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Home My WebLink AboutPermit Plumbing 2004-11-2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01356 ISSUED: 11/0212004 APPLIED: 11/02/2004 EXPIRES: 05/02/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 802POLTAVAST ASSESSOR'S PARCEL NO.: 1703342203100 Springfield TYPE OF WORK: Plumbing Only TYPE.OF USE: PROJECT DESCRIPTION: Approx 401fwater line ~Cl",'t-- . _ I~ \\\~ ,co ~Cl\ Owner: DUANE CORNELL \.. ~i-\'I<-?~",W \ ~Cl'" Address: 802 POL T A VA S~\~l'j~JI1'E~~\\l~J3~~'t:.\) ~\l\ ~(.Q..':l\ _ \I~\):;~~ \\\\':> , R-\~"-V . "Q. I;) .~ \>-Ij\\$) ~~,,'t:.$ j.CO.l\l'<rRACTOR INFORMATION I ~~~ ~\)~. Con 1\~ai'l License HOF AN NORTHWEST INC 71162 Repair Residential Phone Number: 541- Contractor Type Plumbing Expiration Date 01/16/2005 Phone 949-380-4161 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: V1hr Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla occu~~l\J I DEVELOPMENTINFORMATI01~'\SP;;~~oD -,,"I>1'\\O~~'6'J ~i~'it3ARKING Overlay Dist: l)>'f\'c;.>~~ ~~~;~ # Street Trees ~ca\\O(\ $\~\O ds'i'd) ~ Paved Drive Rfl.d.~~~ Po 9~ ~ E>AO'ICiJ" '. % of Lot Cove~1II '(01) ((190~ _....Gl1l. V:dn U\\~ !."AD,~ OOsO. ~06"O~v:,: ~wr' _..\XIl\Q ..... '{j\'<J dAr;1J''''-- I PUBLIC IMPROVEMEN~f'" ~..I Sidewalk Type: DownspoutslDrains: Frontyard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa!!e 1 of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01356 ISSUED: 11102/2004 APPLIED: 11/02/2004 EXPIRES: 05/0212005 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 11/2104 11/2104 11/2104 1200400000000001550 1200400000000001550 1200400000000001550 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 Remrired T nsnectinns I 1I11.lf II 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 herehy 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 treet, 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 m :"ri"""~ \/,10\J7 I \ I'G / D4 r or cont~ctors Signature Date '( ( \ Paee 2 of2 225 Fifth Street Springfietd, Oregon 97477 541.726-3759 Phone Job/Journal Number COM2004-0 1356 COM2004-0 1356 COM2004-01356 Payments: Type of Payment Check 11/2/2004 . RECEIPT #: Description + 7% State Surcharge + 10% Administrative Fee Water Line - 1st 50 Feet PaId By HOFFMAN NORTHWEST .~.l ~. ~ tliii.ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200400000000001550 Date: 11/0212004 Item Total: Check Number Authorization Received By Batch Numher Number How Received djb 332680 In Person Payment Total: Page I of I 9:30:56AM Amount Due 3.15 4.50 45.00 $52.65 Amount Paid $52.65 $52.65