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HomeMy WebLinkAboutPermit Plumbing 2000-5-17 I, I . I Job# 00-00743-01 I e- Page 1 of2 TRANS~:01-0001768 DATE:MAY 17 2000 AHT RECD:l $ 20.00 CHANGE:$ 3.50 CASHIER: 059 v CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00743-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 657 Quarry Rd Spr Assessors Map#: 17035334 Lot: Block: Addition: Tax Lot #: 06900 Subdivision: Owner: Address: Don Mickel P.O,Box 71 Phone Number: 541-747-4871 Office Use City/State/Zip: Springfield, OR 97477 AlleratioRlOTICE: Value: $0 -:-: ~!:'."".[:;~,~~""~~.^.II C=VOICCICTI-JJ:\AtnRK AUTHORIZED UNDER THIS PERMIT IS NOT l.ulvilll1ENCED OR IS ABANDONED FOR ANY 180 DAY PER'#lOf Buildings: Occupancy Group: Heat Source: Sq. Footage: Scope Of Work: Plumbing Drywell Quad Area: # Of Units: Constr. Type: Water Heater: Land Use: Zoning Code: Bedrooms: Range: To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a,m. will be made the same working day, inspections requested after 7:00 'I,m. will be made the following working day. \1I17"~ .:.. ,. ,... . UO!leO!I!lON "l!l!ln UObSJC .U' ," . Required InspectiC)i1s3~_~::=:::~' ., I Plumtliil'"'111J ""04'110 selda:> 'lIBIl..1 g .OLlftnn., '" DryweU -Engineered Drywell is required.LUU-G~Ol:i\l . .1Jollas em qejn, ":~ '., ' \I!I!ln u06SJoav.l AL ,'r, l., " ""~<:~I'l"'h" Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 [Ar~a (Sq. Feet} _ MaIO: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet}: Proposed Units: Total: Fee Paid On Receipt# Plumbinll 05/17/2000 1768 05/17/2000 1768 05/1712000 1768 Value/Quantity Fee Amount Minimum Plumbing Permit Fee State Surcharge For Plumbing Permil . Plumbing Administralive Fee Total Plumbing Grand Total 1 $15.00 $1.05 $.45 $16.50 $16.50 . ,i . I Job# 00.00743-01 I . Page 2 of 2 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein is true and correcl, 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 wilh ORS 701,055 will be used on this project. I further agree to ensure that all required inspections are req:st:2 proper lime and thatt~e project address is readable from the slreet. __ ~ ?"Z-.-./___ 'Signature r ~ Ii ()O / Ii Date