HomeMy WebLinkAboutPermit Miscellaneous 2008-9-8
CITY OF SPRINGFIELD
Status
Issued
I
Building/Combination Permit
PERMIT NO: COM2008-01357
ISSUED: 09/08/2008
APPLIED: 09/08/2008
EXPIRES: 03/08/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 890 MOUNTAINGATE DR
ASSESSOR'S PARCEL NO,: 1802032208300
Springfield
,
TYPE OF,WORK: Backtlow Device
,
,
,
TYPE OF;USE: Addition
Public
PROJECT DESCRIPTION: Install Backtlow Device in Park
Owner: WILLAMALANE PARK'& RECREATION DISTR
Address: 250 S 32ND ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Landscape
Contractor License,
EASDALE BACKFLOW AND IRRIGATION 7305
,BUILDING INFORMATION t
Expiration Date
03/31/2009
Phone
541-926-8119
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:.
Range Type:
Energy Path:
, Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ff Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
. I DEVELOPMENT INFORMATION I'
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I . I
Street Improvements: , Sidewalk Type:
, ; TION' 0 gon law requires you to I
Storm Sewer Available: ATTEN . ,re h 0 n Utility . Downspouts/Drains:
Special Instruction: follow rules adopted by tel re~~ set forth
. Notification Center, Those ru es a
Nt' in OAR 952-001-0010 through OAR 952-001-
o es, 0090, You may obtain copies of the rules by
, ,'I - ._J._~ 1I\1.....to.. tho tolAnhnne, '
4.lClII'b1tj f~.~ th~.Or~ci9~1~:lIllY I~Ul;;;va~v'-1 I I
num erC~riter is 1~ti~nr,qescrinti~n- d!A.l'L E~PIRE IF THE WORK
$'p S F 1% ii~">ZiD ~'iJ;)ER THiS PERMIT IS NOT
Description Type of Construction erl,qlt" '1""'-~'~B,~.rd.~)AmlW a~ANDON. <l:i',J:/'\R Date Calculllled
ormuhpler "" "'or' I" mount"!:.S IL!J~
.{ '1." "I 'PERIOD
.. ,,'l' .1 li,HI '. ' .
Page I of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008~01357
ISSUED: 09/0812008
APPLIED: 09/0812008
EXPIRES: 03/08/2009
VALUE: .
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726"3769 Inspection Line
Total Value of Project
Fees P3id .1
Fee Description
+ 10% Administrative Fee
+ 12% Statc Surcharge
+ 5% Technology Fee
Backflow Device
MinimumlAdjustment Plumbing
Amount Paid
Date Paid
Receipt Number
$5.20
$6,24
$2.60
$17,00
$35.00
918/08
918108
918/08
9/8/08
.918/08
2200800000000001354
2200800000000001354
2200800000000001354
2200800000000001354
2200800000000001354
Total Amount Paid.
$66.04
I Plan Reviews I
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.
I Rellllired Insllectio~s 1
Backtlow Device: Prior to covering and provide a copy of the test reporton 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 wo~k performed shall be done in accordance with
'the Ordinances of the City of Springfield and the Laws of the State of Oregon p~rtaining to the work described herein, and
that NO OCCUPANCY will be made of any strnctnre 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. .
, .~----
~ ------=- ---~-.-- ~ -------
c:=..-- ~.._. ~_;""'_
t-j'-IJ(
Owner or Contractors Signature
Date
"
Pag.e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541=726~3759 Phone
Job/Journal Number
COM2008-0 1357
COM2008-0 1357
COM2008-0 1357
COM2008-0 1357'
COM2008-0 1357
Payments:
Type of Payment
CreditCard
"
cReceintl
RECEIPT #:
Description
Sackflow Device
Minimum! Adjustment Plumbing
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
DAVE EAS8ALE
City of Springfield Official Receipt
Development Services Department
. Public Works Department
2200800000000001354
Date: 09/08/2008
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
IIh 238194 In Person
Payment Total:
Page 1 of 1
1:10:54PM
Amount Due
17,00
35,00
2.60
6.24
, 5.20
$66,04
'Amount Paid
$66.04
$66,04
,
9/8/2008