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Home My WebLink AboutPermit Plumbing 2006-9-7 . CITY OF ~rKlJ'It.."lJ!,LD Building/Combination Permit PERMIT NO: COM2006-01159 ISSUED: 09/07/2006 APPLIED: 09/07/2006 EXPIRES: 03/07/2007 VALUE: . Status 'Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 617 HAMILTON ST ASSESSOR'S PARCEL NO.: 1703341208100 Springfield TYPE OF WORK: Backllow Device PROJECT DESCRIPTION: Backllow device TYPE OF USE: New Residential REQUIRED PARKING ~ Total: ~\)<<:' ~ Handicapped:, S ~ Compact::("'<' (:::. " \)'1:- ~~ 'X:-~ << <:(~ <<'<; ~<$> vi! ,,"" ,,'0 :o..,v " ~. . c:f"?' ~<S' ~ Sidewalk Typ'C: -::;,'iif: ~ ~ <;0~' ...~~~'y~ ~ '0 ~ DownspoutslDralDs: <<'<; ~~~'"" ~\)'<"~V ~ ^' ~ ~<<; ~\) "?' \)~ ,,'0 ~;;;:. ~ Owner: MURANDI ANDlKA A Address: 617 HAMILTON ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMA T10N I Contractor Type Plumbing Contractor bicense WILLIAM WARREN KINGSLEY 11 .. ;\~e'O ~'i'~6071.>(<\ I BUILDING fNFORMAilON'I':\)\)\~ Q,v. ,\ \.' ~e;J v... '":J- eS '0 ..,n,e ,,'01 <oJ o~ <"~ 0"'" ~f)~tori~~b'Oe ,,())'<' >(<\e t,,00e R-3~<,-~'\~ cHeight.ofSt~ucture, 0\ \!e~e~ ?J.\\00 v ~e' o\.'U. f'\ \. (\\'CJ e .~\c \>0 >II ~oJ ripe of,Reat:c:,o~ .~" \,-0\\ VN\O~o. c?J.~00~ir~r'typeY ~o\~~\~\I.'\ n.~~\' ~0\\\\,,<0 <;\<:Ra~g() Type: ,,00 v ::,7:'7)' \0 or" -{et\,'e!1lyI'Patli:e~cfY'" , g\,)' -.. \,'1.' ;,i'(\'(i .3J eJl ~wSpril.'Jded ~~ilding: r:O ._,,~ ~,e # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: nla I DEVELOPMENT INFORMATION I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC I~PROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuatio,n Descriotion I DescriPtion $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Paee I of 2 Phone Number: 541-343-0119 Expiration Date 11/05/2006 Phone 541-729-5575 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: Value Date Calculated . . U 1 i' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-0II59 ISSUED: 09/07/2006 APPLIED: 09/07/2006 EXPIRES: 03/07/2007 VALUE: Status Issued .225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid 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 9/7/06 9/7/06 9/7/06 9/7/06 9/7/06 Receipt Number 1200600000000001382 1200600000000001382 1200600000000001382 1200600000000001382 1200600000000001382 Total Amount Paid $55.35 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 ~\~,~uired \nsnection~ Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. By signature, 1 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 ca ~ is loc.'<t,d at the front of the property, and the approved set of plans will remain on the site at all "..'''rior.r;'''''''' ',~\ 1/7/0& - owoo'o.il~ik" Omo ' Y .-_-r Paee 2 orz 22~ Fiftl~Street Springfield, Oregon 97477 541-726-3759 Phone . ".