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