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Home My WebLink AboutPermit Plumbing 2007-2-20 , . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00255 ISSUED: 02/20/2007 APPLIED: 02/20/2007 EXPIRES: 08/20/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1190 S A ST APT I ASSESSOR'S PARCEL NO.: 1703354107601 Springfield TYPE OF WORK: Backllow Device Owner: Address: TYPE OF USE: New 0 PROJECT DESCRIPTION: hackllow device for irrigation . VII ,G\W ''''lUll;;'' YOUU~'Y ,\'1""11-\'11 \ IUI'LUI~9 .'h"thAOregon tl.~.. 1olloW r.u\e~~~~~;~1hose t>j,'Cie ~~1ii~0s,I1-501-0399 Noti1icat'~~.OO1_001 0 thrO~gh 0, the rules t in OA~?, _'>V nbtain cop'e.~ ~ .~I"nhone UU~V. '--... _ ':"ntAf. ,I'lUI"" ':.- Notitication I CONTRACTOR--JNF(1)RM:4.UON..tgon Utility nAA) nUlllV.," - . 1.800-332-2"...... Contractor C'lJjt~~~e ,Expiration Date MEDALLION LANDSCAPE SERVICE INC 7118 02128/2008 Commercial TUSKI BRIAN J 630 RIVER RD EUGENE OR 97404 Contractor Type Landscape Phone 541-933-2745 BUILDING INFORMATION I # of Units: Primary Occnpancy Gronp: Secondary Occnpancy Gronp: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structnre: Sq Ft 1st Floor: TYPOOii~: IFS~~P!lWlOor: watl~~eERMIT SHALL EXPIRE ;"1lq ~t l!'WB'\ent: Ran e 't!lI'iRIZEO UNDER THIS PErsYjIFtlCarage/Carport Ene a\\I: "F OR IS ABANDOm'.pFliQflher: spriMli1h\iitl\lIj~ nlOOn/a Occnpant Load: ,;,Jj\' ~,~~_ ~.v DF" . , DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Sethack: Side I Set hack: Side 2 Set hack: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion I Description Tvpe of Constrnction $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Value Date Calculated Paee I of2 . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00255 ISSUED: 02/20/2007 APPLIED: 02/20/2007 EXPIRES: 08/20/2007 VALUE: Status Issued 225 Fifth Slreel, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project F..... P.lIid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% Slale Surcharge Backtlow Device Minimum/Adjustment Plumbing Sidewalk Permit Amount Paid Date Paid Receipt Number $4.50 $2.25 $3.60 $14.00 $31.00 $80.00 2/20/07 2/20/07 2/20/07 2/20/07 2/20/07 2/28/07 1200700000000000173 1200700000000000173 1200700000000000173 1200700000000000173 1200700000000000173 2200700000000000273 Tolal Amount Paid $135.35 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. IR"llu~ Backtlow Device: Prior to covering and provide a copy of the test report on site at tbe time of inspection. Sidewalk - Curbside: After forms are erecled but prior to placement of concrele. By signature, 1 stale and agree, that 1 have carefully examined the completed application and do bereby certify that all information hereon is Irue and correct, and 1 further certify Ihat any and all work performed shall be done in accordance wilh the Ordinances of the City of Springfield and Ibe Laws of the Slate of Oregon pertaining to tbe work described herein, and that NO OCCUPANCY will be made of any struclure without permission oftbe Community Services Division, Building Safety. 1 furlber cerlify thai only conlraclors and employees who are in compliance wilh ORS 701.005 will be used on Ibis project. I furlher agree to ensure thai all required inspections are requested al the proper time, Ihat each address is readable from the slreel, Ihallhe permit card is localed allhe front of the property, and the approved set of plans will remain on the site at all times during construction. U)~ 2. /~;3 /07 Owner or Contractors Signature Date Pa~e 2 of 2 r I~" .I . . CITY OF SPRINGFIELD, OREGON SPRINGFiELD ' ~ ~~.~~ 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~ ~~ e; CilyJobNumberCO""",, 2-007- 002 ~ . ""~ l~~ ~ ~ ..~j " Ij ~ (1 Owner ~ / "70 <(,--,--1 Address b .> , (~ l l~ -<A'r-14 ~j ,~l ~l ~1 ~ f"\ 11 ~ ~ .,~ ~ Cd) ~l ~ ., e!!(. 12J ~ ~ ~ ~ ~ ~~ ~ ~ r~:l ,~~ ~) ~, . !l ~) Job Location I / '10 S Assessors Mor i 703 :SS l.( I j/ 07- Tax T nt .jJ ;. /"0-'\/ Ti-<-.f/</ (L\V~ ~cl 076C( PhOI"". rn / DJ 99' City EVCG-{--:r.