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Home My WebLink AboutPermit Backflow Test 2010-8-13 (2) ;t(!'\'.~ . .....,".', !.~' .' "J"i~;!:; :~';;~~.f:1:~~;':' . ~f'\ ..;~,... .~"- > .",- SP."RINGFIEL~..' , .-- ,,~"i',r!!:b 1'> ."e<;::. ..< ,,0;.... ,.,,""- '" OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00047 IVR Number: 811110813589 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield.OLuS PROJECT STATUS: Issued ISSUED: 8/13/10,." " . ..... "\ ;1).-: APPLIED: 8/12/10-,,,,, , , ' , .1 EXPIRES: 2/812011 VALUE: $0.00 SITE ADDRESS: 4950 HOLLY SPRINGFIELD ASSESOR'S PARCEL NO: 1802042204000 SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow device Phone Number: OWNER: ADDRESS: JHD3 LLC 2464 SW GLACIER PL REDMOND OR 97756 .: ~l i f~}'\t:t.. ';.:.\ .)~. :i~'" CONTRACTOR INFORMATION ~ Contractor Type Contractor Name . ,.~, ' Lic Type Lic Exp Lic No Phone BUILDING INFORMATION I # of Units: o # of Stories: I Height of Structure: Type of Heat: Water Type: Range .Type:: . ,.:;'1.;;,,;,::..-: # of Bedrooms: '- ... ~azmai:L:: :",1'" Sprinkled Building: Fire Alanns: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Struct~r~il'SpeCial~ Code.Edition: . ::..,;;.:':~';".: ~S,~';;-,? \..-..,.. . NT+;i .:-, (.;~: ,:~ . ,,,~,,^,,;>~.lt~J[1Jp'.nnatton Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon,Utility t>Jptificatio~. Center is 1-800-.::132-2.344). "1. _,',~. h~;!, 1 ',' . ' 1 . " "'. ~~ .._.~ 'y '"i Springfield Building Permit Bf13f2010 2:14:38PM Lot Size: Sq Ft 1 st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: I NOTICE: - " '{I";;";;;'"';;':''''' THIS PERMIT SHALL EXPIRE IF THE WORK :;,: AUTHORIZED UNDER THIS PERMIT IS NOT ~~. COMMENCED OR IS ABANDONED FOR ,,:,f::( ANY 180 DAY PERIOD. ".....'[ .. ".. Page 1 of 3 www.ci.springfield.or.us CITY OF SPRINGFIELD BuildingJ:Resil:l~ntial P~rmit C":,:::.';'.~'" <:'-';,~., ::~.~;;! '~ : . rr7.".:.-:-, <t'fl'l';':-:-';,; ,. PERMIT NO: .,8,1;1'~SPR201 0-00047 "'.'........./.." .. ""~...'....;-, ,., 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 S~~~;G.~.I.E~ .?~ . d?.3. OREGON pe rmitcenter@ci.springfield.or,us IVR Number: 811110813589 PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/12/10 EXPIRES: 2/8/2011 VALUE: $0.00 SITE ADDRESS: 4950 HOLLY SPRINGFIELD ASSESOR'S PARCEL NO: 1802042204000 SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow device DEVEUo'PMENT INFORMATION I Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # StreetTrees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: ;;.',U Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: pustlCir;;I!'ROVEMENTS I ~'ll}/!f.~ ,',"r:~~{(,',~: , ::"..~,;:,,',':,,:U "~':"~1r;:, ~:. t\~:, " Sidewalk Type: Downspout/Drains: .,1 ""'1 ;::;-:Naluation~D.~~.cription ~ H: w.:-,' '".'tJ."S' l. .'.~ Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value E V~;;:;:;;;' dO' . " " DescriDtion Backflow preventer Balance of Minimum Plumbing Permit Fees State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid ",~,-;, ~:!r;-::;;,c ']1' '~:~_~'.:-~'?~~~"~i~t;tF-I€~$J~Aip:f;_-;<---~~;"F~:ii~t;;;~;'4i~;';::, 1l Amount Paid Date Paid $19.00 08/13/2010 ,f" ,.$39,,00 08/13/2010 ;-,'",rji;"""'i,\J.l:$6~96.' "; , 08/13/2010 11:~~?i:~ '~i#!t.::~r$~i9'o .~"; :", 08/13/2010 ;~.:;:~...:~t' ':,"~L~$6i;86 ' :;' . :,,_i~' ,m,:, 1': -~. ," , 'l~':". < ~t~~d ReceiDt # 224439 224439 224439 224439 'n" ' Springfield Building Permit 8/13/2010 2:14:~8PM.. Page 2 of 3 ":,~:11l.,~ ' ("'~:!