The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2004-05-25Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00618ISSUED: 0512512004APPLIEDz 0512512004EXPIRES: 1112512004 VALUE: Owner: Address: SITE ADDRESS: 1428 OLYMPIC ST ASSESSOR'SPARCELNO.: 1703253209500 PROJECTDESCRIPTION: Backflow JAMES CAROL ANN 1428 OLYMPIC ST SPRINGFIELD OR 97477 Contractor Type Landscape Contractor License SCHELSKYS LANDSCAPE AND IRRIGATI 006330 Springfield TYPE OF WORI(: Backllow Device TYPE OF USE: New Expiration Date 02t28t2005 Residential Phone 541-744-713s # 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: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 VN T SHALL EXPIR nla RMI AUIH COMM ENCED OR I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: At,lY 180 DAY PER r0D. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: follow rul Notitication ru1e8 am !€[Type: i n OAR 952-00 1 -001 0 thro4h OAR 952{)0t'^^--_^- ^..3- m-^:-. 00g0. You may obtain copi; o( thc rula byuownspouts/urarns: calling the center. (Note: the blcphonc number for the Oregon Utility Notilicalbn Center is 1 -800€8a-m44|. $ Per Sq Ft or multiplier Square Footage or Bid Amount REQUIRED PARJ(NG Total: Handicapped: Compact: Description Type of Construction Total Value of Project Value Date Calculated (}., lIUltrl-rll\(r II\I (rl{JvrA r r\r1\ | Valuation Description I Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00618ISSUED: 0512512004APPLIED: 0512512004 EXPIRESz 1112512004 VALUE: Fees Paid Fee Description + l0o/o Administrative Fee + 7%o State Surcharge Backllow Device Minimum/Adj ustment Plumbing Total Amount Paid Amount Paid $4.s0 $3.15 $r4.00 $31.00 $s2.65 Date Paid st2sl04 5t25t04 st25t04 5t25104 Receipt Number 1200400000000000803 1200400000000000803 1200400000000000803 r200400000000000803 Plan Reviews To Request an inspection call the24 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 Backllow 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 Springlield 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 70f .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 froqt of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pase 2 oI2 L L:l L] I(equrrgo lnsDecuons I / L 225 Fifth Street Springfield, Oregon 97 477 541,726-3759 Phone orty of Springlield Official Receipt - evelopment Services Department Public Works Department RECEIPT #: 1200400000000000803 Date: 0512512004 2zt2z56PM Job/Journal Number coM2004-00618 coM2004-00618 coM2004-00618 coM2004-00618 Description + 70 State Surcharge + 10% Administrative Fee Backflow Device Minimum/Adjustment Plumbing Amount Due 3.ls 4.50 14.00 31.00 Item Total:$52.65 Payments: Type of Payment Paid By Received By CheckNumber Authorization Batch Number Number How Received Amount Paid CreditCard MARK SCHELSKY djb 000392 015221 In Person $52.65 Payment Total: -Sffi sl25/2004 Page I of I EI