HomeMy WebLinkAboutPermit Plumbing 2007-06-08Building/Combination Permit
PERMIT NO: COM2007 -00842Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 Inspection Line
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06t08t2007
06t08t2007
t2/08t2007
PROJECT DESCRIPTION: Install backflow device for lawn
TYPE OF WORK: Plumbing Only
TYPE OF USE: Addition
Springfield
Residential
Owner:
Address:
Contractor Type
Plumbing
JARED BOOREN
684I SIMEON DRIVE
SPRINGFIELD OR 97478
Contractor
OWNER
PhoneNumber: 541-505-9241
License Expiration Date Phone
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
ATTENTION:O
fo!low rules ado pt e reg
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
Sidewalk Type:
IHIS PEB
REQUIRED PARKING
Total:
Handicapped:
Compact:
Downspouts/Drains:
AUIHOR
n4iI sHAI.I EXP
ANY 1 BO
0R/sA
PER/OD
RE /F IHE
ED FrOB
IZED I)K
BAIVDOil,/Sru IDAY
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
DEVELOPMENT INFI
Description Tvpe of Construction
Page I of2
Value Date Calculated
L
SITE ADDRESS: 6841 SIMEON DR
ASSESSOR'SPARCELNO.: 1702341105400
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Status Issued
225 Fifth Street, Springfietd, OR
541-726-3753 phone
541-726-36?6 Fax
541-726-37 69 Inspection Line
Fee Description
+ l0yo Administrative Fee+ 5oZ Technology Fee
+ 8oZ State Surcharse
Backflow Device
Minimum/Adj ustmen t plumbing
Total Amount paid
To Request an inspec
a.m. will be made the
work day.
Total Value of project
Date Paid
6/8t07
6/8/07
6t8t07
6t8/07
6/8/07
Building/Combination Permit
PERMIT NO: COM2007'00842
ISSUED: 06/08/2007
APPLIED: 06/08i2007
EXPIRES: 12/08/2007
VALUE:
Receipt Number
I 2007000000 00000729
I 2007000000 0000072s
I 2007000000 0000072s
r 2007000000 0000072s
l 2007000000 0000072s
Amount Paid
$4.50
$2.2s
$3.60
$14.00
$3r.00
$ss.35
tion call the 24 hour recording at 726-3769. All inspections requested before 7:00same working day,inspections requested after 7:00 a.m.will be made the following
Backflow Device: prior to covering and provide a copy of the test report on site at the time of inspection.
Own er or Contractors Signature
Pase 2 of 2
Date
a7
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Cito of Springfield Official Receipt
I elopment Services Department
Public Works Department
RECEIPT #: 1200700000000000729 Date: 0610812007 2:04:58PM
Job/Journal Number
coM2007-00842
coM2007-00842
coM2007-00842
coM2007-00842
coM2007-00842
Description
Backflow Device
M inimum/Adjustment Plumbing
+ 5% Technology Fee
+ 8% State Surcharge
+ l0%o Administrative Fee
Amount Due
14.00
31.00
2.25
3.60
4.50
Item Total:$s5.35
Payments:
Type of Payment Paid By Received By
Check Number
Batch Number
Authorization
Number How Received Amount Paid
CreditCard JARED BOOREN Ilh 44853 In Person $55.35
Payment total:
-Sffi
cReceintl Page I of I 618/2007
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