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Permit Backflow Test 1998-7-31
. .. o C~: THIS PERMIT SHALL EXPIRE IF THE WORK ATTENTION:Oregon law requires you to AUTHORIZED UNDER THIS PERMIT IS NOT follow rules adopted by the Oregon Utility COMMENCED OR IS AB.al'4&~\Ie.'i!)/F@~VENTION DEVICE PERMIT I'MlHJdlIlM1~ter. Those rules are set forth , CITY OF SPRINGFIELD in OAR 952-001-001 0 through OAR 952-Q01- ANv 'P(1 1)0 I pr-Rlon BUILDING SAFETY DIVISIO~090. You may obtain copies of the rules by calling the center. (Note: the tele~ho~e mberfor~g~lln 11Q16ym~lcatl0n ~~SPE<ciM\~r Wt>J~GO-~23:V4l9 ~ 225 FIFTH STREET SPRINGFIELD OR 97477 ..' ~::-::::~:::~-~~---~~~-~~-~~:t--~~~------------------------ . ASSESSORS MAP 1I: II 03> ;;t?:. 30 TAX LOT 1I: dM)>r OVNER:~ '-:>{~~~ ADDRESS: J2510 f0/e;;fklAO II CITY: 5ori"'vld./;.~ JdI - / / Wd.y STATE: PHONE 1I: 91/. 7'Ltf 1/34'" 6J R ZIP: 97171 , BACKFLOV PERMIT IS $15.00 + $.75 (STATE SURCHARGE) + $.45 (ADMIN. FEE) = $16.20 CONTRACTOR: '~Ci>-I-f2 ADDRE~ CITY: / ~ .PHONE II: STATE: ZIP: -- ....... CONSTRUCTION CONTRACTORS REGISTRATION II: EXPIRES: BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE BACKFLOV PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION (726-3769). I ALSO STATE THAT ALL INFORMATION ON THIS PERMIT/APPLICATION IS CORRECT. ~~h~ FOR OFFICE USE -------------------------------------------------------------------------------- DATE OF APPLICATION: 7-3/- 9 '{(' RECEIPT #: n;;;oqq & ISSUED BY: TOTAL AMOUNT COLLECTED:Jh /0. {)1J \ JOB #: 97/7?sV 17, mrJfJnfldO -------------------------------------------------------------------------------- , , 16'(1,:,1 ~Y8 ~8: 3~ _..~~1~~~~. CALCULATIONS FUTURE B HOI-IEe ClI<NT fu Tu.. {LE- I ;J;, A PAGE tj'2 I:S lot u MI"_S "--::~~;:l~.'" r.. c' "":7"">_, , ' :to:.-~_ '..-;,.--"""7.....,.. . -..-:. W Il.-..I,,"~.,~_ ~r.~Yi..i;\~'" SHUT NO. 0' C.A.LClJLA TED BT DATE S'TRIJCTURAL BUILDINO OESIGN . FIRE PROTECT\ON CODE CONSUqAKT . Pt..AN CHEOCING CONSTRUCTlON IN.iPEcnON CH~Cl(~D B" DATE \I'C'_ "'.... /()5[,c;..J...,. ~n ~TiD.... LeY p,.n:)~::vF(" KIJSJ.LL~;'( Sp~I~(r FIE LG ,Of.- / It IFf-A L. O},\ 8M I:::.... Of\\' '/ ,--~~_._.._._.__. . ,~LjE."H-: '::::UT\liLF F; /'J.lIMf"<;' P Q 6:))( 74 z.s E u,:" 1::1,) E- 1 Dr:. q 740 ( ~y~"- cRJjE( - .l2f, S ( G L.