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HomeMy WebLinkAboutPermit Backflow Test 2000-2-22 / ( . .. . .../ I Job# 99.{J1 054.{J1 I Page 1 of2 TRANS#:01-0000664 DATE:FE8 22 2000 AMT RECD:2 $ 26.50 CHANGE: CASHIER: 059 . CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 99-01054-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Addition: Tax Lot #: 01600 Subdivision: ~A~ 0~()-) Location Of Proposed Site: 4006 Assessors Map#: 17033442 Lot: Block: Franklin Ave Spr Owner: Address: Steve Roth 1403 Wimbledon Phone Number: 541-741-9828 City/StatelZip: Springfield, OR New Value: $0 Scope Of Work: Backflow Device Contractor Type General Contr Contractor Property Enhancement Co Po Box 41925, Eugene, OR 97404 Registration # 120562 Expiration Date 2/24/2001 Phone 541-688-7062 Quad Area: 5CNW # Of Units: Constr, Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: 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 working day. Rough Gas Rough Mechanical Gas Service Final Gas Final Mechanical Required Inspections I Mechanical I -After line is installed and capped if not attached to an appliance. - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure tes -When all gas work is complete. -When all mechanical work is complete. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ,Area (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: r . . Job# 99-01054-01 I Paid On Receipt# Transfered Records 08/04/1999 35102 # ,. Fee Plumbing Permit Total Transfered Records Minimum Mechanical Permit Mechanical Administrative Fee Mechanical Issuance State Surcharge For Mechanical Permit Total Mechanical Mechanical 02/22/2000 664 02/22/2000 664 02/22/2000 664 02/22/2000 664 Grand Total . Page 2 of 2 Value/Quantity Fee Amount I 15 $15.00 $15.00 1 $15.00 $.45 $10.00 $1.05 $26.50 $41.50 By signing this permit/application, I agree to call for an inspection once the backflow prevention device has been installed and is visible for~tion 6-3769). I also state that all information on this -? ....:..v.>' ) permit application is true and co cl. ~ ~ ...L, '~ 2- zz. SigffiitUre - Date