~ ~ <a of Springfield Official Receipt _elopment Services Department Public Works Department Job/Journal Number COM2006-01159 COM2006-0 1159 COM2006-0 1159 COM2006-0 1159 COM2006-0 1159 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Date: 09/07/2006 1200600000000001382 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Backflow Device Minimum/Adjustment Plumbing Paid By ANDlKA MURANDI Item Total: Check Number Authorization Received By Batch Number Number How Received djb 09157B In Person Payment Total: Page I of I 2:03:36PM Amount Due 2.25 3,60 4.50 14,00 31.00 $55.35 Amount Paid $55.35 $55.35 9/7/2006 . . . . j......__.._...__......n._._.....__ -~._-- .._---.~ -- ---.--.-- .A PNWS.AWWA 736929 i.g!'NEW 'tJ'EXISTING BACKFLOW ASSEMBLY TEST REPORT D REMOVED PROPERTY ./I . . . 0 REPLACEMENT OWNER: /7Ud;I::Q JJ7UPD.nd,. PHON.' ?'r?-ol)r MAILING /' 7 j ) I ADDRESS: h / /7'" 4' .h?.> 1-<::- "t.? </7/."/ STATP~V / 15 / 7 ,i/ d' '" / /.,L?J'V? . . STREET DR.P:o'A.)zi.D,C.V.A. D R.P.D.A DD,C.D.A Dp.V,B.A. DS.V.B.A. DAV.B, DAlR GAP SIZE:. L.l{).~ MAKE: ~Cl /;/{ MODEL: 00 7/-'1/ ~~~~~OR: ? // /Y ~~~~R: A ?o '6'6? ASSEMBLY /) .. LOCATION: 1\) 'U~,.. e>..t:..rYh-M.,t den r CITY ASSEMBLY ADD~Il'~~. ZIP f' /"7< ;7 7 ,. = ~...." .t'""'" r' ~....", / .,i</ REDUCED PRESSURE ASSEMBLY I P. V.B.A I S. V.B.A. "CHECK ,:DOUBLE'CHECK:[IAlR CHECK PRESS DROP CAli CHECK #1 INLET INITIAL REl.IEF VALVE (BlITlOHT ~.z f' IOPENED AT: PRESS DROP TEST OPENED AT ~ MIN Z PSIU ILEAKED 0 PSID RESULTS BUFFER A - B-1 CHECK #2 P5lD MIN 3 PSI M ITIGHT 'IY!' /7' DID NOT FAILED RELIEF VALVE r, "'" OPEN D D PASS D FAIL D ILEAKEDD INITIAL TEST PASSED,IW FAILED D DATE: '71 '5/~ P~D SYSTEM PSI COMMENTS REPAIRS AND/OR PARTS .,-' ~,. t -... - "'.. TEST 'AfTER . REPAIRS REDUCED PRESSURE ASSEMBLY I P.V.B.A.lS. V.B.A.' AFTER REPAIRS ~~::;~OP (A)li~;\;:'.'PT'.V.A..y;-"""'.;,j DATE: RELIEF I CHECK #1 -.:..... OPENED AT PRESS DROP OPENED (B) . TIGHT 0 PSlD BUFFER omrlPQD I CHECK #2 A.B" JT D _HI! IGHT PSID PSID PSID IN COMPL.El1NG AND SUBMrrnNG nns TEST R1::POltT, lliE TESTER CERTIFIES TIiAT lliE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE WTTlt ALL APPLICABLE RULES AND REGULATIONS OF' THE WATER SYSTI:M, AND &"TATE REGUl.ATIONS. GAUGE CALIBRATION DATE ;>1/"; I ( DETECTOR METER READING ..--7.,4' /. -~ ~7~;v-j/ ;.A/--4~' TESlJ'R SIG~^nJRE - U . . .' -r.- ...-- U/~-//ft!'7-,- tt./ /<; /n~"~/.,,1J{~--/L TE~;'t7r)\"'ii!' .l/~"'-2/ Eu-"; 0'" fT77/o J TEW~f?'~ ;::k~ )Pt'!(".J"rf(f/~5" COMPANY NAME I PASSED D I I !. REPORT RECEIVED BY ! 1._. ._.__._...... (REPRESENTATIVE OF' OWNER) '.-. d:~/ O?dg:}'C!;>? PHONE' 2'l'1.:S5" 75 ~ERVICE RESTORED j JOt.:_i~ WHITE. Water System Copy PINK. Cuslomer Copy YELL9W . Tester Copy I '~"''''r