HomeMy WebLinkAboutPermit Plumbing 2003-5-29
/....
.(
.~--
""
.J
I
City of Springfield
. Plumbing Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
PLM2003-00033
5/29/2003
5/29/2003
11/29/2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
Springfield
TYPE OF WORK:
TYPE OF USE:
~~ '
Pk~~ CONTRACTOR:
o~Y.,~~~~~~
Y.,~ S ~Y{J ~\Y.,~
~\.,\., \~ SJ~\'
~~. ..~\\ S~~\)Y.,~ ~~~~
~,\'\ ~~\'I.' \) \') ~ \S ~
~ ~\S ~ ~~t~ x.'V \:S ~~\:S . CCB~,., , "
'\ ,,\ \,--X:~~~~<;';'N'~ ~;",. .:,<,"
\ ('\~,\ ~'> <)
Am)runt~ld Date Paid
~' '
~ 5.90
4.13
45.00
14.00
2222 R ST
1703251301100
New
Residential
150 ft storm sewer
OWNER! APPLICANT:
HARLOW DENNIS C & LINDA R
2222 R ST
SPRINGFIELD OR 97477
EXPIRES
Descriotion
Receiot Number
Reauired Insoections:
OS/29/2003 1200200~o'000001353
OS/29/2003 qR@2eO'oQQ~0'Ob.,Qp53
OS/29/2003 ~eJ$O:>N~tO()()OP~'(o)O 1353
OS/29/2003 O~\ \'0-\1'1 X\em562~Q{),(f(i)~WQ~f3?3
. .~.0\eg00 'O~~ 0 ~\}\0S rp..~ 9':> \}\0s Yj')
_ ~,,0' OO'Q'\! ~'(\OS ~~'(\ 0 \'(\0 ~ 0{\0
/"\ ~\ . ...C; '(}: .o{. _ .",~O _ "- 0\ 'nQ~ ,'.(\{\
lA' ~\)'- C0\'- Q'\v' ~\'.; "\~. .~(jQo'
.. '. ,\~a\l'l '(;\(\ . A,)) _',(\ CO . \'(\0 \0\\'\ .
To Request an mspection call the 24 hour recordmg at 726~17~9v'(.&h!)~R.ectIo~teque~~'<f:be&>~\7i:O~~.m. WIll be made the same
working day, inspections requested after 7:00 a.m. will be\Qfa'a~'\fJ.\e:rtfio't'\4rg\~~~n~~e:r."\,)\\~'2.'?Jbr
_ () ,In\} _ (",0 _~o.~ . t1,1?)
\" ~.' \\\V ....01' ~\)-
o~IlJ ~\\{\~ \O~ \'(\e . S V~
C'(}: ~0~ 'f\\0~ '\
{\'V~ C0
1 Storm Sewer Line: Prior to filling trench.
+ 10% Administrative Fee
+ 7% State Surcharge
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl 100'
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. I further
certify 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 proper time, that each address is readable from the street, and that
the approved set of plans, if applicable, will remain on the site at all times during construction.
/Jp~ ? g/L
'-OwnetofcOntractors Signature
.J J-- -:?-r~ ctJ
Date