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Home My WebLink AboutPermit Plumbing 2004-5-26 . .~., CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00623 ISSUED: OS/26/2004 APPLIED: OS/26/2004 EXPIRES: 11/26/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 35th and Commercial ASSESSOR'S PARCEL NO.: 0000000000000 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: PROJECT DESCRIPTION: Backflow device for public infrastructure project / irrigation New Public Owner: CITY OF SPRINGFIELD Address: 225 FIFTH STREET SPRINGFIELD OR 97477 Phone Number: 541-726-3753 I CONTRACTOR INFORMATION. Contractor Type Landscape Contractor GRANTS LANDSCAPE SERVICE License 10250 Expiration Date 10/31/2004 Phone 541-342-1835 I BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Stru~'p"reO , I S9. Ft II!. Floor: TypNflmiT~ON: regon aw requ nm.)mHlt Floor: WatQlI~ypPilles adopted by the OreggqtFltii1Yement: Rlll~~l~n Center. Those rules a~~lRnl1ge/Carport Eder~962-001-o01 0 through OAIS~F?~\rr: sptnlRlM'tBta:i.nJin'g:obtain c~s of thadillpirb~oad: '-'~--t.-.. a.L::.i-. ........ +...I~I::''''''''''''''O ~tlr~~.... ,.~,. ~-. ....~!'..r-.!!!IIIIIItI'~ DEVELOP ~ tility Notification Center is 1-800-332-2344). REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: . Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: Notes: Description Type of Construction I Valuation Description I $ Per Sq Ft Square Footage or multiplier or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 ~ ". . . CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2004-00623 ISSUED: OS/26/2004 APPLIED: OS/26/2004 EXPIRES: 11/26/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees paiiJ Fee Description + 10% Administrative Fee + 7% State Surcharge Backflow Device Minimum/Adjustment Plumbing Amount Paid Date Paid $4.50 $3.15 $14.00 $31.00 5/26/04 5/26/04 5/26/04 5/26/04 Receipt Number 1200400000000000807 1200400000000000807 1200400000000000807 1200400000000000807 Total Amount Paid $52.65 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 Reouired InVlections I 1 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 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 ofany 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 durin constru ti / I~ F;;2-1o -t7 Y --- --- Owner or Contractors Signature Date Pae:e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541"-726-3759 Phone . .ty of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 1200400000000000807 Date: OS/26/2004 11:01:31AM Job/Journal Number COM2004-00623 COM2004-00623 COM2004-00623 COM2004-00623 Description + 7% State Surcharge + 10% Administrative Fee Backflow Device Minimum/Adjustment Plumbing Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 3.15 4.50 14.00 31.00 $52.65 Amount Paid Check REXIUS djb 54442 In Person Payment Total: $52.65 $52.65 5/26/2004 Page 1 ,of I