The URL can be used to link to this page

Home My WebLink AboutPermit Backflow Test 2008-7-16 Status Issued 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fdx 541-726-3769 InspectIOn Lme SITE ADDRESS 949 S 56TH ST ASSESSOR'S PARCEL NO 1802041108800 CITY OF :'nurliGFIELD Building/Combination Permit PERMIT NO, COM2008-01068 ISSUED: 07/16/2008 APPLIED, 07/16/2008 EXPIRES: 01/16/2009 VALUE SPRINGFIETYPE OF WORK Backllow DevIce PROJECT DESCRIPTION Bdckllow device Owner MINIUM DENNIS R Address 8745 THURSTON RD SPRINGFIELD OR 97478 Contractor Type Landscape # ofUmts Primary Occupancy Group Secondary Occupancy Group Primary ConstructIon Type Secondary ConstructIOn Type # of Bedrooms Frontyard Setback SIde 1 Setback SIde 2 Setback Rearyard Setback Solar Setbacks Street Improvements Storm Sewer Available SpecIal ImtructlOn Notes DescriptIOn Tvpe of ConstructIOn TYPE OF USE New ReSIdentIal I CONTRACTOR INFORMATION. Expiration Date 03/31/2009 Phone 541-451-4946 Contractor License SCHAEFER & SONS INC _ . ....0 v&Jlta ':rrENTI'l'''BfuL=D?N6.I'~MM'MWlYh ,.. \ 'I" , "IT' J'l ' It. follow ru \;"C~~-' r ThOse IUle. AR 952-001- rJ:.~~~~-0011~~~~~e lules by 090 '(ou may III the telephOne o ~\iing the c ~\.l\lhty Notification number for \hR~g~32-~4). C8n\81'1"" Energy Path Sprmkfed Buddmg n/a Lot SIze Sq Ft 1 st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other Occupdnt Load I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay DlSt # Street Trees Rqd Paved Drive Rqd NOT/C~:t Coverage T"JI: r~-"'ll'" ^'\"J \ -'fl"-tr --..- ..... ---- :: :."':.. ';~!1~. J ....{U..>-J.,. 1(', .1L.. i IlL... vvwnl\ ~~JlIIS PERMIT IS NOT COMMENCED OR IS ABANDOtt<mvli1Mfype ANY 180 DAY PERIOD. I Valuation DeSCrtDtlOn I $ Per Sq Ft or multIplIer Square Footage or Bid Amount Pa~e 1 of2 Total Handicapped Compact Downsponts/Drams Valne Ddte Calculdted Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-01068 ISSUED' 07/16/2008 APPLIED, 07/16/2008 EXPIRES: 01/16/2009 VALUE: 225 Fifth StI eet, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 FdX 541-726-3769 InspectIOn Lme Total Value of Ploject Fees Paid I Fee DescriptIOn + 10% Admmlstrahve Fee + 12% State Surcharge + 5% Technology Fee Backflow Device MIDlmum/Adjustment PlumblDg Amount Paid Date PaId ReceIpt Number $500 $600 $250 $1600 $34 00 7/16/08 7/16/08 7/16/08 7/16/08 7/16/08 1200800000000000785 1200800000000000785 1200800000000000785 1200800000000000785 1200800000000000785 Total Amount Paid $63 50 Plan RevIews I To Request an mspectIon call the 24 hour recordmg at 726-3769 All mspectlOns requested before 7:00 a m will be made the same workmg day, inspectIons requested after 7,00 a,m. WIll be made the followmg work day I Reo~ired Tn.,?~cho.~,~ I Backl10w Device Prior to covering and provide a copy of the test report on site at the hme of IDspectlOn By slgnatnre, 1 state and agree, that 1 have carefully exammed the completed apphcatlOn and do hereby certIfy that all mformahon hereon IS true and correct, and I further cerhfy that dny and all work performed shall be done m accordance With the Ordmances of the C.ty of SprlDgfield and the Laws of the State of Oregon pertammg to the work described herem, and that NO OCCUPANCY