HomeMy WebLinkAboutPermit Backflow Test 2006-6-5
.
. CITY OF ~rKll~'-'J< IELD -
Building/Combination Permit
PERMIT NO: COM2006-00683
ISSUED: 06/05/2006
APPLIED: 06/05/2006
EXPIRES: 12/05/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
'541- 726-3676 Fax
541-726-3769 Inspection Line
Owner:
Address:
TENHAEFF STEVEN C & ELAINE B
1612 RAMBLING DR
SPRINGFIELD OR 97477
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Springfield TYPE,OF,WORK:'Backtlow Deviceh
' - . ~r Tho~e fU:C' ;" e set IUI ~
, .' . " 'AH ". 2-001-
TYPE OF. USE:" 'NeW'l ~.l - Residential
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Cr"IGr IS 1-8~
SITE ADDRESS: 1612 RAMBLING DR
ASSESSOR'S PARCEL NO,: 1703252209200
PROJECT DESCRIPTION: Backtlow Device
I CONTRACTOR INFORMATION I
Contractor Type
Landscape
Contractor
LANDMARK IRRIGATION CORP
License
6049
Expiration Date
02128/2008
Phone
541-686-9493
# of Units:
Primary Occupancy Group:
Secoudary Occupancy Group:
Primary Constructiou Type
Secondary Construction Type:
# of Bedrooms:
BUILDING INFORMATION I r:".L ~>,,-.i IE IF THE WlJi,f\
, \'lll-1 'K i '- n UNDER THIS PH)I\~IT IS I~O I
# of Stones:.,,,, ."', 'l':tL' lJh I" Ab ,1,.~I~~~~e'=l ~lJK
Height ofStructure.l~ " v "Sq Ft ISt Floor:
Type of Heat!,'" i, 1 L'''' t'lRIOD. Sq Ft2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft GaragelCarport
Energy Path: Sq Ft Other:
Sprinkled Building: nla Occupant Load:
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description
Tvpe of CODstruction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pace 1 of2
.
. CITY VI' ~rKll~'-'J<lELD'
Status
Issued
Building/Combination Permit
PERMIT NO: COM2006-00683
ISSUED: 06/05/2006
APPLIED: 06/05/2006
EXPIRES: 12/05/2006
VALUE:
225 Fifth Street, SpriDgfield, OR
541.726.3753 PhODe
541.726.3676 Fax
541.726.3769 IDspectioD Line
Total ValDe of Project
L.Fo>o>s Pllid I
Fee Description
+ 100/0 Administrative Fee
+ 8% State Surcharge
Backtlow Device
MiscellaDeous PlumbiDg
AmouDt Paid
Date Paid
$4.50
$3.60
$14.00
$31.00
6/5/06
6/5/06
6/5/06
6/5/06
Receipt Number
2200600000000000726
2200600000000000726
2200600000000000726
2200600000000000726
Total AmouDt 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.
I~O'()~
Backtlow Device: Prior to coveriDg and provide a copy of the test report on site at the time of iDspection.
By signature, I state aDd agree, that 1 have carefully examiDed the completed application aDd do hereby certify that all
iDformatioD hereon is true and correct, aDd I fDrther certify that aDY and all work performed shall be done in accordaDce with
the OrdiDaDces of the City of SpriDgfield and the Laws of the State of Oregon pertaiDiDg to the work described herein, aDd
that NO OCCUPANCY will be made of any structure without permission of the CommuDity Services Division, BuildiDg Safety.
I further certify that oDly contractors aDd employees who are in compliance with ORS 701.005 will be used 00 this project.
I further agree to ensure that all required iDspectioDs are requested at the proper time, that each address is readable from the
street, that the permit card is located at the froDt of the property, aDd the approved set of plaDs will remain on the site at all
times during construction.
OWDer or Contractors Signature
Date
Pace 2 of2