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HomeMy WebLinkAboutPermit Plumbing 2005-06-10OF Buildin glCo mbination Permit PERI{IT NO: COM2005-00715ISSUED: 061101200sAPPLIED: 0611012005E)PIRESz 1211012005 VALUE: D Status: Issued 225 Fifth Street, Springfield, OR 541:7263753 Phone 541-7263676Fax 541:7 26-37 69 I nspe ction Line SITE ADDRESS: 2269 9TH ST ASSESSORS PARCELNO.: 1703261204308 PROJECTDESCRIPTION: Backflow device Springfield TYPE OF Backflow Device TYPE OF USE: New Residential Owner: Address: DAVID CAFFEY 2269 9TH ST SPRINGFIELD OR 97477 Phone Number: 541- Contractor Tvpe Landscape Contractor GEORGE W GUNN Expiration Date 09/30/2005 Phone 541-942-9752 License 1031s CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: R-3 Secondary Occupancy # ofStories: Height of to forth 1- # Street Trees Paved Drive Rqd: o/o of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla 0090. catl ing the Frontyard Setback Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacls: number for the o Cente ris Street Storm SewerAvailable: Special Inshuction: Notes: Sidewalk Type: Downspouts/Drains REQUIRED PARIilNG Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Tvpe of Construction lof2 Value Date Calculated h d I lru I I .l-rl1\1, rNI UruVlq,! Illfl Primary Construction by Valuation Descrintion I Status: Issued 225 Fifth Street, Springfield, OR 541:7263753 Phone 541-726-3676Fax 541:7 2637 69 Inspe ction Line F SPRINGFIELD Buitding/Co mbination Permit PERMIT NO: COM2005-00715ISSUED: 0611012005APPLED: 06/10/2005EICIRES: 1211012005 VALUE: Fee Description + l0o Administrative Fee + 7Vo State Surcharge Backflow Device Minimum/Adj ustment Plumbing Total Amount Amount Paid $4.s0 $3.15 $14.00 $31.00 $s2.6s Total Value of Project Date Paid 6fi0t05 6n0t05 6n0t05 6/10/05 Receipt Number 1200500000000000819 1200500000000000819 r200500000000000819 1200500000000000819 Plan Reviews To Request an inspection call the24 hour recording at 72G3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Backllow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Reouired fnsnecfions By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the wonk described herein, and that NO OCCUPAIICY will be made of any structure without permission of the Community Services Division, Building Safety. I further certi$ that only contractors and employees who are in compliance with ORS 701.005 will be used on this proiect. I further agree to ensure that inspections are requested at the proper time, that each address is readable from the street, that the ts d at the front of the property, and the approved set of plans will remain on the site at all times /'/O -A'- Owner or Contractors Signature 2of2 Date I ees raro I 225 Fifth Street Springfield, Oregon 97 477 541-72G3759 Phone City of Springfield Oflicial Receipt rvelopment Services Department Public Works Department RECEIPT#: 1200s00000000000819 Date: 0611012005 2z39z25PNI Job/Journal Number coM2005-0071s coM2005-00715 coM2005-00715 coM2005-00715 Description + 7o/o State Surcharge + l0% Administrative Fee Backflow Device Minimum/Adj ustment Plumbing Amount Due 3. l5 4.50 14.00 31.00 Item Total:$52.65 Payments: Tlpe of Palment Paid By CheckNumber Authorization Received By Bdch Number Number How Received Amount Paid Check GUNN LANDSCAPING djb 2847 In Person $52.65 Payment Total: --Sffi I 6n012005 lofl KN ( (.1l-t ^\t 2z5FtYtH STREET . SPRINGFIELD,OR 97477 o PH:(541)726-3753 o IAX: (541)726-!1689 City Job Number,Con tz-oo - oo?tf ZZ6 7 ?+Q \+rp{ {Js ()ofi Job Location Assessors 703 6t Tax Oq3o T*,E cA-#Ec.rtE{t-i-{ Ct Address 2(-5T City ep fr-D BACKFLOW PERNIIT IS $52.65 (includes ?) rules ar€ s€[ 0090. You maY obtain coPies d the rulec bY 7L Fee) Can lracto r I n form ati on calling the number for center.the the Center T )rN Irfi -1Ht-.{ $-{() /1l.-{-i ()t)r qn{ (J Aht -ll-{A\J rF{,F)(-F(() () L{AH-i Bc !-{t{-'{ V1l-tt)d l-q Contractor 22(-- -,,7)* sr re -l 1 r^r,/h e,j 6L zip q7v)7 S fete.City Construction Contractors Regi I oSt{Expires ? ^3a -o{ By signing this permit/application, I aglee to call for an inspection once the backflow prevention devise has been installed and is visible for inspecti on (726-3769). I also state that all information on thi s permit/application is cpwsdl-) 6^/6 d{ For Office UI\L A'to - Of C ERIODDate of Application Checked for Delinquencies- Checked for Historical Status Shared Drive (T:)/Building Fomrs/Backflow Prevention l -03 doc Tnf Phone- MIT S t\nENCED HALL EXPIRE OR IS ABAN DONED FOR