HomeMy WebLinkAboutPermit Plumbing 2005-3-16
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~ CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2005-00300
ISSUED: 03/1612005
APPLIED: 03/1612005
EXPIRES: 09/1612005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 552 HAMILTON ST
ASSESSOR'S PARCEL NO.: 1703341206100
Springfield TYPE OF WORK: Backl10w Device
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Backflow
~ Owner: MARTIN JAMES G & BONNIE C
Address: 3355 LAKE WOOD DR
EUGENE OR 97408
I CON!RACTOR INFORMATION I
Contractor Type
Landscape
Contractor
THOMPSON LANDSCAPE
License
6381
Expiration Date
06/30/2005
Phone
541-686-3469
BUI~DING INFORMATIONI
# 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:
nla
;
NOTICE: E.XPIRE. \I,-DEVEU?RMENT INFORMATION I
1\1\S PE.RM\1 S\1All 1\1IS PE.RM\1 IS NO \
Frontyard ~~'~l'~J<.:\\Zt.D UNDE.R BANDONED FCOverlay Dist:
Side 1 Setback:v\MENCED OR IS ,II. # Street Trees Rqd:
Side 2 Setb~^~~\y 1130 DAY PERIOD, Paved Drive Rqd:
Rearyard Setbacl{: % of Lot Coverage:
Solar Setbacks:
....,.
REQUIRED PARKING
Total:
Handicapped:
Compact: .
Street Improvements:
Storm Sewer Available:
Special Instruction:
. _... _~""lrp.S VOu to
I PUBLIC IMPRO\IBMe~I~;t~d~Ythe Oregon Utl;l~h
. 'V"," - :1"'" <:C\ r~es are set 0
N t',fication CentersioeWiIK DeAR 952-001-
. 0 1 On10throug v
In OAR 952-00 - 'D~?rW\9,l!9I.PJI81il...u\eS by
0090. You may obta Note: the telepho~e
calling the center. (on Utility Notification
number for the\50r1e8g 00-332-2344).
Center -
Notes:
I Valuat,ion Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2elof2
.
.
. LIl l' VI' ~rRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00300
ISSUED: 03/16/2005
APPLIED: 03/16/2005
EXPIRES: 09/16/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
,Fp.p.~ tlWU
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
BackOow Device
Miscellaneous Plumbing
Amount Paid
Date Paid
$4.50
$3.15
$14.00
$31.00
3/16/05
3116/05
3/16/05
3/16/05
Receipt Number
2200500000000000297
2200500000000000297
2200500000000000297
2200500000000000297
Total Amount Paid
$52.65
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 R,M'lirp.r1 T~
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
timesd ingCOnstr~
. 0/;6(03
Date
"-'
Owner or Contractors Signature
Paee 2 00
. 225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00300
COM2005-00300
COM2005-00300
COM2005-00300
Payments:
Type of Payment
Check
:i
'/
3/16/2005
.
RECEIPT #:
~8~:.'
~~\
..-.-..,- . '.~ .'
~ of Springfield Official Receipt
.elopment Services Department
Public Works Department
2200500000000000297
Date: 03/16/2005
Description
Backflow Device
Miscellaneous Plumbing
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
THOMPSON LANDSCAPE
Received By
Ikw
Page I of 1
Item Total:
Check Number Authorization
Batch Numher Number How Received
2302
In Person
Payment Total:
11:37:36AM
Amount Due
14.00
31.00
3.15
4.50
$52.65
Amount Paid
$52,65
$52.65