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HomeMy WebLinkAboutPermit Plumbing 2003-10-22 '" . . . CITY OF I)I"Kl)'\jljt<U,LD Building/Combination Permit PERMIT NO: COM2003-01075 ISSUED: 10/2212003 APPLIED: 10/2212003 EXPIRES: 04/22/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1595 RAMBLING DR ASSESSOR'S PARCEL NO,: 1703252209400 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Replace 40ft water line Owner: MYRON VAN ETTEN Address: 1595 RAMBLING DR SPRINGFIELD OR 97477 Phone Number: 541- I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor HOFFMAN NORTHWEST INC License 71162 Expiration Date 01116/2005 Phone 949-380-4161 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 BUILDING INFORMATION I \0 "o~ leS 1 ~~'\'1 # of Stories: -I'Ile~~\ 01' U \ 8t'Size: Height of Struc~llj:e \'3' :l\e oleg Ie se ~~t 1st Floor: Type qf,t\,fii'(:e eO '0'1 ~ 1~\aS ~~ g'=>'S'q F~2nd Floor: ~~\l\1~'tYI!~:;)~~ i,\\ose ~9P 0 :l\e 1..sq>F.t Basement: ~\ ~ng~er'h>S:\\01. '\0\,\\10 iaS 0\ ~ ~a9~~,,~arage/Carport \0\~~2g.(dP~l',:\ .00 a.il\ c09 "\,\\e \e ~\~ther: \0\\\\ ~ 9'=>?; a.'! 0'0\ ,\~O\?;\i\\\'j ~OA,~mpervious Surface Area: r\l' ." rl\ _'Al _ u _nA..., I DEV,EooP,M.~\INEORMitl()Nll-~ l...... ;'\'~" t\....' ....'Oe ".<' n~"" (",n Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: REQUIRED PARKING Vlhr SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I 'i\"- Sidewa1kJ'.vl\r\~'t. ~~Q\ . ~~^~~~i}, \~ ~1.)1\~~~~\\ ~~:~~.,'t\\~\)Q~'t.\)'~a~ \~\'O ~Q'i\\lt.\) U Q'i\ \~ t>.~ t>.U\,~~~\'\Ct.\) ~'t.'i\\Q\)' r,Q'" "nll.'i ,~l .\- I Valuation Descrfotion I Notes: Description Type of Construction "SPerSqFt or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01075 ISSUED: 10/2212003 APPLIED: 10/22/2003 EXPIRES: 04/22/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Water Line - 1st 50 Feet Amount Paid Date Paid Receipt Number $4,50 $3,15 $45.00 10/22/03 10/22/03 10/22/03 1200200000000002358 1200200000000002358 1200200000000002358 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. I Reouired TnsneetionsJ I Water 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 witb 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 ",~~;n:~~~~~J7 /0 /?~ J(;~ <./ '( {..I Owner or ConlTactors Signature Date J Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-OI075 COM2003-OI075 COM2003-0 1 075 Payments: Type of Payment Check .~'~"'.''-'..'''''~'''. Wit . , I .. ) ~. . , . ! _~,,","'>,"L --..: ; Receipt #: 1200200000000002358 Description + 7% State Surcharge + 10% Administrative Fee Water Line - 1st 50 Feet Paid By HOFFMAN NORTHWEST Received By djb f..:heck Number Batch Number Authorization Number City of Springfield Official ReCeipt- Development Services Department Public Works Department i Date: 10/22/2003 1:06:01PM Amount Paid Item Total: 3.15 4.50 45.00 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52,65 . .