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Home My WebLink AboutPermit Plumbing 2008-2-1 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-001l8 ISSUED: 02/01/2008 APPLIED: 01/28/2008 EXPIRES: 08/01/2008 VALUE: ~~~iiI :..:'....:.1.. II&: '..Ii *..f' ,,) ',~ "",'"-,""'".,,,'" ,-,.,_.. ,.. Status Issued 225 Fifth Street, Spriugfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspectiou Line SITE ADDRESS: 650 Q ST ASSESSOR'S PARCEL NO:: 1703262405500 Spriugfield TYPE OF WORK: Backtlow Device TYPE OF USE: Alteration PROJECT DESCRIPTION: Install Procter and Gamble Spill Resistaut Pressure Vacuum Breaker Owner: Address: FRED MEYER 3800 SE 22ND A VENUE PORTLAND OR 97202 I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor License PORTLAND MECHANICAL CONSTRUCTl01S1807 ~UIL~ING INFORMATION I " >""'-, # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secondary Occupancy Group: Type of Heat: Primary Coustruction Type ATTENTION' 0 . Water Type: Secondary Coustruction Type:follow rules ~d;egcro.~ ~es you to # of Bedrooms: Notification Ce t Pte<<El?/{r~gon Utility . .~~F.E~:?01~;;;ci~~~~ct~~~:~~~~ ula calling the ~t~;H'dV",,~;rION I numberfo th 0 r t-.~~f{J,bl~jJllon~ Ce~ter~8 ~1:a:;t~~?tificaljOn 12......}. # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Commercial Phone Numher: 503-232-8844 Expiration Date 06/13/2010 Phone 503-656-7400 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupaut Load: REQUIRED PARKING Total: Haudicapped: Compact: Sidewalk Type: Downspouts/Drains: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK ';U-:-!'ORIZED UNDER THIS PERMIT IS NOT I Valuation DescriDtilmtENCED OR IS ABANDONED FOR Sqf,.~'I ~o~PaPiW PERIOD. o \ Value or BId Amount Notes: Description $ Per Sq Ft or multiplier Type of Coustruction Page I of 2 Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Backflow Device MinimumlAdjustment Plumbiug Total Amouut Paid Amount Paid $5.00 $6.00 $2.50 $16.00 $34,00 , $63.50 Total Value of Project Fees P3id I Date Paid 2/1/08 2/1/08 2/1/08 2/1/08 2/1/08 I Plan Reviews I U 1 Y OF SPkll'luFIELD ' Building/Combination Permit PERMIT NO: COM2008-00118 ISSUED: 02/0l/2008 APPLIED: 01128/2008 EXPIRES: 08/0112008 VALUE: Receipt Number 2200800000000000138 2200800000000000138 2200800000000000138 2200800000000000138 2200800000000000138 To Request an inspection cait 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 a.m. will be made the following work day. I RrOluired Tn~nection,s I Backllow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. By siguature, I state and agree, that I have carefully examiued the completed application and do hereby. certify that all informatiou hereon is true and correct, and I further certify that any and all work performed shall be done in accordauce with the Ordiuances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, aud that NO OCCUPANCY will be made of any structure without permissiou of the Community Services Divisiou, Building Safety, I further certify that only coutractors and employees who are in compliance with ORS 701.005 will be used ou this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readahle 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. 7l2u~ Qh6k Owner or Contractors Signature Page 2 on c71- /-t/B Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-00I18 COM2008-00 118 COM2008-00118 COM2008-00II8 COM2008-00I18 Payments: Type of Payment Check cReceintl City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200800000000000138 Date: 02101/2008 8:44:25AM Description Backflow Device Minimum/Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Amount Due 16.00 34.00 2.50 6.00 5.00 . $63.50 Paid By PORTLAND MECHANICAL CONTRACTORS INC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 45297 In Person $63.50 Amount Paid Payment'Total: $63.50 Page I of I 2/1 12008