~'f;r': ."\:::,11..';,'.'''-'' ,~.,,='" ,., ' .. CITY OF:5PRINGFIELD ~ "t'J~"t""', ,.. -.~.c 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building' {Residential Permit PERMIT NO: 811-SPR2010-00047 IVR Number: 811110813589 permilcenter@ci,springfield.or.us PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/12/,10.. , .;;:!\c~ \;.'. -~.~O::\,-','~'!" SITE ADDRESS: 4950 HOLLY SPRINGFIELD ".,:;:~f' ~;~!,;,~\,,!J. " - ' SCOPE:'Backflow Device ASSESOR'S PARCEL NO: 1802042204000 :;~:lFE' ":~:ifi .... WORK INVOLVED: New .y. TYPE OF STRUCTURE: Residential EXPIRES: 2/8/2011 . VALUE: $0.00 ~ '- , Backflow device ":". ;~o:- c- - ...= ~ .h'PI 'R' . ..- i .~. '"'". _c;/","'f"",,~;+L,_ "'~'-<." 0~ .. '~''W;=''''. an BYleW ;::l,it .",-,'f~. -" :;~~::L' ~f~ \"."~,-' <''J't> ~": 4-:1 ~,P', . .~.~ :1 PROJECT DESCRIPTION: E.' " t "". ,,,- "":'4", -~ DeDartment Application Acceptance Initial Review Planning Review Public Works Review Structural Review Permit Issuance Received Due Date ComDlete Result Reviewer Comments 08/13/2010 08/12/2010 08/12/2010 Over the Counter David Bowlsby 08/13/2010 08/13/2010 08/13/2010 Over the Counter David Bowlsby Over the counter permit 08/13/2010 08/13/2010 08/13/2010 Not Require? David Bowlsby Over the counter permit 08/13/2010 08/13/2010 08/13/20.10 Not Requiced David Bowlsby Over the counter permit 08/13/2010 08/13/2010 08/13/2010 Not Requi~ed David Bowlsby Over the counter permit 08/13/2010 08/13/2010 08/13/2910 " ~Issuedr ,~f:\ 1 David Bowlsby INSPECTIONS REQUIRED I Inspections 3620 Backfiow Device 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 or 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 c'?!]P!~,n,?'EJ1Vf!t~9~,~?,q1 ,~~.5 will be used on this project. I further agree to ensure that all required inspections are requested at th~:~~9pe,~~t!W..r:,:"trfat'~~_ch address is readable from the street, that the permit card is located at the front of the property, and the aPP!?v,~d;s.~1:of,plans will remain on the site at all times during construction.:"'~,. :, ,I. ,,'.'VI,'I rl VI A- ~,4- fill- ~.Mll"'(.(( "i;,A-(.\L. FLoW ~ sj~~= I Owner or Contractor Signature Date '1',,' .:'r,:J, "~~T~J~;:'l ."I~~~,";'j~ .:;! ~P,'~':f'T.' '. J/:f .;.,(;' -\~1t~::~~1~~;~;~~:. Springfield Building Permit ',-8/13/2010 2:14:38PM Page 3 of 3 \ ..,,- ~c:.:\ ~:, "r,.;.' i2 . . S)~~N~~,I,~~ ~ . +OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 www.ci:springfield.or.us permitcenter@ci.springfield.or.us I':. RECEIPT NO: 2010000058 "D'E'SC'RlnTIO'N", Y'F '1'4.=FC',FT ,,-'- t.!._._,..__~~....._."..i:JL"'\"" '"..' ,...~,..., . Backflow preventer Balance of Minimum Plum~ing Permit Fees RECORD NO::'8iI-S'PRi~)O-00047 DATE: 08/13/2010 - '}:::;D~,~:"t:Y~~~~~or~.t~ L ~~.. ;~C.C;.o.UNT~C_6PE_~:,',}L~~l2~MO.lJ~\itDJjE~:2i~i:~~~; 224-00000-425603 $19,00 224-00000-425603 $39.00 -...------,.--.,--- State of Oregon Surcharge (12% of applicable feesJ._..___~3.1..:00000-215004 $6,96 Technology fee (5% of permit total) 100-00000-425605 $2,90 TOTAL DUE: $67.86 ,F~>>i~, .,', '..,. AMO\JNTF;>AID,>'Z,'ZP"" .1 $67.86 I ;';;I;lA YMENT.TYPEist~PA YOR:3:FC;..sIlTER:DBOWt:SBY;~~f c_bMME~:f.S,;;;';+~'!'. Check Dave Easdale 4474 -,J, ~_:"~ "1-:;.~~D::.' J;,:;.~.:: ~ ,k ' .' ,..... . . .~:;'~;'j ; ':"\':").t" ;- : \