The URL can be used to link to this page

Home My WebLink AboutPermit Backflow Test 2010-8-13 (3) .; ; S~~.I..H..G...FI E~.D . n;:? ,.:'::A!i!'k. '<it ~ ;'o.' ~'o/,7r . OREGON CITY 01= :SPRINGFIELD :,,; 4_ .'..', ':i~: . Building'l!ResN~l;ltial' Permit ..' d I.. ' PERMIT NO: 'il11-SPR20'10-00048 ).11 www.cLspringfield.or.us IVR Number: 811152336783 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/12/10 EXPIRES: 2/8/2011 VALUE: $0.00 SITE ADDRESS: 4828 GLACIER SPRINGFIELD ASSES OR'S PARCEL NO: 1802051105300 SCOPE: Backflow Device WORK INVOLVED: New TYPE,oF STRUCTURE: Residential PROJECT DESCRIPTION: -. qo.o.: . ,. . Phone Number: Backflow device OWNER: ADDRESS: .. '~'rly. JHD3 LLC 2464 SW GLACIER PL REDMOND OR 97756 Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lic No Lie Exp Phone # of Units: BUILDING INFORMATION ~ FR.-... ?H:c;rr-t"t!" ~~!,.> # of Stories: "' ".': I Heig~l~fjSt~uc~ure: Type of Heat: Water Type: Range Type: o # of Bedrooms: Hazmat: Sprinkled Building, :I,!1. Electrical Specialty Code Edition: Springfield Fire Code,tE~itio~: Mechanical'Specialty/Code -Edition: !VIunicipall Development Code: Pluihbiri,9 Specially Code Edition: Residential Specially Code Edition: Structural Specialty Code Edition: Site Information' 'I Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land 'Hazard-Area: Retaining Wall: Soils Report Required: "'~ '.'"" . , :"~~",-",,,~~,,1;.~"o....."''''..' '",< '('. , ATTENTION: Orego~;I~ r:J:..'~1;~ y<oUio ~l'\lT}' vy . follow rules adopte9Rf)hl?,9s.~,gon Utility Notification Center, -m,osli mles are set forth in OAR 952-001-0010 th'rough OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the teiephone number for the Oregon Utility Notification Center is 1-800-332-2344). 1\. Springfield Building Permit aJ1312010 2:18:00PM ,', I, ,,',,;o.j . {: I., -'i~ :t'I,~ ,\ , ,', :r, ;i.;U:~~': ~~;~.; ."i / . o.,. , Lot Size: Sq Ft 1st 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 ilUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of3 .:1 . www.cLspringfield.or.us ;" .,' ,'" ..., ; .,~.\ c ... _-'.' l' CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00048 IVR Number: 811152336783 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 S~RIN~~ tIIi.~~.. . -.-.f~ .. OREGON permitcenler@ci.springfield.or.us PROJECT STATUS: Issued ISSUED:i8/13/10 -. ..,....,.{... ..,.'" ,.L<..,~~~. APPliE'D: 8/~2/10:' -. EXPIRES: 2/8/2011 VALUE: $0.00 ,.', .,.... SITE ADDRESS: 4828 GLACIER SPRINGFIELD ':5 'i ASSESOR'S PARCEL NO: 1802051105300 ':'. '~J.';' SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow device DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: . % of LotCove~age:n ~~',,~ Highest po,i,nt.-p~~structure t~;I; north propertY;lin~: ' Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: ''-!t.~~, ,il~';;~/<( . :.!1'tb: }Jr~'/hu' :,,,;'.".:!-:... '" ~ 11 '''I' Valuation Description I Descriotion Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value " .., , -'sf{,t:~~~-~~C~Z1"f0..~;#?:Tf>,';'~ if .=;~ -":"'~;Q,4c;G:;;F.iES:pAiD"'H c,;, , l ~ l,J'\'.I...Amount Paid .~..;l;1".i $19.00 $39.00 $6.96 $2.90. $67.86 -.-.