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HomeMy WebLinkAboutPermit Building 2000-6-6 .~ \ . I Job# 00-00881-01 I . Page 1 of2 TRANS#:01-0002036 DATE:JUN 06 2000 AMT RECD:2 $ 16.50 CHANGE: CASHIER:032 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00881-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 4288 Cole Way Spr Assessors Map#: 18020524 Lot: Block: Addition: Tax Lot #: 06900 Subdivision: Redwood Owner: Sierra Builders L1c Phone Number: 541-744-8267 City/State/Zip: Creswell, OR 97426 New Value: $0 Address: 83188 Enterprise Road 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 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 working day. .: '_I, .'-':\o.....;I.,l::;),...;Ic.:,~.,.:::yuub~iuUl Tallow rules adopted by the Oregon Utilil\ . ..... - -. ., Required Inspections ................~'.....; "".....,l\Jl. III\J';;:J;;' tl.lU::;;~Ctloo:ttlIUIUI I Plumbinll 1'1 OAR 9b2-001-001~ (:'ro~gil OAo-1952.001. -After device is installed but before backfilling tre~~~?' You may obtain copIes of the rules b) "ailing the center. (Not:::: the tel::phone number tor the Oregon Utility Notification rr.'!....to~;(" 04 -"1f1~)~"''}_?~?'M4). Backflow Device Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 rArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Fee NOTICE: Total: THIS PERMIT SHALL F)(PII=li= Ii=TI.Jt= '^'''ov Paid On Receipti~: ~~v!i1l!~C!l)I~lrtttYHIS PWMKrWo~fitr PI b' - -.. "b'.;\\vcuvn '''f\Of\I~UUNI::DFOR um mil .... 06/06/2000 2036 "'''' I u DAY PERIOD. $5.00 Minimum Plumbing Permit Fee \ . Job# 00-00881-01 . Page 2 of 2 Value/Quantity Fee Amount Fee Paid On Receipt# Plumbinll 06/06/2000 2036 06/06/2000 2036 06/06/2000 2036 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 " . . BACKFLOY 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: LfJ-~~ C-..ok w c..y ASSESSORS MAP #: OIINER: L, \ 0((' r~ ADDRESS: ~ ~ \ cg ~ CITY: r'('C <, Wt,\\ TAX LOT #: \+o"""'~c;. ~V\",-,r ~(~"t'L ~& STATE: 0 i.(. PHONE #: /4 ~ ~ <g ';). Co 1 ZIP: BACKFLOY PERMIT IS $15.00 + 1.05 (STATE SURCHARGE) + $.45 (ADMIN. FEE) =$16.50 CONTRACTOR: [1\ I: s 'P D<<....\lU' ADDRESS: ~_O. \3o'j.... ~I CITY: A hl/l\(JoI"l. €fi\ STATE: <9\(. CONSTRUCTION CONTRACTORS REGISTRATION #: \d.~ '< ~ \)~c....w L-^,.J V c.~ o,.J. rt(\;O'\~;O '" PHONE #: C, % ~-l~~\ ZIP: '1140~ EXPIRES: ~-~\ -';)....000 BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE BACKFLOY PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION (726-3769). I ALSO STATE THAT ALL INFORMATION ON THIS PERMIT/APPLICATION IS CORRECT. a~'-tf? ~ h~6-d-0c90 DATE FOR OFFICE USE DATE OF APPLICATION: JOB #:D:::>.....CO ~CZI-O ( TOTAL AMOUNT COLLECTED: :J:> ::0: -l -l C ::0 :J:>:J:> ::0 -l ::z: rrI rrI CJ) c-:s.. ** C") oc....... :I> .. c:= 0 CJ) I\l ::z: ..... ----------------------------------------------------------------------------~f)~o~ rr1 :x: C"'- C) :::O:D~ 0 .. :z: 0- I\l I\l om. 00 ~':':'g;8~ ISSUED BY: RECEIPT #: