HomeMy WebLinkAboutPermit Building 2000-6-6
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I Job# 00-00880-01 I
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Page 1 of2
TRANS~:01-0002033
DATE:JUN 06 2000
AMT RECD:2 $ 16.50
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00880-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4276 Cole Way Spr
Assessors Map#: 18020524
Lot: Block: Addition:
Tax Lot #: 06900
Subdivision: Redwood village
Owner:
Sierra Builders L1c
83188 Enterprise Road
Phone Number: 541-744-8267
City/State/Zip: Creswell, OR 97426
New Value: $0
Address:
Scope Of Work: Single Family Residence
This is a copy with a new Application Number
Contractor Type
Landscape
Contractor
Decker landscape and irrigation .
27390 8th st, alvadore, OR 97409
Registration # Expiration Date
Phone
541-688-7991
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call Ihe 24 hour recording at 726-3769. All inspeci!o.".!!, ~eq\lested ~efore ,7:00IUllb" yOU ~L
a.m. ~i11 be made the same working day, inspections requested after 7:00,ed~;vVfill,e~<.I1J'!9-lil~tbeJ!o.IIowihg!gon Utility
working day. 'Iotilicatlol' Cente, Those rules are sat forth
. . . ",",^" u,",".ill"'-'1()10 l'lrouah OAR 952-001-
ReqUired Inspections bt . copl'es 01 tna rUles oy
J090. You may 0 am
I Plumbinll I callin9thecenter.(Note:.t~etel~~ho~a
Backflow Device -After device is installed but before backfilling tr.~D.q~Jer for the Oregon Utility Notification
. ('r-:""j~".l":: I ,'1r)~)~'":.'1,?~?~44).
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D'
rArea (Sq. F, ,I)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Total:
Height (feet):
Proposed Units:
NOTICE:
TMIS PERMIT SHALL EXPIRE IFTHE WORK
/lIITI-l('\J:l17I=n 1II\Inl=RTHIS PERMIT IS NOT
Fee
Paid On Receip(#:OMM~J'JlQt~IMjlANDlFlfiPArhl6Lnt
Plumbinll ~I~T I~ODAYPt::HIUU.
06/06/2000 2033 $5.00
Minimum Plumbing Permit Fee
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Job# 00-00880-01
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Page 2 of 2
Value/Quantity Fee Amount
1
Fee
Paid On Receipt#
Plumbin!l
06/06/2000 2033
06/06/2000 2033
06/06/2000 2033
1
$1.05
$10.00
$.45
$16.50
$16.50
State Surcharge For Plumbing Permit
Backflow Prevention Device
Plumbing Administrative Fee
Total Plumbing
Grand Total
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 701.055 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.
Signature
Date
..1 .'.
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SPRINGFIELD
BACKFLOV PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTH STREET
SPRINGFIELD OR 97477
OFFICE: 726-3759
INSPECTION LINE: 726-3769
JOB LOCATION: L\ a.. '110 Lo \L LJ <>-..~
ASSESSORS MAP 1I:
OIINER: ~ ~.p.ol' (' 0\..
ADDRESS: <61 \ ~~
CITY:~n.') \IJ\.. \\
TAX LOT 1I:
\\-." "",~.s
E-,^~rp{h.L R.~
STATE: OR
PHONE 1I:
lLfl.\-<b).,(P7
ZIP:
BACKFLOV PERMIT IS $15.00 + 1.05 (STATE SURCHARGE) + $.45 (ADMIN. FEE) =$16.50
CONTRACTOR: e l\iS ~, \)lLL'l.~(",
ADDRESS: Q,O, \SOf-. q,l
CITY: A\.J",J.o('\.. STATE: 0\t,
CONSTRUCTION CONTRACTORS REGISTRATION 1I: l:)" '1 <::; '\
'\)p~( "\.LU' Lo,.,Jsc..oft Q",J. I"'f"~~,t\'n'O'"
PHONE 1I: .~~~- 7'1<;\
ZIP:j]40"
EXPIRES: '&- '5 \ - ).. 00 0
BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE
BACKFLOV PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION
(726-3769). I ALSO STATE THAT ALL INFORMATION ON THIS PERMIT/APPLICATION IS
CORRECT.
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SIGN"ATURE
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FOR OFFICE USE
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TOTAL AMOUNT COLLECTED:
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ISSUED BY:
DATE OF APPLICATION:
RECEIPT 1I: