HomeMy WebLinkAboutPermit Plumbing 2006-7-21
.
. CITY OF SPRIN\.Jl'l~LV
Building/Combination Permit
PERMIT NO: COM2006-00923
ISSUED: 07/21/2006
APPLIED: 07/21/2006
EXPIRES: 01/21/2007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Iospection Line
SITE ADDRESS: 4501 FRANKLIN BLVD SPACE I
ASSESSOR'S PARCEL NO.: 1703344400200
Eugene
TYPE OF WORK: Backllow Device
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: install backllow device
Owner:
Address:
OPAL COUNTS
82441 RIVER DR
CRESWELL OR 97426
Phone Number: 541-554-2181
Contractor Type
Plumbing
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cen " of Stones:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building,
Expiration Date
01116/2007
Phone
541-228-6305
# of Units:
Primary Occupaocy Group:
Secondary Occupaocy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basemeot:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
pia
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Froutyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
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Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paeelof2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00923
ISSUED: 07/21/2006
APPLIED: 07/21/2006
EXPIRES: 01/21/2007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Iospection Lioe
Total Value of Project
L.F....s Pai&J
Fee Description
+ 100/0 Administrative Fee
+ 8% State Surcharge
Backllow Device
Minimum/Adjustment Plumbiog
Amount Paid
Date Paid
Receipt Number
$4.50
$3.60
$14.00
$31.00
7/21106
7/21106
7/21106
7/21106
1200600000000001127
1200600000000001127
1200600000000001127
1200600000000001127
Total Amouot Paid
$53.10
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.
Backllow Device: Prior to covering and provide a copy ofthe test report on site at the time of iospection.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true aDd correct, and I further certify that aoy and all work performed shall be dooe in accordance with
the Ordinances ofthe City of Springfield and the Laws of the State of Oregon pertainiog to the work described herein, and
that NO OCCUPANCY will be made of any structnre without permission of the Community Services Division, Building Safety.
I further certify that only contractors aDd employees who are in compliaoce with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper lime, 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 duriog constru70,
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Owner or Contractors Sigoature
Date
Pal!e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-i7Z6~3759 Phone
.
Job/Journal Number
COM2006-00923
COM2006-00923
COM2006-00923
COM2006-00923
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
~
~
~_. -
<;&of Springfield Official Receipt
_Iopment Services Department
Public Works Department
1200600000000001127
Date: 07/21/2006
Description
+ 8% State Surcharge
+ 10% Administrative Fee
Backflow Device
Minimum/Adjustment Plumbing
Paid By
HOFFMAN NORTHWEST
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
332863
In Person
Payment Total:
Page 1 of I
2: 17:23PM
Amount Due
3,60
4.50
14,00
31.00
$53.10
Amount Paid
, $53,10
$53.10
7/2112006