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Home My WebLink AboutPermit Plumbing 2006-6-13 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00728 ISSUED: 06/13/2006 APPLIED: 06/13/2006 EXPIRES: 12/13/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2246 BONNIE .LN Springfield TYPE OF WORK: Backflow Device ASSESSOR'S PARCEL NO.: 1703251209~00"...,_. I' ,;") /...... . . c.,, r;;r~'i;'a TYPE OF USE: New Residential PROJECT DESCRIPTION: Install backflo~ devic~ '.~ " ,'" .:.8 yo~! tc ~ ~ r." . - .~~: :\-- T "_;,,1. -f)r n.;' '''';~ jO{ '.1r:.'-= r-- ~ ,J':i!f.jl Owner: JAMES HERSHNER Address: 2246 BONNIE LN , SPRINGFIELD OR 97477 / . I. ..~" -~:f ;:~I-" :~j/-1,r~ ~ ;;~ ;(j!Til I ~;J"i; ., ,..,....."1_0'..,.. ,,"'-<:,::']"",. ' UI_ 'I r I,; ;'r::)' ".1 ~'. I L;r/',.,C :...., "'. ,~. ~I''''r.:C''':;C~~uy , ""')LI._:;,);..>_,~'_,' '" ~~:I/Cc;~'jo,-, Phone Number: 541-726-0364 I CONTRACliOR INFORMATION' Contractor Type Landscape Low Voltage Electrical Contractor REXIUS FOREST BY PRODUCTS INC REXIUS FOREST BY PRODUCTS INC License 7216 7216 Expiration Date 10/31/2006 10/31/2006 Phone 541-342-1835 541-342-1835 BUILDING INFORMATION I VN # 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: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 n/a THIS PER/Iii I ""-:11 , I DEVELOPMENT INFORMATION I ,~UThORiZEri Uj~';J'ER ':/'I-::;~"r: ',,'It V~''.J, :;~ F~ontyard Setback:GOivii\ljE!\jl;~J OR IS . ~,~,S 1-'~0\;e.d,ay::p,i~~j'r SIde 1 Setback: t^"1 ... ~!. ,\ \' .:JE' AuA:Yu(Jf:;I~~tJ~et,Nees Rqd: Side 2 Setback: -., ,RIOG, Paved Dnve Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: . REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pae:e 1 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00728 ISSUED: 06/13/2006 APPLIED: 06/13/2006 EXPIRES: 12/13/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Fee Description + 10% Administrative Fee + 8% State Surcharge Backflow Device Low Voltage - Residential Minimum/Adjustment Electrical Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Number $9.00 6/13/06 1200600000000000859 $7.20 6/13/06 1200600000000000859 $14.00 6/13/06 1200600000000000859 $25,00 6/13/06 1200600000000000859 $20.00 6/13/06 1200600000000000859 $31.00 6/13/06 1200600000000000859 Total Amount Paid $106.20 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..ReouiredJQsnections I Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Low Voltage: Prior to cover. Pae:e 2 of 3 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00728 ISSUED: 06/13/2006 APPLIED: 06/13/2006 EXPIRES: 12/13/2006 VALUE: 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, ~ ~/J /J C, I 3-tl6 ~~//()y-. Owner or Contractors Signature Pae:e 3 of 3 Date LD2- (all ~/ Lc.roCo NM ~ SPRINGlI"lIS ~""3 , ' . 3. ,225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELEclKlCAL PERMIT APPLICATION h. / City Job Number (lj) IIV\ Zc::::::>c::> b ~ 0 <:::) 72--8 Date i 6 1. ;);2(1 II [3fJ Ilfl.q'L LY\ LEGAL DESCRIPTION . 17032S (l.- o 7. )<JO JOB DESCRIPTION ) t'\ J,1j I ,\;.or.' 1\ IL/a,r Gn+r A! t.ar , Permits are non-transferable and expire if work is . not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor ~D/lLIu!) /J 7 r 15/t il~ Hd( ruA p' City L~ Phone Address v Supervisor License Number Expiration Date' Constr. Contr. Number 7c?