HomeMy WebLinkAboutPermit Plumbing 2005-3-21
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Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00319
ISSUED: 03/21/2005
APPLIED: 03/21/2005
EXPIRES: 09/21/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541.:.726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 425 BLACKSTONE ST
ASSESSOR'S PARCEL NO.: 1703233408900
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Backflow Device
Owner: LAFLEUR DAVID & KAREN
Address: 425 BLACKSTONE ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Landscape
Contractor License
DECKER LANDSCAPE AND IRRIGATION 6746
BUILDING INFORMATION.
Expiration Date
09/30/2005
Phone
541-688- 7991
# 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 Ist Floor:
Sq F( 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved D~tre Rqd:
% of.LoC~~iverage:
, '0'" 'i ,\\\\\ ' ~'v\
,0-\\ ~v vj~- Il'n
",;,,0; ",0 ,..,\ ~-. HI TIPe.
.,~\. "...v-'..... J \ II"'"' -" _.
(.\)\ ' \1~P.VP~I.{:;,LN'tJ?8.0Y~~ENTS I T HIS PER M ITS
,,\e0"OJ \V or' \V. e AUT .~,.. HALL EXPIRE I
Street Improvements: ':\~~/ R\'60 oc:P ~'(\ ~ ~,"\e ~o'0 \\ '~ld.e,l,VMItJ1[r~mE F THE WORK
~-'\\u ~p ~\~ ,\0'J. 0 ,:\e"V 'f,-,o COMA!I:: L V R THIS PERMI
Storm Sewer Available::\,\~\ . ~'O '0- ~\e'{' \0 ~ 09\e'O "S:-e \e "i-..\\\c,'O- Do~,H.SpQjIg.wf.ai~~A T IS NOT
Special Instruction: ~ ~o~ '(~ ~ 0'6('\.\,00 i\'" G. 0\0': ':\''! ~o bt\. ANY 180 DAY PERIOu NDONED FOR
\0'\ . r?>-\\o"f"f0V 0'O'\; ~ \')\~\ ("lr:,,~' D.
"'\~\V 0"'>'" "I.'! .e"" ~ 0-(,'
Notes: 'N-O'" ~ J ~CJ" :(\'" ~O Il,n,(.
'. o~ --{0'0 eC,e 0'<.0o..<::{Y"
\{\_f'\. ... ~ .V\e .... .'
<)\)J c,~\\' '~'( \0\ - ~I'~ ''''' I
<;:o.~~'O (/0'0 Valuation Description
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
Description
Type of Construction
Value
Date Calculated
Pal!:e 1 of2
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Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00319
ISSUED: 03/21/2005
APPLIED: 03/21/2005
EXPIRES: 09/21/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
LFees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Backflow Device
Minimum/ Adj ustment Plumbing
Amount Paid
Date Paid
$4.50
$3.15
$14.00
$31.00,
3/21/05
3/21/05
3/21/05
3/21/05
Receipt Number
1200500000000000353
1200500000000000353
1200500000000000353
1200500000000000353
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 Insnections 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
times during construction.
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Owner or Contractors Signature
Date
Pae:e 2 of2
225 Fifth Street
Sptingfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00319
COM2005-00319
COM2005-00319
COM2005-00319
Payments:
Type of Payment
Check
3/21/2005
RECEIPT #:
Description
Backflow Device
Minimum! Adjustment Plumbing
+ 7% State Surcharge
+ 10% Administrati ve Fee
Paid By
DECKER LANDSCAPE AND
IRRIGATION
C'ity of Springfield Official Receipt
velopment Services Department
Public Works Department
1200500000000000353
Date: 03/21/2005
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dIm
6338
In Person
Payment Total:
Page 1 of I
1:13:36PM
Amount Due
14.00
31.00
3.15
4.50
$52.65
Amount Paid
$52,65
$52.65