{ c cd.. Statp Zip 9'7tfo It_ BACKFLOW PREVENTION DEVICE PERMIT FEE: $55.35 . Contractor Information . ..-.' - Contractor .In R P cr - ~ ~ /./ Address p 0 8~ ~ 6I! City --5/ f'Q /6> pJL.,.ca.v.. Phonp State D It.. Construction Contractors Registration # 7 II t 0erv/c-",- INC ? Y'/- 6 ~ys Zip 7' '7 Y ~? Expires -2 - .;; '1:" D f? By signing this permit/application, I agree to caU for an inspection once the backflow prevention device has been instaUed and is visible for inspection (726-3769). I also state that all information on this permit/application is correct. . Signature.7L C~~ For Office Use . Date of Application ;/i~-r L----- Datp ;/Z~7 Checked for Delinquen~: PO Checked for Historical Statuo L- Shared Drive {T:}lBuilding FonnslBackflow Prevention8-06.doc . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00255 ISSUED: 02/20/2007 APPLIED: 02/20/2007 EXPIRES: 08/20/2007 VALUE: Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1190 S A ST APT 1 ASSESSOR'S PARCEL NO.: 1703354107601 Springfield TYPE OF WORK: Backflow Device TYPE OF USE: New Commercial PROJECT DESCRIPTION: backflow device for irrigation Owner: TUSKl BRIAN J Address: 630 RIVER RD EUGENE OR 97404 Phone Numher: 541-501-0399 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor MEDALLION LANDSCAPE SERVICE INC License 7118 Expiration Date 02128/2008 Phone 541-933-2745 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: BUILDING INFORMATION I N (1 ytj ~~ies: Lot Size: r\f~i~~MZ'!fflj{fL EXPIRE IF THE wq)m<'st Floor: ll1V~QRt~liQ:UNDER THIS PERMIT 1~~P~:~e::::: C~gHlfiOO OR IS ABANDONED FOBj Ft GaragelCarport A.!H.JefllXl'flAl\l PERIOD. Sq Ft Other: '!:prinki'ed 'Building: nla Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: ~~IOf~on law mquires you tQ Handicapped: AI>Af~ rIVIil&l8led by the Oregon U\;\ ty Compact: fo~~~wfe !jlth'1Mr~hOse rules are set forti ~o~~~~~~.o:;1-001 0 through O!,R 952:~O ~ I P~ 1~'I!RO~l\'Wr:sr:~th~t~I;Ph~~~ - Call1ll\J LIIU...~..J. , Uti~~\iti~liP'n l1umb&rfol'tOO 0I'ag0fl 'l...?:U4) Center Is 1-800-33'uownspiJutslDrains: Frontyard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: , Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of2 . .CITY OF ~r1<ll~\.JFIELD Building/Combination Permit PERMIT NO: COM2007-00255 ISSUED: 02/20/2007 APPLIED: 02/20/2007 EXPIRES: 08/20/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fees tiW!.I Fee Description + 100/0 Administrative Fee + 5% Technology Fee + 8% State Surcharge Backflow Device Minimum/Adjustment Plumbing Amount Paid Date Paid $4.50 $2.25 $3.60 $14.00 $31.00 2/20/07 2/20/07 2/20/07 2/20/07 2/20/07 Receipt Number 1200700000000000173 1200700000000000173 1200700000000000173 1200700000000000173 1200700000000000173 Total Amonnt Paid $55.35 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. L..lUruired T~ . Backflow Device: Prior to covering and provide a copy ofthe 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 forther 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 Divisiou, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used ou this project. I further agree to ensure that all required inspectious 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 ~_ / - r:~. 2 _.2D-O? Owner or Contractors Signature .Date Paee 2 of2 225 Fifth Street Spf\~gfiefd, Oregon 97477 541-726-3759 Phone . .Jr~;. ~~.~ '="..~.".....' .'.'...'., . ; '.", -~, ". ~ . . -' ....,~...,- -- - "'.' -.,- Cwf Springfield Official Receipt ~opment Services Department Public Works Department Job/Journal Number COM2007-00255 COM2007-00255 COM2007-00255 COM2007-00255 COM2007-00255 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Date: 02/20/2007 1200700000000000173 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Backflow Device Minimum/Adjustment Plumbing Paid By KENNETH CORNELIUS Item Total: l.:heck Number Authorization Received By Batch Number Number How Received djb 098204 In Person Payment Total: Page 1 of 1 10:53:52AM Amount Due 2.25 3.60 4.50 14.00 31.00 $55.35 Amount Paid $55.35 $55.35 2/2012007