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Home My WebLink AboutPermit Backflow Test 2005-9-21 1_6~1!I1!'I~F,1~, ~' , , . Ii ~. . Lll t' OF SPRINGFlJi,LU Building/Combination Permit PERMIT NO: COM2005-01276 ISSUED: 09/21/2005 APPLIED: 09/19/2005 EXPIRES: 03/21/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2561 NOVA ST ASSESSOR'S PARCEL NO.: 1703224405103 Springfield TYPE OF WORK: Backflow Device TYPE OF USE: New Residential PROJECT DESCRIPTION: Install backllow device Owner: Address: IDA E HODGIN TRUST 2561 NOVA ST SPRINGFIELD OR 97477 1'U, . ~"t ,. Contractor Type Landscape , CONTRACTOR INFORMATION I ",..... <' '\" ",..J Contractor ~~ . ,.' oj GRANTS LANDSCAPE SERVICE License 7216 Expiration Date 10/31/2005 Phone 541-342-1835 .." ,,' I BUILDING INFORMATION I ',. ,. '-, >...; .,). . " \.-.. ,) Primary Occupancy.Group:' " <R-3->" Secondary Occupancy Group: ' ~.. ~... Primary Construction Type ',", >VN Secondary Construction-Type:'-'" # of Bedrooms: ' "..' Frontyard Setback: Side 1 Setback: Side 2 Sethack: Rearyard Setback: Solar Setbacks: # of Stories: ~ ,0 ;:\ Lot Size: Height of Structure ",0 v-if fS" Sq Ft 1st Floor: Type of Heat: .~e" O~ e"O ",<:J'Sq Ft 2nd Floor: Water Type: ,e<i> ,eC$ ,e C; ~'l; cJsiT Ft Basement: Range Type: ,'/}~ ~e O~e" 'If -j$:' OJ ,~e (~.q>FI, Garage/Carport Energy Path: O~ '0"'.'" ,v ~ 0 .;s-e ~f'Sq:Ft Other: SprinkJed8tiiliting",0.,e ovC$ iis ,ve ~6'i:cupant Load: .. ................." __.... ",rQ'J ,....0 . ,0 I DEVELOPMEiU'iNF()IWA:rioN;'~""~~' AV v' v ~. :;:>'- " ~. ~'l; ~.. ~ \ ;,o~):)<:J 0 e" Q,O ,? n~'e'jllay)Disi1' .co.'/}"'. q,~ O,e 'O~ "" _'~' -....J ," c; " # Stre~(Tr~j'R,qd: .;s-e 'of.> P~ed'DriveRqd:,o' ",e' " "'.....J. "". r"\ f:::' % of Bot Coverage::,<O 'oJ~,. ~ REQUIRED PARKING # of Units: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsffirains: Notes: I V~llllation Descriotion I 11111111 Description Type of Construction S Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa!!e 1 of2 '. . . Ul t' OF SPRINt.J'lJi,LU: Building/Combination Permit PERMIT NO: COM2005-01276 ISSUED: 09/21/2005 APPLIED: 09/19/2005 EXPIRES: 03/21/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54 I -726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Backllow Device Minimum/Adjustment Plumbing Amount Paid $4.50 $3.15 SI4.00 S31.00 Date Paid 9/21/05 9/21/05 9/21/05 9/21105 Receipt Number 2200500000000001305 2200500000000001305 2200500000000001305 2200500000000001305 Total Amount Paid S52.65 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. Backllow 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 construc Ion. /' '7' ,;J../-O) Owner or Contractors Signature Date Paee 2 of2 " 225 Fifth S~reet , Spridgfield, Oregon 97477 : 541-726-3759 Phone Job/Journal Number COM2005-0 1276 COM2005-0 1276 COM2005-0 1276 COM2005-0 1276 Payments: Type of Payment CreditCard :' :f' :, "r 9/2112005 . RECEIPT #: ~ 2200500000000001305 Description + 7% State Surcharge + 10% Administrative Fee Backllow Device Minimum! Adjustment Plumbing Paid By JERRY D DELAPLAIN Received By jmp Check Number Batcb Number Page I of I J1Lty of Springfield Official Receipt .velopment Services Department Public Works Department Date: 09/21/2005 Item Total: Authorization Number How Received 211253 In Person Payment Total: 10:33:39AM Amount Due 3.15 4.50 14.00 31.00 S52.65 Amount Paid S52.65 552.65