HomeMy WebLinkAboutPermit Plumbing 2004-4-16
. Status
Issued
/..', . CITY OF SPRINGFIELD .
Building/Combination Permit
PERMIT NO: COM2004-00436
ISSUED: 04/16/2004
APPLIED: 04/16/2004
EXPIRES: 10/16/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1670 H ST
ASSESSOR'S PARCEL NO.: 1703362106200
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION: 50' Sanitary line replacement.
Owner: MCDANIEL GARY M
Address: 1670 H ST SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
GARY ALAN MUSTIN
License
129990
Expiration Date
06/24/2004
Phone
541-463-7568
BUILDING INFORMATION.
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
~ Impervious Surface Area:
.t"'~ .
L ~VF;~~ENT INFORMATION. ",-0
0..(,- \, ...~\\ C\~ ....\O~ .~{clmQUlRED PARKING
~~~ r.v~~' ~v er:,"') -0~ (\,
Frontyard Setback: ~~ ~S -X ~Y.-\) Overlay Dist: o..~\i.. O~ e"'- \I\~pl:
Side 1 Setback: ~~\,.\,.~ '\~ ~\)\) # Street Trees Rqd: '(>.~ '(0 O'(et:$~0 ~ b"findjcapped:
Side 2 Setback: ('"~. ...~~ S ~'\)Y::. ~~~ Paved Drive Rqd: O~ '\ ...l.;s.0 ~'0r:, 'i>-<?-- ~ <.~~act:
~'\\" <_~~' '\) ~ ~ ~ ~ '!.,et:$ 0.'0"') e <. O:'(\e 0'<" ~
Rearyard Set\~cK.S ~v ~1.Y::. \) \) ~\) . % of Lot Covera~p R",-0 -<...~6~ ~f0~ 0' ~ ~0~~ Z>-~o
Solar Setbacks:,\~ .o(~\:)~ ~\0Y::. ~ -X<? ~0.'O '(>.0.0 :<.. \). .;s.~0 'R\er:, 0 '\.0 ~\V
,\... . ~Y ..... t-:: ,......Y... I "C; "..'\.0 -;.. ., ;".0 . ~ ~O_
r~\)~',\~\) v I PUBLIC IM~j~l:~~'~2r\)d:>'\.~~~0;-0~~~?~b.IF
Street Improvements~ "\ o~~\V a. ~<;j ~'(>.~ve~id~~W-TYpe:
~ 'i>-"'.J"O~ e u ..9-
\~ 0 B\)' . ~f0 ~ '!.. .;s.Y>}twnspouts/Drains:
\)<::5 r~'\ 0'( ,0,' -
v ~'O ,..
. ~\S"
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
SETBACKS
Storm Sewer Available:
Special Instruction:
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
Paee 1 of2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00436
ISSUED: 04/1612004
APPLIED: 04/16/2004
EXPIRES: 10/16/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid-l
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Sanitary Sewer - Ist 50 Feet
Amount Paid
Date Paid
$4.50
$3.15
$45.00
4/16/04
4/16/04
4/16/04
Receipt Number
1200400000000000493
1200400000000000493
1200400000000000493
Total Amount Paid
$52.65
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;
L Reauired Insoections I
1 Sanitary Sewer 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
times during construction.
rJL.~--; 0~....-'
U(./ / ----- ,.,
Owner or etmtractors Signature
t/-//-/0q.
Dati ---- /
Pa2e 2 of2
. 225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
""!~y of Springfield Official Receipt
..;velopment Services Department
Public Works Department
Job/Journal Number
COM2004-00436
COM2004-00436
COM2004-00436
Payments:
Type of Payment
CreditCard
4/1612004
RECEIPT #:
1200400000000000493
Date: 04/16/2004
Description
Sanitary Sewer - 1st 50 Feet
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
GARY MUSTIN
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Jmp 000358 024934 In Person
Payment Total:
Page 1 of 1
lO:17:39AM
Amount Due
45.00
3.15
4.50
$52.65
Amount Paid
$52.65
$52.65