HomeMy WebLinkAboutPermit Building 2000-9-28
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Job# 00-01445-01
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Page 1 of 2
TRANS#:Ol~0003326
DATE:SEP 28 2000
AMT RECD:2 $ 121.21
CHANGE:
CASHIER:061
COMMERCIAL PERMIT'
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01445-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
, Location Of Proposed Site: 860 Beltline Rd Spr
Assessors Map#: 17031500
Lot: ' Block: Addition:
Tax Lot #: 02400
Subdivision:
Owner:
Advance Imaging Center
1200 Hilyard Street
Phone Number: 541-687-7134
City/State/Zip: Eugene, OR
Alteration Value: $0
Address:
Scope Of Work: Office
New sink
Contractor Type
Plumbing Contr
Contractor
Robinson Plumbing Inc
Po Box 23753, Eugene, OR 97402
Registration #
107124
Expiration Date
7/13/2001
Phone
541-345-6909
Office Use
land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: 'JTENTIO~?dbC)~llffi:1EWrequiresyou to
Range: f~lInw rules ~ab~idtWWe OregOn Utility
! ()tifin~tion Center. Those rules are set forttl
To request an inspection call the 24 hour recording at 726-3769. All ins.. p,e~.,g~S'~.E2fi~r1U~. 6i\~Wi~aHtt}AR952~001~
a.m. ~i11 be made the same working day, inspections requested after 7:'?i~B:rvo%iffi~~ WcfirPilQ~~%~f1~e rules by
working day. r:allinQ the center. (Note: the telephone
R . d I t' .. . ' ,_..~ - ,",W^n^n I Itili+\, I\ln+if\c!:ltinn
, equlre nspec Ions . '...', ,~"" ,u. ,..~ '~{;J- -." 'J . ,., ,
r'."......::" I" ,,,Qnn..3"?-?344)
Plumbing .:;T\ I vc;..l",' .- . ~- oJ ....- - .
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Rough Plumbing
Final Plumbing
- Prior to cover. t..., .
- When all plumbing work is complete.
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Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
-Area (Sq. Feet)
Main: Accessory:
NOTICE:
# Of Stories: A'ei~/ffeiit)T SHALL EXPIRE IFTHE WORK
Current Units: ~l0"'R~M!.f!fl)i~~DERTHISPERMITISNOT
Census Code: Does not apply COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD. '
Total:
..
Fee
Minimum Plumbing Permit Fee
Number of Fixtures
State Surcharge For Plumbing Permit
Plumbing Administrative Fee
Total Plumbing
Sanitary Sewer
SDC Administrative Fee
Total System Development
Grand Total
Job# 00-01445-01
Page 2 of 2
Paid On Receipt#
I, Plumbing
09/28/2000 , 3326
09/28/2000 3326
09/28/2000 3326
09/28/2000 3326
Value/Quantity
System Development
09/28/2000 3326
09/28/2000 3326
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 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. I further agree to ensure that all required inspections are
requested at the proper time, that the project 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 times
during construction.
(JJ
IV
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Signature
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Fee Amount
1
$5.00
$10.00
$1.05
$.45
$16.50
2
$99.72
$4.99
$104.71
$121.21
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Date