ -- / - ),- 01
Signature Date
100
$2.80
$40.00
$1,20
$44.00
$44.00