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Home My WebLink AboutPermit Backflow Test 2006-7-21 . . CITY OF SPRIN\.Jt<lJi.LV Building/Combination Permit PERMIT NO: COM2006-00923 ISSUED: 07/21/2006 APPLIED: 07/21/2006 EXPIRES: 01/21/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4501 FRANKLIN BLVD SPACE I ASSESSOR'S PARCEL NO.: 1703344400200 Eugene TYPE OF WORK: Backllow Device TYPE OF USE: New Residential PROJECT DESCRIPTION: install backllow device Owner: Address: OPAL COUNTS 82441 RIVER DR CRESWELL OR 97426 Phone Numher: 541-554-2181 Contractor Type Plumhing \ l;~(j\,\ \@ ~_ ,,,IN teC\u l~:-A 1l1\\iW :not.t VIV"'-. ,-", tile u,vo. ~"I \61'" "'11E.~u\es ,,11l!:ONTRi\CT\OR'INFORMA:rION 1 10:\~~ lioO ceol"''' . tllloU9o V'; e (UleS, 'I Conttllcfor'l. 52-00~ -OO~ 0 collies 0\.11 IIJ::acense HOFF~NP~~h~1i!!WESi"f~~ote" '.lIe \~~~tiZH62 UU~~i\i09 111'1 'Buiii>iNGINFORMATlON I bellol.. \>UU-vV- llU!1\ tel IS 1- . cell " of Stones: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 01116/2007 Phone 541-228-6305 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION 1 REQUIRED PARKING Frontyard Sethack: Side I Setback: Side 2 Setback: Rearyard Sethack: Solar Sethacks: Total: Handicapped: Compact: 't\ \)?- 'to: ,\\'C- v.\)\ .~t- \'t A'S I PUBLIC IMPROVEMENTS 1\\'-'-'- 'C-r.~~S ?'C-W~~ 'tCl'i'- ..,,\\U- ~\\ v' co.\' .,\,:(\>{i \\v o'C-?-\l" '0v.\)ISid.,wallCType: \\\S ' It:v ?- \'0 t'V \ ~\\\Cl?-~'V'C-\) C) ~~nspoutslDrains: 1>' Cl~~'2 \)\,-'l?t: 'V ~ \'OIJ \,->{i . Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00923 ISSUED: 07/21/2006 APPLIED: 07/21/2006 EXPIRES: 01/21/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project L.F....s Pai&J Fee Description + 100/0 Administrative Fee + 8% State Surcharge Backllow Device Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Numher $4.50 $3.60 $14.00 $31.00 7/21106 7/21106 7/21106 7/21106 1200600000000001127 1200600000000001127 1200600000000001127 1200600000000001127 Total Amount Paid $53.10 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 ofthe 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 ofthe City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed 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 constru7n. ~I /-"""'7 ,/).) lOb Owner or Contractors Signature Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-i72'6~3759 Phone . Job/Journal Number COM2006-00923 COM2006-00923 COM2006-00923 COM2006-00923 Payments: Type of Payment Check cReceintl RECEIPT #: ~ ~ ~_. - <;&of Springfield Official Receipt _Iopment Services Department Public Works Department 1200600000000001127 Date: 07/21/2006 Description + 8% State Surcharge + 10% Administrative Fee Backflow Device Minimum/Adjustment Plumbing Paid By HOFFMAN NORTHWEST Item Total: Check Number Authorization Received By Batch Number Number How Received djb 332863 In Person Payment Total: Page 1 of I 2: 17:23PM Amount Due 3.60 4.50 14.00 31.00 $53.10 Amount Paid . $53.10 $53.10 7/2112006