The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2006-8-10 225 FIlTH STREET . SPRINGFIELD, OR 97477 . PH:(54 1) 726-3 753 . FAX: (541)726-3689 ~.~ /' OlN'\ -7 '"'0 b _ 0 (0 S Z. Q) City Job Number '- ~ 0." ;j" Job Location-b n LJ J t: erA \4', \ \ ~i;, Assessors Mar t 70 Z ?4,:rewr .e~ f'7"""dj ~; ~\ 7.....,...,.,.'..':,~ ~... ; t..~ 0" 'r~(1 Ed y .,,:i 'f.<0,,,,--q ~j f;'lf\......f ~i- ~\ , ~i' (jj)y 1") '\. ~4 0... ..:!i ? (j)' Q~ ~, ~1 OJ .. ,.:11 t ~+ ~. ~' ~.. ~... ",F (1); ~i ~k , ~i ? ~ f!''\ "-".-?' ~" ~,~et ~,...,. i % ~ r . ~- Loop, 5,()rl'~~;~_)rJ Tax Lot q 7c..JJ~ of> S-CO Owner 1Je-+l"f '~CL.+hhi 11\ Address ho Y I r- eff\ \4'\ \ \ Le>::-}/:J City "/Jr~ T),. .~; e j rl -, '-.J Phonf' 1'-1 / -~ ~ g (...., ~ Statf' clR ZiP--9-/47P BACKFLO\V PER1\UT IS$f,2.(;5 (includes Permit Fee, State Surcharge & Administrative Fee) , . 5J~3r Contractor lnformation \r- \N~~~_ . Contractor fJr1I~t=':7)~:< -- t'7?eJ>-40/ J ~""fi.f\~\til~~" e " Il.\01 \ct. \\ S\\~\..\.. \\\\S ~WN tGt\ t Address-/)' ') ~ rj tp ,~tJ'-L-rer ~!=.~W\-\J \.}\\\\)f%h~\)~2 f' --- 990 .~ \ \I.lG~\L\: n \\0 \S 'PI: . '." c~ . ~\) \ P 1:;'lJfp'l' \). .- City - ') IJr'^) f:'<, Ir/ ~GS~&~'tf\'f~~\G Zip 9 /'-/ '"") l' r . \.J ~':{ '\~\) , Construction Contractors Registration # LC-'T>#bb9S Expires I?U J~ '"'] \,,11 By signing this permit/application, I agree to call for an inspection once the backflow prevention devise has been installed and is visible for inspection (726-36g_Q)S\h~s0Q;tatfu~t all information on this pennit/application is correct. . (\7VSZ-ZSS-O 068)081.\\ )o\. )~q\IIB::> N f-1\1\$\ u , U8::> 81.\\ u. /l - . uoW~::>W.\o" 81.\\ ',8\ON) )8\ f--eW no}. '0600 ~ ~ 8uol.\d8101 0 S8IdO::> U\B\qO O-Z96 B"JO U\ , Signature" .,.., J CJ,,_, ""."t8L1\\. y~~./')\\110~00-~~J u<p~ate~/ o,J0~ _ ~00-Z96 'd'v'~8InJ 8501.\1 'J~1 pB s81n1 MO\\O~ I.\\~O\,~:S\ ~~~8)0 81.\\ ~?, ~~~~o :NO\lN311"J I\~\\~'I' . ~ nt'..8) I~\v\ -. l[,q...\($fflC~ 'Use ~~/ob Checked for Delinquencie~ ~ Date of Applicatior ---- Checked for Historical Status Shared Drive (T:)/Buildillg Fomls/I3ackflow Prevellliolll-03.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01032 ISSUED: 08/10/2006 APPLIED: 08/10/2006 EXPIRES: 02/10/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6041 Fernhill Lp ASSESSOR'S PARCEL NO.: 1702343406500 Springfield TYPE OF WORK: Backflow Device TYPE OF USE: New Residential PROJECT DESCRIPTION: Backflow device Owner: PETER RATHBUN Address: 6041 FERNHILL LP SPRINGFIELD OR 97478 Phone Number: 541-747-3962 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor License Expiration Date Phone MEADOW LANDSCAPE SERVICES 6695 04/30/2008 541-726-9903 I BUILDING INFORMATION , ~\)'0'f.. ,~\:. ~\)' # of Stories: !lIe~' ~ \S Height of Structure \. \:.~ ~'6l 6f.j'0 Type of Heat: ~~. S~~\: '0 ,S\} ~\t: oor: Water Type: ~~\'" '0~\\ \J~\J'? ~~"Basement: Range Type: ,~\S x>'? ~\t\:.\J \)'0 \S "'~. Ft Garage/Carport Energy Path: ~,~\j ~CJ\:.\J x>\:.~\~ Ft Other: Sprinkled BUildi~~~~~ ~ \9~ . Occupant Load: "~, (,,9.; I DEVELOPMENT INFORm;\TION I R-3 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: .. VN REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: , . Overlay Dist: ,\.' # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: i\U~'J '.).}f\U S\ ~~ ~~o: ~_(\OCO-" f" ~\\\ ~O\. nu\\\'e'). ('f"I . I PUBLIC IMPROW9Ni~~~t~O~~\U~')[-.;~'f\or-'~vO u\ o~" .~\ ~1QO -1.,-}6 '0 \\o~ \\'2.')\\\): i\ ~\\\. AO') UIS[de.w~tJ{)'Fy.8WZ')W. \ uO . o~\~ s~\1.). a "OU \~'J \) . to.,O\\O ~uo0i ~\\\ \0 X){\O~\\\ DO~D"spou~n\:.}.'<J [-.0. s?J\{\~ () ~'-QO ~{\~ ~SO\\~~\OO?~~O\\.~'3 "oO-~S s ~~'2. S~O ~\\\ [-.o.uoU~~O . - \\\~O\ \~ uOU~~ :o~~ l'J''2.\ f-"\\\\\~.r. c.3~\" Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I U\' I Valuation Description Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2:e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01032 ISSUED: 08/10/2006 APPLIED: 08/1012006 EXPIRES: 02/10/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid J Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Bacldlow Device Minimum/Adjustment Plumbing Amount Paid Date Paid $4.50 $2.25 $3.60 $14.00 $31.00 8/10/06 8/10/06 8/10/06 8/10/06 8/10/06 Receipt Number 1200600000000001246 1200600000000001246 1200600000000001246 1200600000000001246 1200600000000001246 Total Amount Paid $55.35 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., L Reouired Insoections , 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. 'Jt1~ ..e(.D~ -- ~0b Date Owner or Contractors Signature Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone C:L.., of Springfield Official Receipt 1. ,dopment Services Department Public Works Department Job/Journal Number COM2006-01032 COM2006-01032 COM2006-01032 COM2006-01032 COM2006-01032 Payments: Type of Payment Check cRecei01tl RECEIPT #: 1200600000000001246 Date: 08/1 0/2006 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Backflow Device Minimuml Adjustment Plumbing Paid By MEADOW LANDSCAPE SRVCS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 6506 In Person Payment Total: Page 1 of 1 2:59:23PM Amount Due 2.25 3.60 4.50 14.00 31.00 $55.35 Amount Paid $55.35 $55.35 8/10/2006