HomeMy WebLinkAboutPermit Plumbing 2004-10-13
-iiii:4ii
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-01270
ISSUED: 10/13/2004
APPLIED: 10/1312004
EXPIRES: 04/13/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1308 R ST APT A
ASSESSOR'S PARCEL NO.: 1703252301202
Springfield TYPE OF WORK: Apartment Building
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION: Backflow device
Owner: SHEPARD CHARLES N TE
Address: PO BOX 8516 COBURG OR 97408
5\\..:t~ · to=A '3
~
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
UMBRELLA PROPERTIES
BUILDING INFORMATION I
License
Expiration Date Phone
484-6595
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION'
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Sidewalk Type:
ATTEm"U~o(J~~~w requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
Notes: NOTICE: In OAR 952-001-0010 through.OAR 952-001-
THIS PERMIT SHALL EXPIRE IF THE WORK no~m You mav obtain copies of the rules by
AUTHORIZED UNDER THIS PERMI-:- I:; f~Qi. .. I. calling the center. (Note: the telephone
COMMENCED OR IS ABANDONED ~MaluatlOn DescrIptIOn number for the Oregon Utility Notification
ANY 180 DAY PERIOD. 'Center is 1-800-332-2344).
Description Type of Construction $ Per Sq Ft Square Footage Value Date Calculated
or multiplier or Bid Amount
Storm Sewer Available:
Special Instruction:
Total Value of Project
Page 1 of2
...
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-01270
ISSUED:- 10/13/2004
APPLIED: 10/1312004
EXPIRES: 04/13/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid'
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Backtlow Device
Minimum/Adjustment Plumbing
Amount Paid
Date Paid
Receipt Number
$4.50
$3.15
$14.00
$31.00
10/13/04
10/13/04
10/13/04
10/13/04
3200400000000000289
3200400000000000289
3200400000000000289
3200400000000000289
Total Amount Paid
$52.65
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.
I Reouired Insoections 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
ti1f:;;;;
Owner or Contractors Signature
JOhBtf'
Date f '
Page 2 of2
" .
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
lity of Springfield Official Receipt
"~velopment Services Department
Public Works Department
RECEIPT #:
3200400000000000289
Date: 10/1312004
3:18:44PM
Job/Journal Number
COM2004-01270
COM2004-01270
COM2004-01270
COM2004-01270
Description
Minimum! Adjustment Plumbing
Backflow Device
+ 7% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
31.00
14.00
3.15
4.50
$52.65
Amount Paid
Check
UMBRELLA PROPERTIES
dim
60518
In Person
Payment Total:
$52.65
$52.65
10/13/2004
Page 1 of 1