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Home My WebLink AboutPermit Plumbing 2007-8-27 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01269 ISSUED: 08/27/2007 APPLIED: 08/27/2007 EXPIRES: 02/27/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1228 35th ST ASSESSOR'S PARCEL NO.: 1702303409702 Springfield TYPE OF WORK: Awning TYPE OF USE: New Residential PROJECT DESCRIPTION: Backflow Device Owner: SCOTT MERRIL YN E Address: 1228 35TH ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor MEDALLION LANDSCAPE SERVICE INC License 7118 Expiration Date 02/28/2008 Phone 541-933-2745 BUILDING INFORMATION I # 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 I Frontyard 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 IMPROVEMEm:~'.ff\lIIUI\I: urego~ law requires you to .. : r~!es adoptea by the Oregon Utility ~otlflcatlorSlUl"ew.lIlk ~pee rules are set forth In OAR 952-001-001 0 tt).(oU[~.OAR 952-001- 0090. You ~91V_'M H6ffl~~bf the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Street Improvements: Storm Sewer Available: Special Instruction: Notes: Nnnr.g:. l~~H6~~ZMED'T USHAll EXPIRE IF THMtion Description I NDER THIS PERMIT S NOT Descr~nq.MMENCE.Q,.o.f!;t.MitWQaNED F~rfer ~q ~t Squa.re Footage ~1'1J'?~ 80 DAYJJERIOD. <<Yllnultlpher or BId Amount Value Date Calculated .-...#...:.~ Pae:e 1 of 2 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01269 ISSUED: 08/27/2007 APPLIED: 08/27/2007 EXPIRES: 02127/2008 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 I 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 8/27/07 8/27/07 8/27/07 8/27/07 8/27/07 3200700000000000572 3200700000000000572 3200700000000000572 3200700000000000572 3200700000000000572 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. 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 ~zcon't'~ t'~ y 7-0 ? / Owner or Contractors Signature Date Pae:e 2 of 2 Q o .~ ~ cd U .~ 1 ~ < ~ .~ S H C) rl C) U .~ > C) n Q o .~ ~ Q C) ;>- C) H r: ~ o 1 r I 1 V I U cd 01 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 , Kl' 1 -- D I =< ~ (1 City Job Numbf'r 'c.---< u v lo Job Location / 2... 2.. r .3 5' ri ..fl s/ P-f Assessors M~!, . Tax Lot Owner ?H~ry.i/YN I .:z..:z 3' :3 S It s;:; 9 ~ , S tatp D/f ~ c. D//~ fr- . Phonf' ?-<G-So;?-<. Zip ?? Y ~ '? Addres~ City BACKFLOW PREVENTION DEVICE PERMIT FEE: $61.50 Contractor Information Contractor /Yl eY ?<.-. Addres~ rD. B :::>)(' City ..5~ f~ , ~ ~-I! ~ N ~ oS c... e:>- Y -<-- .; . ,Phollf> 7 V I - b ? '1/ J . State D /( Zip /' 7 Y '2 / ? ! ;ffExpires ~ _.::? $'- CJ? 1/1 r~ ~{ (;S<7 Construction Contractors Registration # By signing this permit/application, I agree to call for an inspection once the backflow prevention device has been installed and is visible for inspection (726-3769), I also state that all information on this permit/application is correct. Signatun~ J<- ~..~ . DatI" 1 ~ -2 ? - D ;- For Office Use Date of Application ~<) '2-,., .1 ()-7 --------- ------- Checked for Historical Status Checked for Delinquencit"" Shared Drive (T:)/Building Fonns/Backflow Prevention 7.07.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-0 1269 COM2007 -01269 CO M2007 -01269 COM2007 -01269 COM2007-01269 Payments: Type of Payment CreditCard cReceint I RECEIPT #: 3200700000000000572 Date: 08/27/2007 Description Backflow Device Minimum! Adjustment Plumbing + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By KENNETH CORNELIUS Item Total: Check Number Authorization Received By Batch Number Number How Received njm 00184c 00184C In Person Payment Total: Page I of I 11 :40:56AM Amount Due 16.00 34.00 2.50 4.00 5.00 $61.50 Amount Paid $61.50 $61. 50 8/27/2007