~~- ...!." "" -'.,,,,,"~V*-/ - r ,;; -i/~:. DescriDtion !3ackflow 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 0811312010 ReceiDt # 224440 224440 224440 224440 .0,:.., ,.:;~1~r:"' ;;..,:l~:;';;;,;:, . . . .-,~,. ',' <\ : .~.., Springfield Building Permit 8/13/2010 2:18:00PM Page 2 of 3 ..j.. 'c' www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00048 IVR Num~~r: 'S111!r2336iil3 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541.726.3676 permitcenter@ci.springfield.or.us PROJECT STATUS: Issued l ',h, :~' ISSU'Eb":;S/13/10' APPLIED: S/12/10 EXPIRES: 2/S/2011 VALUE: $0.00 SITE ADDRESS: 4828 GLACIER SPRINGFIELD ASSESOR'S PARCEL NO: 1802051105300 SCOPE: Backflow Device WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: [;.,::...,. ;. ;:<, '; :~;'~'",'.,;, 'C' :' ,'......."-.,.-.. -~~ Backflow device ~"~,, 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 Due Date 08/12/2010 08/13/2010 08/13/2010 08/13/2010 08/13/2010 08/13/2010 '"'~C~-~:'~!)~!~f ~~~:~~;T:~~:' ,,\_'~,: ComDlete,~ Result 08/1212010 Over the Counter 08/13/2010 Over the Counter 08/13/2010 Not Required 08/13/2010 Not Required 08/13/2010 Not Required 08/13/2010 Issued INSPECTIONS REQUIRED , +e< -'C;r.j~~~~:~ :" -2.,.j,~j'..;_. Reviewer David Bowlsby David Bowlsby David Bowlsby David Bowlsby David Bowlsby David Bowlsby Comments Over the counter permit Over the counter permit Ove,r the counter permit Over the counter permit Inspections 3620 Backflow Device " By signature, I state and agree, that I have carefully examined,the completed appiication and do hereby certify that all information hereon is true and correct, and I further certify~that'any and '~lI'work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws o(thre',~State or Oregon~ pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without pe'r;.t,'ission of the Community Services Division, Building S<;lfety. I further certify that only contractors and employees who are in compl'iance 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~)ri't ~ ~h",\$ 'fJ1rCM-\~,:;",'-C." . ~):/o Owner or Contractor Signature ~ i~JB\' L.Lf:~"):~VDate -;;?~ '~~tL;':' ~l'lt~~:::.:f 'i28~O "'Vl;r:r. ' :'Oii ' ;'::X;-" " ,:;:J;'!"'" " ..:,f;!.: r ......t.' Springfield Building Permit 8/13/2010 2:18:00PM Page 3 of 3 ,:,ti!~~:. ",.r..1-;., :W;\-:,":ii:~:,,' SP.::~G~~~ ~~ ~.OI(EGON .' . \ ~);~- CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 TRANSACTION RECEIPT www.ci.springfleld.or.us pe rmitcenter@ci.springfield,or,us RECORD NO: 811-SPR20 I 0-00048 DATE: 08/13/2010 .',. i'.ii,;, ~c~::.;:~. -,>-)(CCQI.JNT&ODE::zc'. ':;,:i~nnPJ'!N't[).UE; .,'.~ . l!, ::':' .... _.:=~ 224-00000-425603 __~2.~:!!Q. ......~,. .'. 224~00000-425603 $39.00 .,~ ".'l. 821-00000-215004 $6.96 100-00000-425605 $2.90 TOTAL DUE: $67.86 k-'~f"AY-M-EN'tT'tPE, . - "'PA'tOR~~CASHIEBD~o\;ifs~YJ1"_%'f-'C~QnnME:NTS:' Tt.y;~.> ,-,,~ .'tc 'AMQl!.~tpj.,!!:!' '';;;',..;_..:.j Check Dave Easdale $67.86 RECEIPT NO: 20]0000059 LQES..CRI'pTIQN~ .. Backflow preventer Balance of Minimum Plumbing Permit Fees State of Ore90n Surcharge (12% of applicable fees) Technology fee (5% of permit total) ~ .' ,-, 4474 ,"I" ,; 'J:~1~~. . ,,.,.~~: ~~~,;~? '. :i:,~h:: ~~t~t;' .;,q ,"i"~" , 'f --,.. l}~_ " 1"', '.',