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Home My WebLink AboutPermit Plumbing 2008-7-3 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00987 ISSUED: 07/03/2008 APPLIED: 07/03/2008 EXPIRES: 01103/2009 VALUE' Status Issued 225 FIfth Street, Sprmgfield, OR 541,726,3753 Phone 541,726,3676 Fax 541,726-3769 InspectIOn Lme SITE ADDRESS 4134 FILBERT MEADOWS Way ASSESSOR'S PARCEL NO 1802064109700 SPRINGFIETYPE OF WORK Backflow DevIce PROJECT DESCRIPTION Backflow devIce TYPE OF USE New ResIdentIal Owner CHRISTIE THOMAS R & JEANNE Address 14234 128TH PL NE KIRKLAND W A 98034 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor STAR LANDSCAPE License 6196 BUILDING INFORMATION I # of U mts # of Stones Pnmary Occupancy Group R,3 HeIght of Structure Secondary Occupancy Group Type of Heat Pnmary ConstructIOn Type VB WMWr~.JIres you \0 Secondary ConstructIon Type ATTENTION oregll!J(ll~gOn Utility" # of Bedrooms talloW rules adopte ~!lJtI!\l}l'b!\re set tog1 ~~~~~~~_~~~~~~1 ,,~~~ !,8:~~~~.!>; nla 0090, '(ou II'VML~MENIJeI~iiTION I calling th" -h Oregon L."rr'l ,.Ie).- number tor \ e WlC\Cl-332.-2344.. center IS U'Veflay Dlst, # Street Trees Rqd Paved Dnve Rqd % of Lot Coverage Front yard Setback Side 1 Setback SIde 2 Setback Rearyard Setback Solar Setbacks I PUBLIC IMPROVEMENTS I Street Improvements Storm Sewer A vatlable SpecIal InstructIon ExpIratIon Date 02/28/2010 Phone 541,998,2039 Lot S,ze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other Occupant Load REQUIRED PARKING Total HandIcapped Compact SIdewalk Type Downspouts~ "Ol\C~~M'i S,",M.\. ~~~~~~{ IS \-IOi ~~:ORIIE?_U~~~: ~aMmO\-lE\) fOR I I.;wJ,\~r..:i:".~ ~lRIO\). . V aluaho~ ,I}e~~tfi':'l" Notes Description $ Per Sq Ft or multIplIer Square Footage or BId Amount Type of COllstructlOn Page I of 2 Value Date Calculated --......... ~ UAd ~.I Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00987 ISSUED. 07/03/2008 APPLIED: 07/03/2008 EXPIRES: 01/03/2009 VALUE: 225 FIfth Street, Sprmgfield, OR 54],726,3753 Phone 54]-726,3676 Fax 541,726-3769 ]nspectlon Lme Total Valne of ProJect ,Fe,es Pmd" Fee DescrIptIOn + 10% Admmlstratlve Fee + ]2% State Surcharge + 5% Technology Fee Backflow DeVice MIDlmum/AdJustment Plumbmg Amount PaId Date Paid $500 $600 $250 $1600 $34 00 7/3/08 7/3/08 7/3/08 7/3/08 7/3/08 ReceIpt Number ]200800000000000734 ]200800000000000734 ]200800000000000734 ]200800000000000734 ]200800000000000734 Total Amount PaId $63 50 I Plan RevIews I To Request an inspectIon call the 24 hour recording at 726,3769. All mspectIons requested before 7:00 a m wIll be made the same workmg day, mspections requested after 7:00 a.m. wIll be made the followmg work day. I Reo\,irf'd Insnectlons . 