HomeMy WebLinkAboutPermit Plumbing 2004-9-22 (2)
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CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-01151
ISSUED: . 09/22/2004
APPLIED: 09/1612004
EXPIRES: 03/22/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-375~'oPhOne
541-726~3676Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4548 ASTER ST 4550
ASSESSOR'S PARCEL NO.: 17023243 PARCEL 2
SPRINGFIE TYPE OF WORK: Plumbing Only
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Utilities for lot partition
Owner: RAKOCZY WELKER ENTERPRISES INC
Address: PO BOX 395 CRESWELL OR 97426
Phone Number: 541-513-2228
I CONTRACTOR INFORMATION.
Contractor Type
Plumbing
Sewer
Contractor
RS PLUMBING CONTRACTING
T C EARTHWORKS LLC
I BUILDING INFORMATION.
License
103816
Expiration Date
01104/2006
Phone
541-461-4714
541-543-3786
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION.
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:, '
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Dr;ive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Impr~FttfON: Oregon taw requires Y~~ilivty
'~, u;' . t d by the Oregon
Storm SewW_Q~ adop ease rules are set forth
Special I"NO~MI1..;Center. Th hOAR 952-001-
In'-GAFf'9-S2-001-001 ? th~o~~s of the rules by
Notes: 0090. You may obtalO ~oie: the telepho~e
___lIinn the center. ( 'u Tl tl~+ifil"':Itlnn
. mber for the uregu11 ... 1 ' ,-
nu Center is 1-800-332-21~)aluation Description I
~t9fl'E1E :Type:
~r&~ffi~~~L EXPIRE IF THE WORK.
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Description
Type of Construction
$ Per Sq Ft
or multielier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
4!' ~~~.aU~,gfi~~~\ >'","'_",.,~,
.~,
If
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01151
ISSUED: 09/22/2004
APPLIED: 09/16/2004
EXPIRES: 03/22/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$0.00
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
L Reouired Insoections I
Water Line: Prior to mling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to mling trench.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
~$Zhe fro t of the prope~, and the apProve~;;:;;~emaiO on the stre at all
, ',/ r., I v/?""J I v ~ I I
OwnW or Contractort Signature Date
Pae:e 2 of 2
...... 225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-01175
COM2004-01175
.COM2004-01175
COM2004-01175
COM2004-01175
Payments:
Type of Payment
CreditCard
9/22/2004
n~ty of Springfield Official Receipt,
~velopment Services Department
Public Works Department
RECEIPT #:
1200400000000001380
Date: 09/22/2004
3:00:22PM
Description
Wood Stove/Insert
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Amount Due
30.00
15.00
10.00
3.15
4.50
$62.65
Paid By
MICHAEL J EARLS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dIm 861419 In Person
Payment Total:
$62.65
$62.65
Amount Paid
't~~~.
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