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HomeMy WebLinkAboutPermit Backflow Test 2008-10-31 Status Iss u ed CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-01606 ISSUED: 10/31/2008 APPLIED: 10/31/2008 EXPIRES: 04/30/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3771 Olympic St ASSESSOR'S PARCEL NO.: 1702300002105 Springfield TYPE OF WORK: Backtlow Device TYPE OF USE: Commercial PROJECT DESCRIPTION: Owner: Address: BFD INVESTMENTS LLC. 5729 MAIN ST PMB 242 SPRINGFIELD OR 97478 , I, CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Constrnction Type Secondary' Construction Type: # of Bedrooms: . ,.... you to A11~BUILDING-IN:(i)~:~~~'n Utility follow rules adopLQ C Y . rules are set forth Notificati(l,.q~SJor;les:~t;~:;" hOAR 952-001- , OAR 9~lgbt of,Strncture9 f the rules by In . 'OJ' n copies 0 0090., YO:YP"',!f<~~a. : Note: the telephone callingWatet6fype. ( Ut'l.ty NotificatIOn . an '\l1JJ.u'cgon II numbeR g lP~' 800-332-2344). KileOlgyt'Plitn: Sprinkled Building: , n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft B'asement: Sq Ft Garage/Carport Sq Ft Otber: Occupant Loa'd: I DEVELOPMENT I~FORMATlON I REQUIRED PARKING Total: Handicapped: Compact: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: NOTICE: % of Lot Coverage: " THIS PERMIT SHALL EXPIRE IF THE WORK --~;';-;-; llf'"'r"" -I'I~~':.""IT 'r. ..nT MUlrr. iL!lll..........;u.. .-..~- COMr ,Il.f.K:~f~FOR ANY 180 DAY PERIOD. Sidewalk Type; Street Improvements: Storm Sewer Available: Special1nstrnction: DownspoutslDrains: f' Notes: I Valuation DescriDtion ,I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calcnlated Pa~e I of 2 Status Issued CITY OF ~t'Kll~GFIELD ' Building/Combination Permit PERMIT NO: COM2008-01606 ISSUED: 10/31/2008 APPLIED: 10/31/2008 EXPIRES: 04/30/2009 VALUE: 225Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fee~ Pai? I Fee Description + 10% Administrative Fee + 12% State'Surcharge + 5% Technology Fee Backflow Device Minimnm/Adjustment Plnmbing Amount Paid Date Paid Receipt Number $5.20 $6.24 $2.60 $17.00 $35.00 10/31/08 ' 10/31/08 10/31/08 10/31/08 10/31/08 3200800000000000716 3200800000000000716 3200800000000000716 3200800000000000716 3200800000000000716 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 ReolJire~, r~snect~,~ns I By signatnre, I state and agree, that I bave carefully examined the completed application and do hereby certify that all information hereon is trne 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 tbe work described herein, and that NO OCCUPANCY will be made of any structnre without permission of the Com'munily Services Division, Building Safely. I further certify tbat only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure thatall 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 tbe site at all times during cons~niction.. "A 1 I <- ~,.AYp,&- <'0 ~J/.OP Owner or Contractors Signatnre Date Pa2e 2 on , 225 Fifth Stl;eet , . ' Springfil'4I, Oregon 97477 541f,726~3759 Phone . City of Springfield Official Receipt' Development Services Department. Public Works Department' Job/Journal Number COM2008-0 1606 COM2008-0 1606 COM2008-0 1606 COM2008-0 1606 COM2008-0 1606 Payments: Type of Payment CreditCard cReccintl RECEIPT #: 3200800000000000716 Date: 10/31/2008 Description . Backtlow Device Minimum/Adjustment Plumbing + 5% Technology Fee + 12% Slate'Surc'harge + 10% Administrative Fee Paid By JAMES R CLA YTON Item Total: Check Number Authorization Received By Batch Number Number How Received cJc 501220 In Person Payment Total: . Page I of I 1O:28:30AM Amount Due 17.00 35,00 2.60 6.24 5.20 $66.04 Amount Paid. $66.04 $66.04 . 10/31/2008