<lu 10{ 3/ /t, {P I Expiration Date Owners Name ~ e--s t-le:rsh lI\ t:'< Address ,)#.ll (P 13D f\ r\ I't. t-'^ City Sf.) f' . ~ fi Ue( Phone 7:2 U' 0'3 ~ if . , OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. , ~. ~.: ~:}. :Cr"h (' \ .' " -~ " ~ 1'_ . L 200'Amps or less . ,_",.t~l. . .,.-1 S5:"-nr11J 63.00 - '" .' .1, j G ""'\,,',-.. .-; t' . C2,OE'Amp.~to 400 Amps" -::> 01 J]2 ru/;,!,~ h" $ 75.00 nL;'~;":401:An1p~.:.t~600_~m~~,:. rhe t2!ephonA J $125.00 60lfAmps ,to )(),do~J.:m~2~l!ty Notification $163.00 - . ~vv-..:J5' 23 Over 1000 AmpsNolts - 44). $375.00 Reconnect Onl):' $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 D. New Alteration or Extension Per Panel One Circuit $ 43.00 _,~ac4 :.t4_ditipI;lal pr.<;pit, or :w~!h ':j r: 1FT liE VII 0 l~ f< S~~ice 'orF~eder'Penhit ~I\, II ol_ I ,$ 3.0,0 /\ T \ PI F UNnER THIS PtlilVll1 I::J !\101 E. /'. ~I':' .~ :~':~' ~, \' ~J C Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential ' I $ 25.00 Z5 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. If) '$60 VY-o S:')'!.O 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/ElectricaI Permit Application 1-03,doc '225 frITH STREET. SPRINGFIELD, OR 97477 . PH:(541)7Z6-3753 . FAX: (541)726-3689 = o .,,~ t~ ~ ~ Assessors Mar ...~ : .. ,14 ~~ Owner '=S-AVV1 e-s ~ rt"",,14 Address ;;;;L/ II) ~ ~! ~ ~'-lj t ~ ~ ~ ....>, ~ o = o ...~ l~ 5 ~ ~ ~ ~ o ~;-t "~ ~ 7zF City Job Number tOvv\ ZOO b -00 Job Location ;J:2L/ & 1'$1)/1 n ,. I LV\. 170~2S12 () Y so 0 Tax Lot ;-/-c;-r 5: (".. t?1 ~ J?() /J /J:? Phon~ 7;2lj -0] fAl./ LVl City .\,0/'1' ,.rz~/'()jd.. -; ./ Statf' tp IL Zip q7l/77 BACKFLOW PERMIT IS ~(in~ludes Per~tJ1'~e, State_~~f?~~r~e ~i:tdministrative Fee) , .....l__ ,) 'r" 0(' 'c ' 5..1r. ,_..-"Jl- J, '~..,l.'dhC/\HSJ2-CC'j- I", )', i:",U may obtain cc:p:.ss of the rules b C"llr]-'th t (' Y <.,011. ~ 8 cen er. J':..)te:1I1e telephone number for the Oregon UWity ~~otjfication Center is 1-800-332-2344l. Contractor Information Contractor X~ , (A,~ Addre~~ / d- ") r JJA-II~ I City btA.} ~ ;; ;J r ~ ff1~ Nt' JI IW: ~ Phonp oft.. Zip 9 7~/:z- Expires /0/ 'S / I () (p State Construction Contractors Registration # 7,?itf 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 (726-3769). I also state thatall information on this permit/application is correct." .'ti I:G" . WOOl\. ~/J . \~~H~~~~6 ~~~~~ f~~R~~~~~TE\S N~l Signature.~~~nMMFI\I(~ED OR IS ABANDONEBXt~R .) l,r/ P7/ - P\~IY i SO 0 W PERIOD. For Office Use Date of Application ,;;j~b ~ Checked for Historical Status ~ Checked for Delinquencie~ l:; bft/ iO Shared Drive (T:)/Building Forms/Backflow Preventionl-03.doc 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone C" - of Springfield Official Receipt 1. ,elopment Services Department Public Works Department Job/Journal Number COM2006-00728 COM2006-00728 COM2006-00728 COM2006-00728 COM2006-00728 COM2006-00728 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200600000000000859 Date: 06/13/2006 Description Backflow Device Minimum! Adjustment Plumbing Low Voltage - Residential Minimum/Adjustment Electrical + 8% State Surcharge + 10% Administrative Fee Paid By REXIUS FOREST BY PRODUCTS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 613123 In Person Payment Total: Page I of I 2:34:03PM Amount Due 14.00 31.00 25.00 20.00 7.20 9.00 $106.20 Amount Paid $106.20 $106,20 6/1 3/2006