wIll be made of any structure Without permission 01 the CommuDlty Services DIVIsIOn, BUlldmg Sdfety 1 turther certify that only contractors and employees who are ID compliance With ORS 701 005 Will be used on thIS project I further agree to ensure that all required mspectlOns are requested at the proper time, that edch addl ess IS readable from the street, that the permit card IS located at the front of the property, and the approved set of pldns Will remalD on the site at all times dunng construction ?7~-~r -'" Ow;'-r or c~~ure Date Paee 20f2 ~: (Q) ",I'!'!!!!!l. c~ ~> 14~ ~ .~ .r--4 ~~ f?\l~ ~ <(,..- ~ _(1 4 I~ ".e~l r-~ :"4 ~ ~q <aJ)) ~ .,)~4 > ~ Q ~~ ~j (Q) ".I'!'!!!!!l~ C\ c: ~ ;;?> ~ ~j ~j ~ ~ o ~~ ~4 'r~ CQ) ~. .~ ~-\ , l r--1 : ,<,;. 'Clw'XJ;U\ < 'So ,RJj' .L\ C,g,n;E;m ~;l ,;, 'V'\, ' '~:%t .:'<,ik,: ,;,Jl','T.w~%z~_ ~u'~" '~,,:"WI\ili;';\ttJ It'\{~;"~!i~,,,.,.''"i;; ,af;;,,,,,",~-,,,,~ ~.:-"'~ "'~"'~Wr~w:, pI ~m~"':*",~, <" ~ ~ 0:" ::'l:10fi''''*y''''**=tt!LA';kxtl,tX~'1.J1'l~lt_- SPRINGFIELD' 9 ~~- 225 F1ITH STREET" SPRINGI1ELD, OR 97477 " PH (541)726-3753 . FAX (541)726-3689 r CIty Job Number L OtM( Z-,O C~- Job Locat,nn _S;~l .s: (SazOy' \ \ C>/~8 rt::: ~J. - , s/ Assessors Ma~ Tax Lot nY',f'Oo - Owner I ~/:7/7' J ~ ,./'/'i./"J /~"A .--... - (bfh P-d CIt:' g7cn~ ,l...""rc;L ~~, J-fl- /t? ZIp 9' 7'17/" Addre~< PhoT''' Statp (//1/-- d BACKFLOW PREVENTION DEVICE PERMIT FEE: $63.50 Conuacwrlnformauon Contractor // /kaj ~_/ ~.r? vfic c:.'.--;;7-( _ Address ,ji/j ~p",- k.Jk/ /J~ PhO: 5Y/---~JI-</9 v.c. CIty bk~/p~./ Or-f'/-- lo,~!ltliH\1 ZIp /~YJ) _A, N Olegv" - Ole ' !'J\f.~,n\O id0p).ejlb'jlhe Ie h/J'?/ZJ" 7-A; -09 ConstructIOn Contractors RegIStnlti8~r~PT~#r~f\ 952 t ExpIres.:{:'.p / ~ t):7 ...L.....trhf'.a\IOO -:.l\J>"ir-..M"\t~ "J-1'horme=- J " 0I\R90'i.- v-blain COpl"~ ~ telephOne rr J:.,' / / /:f I~090 '10~:eaJe~lel' tNOI~I~~~NO\ltlca\lon L'~/ ::':;jW-5oJCc"5t.r(" By SIgrung tills pemllt/apphcat'?~~~l!!'R(I\1e.~~0--3Ql!.~btIOn once the backflow preventIOn deVIce has been mstalled and IS VlSlbl~'tlir m6PJIdtl'bllt (J~~-3769) I also state that all mformatIOn on thIs permIt/applIcatIOn IS correct Slgnaturp J ^ ...-----:7 ~ /y ?~ /t: -{)f Datp ,'~f\~'4-. For Office Use 'f!<;' \~~~ \~ \\0' ~ t1-~ 'Vt.\'\('<~' - ~Oy. ~~~~~~~~ ~~;~~ ~~~~O\\t.~ V\I~ OW(,..~ (')\'\ f.- 1../ f>.~~~'t..~Ct.~ 'Y'j..\O~' ~ ~"~"'9I:l'~./ilrstoncal Statu< v~~'( ,<> ' Date of ApphcatIOn %;01" Checked for DelmquenclPO r.------ Shared Dnve (T )IBUlldmg FormsIBackflow Prevenbon 1-08 doc 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone ~~ CIty of Sprmgfield OffiCIal ReceIpt Development ServIces Department PublIc Works Department Job/Journal Number COM2008-0 1068 COM2008-0 I 068 COM2008-0 I 068 COM2008-0 I 068 COM2008-0 I 068 Payments Type of Payment Check cRecemll RECEIPT #. 1200800000000000785 Date- 07/16/2008 DescriptIOn Backflow Device MlmmumJAdJustment Plumbmg + 5% Technology Fee + 12% State Surcharge + 10% Admmlstral1ve Fee PaId By ALL SEASONS LANDSCAPE Item Totdl Check Number AuthOrizatIOn Received By Batch Number Number How Received dJb 19235 In Person Payment Total Page I of I 11 38 18AM Amount Due 1600 3400 250 600 500 $63 50 Amount Paid $63 50 $63 50 7/16/2008