HomeMy WebLinkAboutPermit Plumbing 2005-9-7
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITYOFSPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01218
ISSUED: 09/07/2005
APPLIED: 09/07/2005
EXPIRES: 03/0712006
VALUE:
. SITE ADDRESS: 6936 IVY ST
,f ASSESSOR'S PARCEL NO.: 1802022306600
Springfield TYPE OF
Backnow Device
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Backnow device
Owner: BRENDA WELT
Address: 6936 IVY Sf
SPRINGFIELD OR 97478
Contractor License Expiration Date
GEORGE W GUNN fr;~;-;-;;:;: -;,.:~;;.~.~;~3~~~~.::: ~:~ :~9/30/2005
, B~~GdNIi'~dT"ON' Oregon Utility
Notification Center. Those rules are set forth
In 0'Alfi~eu1-o010 through OAR 952'a!1~e:
oO~i~eLq1iay obtain copies of the rul.fuIJ.ID 1st Floor:
~RJcPmea~'nter. (Note: the teleph;~\!-F't 2nd Floor:
nUJlr~r IPlfie Oregon Utility Notifica~,Q...Ft Basement.
Kange lY.lle:. 1-800-332-2344). ~ Ft Garage/Carport
Ener P'a\~~ IS Sq Ft Other:
Sprinkled nla Occupant Load:
Contractor Type
Landscape
# of Units:
... Primary Occupancy Group:
:' Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
S treel
Storm Sewer Available:
Special Instruction:
Notes:
Description
Tvpe of Construction
R-3
Phone Number: 541-
'CONTRACTOR INFORMATION I
Phone
541-942-9752
VN
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
IPUBLIC-IMP,ROVEMENTSI
THIS PERMIT SHALL EXPlh~~~"ia~~ WBl'iK
AUTHORIZED UNDER THIS PQ~~p'o!lJS{PJ'!,ins
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
I Valuation Descriotion I
$ Per Sq Ft
or multipUer
Square Footage
or Bid Amount
Value
Date Calculated
I of 2
.
.
I
CITY OF SPRINGFIELD-
. Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Building/Combination Permit
. PERMIT NO: COM2005-01218
ISSUED: 09/07/2005
APPLIED: 09/07/2005
EXPIRES: 03/0712006
VALUE:
Total Value of Project
L.Fees Paid I
Fee Description
+ 100/0 Administrative Fee
+ 7% State Surcharge
Backflow Device
Minimum/Adjustment Plumbing
Amount Paid
Date Paid
Receipt Number
$4.50
$3.15
$14.00
$31.00
9/7/05
9/7/05
917105
9/7/05
1200500000000001310
1200500000000001310
1200500000000001310
1200500000000001310
Total Amount
$52.65
I Plan Reviews I
To Request an inspection call the 24 hour recor(Jing 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.
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 certil)> 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 wiD be made of any structure without permission of the Community Services Division,
Building Safety. I further certil)> that only contractors and employees who are in compliance with ORS 701.005 will be used
on this project.
I further agree to ensureJ!!nJ all required inspections are requested at the proper time, that each address is readable from
the street, that the per.m~d Is located at the front of the property, and the approved set of plans wiD remain on the site
at all tim~,' -fo"nstructiolL
~~:::7 __u Q""7-c;l.r-
e::--
Owner or Contractors Signature Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-l759 Phone
/
Job/J...rnal Number
COM2005-01218
COM2005-01218
COM2005-01218
COM2005-01218
Payments:
T)1le of Payment
, Check
1.
u
,,;;,
c'
'-'-
"
91712005
.
RECEIPT #:
a~~RJ~~"Jg..D_T" . .___. ;
~!
."~ !
, ~~ "
TO____, . -, ,.! '
...ity of Springfield Official Receipt
.evelopment Services Department
Public Works Department
1200500000000001310
Date: 09/07/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Backflow Device
Minimum! Adjustment Plumbing
Paid By
GUNN LANDSCAPING
Item Total:
Lheck Number Authorization
Received By Batch Number Number How Received
djb 2963 In Person
Payment Total:
I of I
lO:42:59AM
Am... nt Due
3.15
4.50
14.00
31.00
$52.65
Amount Paid
$52.65
$52.65