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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