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Home My WebLink AboutPermit Plumbing 2007-04-12Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00539ISSUED: 0411212007APPLIED: 0411212007 EXPIRESz 1011212007 VALUE: SITE ADDRESS: 4000 E 22ND AVE ASSESSOR'S PARCEL NO.: 180303120370r PROJECT DESCRIPTION: Backflow device Eugene TYPE OF WORK: Backflow Device TYPE OF USE: New Owner: Address: Contractor Type Landscape Contractor TIM K BROWNING Expiration Date 0613012007 Commercial Phone 541-s10-4991 MIRANDA ALBERTO G 4OOO E 22ND AVE EUGENE OR 97403 License 8096 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Fronfyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of storiL${r s pE R [4 il s H A L r Ex p t *ofi?:!a{$os x ffi-.T,,flffif.:? f.lD ! r, rH, s HEf,l,uild$rhoT #i,.i rYp?lr f/r-t Ni; t Ir 0 R I S A B A N ffiiffippg4rent: Range r$H l8() ilAY pFBl0[. s-,i r-icriile/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Sidewilk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid AmountDescription Type of Construction Page I of2 Value Date Calculated LIJI\ II(ALIL'K TI\TryJ lN I Ul(lVLA r rul\ | Valuation Description I LD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00539ISSUED: 0411212007 APPLIEDz 0411212007 EXPIREST 1011212007 VALUE: Fee Description + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Backflow Device Minimum/Adj ustment Plumbing Total Amount Paid Amount Paid Total Value of Project Date Paid 4n2t07 4n2t07 4n2t07 4n2t07 4n2t07 Receipt Number 1200700000000000406 1200700000000000406 1200700000000000406 I 200700000000000406 1200700000000000406 $4.50 $2.25 $3.60 $14.00 $31.00 $55.3s Fees Pa Plan Reviews To Request an inspection call the24 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. Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. leouired Insnections 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 ersure 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. Y- (?- e+. . Ownsr or Signature Pase 2 of 2 Date 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Cif.' of Springfield Official Receipt D -- lopment Services Department Public Works Department RECEIPT #: 1200700000000000406 Date: 0411212007 2z43t24PM Job/Journal Number coM2007-00539 coM2007-00539 coM2007-00539 coM2007-00539 coM2007-00539 Description + 5olo Technology Fee + 8% State Surcharge + 70o/o Administrative Fee Backflow Device Minimum/Adjustment P lumb ing Amount Due 2.25 3.60 4.50 14.00 31.00 Item Total:$55.35 Payments: Type of Payment Paid By Received By eheck Numbei Batch Number Authorization Number How Received Amount Paid CreditCard CAFETO COFFEE CO djb 076977 In Person Payment Total: $s5.3 5 -ffi cReceint I Page I of I 411212007 jrrtraffirn$ 22SFWTHSTREET . SPRINGFIELD,OR 97477 o PH:(541)726-3753 o FAX: (541)726-3 689 Cotv\@o-7- o e=S3 1 City Job Number, &-/,b-u64 (o3 -Job Location Assessors ()3 03 L 9 olo DT-O & ,.//t /n,l-,uDx .Owner |coc E A 7.4->-4la FU io e//€S osAddress cCity \$Y BACKFLOW f,S, $ss.3s C o ntr act or Info r m ati o n Contractor // c. City .=S-?iZr,ud F/(cb* Bona - ConstructionContractorsRegistration# €'cb # 16O70A: - - r',iB.'e By signing this permit/application, I agree to call for an inspection bnce the backflow prevention device has been installed and is visible for inspecti on (726-3769). I also state that all information on this permit/application is correct. For Office Use Date of Application 67 Checked for Historical StatusChecked for Z l/l Shared Drive (T:)Auilding Forms/BacKlow Prevention8-06.doc CIry OF SPRINGFIELD, OREGON a Tax a ,,nor"fll- 3-tO'(7?/ ?zq7 x:"+b _ov a a a e,*" {- t?-Q 7 . e-/'-" gB 05561 F 40110 CommeType 22ND AIIUIES:J ---5C0net-- F erm 5 fG-r-dHoldApp Status Ef Gen'l lnfo S Names (b Permits i$socttvtisc llPayment ii:itsAPTWIn City f check Condit i,rr,S I D etails rint Type Date Status r0ncatxpiral iuC 0mp D lssu at Ciry 0f Eugene Permit lfi File Edit Vier,rr Options Iables Reports V/indnw Help ==3= Iac > { f r e@fl#gHSfin*..lffigD I AVE l- Unit Eldlt. Flaor MIRANDA ALEERTO G ,Alter/Remrdsl Fermit Type Fermit Print*d *6I]9€B tl6I?9ES 00,fi0fi0 12I?6fr8 Brtlr?8 Find P.,, iiim rilENU. PROGO,..#jRLID Application, I lr Received Owner Tenant ffi