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Home My WebLink AboutPermit Plumbing 2006-08-17F Building/Combination Permit PERMIT NO: COM2006-01065Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line ISSUED: APPLIED: EXPIRES: VALUE: 0811712006 0811712006 02n7t2007 * SITE ADDRESS: 2736YOLANDA AVE ASSESSOR'S PARCEL NO.: 1703244103013 PROJECTDESCRIPTION: Backflowdevice Springfield TYPE OF WORK: Backflow Device TYPE OF USE: New Residential Owner: Address: Contractor Type Landscape DAVID ROLLAND 2736 YOLANDA SPRINGFIELD OR 97477 Phone Number: 541- Contractor A & K LANDSCAPIN License 8146 Expiration Date 10t3u2006 Phone 541-746-3271 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Fronfyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: UNDEB ,F IHE W Lot Size: AU R-3 VN CO AN. $ Per Sq Ft or multiplier IHIS PE BANDO BI/II IS NED FORdrAI6{rER l0D Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport " Sq Ft Other: Occupant Load: Water Type: Range Type: Energy Path: Sprinkled Building nla Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: I '" 1" '-;r:-rrr1 REQUIRED PARKING Total: Handicapped: Compact: cse rules are set forth for the Oregon Utility Notification ienter is 1 -800-332-2344). Square Footage or Bid Amount DEVELOPMENT INFORMATION Valuation Description Description Type of Construction Pase 1 of2 Value Date Calculated 1 ou may obtain g the center. (l of the0 'J I't Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2006-01065ISSUED: 0811712006APPLIED: 0811712006 EXPIRESz 0211712007 VALUE: Fee Description + l|oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Backflow Device Minimu m/Adj ustment Plumbing Total Amount Paid $4.s0 $2.25 $3.60 $14.00 $31.00 8n7t06 8n7t06 8n7t06 8fi7/06 8n7t06 Total Value of Project Date PaidAmount Paid $ss.3s Receipt Number 1200600000000001279 1200600000000001279 1200600000000001279 r200600000000001279 1200600000000001279 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. Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Reouired Insnect 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. Vt 8/tz/o<" Owner or Contractors Signature Pase 2 of 2 Date [5.'l rees raro 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone C;tu of Springfield Official Receipt r elopment Services Department Public Works Department RECEIPT #: 1200600000000001279 Date: 0811712006 e:le:l2AM Job/Journal Number coM2006-01065 coM2006-01065 coM2006-01065 coM2006-0106s coM2006-01065 Description + 57o Technology Fee + 8% State Surcharge + lDYo Administrative Fee Backflow Device Minimum/Adj ustment P lumbing Amount Due 2.25 3.60 4.50 14.00 31.00 Item Total:$55.35 Payments: Type ofPayment Paid By Received By eheck Number Batch Number Authorization Number How Received Amount Paid Check ROGER CARLSEN djb 8142 In Person Payment Total:$55.35 $5 s.3 5 cReceint I Page I of I 811712006 *ffitfitl[&