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Home My WebLink AboutPermit Backflow Test 2010-8-13 .. . I ..' S~.RI.N,G,F..IE~ ' .~ &.'~'(fh , , t>~;'S+~~ OREGON CITY OF SPRINGFIELD Building I; Residential Permit ;'\:"1;:1 0';_:' r,;" j' ~ .", www.cLspringfield.or.us PERMIT NO: 81:1-SPR,2010-00049 ....:'1.,,:; )...;-1':, IVR Nu~ber: 811110331335 225 Fifth St Springfield,OR 97,477 Phone: 541-726-3753 Inspection Phone: 541.726.3769 Fax: 541-726-3676 permitcenter@ci.springfietd,or.us PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/12/10 EXPIRES: 2/8/2011 VALUE: $0.00 SITE ADDRESS: 500 48TH S SPRINGFIELD ASSESOR'S PARCEL NO: 1702324407300 SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow device " Phone Number: OWNER: ADDRESS: , ,'-" OWNERS ASSOCIATION FOR WESTWI,ND;ESTATES :,:. , .~',,,, .'":. . i 2464 SW GLACIER PL STE 110 .,~': ",', REDMOND OR 97756 Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lie No Lie Exp Phone BUILDING INFORMA TION ~ # of Units: ,,; ,:;:;:,f".;:, ,~;l. ,". ~: . # of Stories:M,,:' ,,", . I . I Heig~~':?!l~t~~~f~~~.:" : .".~.' ,. '.. .,..;, Type,otHeat: " ','. Jill:.I\ Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alanns: Electr,ical Specialty Code Edition: Springfield Fire c'ode.Editi'~n: Mechanical Specialty Code Edition: ,,' I Municipal} Develo'pm4:mt Code: Plumtiirig'Specialt\r,Code Edition: Re~.id~'ntial Specialty Code Edition: Structural Specialty Code Edition: Energy Path: Site Information Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: ATTENTION: Oregon}fSWJ.equires 1{OU to follow rules adopted~~the.,Oregon Utility Notification Center, l"lrb'lfu fUl~'are'set forth In OAR 952.001-0019~IV;oufJhOAR 952-001- 0090. You may obtaiOibopies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 8/13/2010 . 2:.31:3'SPM':'. \ .~': I. "'.'r'./ I.... ~ "-. ,..: r.' .: ,:i:J'I:;1 <,l'Yi';:-., \"~ " Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: ~ NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT, COMMENCED OR IS ABANDONED FOR .,)' r., . ANY 180 DAY PERIOD....,,', ^;."";: . ,. . ;.- .\. :'.,' ,;i";..;.'I..,,~:.:.. ~ Page 1 of 3 ~ S!',RING. F. IEL~ ~lI.l_. :,~ ~,::? OREGON "( { 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us CITY OF SPRINGFIELD .' ~.. ~ ,. .'. ' , . . ~"; ..' . Buildiirit'l"I'[{esidential Permit PERMIT NO: 811-SPR2010-00049 IVR Number: 811110331335 permilcenter@ci,sp(lngfield.or.us PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/12/10 . '" . EXPIRES: 2/8/2011 VALUE: $0.00 ""'i{." ,:.f';' SITE ADDRESS: 500 48TH S SPRINGFIELD ASSESOR'S PARCEL NO: 1702324407300 '~1~Ii' ;::.;).;;P'; SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow device DEVELOPMENT INFORMATION' REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd:' % of Lot,Coverage: " j " Highest point o~ st~~~t!lre,!Ql\;;'\ .) , north property.I!~!itt ,',' ',: ~ '4 ~P.J Total: Handicapped: Compact: ;,~. '1 s. :, :c <, ~ . PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: ;.....~r} "'. ,_}, , ~'-r..:~~.':'""~:,':-:":"'-":"" ;.'; t.~;i:- J ,', \'/1.1 ::':"! ?i ~'~ " , Valuation Description I Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value , - ~~~"~-0P;7~::-~-;.,~.;"{T~~~4>:-j;-'-:~_~{.;~ft~~~lilb;.l.p"f;E::}:~~:, ,- ! ,Amount Paid" ., ;~';;;i ',' . '$19.96:~": ,~ ", $39.00 .t',;.'::;~~,' ,,'." ..;. $6.96 $2.90 $67.86 . -\0 "~." .,~;~-'Tt ;:t: \. -:1~,:[';;~J~~'~'~;- .' - '- -. "'''1 c '! l '--""'''-4',' ""' , DescriDtion Backflow preventer Balance of Minimum Plumbing Permit Fees State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid Date Paid 08/13/2010 08/13/2010 08/13/2010 08/13/2010 Receiot # 224441 224441 224441 224441 "j ~j,i,l- l ,to: . '~.,~~"i~ '. "i'. ':; :":~,,,;.t " ' Springfield Building Permit -,-:i.: ~ft:'8/13/2010 2:31:35PM Page 2 of3 . '.