HomeMy WebLinkAboutPermit Plumbing 2000-9-5
v
'"
.
~~
Job# 00-01340-01
.
Page 1 of 2
TRANS#:01-0003116
DATE:SEP 05 2000
AHT RECD:2 $ 16.50
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01340-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4265 Cole Way Spr
Assessors Map#: 18020524
Lot: Block: Addition:
Owner:
Address:
Four Seasons Construction
PO Box 50955
Scope Of Work: Plumbing
backflow device
Contractor Type
Landscape
Tax Lot #: 06900
Subdivision: Redwood Village
Phone Number: 541-607-1798
City/State/Zip: Eugene, OR
New
Value: $0
Contractor Registration # Expiration Date
Star Landscape
93066 River Rd, Junction City, OR 97448
Phone
541-998-2039
Land Use: # Of Buildings:
Zoning Code: Occupancy Group: Dwelling
Bedrooms: Heat Source:
Range: Sq. Footage:
......"-r",,..c.
n..... ."--- THEWOHI\
To request an inspection call the 24 hour recording at 726-3769. All in,llP',I[QtloiiS\req'U~llk'd1f,~fd~fi19ft'T\SNOT
a.m. will be made the same working day, inspections requested after 7:l(H.f!t{l\.'l~i!!t!?~f!(a'Qe;ttie\ro'ii5wi~9
working day. A CEO OR IS ABANDONED FOR
COMMEN
Required Inspections ANY 180 UI-\l rc':';;::.
I Plumbing I
-After device is installed but beforeiiackfilling trench.
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
1
(VN) Wood Frame
Backflow Device
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
Minimum Plumbing Permit Fee
Office Use
. e -'01\1 vfegOIt taw requireS yo~ ~c
. Accessory Strulct&&~ ';;;Ies adopted by the Oregon ~~~~l
# Of Stones: !~fftll..~H~~;ter. Those rules :~:52"()01'
Current Units: " ~f.91?9~l!dlO~'~thro~2~~ the rules b~
Census Code: New SF - detas:!J!lI:!. You may obta\ll~ofe:thetelephone
I calling the cenotereg. o~ Utlllty Notification
T I. mber for the r 344)
ota . nu. . "nn ~"?-2 .
""'ontpr 1~ .'" ... ~"\-
Paid On Receipt#
Plumbin!l
09/05/2000 3116
Value/Quantity
Fee Amount
$5.00
:;..
..
.
Job# 00-01340-01
.
Page 2 of2
Value/Quantity Fee Amount
Fee
Paid On Recelpt#
Plumbing
09/05/2000 3116
09/05/2000 3116
09/05/2000 3116
1
$1.05
$10.00
$.45
$16.50
$16.50
State Surcharge For Plumbing Permit
Backflow Prevention Device
Plumbing Administrative Fee
Total Plumbing
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein is true and correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project I further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the street.
Signature
Date
r .,'lO..r
.
.
~/T
BACKFLOV PP..<.,&....ON DEVICE PBRHIT Al'l'LICI\TION
CITY OF SPRINGFIELD
Bup.DING SAPETYDIVISION' '. ,
.... "'.~
.... ,. "
, .
:. '- ,.
225 r:F'IR ~nu!.E'!
SPBINGFIELJ OR 97477
-----------------~~~--------- ----------
JOB LOCAU)N:~:l.~1) (1" 1",-. Wtlt ,,\2E1d.,..-.L2R
. ASSESSORS ~iAP I: 1'30Z-05Z'-{ TAX LOT I:
'O\INER:.Jb~ U ~a.<;'r.'" ~ ('nVl<:.-h...lJ'-h.'J:Y'
ADDRESS: Ij) () fl."" ~f}I, /I PHONE I:
OFFICE: 726-3759
INSPECTION LINE: 726-3769
,;,
cb 9' o-c:::,
IA3g--;)..33 ...,
CITY: r:;;" /, Pn~ STATE: rJe... ZIP: CZ 7.t.{lJ;)...
BACKFi.OV BRKIT IS $15.00 + $.75 (STATE SURCHARGE) + $.45 (ADKIN. FEE) ......$l6.10 ~~ SC
CONTRACTOR: .<:In iR ..lo..l"Oi SraJ).( .
- .
ADDREss:33{)&I" t!-Ild eJ .
CITY: ,1]11'Y':PJl41 fi1:j
CONS'IRUCTION CONTRAClORS REGISTRATION I:
'j , ,~
" -r
PHONE. I:
11B-:kJ_~~
STATE: 0r'L-
(f) 1.3 0
ZIP:::C"..3l J i en 'fLf){
EXPIRES: Z -2 3^ -0 /
BY SIGNING 'tHIS PERKn/APPLlCA'nON, I AGl\F.E TO CALL POR AN INSPEC'lION ONCE THE
BACKFLOV PREVENTION DEVICE BAS BEEN INSTALLED AND IS VISIBLE FOR INSt _~...ON
(726-3769). I ALSO STATE THAT ALL INPORIlATION ON THIS PElUIIT/APPLICATION IS
CORRECT .
~. ~ ~~t....
~URE - .
~'-2? ~ c!l 0
OATE
....,. ,"..
FOR OFFICE USE
. .- '.
______________________________~-----------------------------~~~~~~:----=:-~~-7.--
RECB:P'r i1:
~)! I b
ISSUED BY:
Ib~
])r(
D
JOB I: (")O-OI3l(O~~~
::0 -<:z:
rn rn en
n.. **
..., oen..
.J.) .. mo
en 1'.)"'lJ1-'
:I: I
.....LJ.,.oo
m::::I:: 010
:::o:o~ 0
"ZO>I'.)(..I
- ocn. 0.......
0-. m U'I 0 ........
.........000-.
DATE OF A;>PLlCATION: 09 C> ~ o'D
TOTA:' AKO:JNT COLLECTED: