HomeMy WebLinkAboutPermit Plumbing 2008-3-14
Status
Issued
CITY OF SPRINGl'TELD
Building/Combination Permit
PERMIT NO: COM2008-00357
ISSUED: 03/14/2008
APPLIED: 03/14/2008
EXPIRES: 09/14/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1210 Mohawk Blvd
ASSESSOR'S PARCEL NO.: 1703253310100
Springfield TYPE OF WORK: Backflow Device
TYPE OF USE: Repair
Commercial
PROJECT DESCRIPTION: . Backflow Device
Owner: CAPLACO TWELVE INC
Address: 300 WILMOT RD MS #3381
DEERFIELD IL 60015
I CONTRACTOR INFORMATION I
Contractor Type
Landscape
Contractor
CREA TIVE VISIONS LANDSCAPE
License
7322
Expiration Date
04/30/2008
Phone
503-793-0361
BUILDING INFORMA TIO~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building.
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMA nON I
REQUIRED PARKING
Total:
Handicapped:
Compact:
'(l7Pf:0-2:E8-008- ~ S! JelUeo
UO!l~OmlOi': Al!llln uo6eJO eLll JO! Jeqwnu
",,,-,,,,,rb.a} CoIn mnf\l) 'JA1Uap aU16ullleO
I PUBLIC IMPROVEMEN~SalnJ 84l!O seldoo U!elqo A8W nOA '0600
I\rnnc~' O-ZS~U~VO 46noJ4l O~OO-~OO-ZS6l::1VO ul
Street Improvemefff K:. lpJO! le9~(lf:l~@,\kJIooUtu 'JelUao uO!leO!!!lON
Storm Sewer Ava~~.PERMIT SHALL EXPIRE IF THE WORK A}ll!ln lj5lJWrt0a3~ls1BrrapJ~pp8 SalnJ MOIIOI
Special Instructioe' tiOR/ZED UNDER THIS PERMIT IS NOT ~ nOA SeJln1faJ Mel U006JO :NOIJ.N3l.1.Y
OMMENCED OR IS ABANDONED FOR
Notes: ANY 180 DAY PERIOD.
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2008-00357
ISSUED: 03/14/2008
APPLIED: 03/14/2008
EXPIRES: 09/14/2008
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'
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Backflow Device
Miscellaneous Plumbing
Amount Paid
Date Paid
Receipt Number
$5.00
$6.00
$2.50
$16.00
$34.00
3/14/08
3/14/08
3/14/08
3/14/08
3/14/08
2200800000000000327
2200800000000000327
2200800000000000327
2200800000000000327
2200800000000000327
Total Amount Paid
$63.50
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
I ReQuired Insnections .
Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection.
Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Pa2e 2 of2
~ City
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~ CIty ~A"S'C"C5
r~ OlLCE:Construction Contractors RegIstration # /t!-13
TH~ch'VIlI ::'HALL tXI-'1Kt 11- I Ht VVUKK
~,~JQJHIZED Uf~DER THIS PERMIT IS NOT
C;~[NfR.)DsrgliMfg MlS\~&ililli!aPpOOtion, I agree to call for an inspection once the backflow prevention devIce
AN~O [M$~I~alled and is vIsIble for inspectIon (726-3769). I also state that all InformatIon on this
(j) permIt/applIcatIOn IS correct ATT~NT!ON: ()reC1011 law requires you to
, ~ ?L- fOII"w r'~:"'~ ach!Jtad by the Oregon Utility
~ ,../ /" ./'/ f\IIAI:J~qj'~)f1Center. Thoser~le..2~~e)~Qrt~
(l) Si naturr. 4/Vk / ~/.~ 111 (1:\1'1 9:J2-001-QQaPethro~~~~.
~ g .' ~7 -- - - / / uu.,u YOU may ontam copies or me rUles oy
~, c:7 L/ calling the center. (Note: the telephone
number for the Oregon Utility Notification
~ For Office Use Center is 1-800-332-2344).
o
~' Date of Application 3)/71' / <1 ~
~'
U' Checked for Delinquenci/""
ro
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225 FIITH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
CIty Job Number;)1f7) k - 06:;57
Job Location ~;l; () /Jf~ AClu/~ 6>~
Assessors Ma~
Tax Lot
A // " 7:/.1 J - .-.-1/1 ('
/ ('nr t:.,.vvcv I ,,~c;.. ~ J:.-,"
Owner MlI(J/~/a/<:; ~//J4 300 W drno/V1-
II r'
Address
?D /J1stf 333/
- .' . '"')ZFu tv(
,vt7t/., __
.1iZ-. (oeO/)
Phon/"
Statp
Zip
BACKFLOW PREVENTION DEVICE PERMIT F~~E: $63.50
Contractor Information
contractor~ ~ k67 U!s: #q/"S
Address./."DS:Z;; s.~ ~~CV
~~~ /~
./f8,( Phon/" 9~ ~7P3'-036/
Statf' ~/ Zip 970P}'
752,2. Expires ~ /.5'O~?
~-
Checked for Historical Status
...
Shared Drive (T )/BUlldmg Fonns/Backflow Prevention 1-08 doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-00357
COM2008-00357
COM2008-00357
COM2008-00357
COM2008-00357
Payments:
Type of Payment
CredltCard
cRecemtl
RECEIPT #:
Description
Backflow Device
Miscellaneous Plumbmg
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Admmlstrattve Fee
PaId By
CREATIVE VISIONS
LANDSCAPE
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000000327
Date: 03/14/2008
Item Total:
Check Number AuthorizatIOn
Received By Batch Number Number How ReceIved
nJm 03391 I In Person
Payment Total:
Page I of I
1:32:00PM
Amount Due
1600
3400
250
600
500
$63.50
Amount Paid
$63 50
$63.50
3/14/2008