\ cR- lIE- K.., A uilc 'g -1 ' E'fP eo ~o IJ,pH VJIIJO ~oNc 0, ,Q,OOF lEAL '-.oAO ~ /5AsF +- f L...1- ,)" >; 1:': K_ C;E: Sf (i tJ ELE./I c:.1 JT'S f Y 'T....," F:: C:. -. .-.-~.- --_.....,..... ........^~ TI::'I _ (~A1\ AQA_ali~n '1 , ,,-' (1':.;/ fj::;,/ 1 'J'jtJ 88:39 541744A11a FUTURE B HO/'IEe CUE.' f='t J..J::.\0L~ 2- PlJ':<.. PAGE 83 s ~s__.. ..\', ',I :""". .' ,~:', :~'" -~.. .." ~~"~i.:.tt""",l. ' ';\';"._:,7",_ ,.,. ~ .' "','l:"r! ,11_1'...,1...... ", .!,.,...~......,...\.- ,'If',.\ i.\'.\' OF SHEE'f NO CALCULATIONS DATE CA.l(.ULATED 6T' ST'AUCTURAL BUILDINe) [)ESIG~ . FIRE PAOTEcnON CODE CONSuLIAI\lT . PLAN CHECKlI'IIG CONSTRllCl10N INSPECT10'" DATE CHEC-.:f:D BT fO<t. S:l. -----. W.O.- J ATP~ L f),\ B..A- { J:;.. () F t\ !\ (J,S Eo. ?n. '~:, .L C-<L.. Vr. ... 1<".'\-)(\ )(.("7~. ~~ : 8.8 ~F . . G -::J oS P:5F , ~ ' 7. 7 'ASF' ~.>." =p , .,J.-I r~ A"'hC .....&1.5)(1, S) ~ 97 ~T" it f.DoF " J.3 (5: j ~ '/?(tL)(,S) ~ 1c.,3 \ t C PI T'c,.J.;:: F:iC_ o 4- "- 3.3, 7 21.P 8, cor,) E ::, %u N h~, Nil" IJ i' WALLS /i.:.c' /5,ooF f'1P, < 't' (<.00 F M I r'-' MEAN (<"c;CF *,., '1' , (:!t~) = 1'1. S' C:.0 M, P ((.00 F.: \/" 97('3S' S5) ~ )~3(77 '3~<" ,:,/80 2J, --0 " .3>180/ ~ /%5 til, /3.'....7..133..-<(j)~.3,x " ;',1- "c.,.01'1~H ~, 7r3~ ' I t ... 1,'1i?S jj, i- QTM.o. Ig~(9-X;~:~7{ tl~3) - ;!Sn ~q.. ~ 1,-:238 j1J p.. -- I:Sc,lSQJ.~, ",5.:>l'~\t- ::;.. () "0( ~ '; _~(; :J...,I:J.1 PM "- (:%J!ISC 15.3) '(,S.(,U.S) .,. JOd.:13)cc.SX: 9) J7 . 3.L 3~ 3.33 ..0,3;" -- (j;~}rS(3~J).1(.Sx.S) + IO( 5 <;7I'(,SX.9)] uS'uf="\" (,q01-4--"'>2~ ~ 1~J.j, 3.v7 ~ i/3J. -.;l.S78 ~ ,'OS;!.th "'f.~3 ^ 4'71 1- O...3'i ; 1..):'4 J'Y> - ') .3, ~ . IS =. ,1' .:':> -..'" /J.:J - ,,5'\l?S- 6)5 ~ ,;SOiUl 3,3.3 ,.IDLl)6vJNS ('KoL/r{Jl?[J .5~ 1:::/\ R- PAt>.}E..L. ~/1., 110 ~ %.S =- ~.S7' MI/'..J, (if) -<. 3. ~3' (SMI1LL.~SI ) pi Nk , 1"'P"'1. .c.... ...0... ,......n..... . ,/ ~5/08/1990 08: 39 541744. FUTURE B HO~'IE. P;'\GE El4 CUENT Fu Tu,...IC..E- R N-oMfO' :"._..,__. \,~ Fij ,1"", ,\ /., .~~:~:....' . li::7..,,; il,:'_.. "".' ';If iT~~::,~'.~.~.....~ " 't~i' "\f.."- 'n\I'.\'.._ CALCULATIONS SHH'f NO. ,,",, DJ. .f!, DATE OF CALCUlAT!:;:D BY STFlUCTulU.L BUIL1'::lING DESIGN. FIRE PROTECT10N cooe CONSUL'fAHT . Pl,AN CHECK1NG CONSTRUCTION INSPECTION CHECk-EO 8" DAT~ wo. It) ~'i :J LAT1'=4-A-L 0"-.) ,f)A~ Y-n ('IF N()U~F +F 1-1' PANEL.S A'(OVd0e-..a (iE-/'... 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