The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2004-1-27 -fit -'11 Y OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-00112 ISSUED: 01/27/2004 APPLIED: 01/27/2004 EXPIRES: 07/27/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4155 FRANKLIN BLVD ASSESSOR'S PARCEL NO.: 1703344300100 Eugene TYPE OF WORK: Backl10w Device TYPE OF USE: New Commercial PROJECT DESCRIPTION: Backl10w device Owner: CASCADE ENERGY LLC Address: 25115 SW PARKWAY WILSONVILLE OR 97070-0607 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor TROY CLAYTON LANDSCAPE License 7439 Expiration Date 05/31/2004 Phone 503-358-7975 BUILDING INFORMATION I # nf Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1 st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft BE: Range Type: 'lI f~\)ti~a 'IlJ\'Im/rport Energy Path: ~'Of9900 Ill. \"tl'ij)Ft~ 1$0\ to{\ ~"E~\\~ ~dOP\9~~~S9 t\.1\lP~~W~&~C; Area: , DEVELOPMENqritNF..Q-t.M'A>l'i6~I.O\"fOU.99'S' ~,t \"9 f~~"'O-9 ." I I ~l-ii, I "\ 'Opl ....~ '-IV'" p.9S.t....:". 'O\e.iOC .\"e\uu:,.... :fi&QPARKING iI. Or>: {{\e.~ 0 ~~0\9. Nn\itlC \ Overlay 1Jt~\30. '(OU C90\9f. {'I \,)\i\iW 'T1l\al: # Street iieeb\\lnl19 \\'19 \\'19 Of9go (\_33'2.-'2.3nandicapped: Paved Drive Rqd,oef tof . .e ~ -p.(\ Compact: t\uit r,.....",... % of Lot Coverage: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I,PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Notes: NOTICE: DOR~sW~~~l'JfiK ~\f~E~~~6 ~~~~~ ~~~ PERMliF~:Oi COMMENCED OR IS ABANDONED _ "" ......Y nrOlnn .\.... ..." ,.... I\... I V aluati~n' Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa!!e 1 of2 fit _ITY OF ~rKll~uN1!,LD Building/Combination Permit PERMIT NO: cOM2004-00112 ISSUED: 01/27/2004 APPLIED: 01/2712004 EXPIRES: 07127/2004 VALUE: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~ Fee~ P3id I Fee Description + 10% Administrative Fee + 7% State Surcharge Backflow Device MinimumlAdjustment Plumbing Amount Paid Date Paid Receipt Number $4.50 $3.15 $14.00 $31.00 1/27/04 1/27/04 1/27/04 1/27/04 1200400000000000119 1200400000000000119 1200400000000000119 1200400000000000119 Total Amount Paid $52.65 I 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 Relluired Jn~ 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 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. ~~L / - ().. 7- OJ/. Owner or c(ntraclors Si{nature Date Pa!!e 2 of2 225 Fifth Street "v Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00112 C0M2004-00112 COM2004-00 II 2 . COM2004-00112 Payments: Type of Paymeat Cash Change Job/Journal Number COM2004-00112 COM2004-00112 COM2004-00lI2 COM2004-00112 Payments: Type of Payment Cash Change J:QP~~. ~;-"1 ~}"""':c,o"". Receipt #: 1200400000000000119 Description + 7% State Surcharge + 10% Administrative Fee Bacldlow Device Minimum/Adjustment Plumbing Paid By TROY CLAYTON LANDSCAPE TROY CLAYTON LANDSCAPE Received By djb djb Description + 7% State Surcharge + 10% Administrative Fee Bacldlow Device Minimum/Adjustment Plumbing Paid By TROY CLAYTON LANDSCAPE TROY CLAYTON LANDSCAPE Received By djb djb Check Number Batch Number Authorization Number Check Number Batch Number Authorization Number City'or Springfield Official Re~eipt Development Services Department' Public Works Department Date: 01/27/2004 1:14:02PM Amount Paid 3.15 4.50 14.00 31.00 $52.65 Item Total: How Received In Person In Person Payment Total: Amount Paid $60,00 ($7.35) $52.65 Amount Paid , Item Total: 3.15 4,50 14.00 31.00 $52.65 How Received In Person In Person Payment Total: Amount Paid $60,00 ($7.35) $52.65 I 22" FIfnl STRt:l:r . SrRlNGI'IELD, OR 97477 . I'H:("4 1)726-g7!i:~ . FAX: (!i41)726-%89 t:""li ~j e;) ..),..-J1 ~) Job Location ~j 0) Assessors Ma:-- ..)l1'~jl '. If f'!\ (1 Owner t;"'.\ ~l ~. Address ~; l~_J -J 'r-I~ ~l ~l ~( ~j ~ ~l ~j ~ ~ ..~ ~ Ql t:""l1 ~j e; e.)" I~ I~ ~j ~j ~ ~ ~ ~( ~~jl ~ ~ ~j ~j ~..,.,jj ~j U) ro' . !.l 001 . - . , CITY OF SPRINGFIELD, OREGON City Job Numbe.c..Ov"1 z-oolt -oaf I z... U-Is~ 17b3. 'Y1L/J vtZtrrJl<..(.-td . >1" 5Pt-u.1GfI y;zL) Tax Lot 06/0 a q.f2;u, a It.- PMOUL.-1'5 - I-/f:Q) FfU!7I(<-uIJ '31 uS4- .5R1t~~ 7?L City / rfv IIS17i1.J Zip Stat" BAcKFLOW PERMIT IS $52.65 (includes PcrmitFee, State Surchargc & Administrative Fce) Contractor Information S ~o\l to T/{o-'l1 U.k11 '111</ ~~l'f1W re~~~ UtilitY EN"TIU1'I,""'-- d \:l~ tr'''' ...,.-- e set Uill' 5'10J Nt,;l.~ ~lese.d_~~~e,.noseg::":~~CJS8 -7'17,')' ;~ti\iCe.tiOn vo;~:oo,ott\ro ieS 01 tne rU\"~e. .n ",..,.-1 ~ I", . <:> 952- ~....... cop ...lapnon 07 I City I'd,...., up,u~ n"p '~~eDO'o"- .t~' ,"e 'ZIP. ."1:'" .;Ll 0090, '!OU tn~ centef. ~\" n'ij\\li\'1 NO,\\l...~' - Construction Contractors Registration # ~I~n~~e Ore~~"_'l~?-2.~~~ires !i 11) Ia t./ nUyhu..... ......~- . . Contractor Addrecs By signing this permit/application, I agree to call for an inspection once the backflow prevention devise has been installed and is visible for inspection (726-3769), I also state that all infonnation on this permit/application is correct. NOIlCE: IRE IF 1HE WORK I) 1HIS PERM\1 SH~i~ ~~S PERMI1 IS N01 c:P-;J #-- ~ 1\1l1~O~~I;Ot'\ U~R IS I\BI\~QJiEO~~:2? -0 3 {/" ~u\VM"..II~E- peRIOO . t>.N'( 180 01\'( \. . Signature For Office Use Date of Application 0/ - 27-6 L{ Checked for Delinquencif'< v ~ Checked for Historical Status Shared Drive (T:I/Building Fomlsl&lcknow Prevcnlionl..o3.doc