HomeMy WebLinkAboutPermit Backflow Test 2008-11-3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01614
ISSUED: 11/03/2008
APPLIED: 11/0312008
EXPIRES: 05/03/2009
VALUE:
I
SITE ADDRESS: 130 S32nd St
ASSESSOR'S PARCEL NO.: 1702310000501
Springfield TYPE OF WORK:
PROJECT DESCRIPTION: hackflow device
TYPE OF USE:
Owner: MCGLADE & ALBERTS LLC
Address: 4055 SPRING BLVD
EUGENE OR 97405
- Contractor Type
Landscape
I CON~RA~TOR INFORMATION I
Contractor .-
GREGORY HAFFNER LAWN SERVICE
License
13026 '
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Stoi'm Sewer Available:
Special Instruction:
Notes:
I, BmL~ING INFORMATION I
ATTENTION: OrWoflSi6ries?quires you.to
I _...1.~, ': . n..r.....m) Utll1ty
foihJ\N ! t,WS aco1Hclglit!of,Structure ~
Notific"lion Cent&Type'Of'He~i:S am se, forth
. C-J "R OC2J)"1-OW.' "t'h]T-."n~ OAR 952-001-
]n .,~ ,." c',, a er ype. 'b
0090. You may o;RahgC'type~ of the ruh]es X
CaPing tile cenlE" ,^]r;P'~th'~e telep .one
, nergy a . ~] t'f' ('on
. number for the 'sp.-ilii{]e'd1i\'.lildiR ]: lea I 'nla
r.Anter is ] -tlUU-;j;);o';O;;'l'lT.
I DEVELOPMENT INFORMATION. I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Expiration Date
06/30/2009
Phone
541-935-5361
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport'
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
,
Total:
Handicapped:
Compact:
NOTICE: - .. '-r)'
THIS PER~]iUBllf:~Nt~Rp'fiM~~o~'
AUTHORIZtu u"v~' I TI.. _ .c ,
COMMENCED OR is ABANDONED FOR ,Sidewalk Type:
ANY 180 DAY PERIOD. 'DownspoutslDrains:
, .
I V alua~ion Descr~p,tion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of2
Value
Date Calculated
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone .
541-726-3676 Fax
541-726-3769Inspection Line
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Backl10w Device
Minimum/Adjustment Plumbing
Total Amount Paid
Amount Paid
$5.20
$6.24
$2.60
$17.00
$35.00
$66.04
Total Value of Project
Fe,e.s Pai~ I
Date Paid ;i
11/3/08
11/3/08
11/3/08
11/3/08
11/3/08
Plan Reviews I
CITY OF ~rK11"'-'.HI!.LD
Building/Combination Permit
PERMIT NO: COM2008-01614.
ISSUED: 11/03/2008
APPLIED: 11/03/2008
EXPIRES: 05/0312009
VA.LUE:
Receipt Number
1200800000000001105
1200800000000001105
1200800000000001105
1200800000000001105
1200800000000001105
To Request an inspection call the 24 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. '
Remjjred Insnections .
Backl10w 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 pei-taining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission ofthe Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with10RS 701.005 will be used on this project.
I further agree to ensure that all required inspections are rt;quested at the prope~"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. ,:. " . ~i'
~.-::.- --
Owner or Contractors Signature
Paee 2 of 2
il-}-o[5
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
i
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2008-0 1614
COM2008-0 1614
COM2008~0 1614
cOM2008-0 1614
cOM2008-0 1614
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
1200800000000001105
Date: 11/03/2008
Description
Backllow Device
Minimum! Adjustment Plumbing
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By .
GREG HAFFNER
Item Total:
Check Number Authorization
, Received By Batch Number Number How Received
cjc 020953. In Person
. Payment Total:
Page 1 of I
2:38:27PM
Amount Due
17.00
35.00
2.60
6.24
5.20
$66.U4
Amount Paid.
$66.04
$66.04
11/3/2008