HomeMy WebLinkAboutPermit Backflow Test 2007-9-7
I CONTRACTOR INFORMATION.
License
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SCANNED
SITE ADDRESS: 3909 S REDWOOD DR
ASSESSOR'S PARCEL NO.: 1802061109900
Springfield
PROJECT DESCRIPTION: Backnow
Owner: MANZER ELLEN L
Address: 3909 S REDWOOD DR
SPRINGFIELD OR 97478
Contractor Type
Plumbing .
Contractor
PROGRASS
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Patb:
Sprinkled Building:
_ITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-01366
ISSUED: 09/07/2007
APPLIED: 09/07/2007
EXPIRES: 03/07/2008
VALUE:
TYPE OF WORK: Backnow Device
TYPE OF USE: New
Residential
Expiration Date Phone
503-682-6076
nla
Lot Size:
Sq Ft 1st Floor:
SqFt 2nd Floor:
Sq Ft Basemeut:
Sq Ft GaragelCarport
Sq Ft Other:
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:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
NOTICE:
THIS PERMIT SHAll EXPIRE IF THE WORK
lIU I HUHILtU UI~utl'l I n~: ,..,..,........ ... ......
COMMENCED OR IS AB~fIrollIllaiIoiil/il.)escriDtion I
ANY 180 DAY PERIOD.
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Type of Construction
Pa~e 1 of2
REQUIRED PARKING
Total:
Handicapped:
Compact:
ATTENTION: Oregon law requires you.t.o
follow rules adopte.:'1 b~ !~e.,~~:~~~~~~~l'
f~Ollll~""U" Vv"W" ."-- - OAR 952-001-
in OAR 952-001-0010 through
Osi1i~w)(ft(J'N~~.obtain copies of the rules bV
calling the ~e'nter. (Note: the tel~~ho~e
R8lfl!AA"ll1~~0l1il~gon Utility NotlllcaUon
Center is 1-800-332-2344).
!
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54 I -726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Backl10w Device
Minimum/Adjustment Plumhing
Total Amount Paid
.
Total Value of Project
F..... P~irll
Amount Paid
Date Paid
-=ITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01366
ISSUED: 09/07/2007
APPLIED: 09/07/2007
EXPIRES: 03/07/2008
VALUE:
Receipt Number
1200700000000001173
1200700000000001173
1200700000000001173
1200700000000001173
1200700000000001173
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
work day.
$5.00
$2.50
$4.00
$16.00
$34.00
9/7/07
9/7/07
9/7/07
9/7/07
9/7/07
Backl10w Device: Prior to covering and provide a copy of the test report on site at the time of inspection.
$61.50
I Plan Reviews ,
IR..nllj~
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 he done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certi'fy that only contractors and employees who are in compliance with ORS 701.005 will he used 00 this project. I
further agree to ensure that all required inspections are requested at the proper time, that each address is readahle from the
street, that the permit card is located at the front of the property, and the approved set of plaos will remain on the site at all
times during cons ructioD.
~ (J, .
--)
Paee 2 of2
0<1/ri"7!fJ7
I
Date
225 Fi(tb Street
Springfield, Oregon 97477
541-726-3759 Pbone
Job/Journal Number
COM2007-0 1366
COM2007-01366
COM2007-0 1366
COM2007-01366
COM2007-0 1366
Payments:
Type of Payment
CreditCard
cReceinl1
RECEIPT #:
. ~~~.~~ '.:.
wr.
.- ~
., ..,.... -' .:
Cia Springfield Official Receipt
D.opment Services Department
Public Works Department
1200700000000001173
Date: 09/07/2007
Description
Backflow Device
Minimum/Adjustment Plumbing
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
LONNY R. COKE LEY
Item Total:
<"::heck Number Authorization
Received By Batch Number Number How Received
njm 067638 In Person
Payment Total:
Page I of 1
2:56:26PM
Amount Due
16.00
34.00
2.50
4.00
5.00
$61.50
Amount Paid
$61.50
$61.50
9/7/2007