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
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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
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2z5FtYtH STREET . SPRINGFIELD,OR 97477 o PH:(541)726-3753 o IAX: (541)726-!1689
City Job Number,Con tz-oo - oo?tf
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Job Location
Assessors 703 6t Tax Oq3o
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BACKFLOW PERNIIT IS $52.65 (includes
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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