111111 , By slgndture, ] state and agree, that] have carefully exammed the completed applIcatIOn and do hereby certIfy that all mformallOn hereon IS true and correct, and] fnrther certify that any and all work performed shdll be done m accordance WIth the Ordmances of the City of SprIngfield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and that NO OCCUPANCY wIll be made of any structure WIthout permIssIOn of the CommuDlty ServIces DIVISIOn, BUlldmg Safety I further certify that only contractors and employees who are m complIance WIth ORS 70] 005 wIll be used on thIS project I further agree to ensure that all required IDspechons 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 remam on the sIte at dll times durmg constructIOn [I~~2-- ~ner or Contractors SIgnature 7-'3 ~ 2-0=, 7' Ddte Paee 2 of 2 c; e; -,} . r--!~ I,_~ ~ ~ ..~j " 14 ~ fL'l <(1 I,~ ""e~ ;:~ ~j ~ ~j ~ ~ ..}~ :?> ~ Q ~l ~i e; ..:t~. I~ $;;il ~ ~ ~ ~l !\'!'I\ . ~1 ~ o ~ 'r~~ ~ ~l SPRINGFIELD, n,~ ~I '\f k-~J/' ~ ~~' ~JlI -J ZZ5 f1ITH STREET. SPRINGf1ELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 r ? c-_ 00 9 tY7 CIty Job Numb. - I 01'&/1 ,-cC':>o Job LocatIOn f./j ,-:{ tj h / Jut/ -I- /n~ k k/ /802 ()GL.( I W 4--v 5,P-/Act 0 /L.e.t"~ / o ~ 700 Assessors Ma:, Tax Lot Owner r;;~ C /2r/;'+/.c- Addreso -il J t/ ;:-; /~-?t f- /J1.c.4- cil Pz/ ~4VPhonf' >? VV - If :;- b Clt" ~ Y'hh q 1~f9)~fION Oregon law requlresS't~\l('to p;' Zlf f 7~7 ? .. t J tallOW rUles adoptea oy me uregon ulllny Notification Center Those rules are set forth In OAR 952-001-001 0 through OAR 952-001- BAI19KFtl(i)iWllf'Rll~i"'IJ!..~..01lltOO~t~IYPERMIT FEE' $6350 calling the center (Note the telephone number for the Oregon Utility NotifIcation Contractor Informatlon Center IS 1-800-332-2344). Contractor 5~ ?/fn/,os: CAY ~ Ad,1rpoo f J t) ~ I ;2 f (/..(A. .RcL CIty JWvr.v-~ c: ~ Phnnp ~~y99-Zo;?? ?)/Z. ZIp 9'7,/Y P ~<Z-2~'2DDr \'i' \\\~ \S \:[:,~ \. 0--\l\~\'t.\'-~\\ fr'i)\'- By slgrung tins perrmt/apphcatlOn, I agree \'\~~f!>~;t~t'i~~~'ffi\e backflow preventIOn devIce has been mstalled and IS v1S1ble for msp~g, ~~1{~~\'!'lI~\lliite that all mformatlOn on tins permlt/apphcatlOn IS correct \\\\:\\\'i)\\\1!c.t.~ \:J\\ \\\<;J~' I>-~ ~~t.~ ~ '?~ L / / r,\) ,~\)~ SI~ /~?'/f ~ I>-~'\ \ State ConstructIOn Contractors RegIstratIOn # t,,/?? Datp 7-3-~85- For Office Use Date of ApphcatlOr 7 ~ t ~ Z-&>-e> &='- --- ------ Checked for Dehnquell"lPO ~- Checked for Hlstoncal Statr < Shared Dnve (T )/BU1Idmg FormslBackflow Preventton 1-08 doc 225 FIfth Street SprIngfield, Oregon 97477 541,726-3759 Phone i;i;.~ CIty of Sprmgfield OfficIal ReceIpt Development ServIces Department Pubhc Works Department Job/Journal Number COM2008-00987 COM2008-00987 COM2008,00987 COM2008,00987 COM2008,00987 Payments Type of Payment Check cRecerntl RECEIPT #: Date: 07/03/2008 1200800000000000734 DeSCription Backflow DeVIce MIDlmumlAdJustmenl Plumbmg + 5% Technology Fee + 12% Slale Surcharge + 10% Admmlstrallve Fee PaId By STAR LANDSCAPE Item Total t:heck Number AuthOrization Received By Batch Number Number How Received dJb 6571 In Person Payment Total Page I of 1 1052 46AM Amount Due 1600 3400 250 600 500 $63 50 Amount Paid $63 50 $63 50 7/3/2008