HomeMy WebLinkAboutPermit Plumbing 2007-06-14Status Issued
225 Fifth Street, SPringfieldn OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2007-00875ISSUED: 0611412007
APPLIEDz 0611412007
EXPIRESz 1211412007
VALUE:
SITE ADDRESS: 1122 S 40th Ct
ASSESSOR'S PARCELNO.: 1802061417100
PROJECTDESCRIPTION: Backflow
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Alteration Residential
Phone Number: 541'747'0145Owner:
Address:
MIKE BLANKENSHIP
8063 THURSTON ROAD
SPRINGFIELD OR 97478
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Contractor
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# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
License Expiration Date Phone
541-688-7991& IRRIGATION
\
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range
Energy
Building:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
%6 of Lot Coverage:
Sidewalk Type:
Downspouts/Drains:
$ Per Sq Ft
or multiplier
Sguare Footage
or Bid Amounf
PUBLIC IMPROVEMENTS
Descripfion Type of Construcfion
Page 1 of 2
Yalue Date Calculated
EUTLIJING 11\t.UKNTAT TL'N I
Status 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: COM2007-00875ISSUED: 0611412007APPLIED: 0611412007
EXPIREST 1211412007
VALUE:
Fee Description
+ l0o Administrative Fee
+ 57o Technology Fee
+ 87o State Surcharge
Backflow Device
Minimum/Adj ustment Plumbing
Total Amount Paid
Amount Paid
Total Value of Project
Date Paid
6n4/07
6n4t07
6n4t07
6n4t07
6n4t07
Receipt Number
2200700000000000960
2200700000000000960
2200700000000000960
2200700000000000960
2200700000000000960
$4.50
$2.2s
$3.60
$14.00
s31.00
$55.J5
Plan Reviews
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
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.
7 //'o?
or Contractors Signature
Paee 2 of 2
Date
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lees rato l
t(eourreo lnsDecuons I
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225 FIffH STREET . SPRINGFIELD, OR 97477 o PH:(541)726-3 753 o FAX: (541)726-3689
City Job Cctr( Zm-?-@;r5
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Assessors Tax Lot
Owner
Address
City State- ZiP
BACKFLOW PRE\TENTION DEVICE PERMIT FEE: $55'35
Contractor Cc^oi (o€\
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City
Construction Contractors Registration #f7o s 7- zo--02Expires
By signing this permit/application, I agree to call for an inspection once the backflow prevention device
has bien installed ana is visitle for inspection(726-3769). I also state that all information on this
permit/application is correct.
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For Office Use
Date of Application
Checked for Delinquencies- Checked for Historical Status
Shared Drive (T:)/Building Fom/Bacldlow Prevention8-05.de
CITY OF SPRTNGFIELD, OREGON #'* w*
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Phone
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RICEIPT#: 2200700000000000e60 Date:06/14/2007 3:OE:2SPluI
ob/Journal Number
:oM2007-00875
:oM2007-00875
roM2007-00875
toM2007-00875
oM2007-00875
Description
Backflow Device
Minimum/Adjustment Plumbing
+ 5% Technology Fee
+ 8% State Surcharge
+ 10oh Administrative Fee
Amount Due
14.00
31.00
2.25
3.60
4.50
Item Total:$5s.3s
ayments:
ype of Payment Paid BY Received By
Check Number
Batch Number Number How Received Amount Paid
jmp 027201 In Person
Payment Total:
$s5.3 5lreditCardDECKER LNDSCP
$5s.3s
61141200'7
cReceintl
Page 1 of 1
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