HomeMy WebLinkAboutPermit Plumbing 2005-1-18
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. CITY OF SJ?IUNGFIELD
Building/Combination Permit
PERMIT NO: cOM200S-00065
ISSUED: 01/18/2005
APPLIED: 01/18/2005
EXPIRES: 07/18/2005
VALUE:
..
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4197 FRANKLIN BLVD
ASSESSOR'S PARCEL NO.: 1703344300100
Eugene
TYPE OF WORK: Store
TYPE OF USE: Alteration
Commercial
PROJECT DESCRIPTION: Install backtlow.
Owner: SHELL OIL PRODUCTS US INC
Address: PO' BOX 4369
HOUSTON TX 77210
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
TWIN RIVERS PLUMBING INC
License
17695
Expiration Date
0311112005
Phone
541-688-1444
I BUILDING INFORMATION I
"'~v s ,-
# of Units: 'f.v ~ # '\ ~;PfStories: Lot Size:
Primary Occupancy Group: ;{3.~ <:(x.."<' ~'\) <;; Height of Structure Sq Ft 1st Floor:
Secondary Occupancy Group: 'v\: ,*,"0 '1;)'0"" Type of Heat: ,:,,0 :\ Sq Ft 2nd Floor:
Primary Construction Type ':0~\; ~ "\:?-"" Water Type: '" ~o \)~~ ~Sq Ft Basement:
Secondary Construc':e,n T~P~~~'\)\:S ~ Range Type: &~e; 0<::- e;"O(~JfF;t Garage/Carport
# of Bedrooms: ~\'\J :X,,~~ ~ '\)~ '\ 'fJ'\)' Energy Path: ~ \e; O\e;C$?!>e; \<;,'1: ~,g(Ft Other:
~~ ,"0 <:( ~,,\:,Yv'\) <:(x.."<' Sprinkled Buildi!!.t~ >:s-e; ~rtn/af?:" \JOc~UI)ant Load:
,0.'\ . ,('\ _,(, .j ^O ..-.1 <v () .." ..0 _<\
'~~~~\<:::, \)'- I DEVELOPMENl'W~ORM:iitON~'10'~,~e.1cr'
" ~ '\ ~\V '/>v ~J. <;) v 0"1 . 'S' ~O. REQUIRED PARKING
~~ vt<-'S' ,~:t:Je;<:< ~<;)" .~ v_,o'e.',~~-.I, r1'......
el'!-V'IJ~V!::l' ~,'I> ~ ~ '-' ~'!;
.~...o;~t$ee~'R <1;0 ^,e;\' n~O ",,:>':>
iP'~.~.C 01~ "e;" 0\" S)v
P~'(e!i'~veo :e;v e; ,~
%'ii~~tS~e~ge:\'S' i{'.>
\1 (;)<;)<1l &.-$' \,0 ~,e;
v~ ,(''Oe; (,e;
I PUBLIC IMPROVEMENTS I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback: .
Solar Setbacks:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type: .
Downspoutsffirains:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or. Bid Amount
Value
Date Calculated
Paee 1 of2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00065
ISSUED: 01/18/2005
APPLIED: 01/18/2005
EXPIRES: 07/18/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspectlon Line
Total Value of Project
Fee~, P3W
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
BackOow Device
Minimum/Adjustment Plumbing
Amount Paid
$4.50
$3.15
$14.00
$31.00
Date Paid
1118/05
1118105
1/18/05
1118/05
Receipt Number
3200500000000000022
3200500000000000022
3200500000000000022
3200500000000000022
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.
~red In'illP~tiomJ
BackOow. 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.
~6~
tjff/os
Da, I
Owner or Contractors Signature
Paee 2 of2
225 Fifth Street
,Springfield, Oregon 97477
'541-726-3759 Phone
Job/Jonraal Number
COM2005-00065
COM2005-00065
COM2005-00065
COM2005-00065
Payments:
Type of Paymeut
Check
1/18/2005
.
RECEIPT #:
~
--. -~
JIily of Springfield Official Receipt
"elopment Services Department
Public Works Department
3200500000000000022
Date: 01/18/2005
1:57:46PM
Description
Backflow Device
Minimum! Adjustment Plumbing
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
TWIN RIVERS PLUMBING,
INC,
Received By
jmp
Page 1 of I
Item Total:
Check Number Authorization
Batch Number Number
25298
Amount Due
14,00
31.00
3.15
4,50
$52.65
How Received
In Person
Amount Paid
$52.65
Payment Total:
$52.65