(;'1: ~ www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-S.PR2010-Q0049 IVR Number: 8111'i0331335 . '<:.: , e~'" 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 S~~ING...FI..E.:iJ '. ' .- ->to .~ c:'" OREGON permitcenter@cLspringfield.or.us PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/12/10 EXPIRES: 2/812011 VALUE: $0.00 SITE ADDRESS: 500 48TH S SPRINGFIELD ASSESOR'S PARCEL NO: 1702324407300 SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow device +} Due Date 08/1212010 08/13/2010 08/13/2010 08/13/2010 08/13/2010 08/13/2010 Comolete'; 08/12/2010 08/13/2010' . 08/13/2010 08/13/2010 08/13/2010 08/13/2010 >, ~'plml_J!~li~~/ :t- . .' 'I.... Result Over the Counter Over the Counter Not Required Not Required Not Required Issued ~;P}':~f\" k.,~./~~L;~-'-:';%2:?!.;:;~f;~ :,'~.-~..~, '. " lJ ~. .tTo.,;, ~ -'; ::""'T'; :'l;~-~"T .~ .~:'['f$i :;;p,',",," ~:d,,;,- , """....-f:-;..c......., ">,::,..&~;::q-Y!:c--- Deoartment Application Acceptance Initial Review Planning Review Public Works Review Structural Review Permit Issuance Received 08/13/2010 08/13/2010 08/13/2010 08/13/2010 08/13/2010 08/13/2010 Reviewer David Bowlsby David Bowlsby David Bowlsby David Bowfsby David Bowlsby David Bowtsby Comments Over the counter permit Over the counter permit Over the counter permit Over the counter permit INSPECTIONS REQUIRED ~ Inspections 3620 Backflow Device .~ . ~ j.: j .' By signature, I state and agree, that I have carefully examinedJhe completed application and do hereby certify that all information hereon is true and correct, and I further cer1ify that any an~ lail\vork performed shall be dene in accordance with the Ordinances of the City of Springfield and the Laws oUhelState or Ore-gen' pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without perrr;i~s'ion 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. . ~I~ ~ A. (:do..-. ,~ ~~ ~fID...t o $-):110 { / Owner or Contractor Signature -pjl _. '. . - '~'d~r~~ <.'hf~;h:jDate' , . .I~l!J _.&:~::U '.'20~U .:'vl;,.!i . . :'01,'1.' \ . , \,; .', ~, ..IJ th.;.. I:"~ Springfield Building Permit 8/13/2010 2:31 :35PM Page 3 of 3 'r~\\Y ';\'IA.~;':\;,Y:. ...} .J S~~.I.EL.~... ~'iM ~ \bu., MM~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726.3753 www.ci.springfietd.or.us permitcenter@ci.springfield.or.us "PAYMENT"T,Yf1E~ .:: . Check 4474 RECORD NO: 811-SPR20 10-00049 DATE: 08/13/2010 .s",'Z';*"2'?;:'.-:-~;l~~~"$',4ii;';iACQO).rNt~CJj6E,:i' ".:\ '" ., :';Iv1QU~tD.UE.:..j:-_:~ ..... J 224-00000-425603 $19.00 ""-"--'-"-"~'-~-----' 224-00000-425603 $39.00 - -~,...,- 821-00000-215004 $6.96 .---. 100-00000-425605 $2.90 TOTAL DUE: $67.86 --'t' 'i~J.'i:AMOUNTf1AID;'Ff'Zf'",-. t.. . ..1 $67,86 RECEIPT NO: 20 I 0000060 tDESCRiPflbN~1Jf'iiiF""""- .J Backflow preventer Balance of Minimum Plumbing Permit Fees State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) PA Y0R;,"1lCASHIER.'OBOWLSBY.;' _t~;C::_OIv1MENI.S - '" -,. Dave Easdale ,.'J;.~"~,' ,"',' .'.t"':;" 'Ji;:"<!'''' ,',I;".:,.,. ti;:,. :',.~;? ' '! ")'",,' ~':. " .,....,. ,-. ""',