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Home My WebLink AboutPermit Building 2007-7-17 . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SCANNED .' CITY OF SPRINt-I< IJ'.LU Building/Combination Permit PERMIT NO: COM2007-01057 ISSUED: 07/17/2007 APPLIED: 07/17/2007 EXPIRES: 01/17/2008 VALUE: Status Issued SITE ADDRESS: 1196 Delrose Dr ASSESSOR'S PARCEL NO.: 1703234409600 Springfield TYPE OF WORK: Backflow Device TYPE OF USE: New Residential PROJECT DESCRIPTION: Backflow device Owner: PAUL ROTH Address: PO BOX 70468 EUGENE OR 97401 Phone Nnmber: 541- Contractor Type Landscape I CONTRACTOR INFORMA TmN I Contractor License SCHELSKYS LANDSCAPE AND IRRIGATI 12170 I BUILDING INFORMATION I Expiration Date 08/31/2008 Phone 541-744-7135 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Lot Size: Height of Structure: Sq Ft 1st Floor: Type of Heat: ATTENllOtil!l ~~qUIreS you to Water Type: follow rules a d"OV'll'I6:0regon UtIlity Range Type: Notification R f. C1/WftmiO~ set forth Energy Path: OAR 952 -R/lwough OAR 952.oot- Sprinkled Building: ~~!~ou m smw.~e~ of '!"' ~~_bf -'\log UIII ~....... ,nv.v. ~ . \:~... - I DEVELOPMENT INFORMA TloN-:t>er for the 0,89.0" Utility NotIfIcatIon Center ",~~ARKING R-3 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: U~Tlti: THIS PERMIT ~BX~e'nlM~ AUTHORIZED UNDER (tl)y hhrJ{1 r I~ riJ t COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e I of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01057 ISSUED: 07/17/2007 APPLIED: 07/17/2007 EXPIRES: 01/17/2008 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project F.....~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Backflow Device Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Number $5,00 $2.50 $4.00 $16.00 $34.00 7/17/07 7/17/07 7/17/07 7/17/07 7/17/07 1200700000000000926 1200700000000000926 1200700000000000926 1200700000000000926 1200700000000000926 Total Amount Paid $61.50 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. ~eouired Insner.tions I 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 "G'~ru"..~ _ '/17/07 Owner or Contractors Signature ~ Date Pa2e 2 of 2 225 Fifth ,Street Springfield, Oregoo 97477 541-726-3759 Phone . Job/Journal Number COM2007-0 I 057 COM2007-0 I 057 COM2007-01057 COM2007-0 I 057 COM2007-0 I 057 Payments: Type or Payment CreditCard cReceintl RECEIPT #: ~ . of Springfield Official Receipt "IIIff'rvelopment Services Department Public Works Department 1200700000000000926 Date: 07/17/2007 Description Backllow Device Minimum/Adjustment Plumbing + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DARREN SCHELSKY Item Total: Check Number Authorization Received By Batch Number Number How Received djb 016796 In Person Payment Total: Page I of] 1:5I:26PM Amount Due 16.00 34.00 2.50 4.00 5,00 $61.50 Amount Paid $61.50 $61.50 7117/2007 . . SPRINGFIELD :_-_:-':-'~' CITY OF SPR1NGF1ELD, OREGON /'-"0-,1" ,..,'c/!:" '. 225 FlITH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~( ~( ~ .,~, l~ Job Location ~J ~ Assessors M~r ..~( .,..--,--1, f'l\ l( Owner- f?'t, ~~ ~, Addrers ~; l;-_~ .,~ i:: ~ f,!\\ ' ~~ ~ C1:.b .'> ~ ~\ ~( ~( ~ -.'fI!!!!!I(J I~ ~~ ~~ ~ ~ ~ ~ ~ r-~ ~ ~ ~ ~ ri)j ~. ~~J ~l CitvJobNumberJl"'i..vl 7 007- 01 0':;7 Ilq& J)g ()PP)~ /P. 170J 2'34L/ 4~/ ;fo~ City /UG ,<:::;dJd, --, ()... ( ro S<o {JrIVt. SVt'" , Tax Lnt , phnn", 0,2. 0'60(:) Z' f70 7 Ip BACKFLOW PREVENTION DEVICE PERMIT FEE: $61.50 Contractor Information Contractor .i.~",Jsc:.y.?<- l" Trfi>;"~ ::L"'-L, By signing this pennit/application, I agree 10 call for an inspection once the backflow prevenlion device has been installed and is visible for inspeclion (726-3769), I also state that all informalion on this pennit/application is correct. Signatur'" ~ ------ Addrecs -Sc..~(s,,-.., ~ ;/0 ;fox 7N-r City Cl-<-fo""C t. Stat'" Construction Contractors Registration # {,-sse }~ ~ For Office Use Date of Application 7/;~f - Phon~ o~ 7 </tf-7f S S 7,ip '7 N 0 I Expire. 2./2. ?/of" Oat'" 7//7/07 , ' Checked for Delinquenci~~ Checked for Historical Status Shared Drive (f:)lBuilding FormslBacldlow -"_ ~_:.._ '-07.doc