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Home My WebLink AboutPermit Plumbing 2007-9-20 225 FIITH STREET. SPRINGFIELD, OR 97477- PH:(541)726-3753 - FA.,'{: (541)726-3689 ~. o. . ,....;.( ~~' Job Locatio:n ~ U .~ t n I Owner 1l~\';I~(rY\ ILVhCS nl <:' 1 ..... ~ .,~ 8, ~. (j) ~. (j) U .~. > (j) n\ Q 0.' .~. ~ ~'. C1) ;;> C1) ~ r'l ~' o r !. IJ ,Y1 U ~ rrl $PFJnNG(~D\Efi-WI City Job Number COA/t'Z-C"O 7 - G 143 57 77 (?VII If e.. nD'1 ff'ozo70o Assessors Map Tax Lot C> b5 a-a Address 2-4 (PL( City (f'('\vY\O/1d\ 5,w 6k,Uc, p!e:!{[>_ ~ 116 Phonp 74/ . S tatp 0(( Zip q77~~. BACKFLO'V PREVENTION DEVICE PERMIT FEE: $61,50 Contractor Information Contractor _ SrlHLo' LA-N~ ~ C/JPe ?~O(;~b ~\{V;~_ ~d Phone- 9'9' t -. 2'03 '7 ~7.YC{ r Expires 0 Vo 51 Addres[: City T",^I;.J)~J C~ Construction Contractors Registration # State OR b19~ Zip By signing this permit/application, I agree to call for an inspection once the backflow prevention device has been installed and is visible for inspection (726-3769). I also state that all information on this permit/application is correct. Signature - '_ Z -/2/2 L;., U ;/z(07 Datf> ATTI=t.mr"I' ^-",...,..- ............. J - - - - . ~,..~"'., faW Tl;;"IU Jtfl:i you to For cff~r~S adopted by the Ore~on Utllit\( ',~\I""'QL"",1 eemar. 1 nose rules are set forth in OAR 952..001-0010 through OAR 952-001. OO~O. You may obtain copies of the rules by Date of Application -ailing tho eentsr. (Note, UlEt ISlepnone NOTICe' number for the Oregon Utility Notification Checkmfsr~M1ff~Ar Ch&i@Md, mi.i~~. ~g:E~~i~ ~~~~~~~Zi:J:i~:~g: ANY 180 DAY PERIOD. NED fOR Shared Drive (T;)/Building Forms/Backflow Prevention 7-07.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01431 ISSUED: 09/20/2007 APPLIED: 09/20/2007 EXPIRES: 03/20/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5777 MT VERNON RD ASSESSOR'S PARCEL NO,: 1802030006300 SPRING FIE TYPE OF WORK: Backtlow Device TYPE OF USE: New Residential PROJECT DESCRIPTION: Backtlow device Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 Phone Number: 541-228-1081 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor ST AR LANDSCAPE License 6196 Expiration Date 02/2812008 Phone 541-998-2039 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Lot Size: Height of Structure: Sq Ft 1st Floor: Type of Heat: A I I t:NTION: Oregon la~loJiYWf6'lno Water Type: follow rules adopted by ~<!>~SWt"'lity Range Type~otification Center. Thos~ftuf~~g~1qdrtJllprt Energy Pathln OAR 952-001-001 0 thro~~ilIt9\~~'tJS2-001- Sprinkled BGa(Jl:ng~Ou may oitaain CO~~~l\p'a:~".f3lpo~9:j tv' ('\~lIinn th~ "'1"'\.",,+,..,.. ff.\I",_J_. .1-'__ l R-3 .... \ -. I DEVELOPMENT INF(1)llMAl'Fl(i)N :Ire.- ..'. (.1., ~ VOlllt:, ,;, 1.Lo')\.;-:"',-._.~_ ".~EQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: . I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: NOTICE: . THIS Downspouts/Drams: AUTH6~~Z~~ 3~~~ ~~~i~JHE WORK . COMMENCED OR IS ABANDONED'T IS NOT ANY 1 ~fl n~m3r. FOR I Valuation Descriotion i Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01431 ISSUED: 09/20/2007 APPLIED: 09/20/2007 EXPIRES: 03/2012008 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-t Fee Description + 10% Administrative Fee' + 5% Technology Fee + 8% State Surcharge Backflow Device Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Number $5.00 $2.50 $4.00 $16.00 $34.00 9/20/07 9/20/07 9/20/07 9120/07 9/20/07 2200700000000001475 2200700000000001475 2200700000000001475 2200700000000001475 2200700000000001475 Total Amount Paid $61.50 I Plan Reviews J 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 w.orking day, inspections requested after 7:00 a.m. will be made the following work day. I Reouired Insoections I Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information henion 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 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. ~ ~-~~ "O~ oJ 1-;;0- 0') Owner or Contractors Signature Date Pa2e 2 of 2 225 Fjfth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0 1431 COM2007-01431 COM2007-01431 COM2007-01431 COM2007-01431 Payments: Type of Payment CreditCard cReceint 1 RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001475 Date: 09/20/2007 Description Backflow Device Minimum/Adjustment Plumbing + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By HAYDEN ENT Item Total: Check Number Authorization Received By Batch Number Number How Received djb 099179 In Person Payment Total: Page 1 of 1 9:44:54AM Amount Due 16.00 34.00 2.50 4.00 5.00 $61.50 Amount Paid $61.50 $61'.50 9/20/2007