The URL can be used to link to this page

Home My WebLink AboutPermit Miscellaneous 2004-12-30 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01599 ISSUED: 12/30/2004 APPLIED: 12/30/2004 EXPIRES: 06/30/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4938 DAISY ST ASSESSOR'S PARCEL NO.: 1702333301741 Springfield TYPE OF WORK: Backflow Device TYPE OF USE: New Residential PROJECT DESCRIPTION: Backflow device Owner: BARBARA SHRAUGER Address: 4938 DAISY ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor License Expiration Date LANDMARK IRRIGATION CORP . . 6~49 n \i:lVV I Q'1;.:'f.:~~~{~PP5 tlUILJJIl .Ill'!tIfUJ<s"~HrlN by the Oregon Utility follow ru rules are set forth # of 1\'i9(i\~ation Center. Those h ol\Yl ~t1&I001- HeiglH ef~Q(bflO1-001? thrO~~s 0~\li8tl!ldfbJPr: Type~~.atou may obtain cop. the ~INj~6~'loor: Water ~flhg the center. (Note.,. i~gnent: Range ~YJAAber for the Oregon Utility t Garage/Carport Energy'pa'tn: Center \s 1-800-332-2 Other: Sprinkled Building: n/a Occupant Load: Phone 541-686-9493 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive o'~R~:1 r. E' Co mPWacOt:RK % of Lot Cover-age:J . 1 SHAll EXPIRE If 1HE ~~I~II~E!~\n I INnER 1HIS PERM\1I~rN01 I PUBLIC IMPROV~~~m~ED OR IS ABANUUNtU ru \ ANY 1'BU1JAY ~f~Wa9k Type: Street Improvements: Storm Sewer Available: Special Instruction: Downspouts/Drains: Notes: I Valuation DescriPtion' Description Type of Construction $ PerSq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Page 1 of 2 _~'~~'N~I~,~91 , " :1, ", , . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01599 ISSUED: 12/30/2004 APPLIED: 12/30/2004 EXPIRES: 06/30/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fee~JaiU Fee Description + 10% Administrative Fee + 7% State Surcharge Backtlow Device Minimum/Adjustment Plumbing Amount Paid Date Paid $4.50 $3.15 $14.00 $31.00 12/30/04 12/30/04 12/30/04 12/30/04 Receipt Number 1200400000000001811 1200400000000001811 1200400000000001811 1200400000000001811 Total Amount Paid $52.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. 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. I ReQuired In~eftiqnl~1I1 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. (yI/;.:t1J..~ U) P L,l (./tt' no'" S' O,J r' _ "D'5 /2- so, -D <...( Owner or Contractors Signature Date Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541;726-3759 Phone. . Jiily of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200400000000001811 Date: 12/30/2004 11:21:34AM Job/Journal Number COM2004-01599 COM2004-01599 COM2004-0 1599 COM2004-01599 Description + 7% State Surcharge + 10% Administrative Fee Backflow Device Minimum! Adjustment Plumbing Payments: Type of Payment Check Paid By LANDMARK IRRIGA nON CORP Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1781 In Person Amount Due 3,15 4,50 14,00 31.00 $52.65 Amount Paid $52,65 Payment Total: $52.65 12/30/2004 Page 1 of 1