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Home My WebLink AboutPermit Backflow Test 2009-12-22 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01825, ISSUED: 12/22/2009 APPLIED: 12/22/2009 EXPIRES: 06/22/2010 VALUE: SITE ADDRESS: 250 F ST APT 4 ASSESSOR'S PARCEL NO.: 1703352204300 Springfield TYPE OF WORK: Backl10w Device PROJECT DESCRIPTION: Replacing and moving backl10w device Owner: JMR INVESTMENTS LLC Address: 2206 IRONWOOD ST EUGENE OR 97401 TYPE OF USE: New Commercial I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor TWIN RIVERS PLUMBING INC BUlLDI~G INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Constructioo Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Ra'nge Type: Energy I'i.th: Sprinkled Building: I DEVELOPMENT INFORMATION I Front yard Setback: Side I Setback: Side 2 Setbaek: Rearyard Sethaek: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLI<;: t~PROVEMENTS I Street Improvements~~ION' oregon laW le6;'~g~n Utility .f.!m,..' 'd ted bY t\1e set tortll Storm Sewer A\aH8W'IUles a op i\1Ose rules a.re 952-001- SpeciallnstrucWtmcation cent~~10 t\1roug\1 OA~ lules bY InOAR952-001' btain copiesolt \~ hone Notes: 0090. '(ou m~~tel. (Note: "t~e ~ot~on M,\ling the ~t~!lon Utl~\~l ftumDll' ".. r \8 1-80\1"<1'''- cen\8 I Valuation Descrintion I ~ .. ' Description Tvl)e of Constrnetion $ Per Sq"Ft. . 01' multiplier Square Footage or Bid Amount Pa2e 1 01'2 . License 17695 Expiration Date 03/1112011 Phone 541-688-1444 n/a Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Oecupant Load: REQUIRED PARKING Total: Handicapped: Compaet: NOTICE: K 'TSidewalk.~1 ,ype:'HALL EXPIRE IF THE WOR .nl~l"ct'\V,I," OT Do,vnsp6iits7Dr"iii's,R THIS PERMIT IS N ,iii~i~EN(i-D OR IS ABANDONED FOR ANY 180 DAY PERIOD, Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01825 ISSUED: 12/22/2009 APPLIED: 12/2212009 EXPIRES: 06/22/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Totul Vulue of Project I ' F,eesP.~id I I Fee Description + 12% State Surchurge + 5% Technology Fee Backllow Device Minimum/Adjustment Plumbing Amount Puid Date Paid Receipt Number $6.96 $2.90 $19.00 $39.00 12/22/09 12/22/09 12/22/09 12/22/09 2200900000000001419 2200900000000001419 2200900000000001419 2200900000000001419 Totul Amount Puid $67.86 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections ~equested 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. Reouired Insnections I Buckllow Device: Prior to covering and provi4'~ a copY' of the test report on site ut the time of inspection. By signuture, 1 stute und ugree, thut I huve curefully examined the completed upplicution and do hereby certify tbat ull information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinunces of tbe City of Springfield and tbe Laws of the Stute of Oregon pertuining to the work described herein, und that NO OCCUPANCY will be mude of uny structure without permission of the Community Services Division, Building Sufety. I further certify thut only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further ugree to ensure that all required inspections ure requested ut the proper time, that each uddress is readuble from the street, thut the permit curd is locuted at the front of the property, und the upproved set of plans will remuin on the site at ull times during construction. O~~=Zut~ /2/2.-2... /0/ Date / / .. .: i~'l! 'j:.' Page 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~j.-.b.R,'N~";~,' ..,... ....,. .". .. , , . , <.. - ...... . - . City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0 1825 COM2009-0 1825 COM2009-0 1825 COM2009-0 1825 Payments: TYIJC of Payment Check cRcceintl RECEIPT #: Date: 12/22/2009 2200900000000001419 Description Backflow Device Minimum/Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge Paid By TWIN RIVERS PLUMBING Item Total: Check Number Authorization Received By Batch Number Number How Received njm 31075 In Person Payment Total: .IYj ..il ;', .'. ':, Page 1 of 1 1:10:18PM Amount Due 19,00 39.00 2.90 6,96 $67.86 Amount Paid $67.86 $67.86 12/22/2009