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HomeMy WebLinkAboutPermit Plumbing 2001-10-22 ~. '"" Job# 01-01160-01.1. Page 1 of 2 COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety , mANS#~01-0007046 DATE~OCT 22 2001 AMi RECD:2 $ 1552.04 CHANGE: CASHIER:061 Job Number: 01-01160-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed. Site: 212 Q St Spr Assessors Map#: 17032624 Lot: Block: Addition: Tax Lot #: 01501 Subdivision:, Owner: Marilyn Phillips 212 Q Street Phone Number: 541-747-1499 City/State/Zip: Springfield, OR 97477 Value: $0 Address: Scope Of Work: Plumbing, State Farm Insurance , Sanitary 'sewer connection from previous septic system " IY ~Of(..'t-.7: ~ \'r \ I " ~l.J \ Re. gist'etion # E,X X,fljt3'ffd.' n Date\ \'0 Phone r:,~. \ \.1;:.1 \::.'(\\.. ~ ~~~03 ~\\ S~~Ii~~{~r@BS ~ ~\"=:\) \'(cg41-988-0868 S ?1C.~ . \j~\)~ 'S;ft..N.\)O. '" \'c\~ _c\152-\) .... \e, f:>( . \\\"\v' . -D V" Office Use ~~- ~~~cF::' 9\:;."'(-\O\)' Land Use:CO~ \'OIJ \)~'{. # Of Buildings: Zoning Code: ' ~~~ Occupancy Group: Bedrooms: Heat Source: Range: Sq. Footage:)\) \.0. ,_r\1 \\ll:.7- J, ...\\\\1 \a'J'J'~' on V" n T . t. II h 24 h d' 726 3 69 All' n.~ooon ..r. oxeg - e' t0t't o request an Inspec Ion ca t e our recor Ing at - 7 . rlnSRectlons ~eguestea before 7':00)'\, a.m..will be made the same working day, inspections reqUested:aft~r'i:oo,a.~~~ilr\~ean'aB'eOSt'6'e.f6if6'~lng.r ,... V.\~;:) '" ., I ...,- n r" \ S \::, working day. \0\\0\N {. cen\e~.'O \\,\{OUQ) \ \ne tU e . i~\C'O.\\on 0,\,00'\. ~\es 0 \ 9none ConstructIon Types: ~o~~?> 952,0 '0.'1 obtaIn ~~\e', \ne \e ~\\\ca\\on Occupancy Groups: \n 090. ~OU~~e cen\e~~~ 'on \)\\\\\'1 NAA). # Of Buildings: # Of Stories: 0 ca\\\i'\g ',l:Ieighf1fe%t)~,'?l32-'2.3 bet 'v' - '", 1,01:- # Of Bedrooms: Current Units: nuf{\ <firojfMsed Units: Handicap Access? D Census Code: Does not apply -Area (Sq. Feet) Main: New Contractor Type Plumbing Contr Contractor Eugene Excavation & Plumbing Inc Po Box 40821, Eugene, OR 97403 Quad Area: -# Of Units: Constr. Type: Water Heater: Accessory: Total: Fee Paid On Receipt# Plumbing 10/22/2001 7046 10/22/2001 7046 10/22/2001 7046 10/22/2001 7046 Value/Quantity Fee Amount Minimum Plumbing Permit Fee State Surcharge - Plumbing Sanitary Sewer Footage <Administrative Fee - Plumbing Total Plumbing 80 $.00 $4.13 $59.00 $4.72 $67.85 Residential Improvement MWMC System Development 10/22/2001 7046 1 $34.83 MWMC Administrative Fee SDC Administrative Fee Property Annexed 1979 or Before Office Building - General - MWMC Residential Sanitary MWMC Sanitary Sewer SDC Reimbursement Sanitary Sewer SDC Improvement Total System Development Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certifythat 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. Ifurther agree to ensure that all required inspections are ~ted at the pr<>p~ that the project add:SS is readable from the street, SignatuffljJ Date ..' .. Fee Job# 01-01160-01 Paid On Receipt# I" System Development 10/22/2001 7046 10/22/2001 7046 10/22/2001 7046 10/22/2001 7046 10/22/2001 7046 ,10/22/2001 7046 10/22/2001 7046 Page 2 of 2 Value/Quantity I 1 90 2 1 27 27 Fee Amount $10.00 $70.68 $-441.87 $462.22 $332.86 $576.99 $438.48 $1,484.19 $1,552.04