HomeMy WebLinkAboutPermit Plumbing 2000-9-5
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I Job# 00-01339-01 I
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Page 1 of 2
TRANS#:01-0003104
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: 00-01339-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4277 Cole Way Spr
Assessors Map#: 18020524
Lot: Block: Addition:
Owner:
Address:
Four Seasons Construction
PO Box 50955
Scope Of Work: Backflow Device
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
# Of Buildings:
Occupancy Group: Dwelling
Heat Source:
Sq. Footage:
NUlllil::
To request an inspection call the 24 hour recording at 726-3769. All inspections.refluested Ibefo!j!,i7.;OOFTHEWORK
a.m. will be made the same working day, inspections requested after 7:06'illrir'w\i1I'ti~ ii1!i'iJ'e-'ttfe folibwing
working day. AUTHORIZED UNDER THIS PEHMIT IS NOT
R . d I t' r.nMMFNr.FonR IS ABANDONED FOR
eqUlre nspec Ions
I Plumbin!l I ANY 180 DAY PERIOD.
-After device is installed but before backfilling 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
Land Use:
Zoning Code:
Bedrooms:
Range:
ATIENTION:Oregon law requires you to
# Of Stories: foIlEhlllPlt1(fe6t)pted by the Oregon Utility
Current Units: Notif~ffi~8rd~ft;r.ljose rules are setfortt.
. ioD~952-o01-0010through OAR 952-001.
Census Code. New SF - dtll51:lrrY'ou may obtain coplas of the rules by
I calling the center. (Note: the telephone
Total: numberfortheOregon Utility Notification
:.;e:-tl':~": .,...... --t_:..~:
Value/Quantity Fee Amount
Paid On Receipt#
Plumbin!l
09/05/2000 3104
$5.00
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Job# 00-01339-01
..r "
Fee
Paid On Receipt#
PlumbinR
09/05/2000 3104
09/05/2000 3104
09/05/2000 3104
State Surcharge For Plumbing Permit
Backflow Prevention Device
Plumbing Administrative Fee
Total Plumbing
Grand Total
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Page 2 of2
Value/Quantity Fee Amount
1
1
$1.05
$10.00
$.45
$16.50
$16.50
By signing this permiVapplication, I agree to call for an inspection once the backflow prevention
device has been installed and is visible for inspection (726-3769). I also state that all information on
this permit application is true and correct.
Signature
Date
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BAOOLOV PR.l.,~\~~O!i DEVICE PERKIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAPETY DIVISION
225 F:FTR ::;TREE'!
SPRINGFIELJ OR 97477
JOB WCAUJN: L/ 2- 11 (1(',/.( ~
. ASSESSORS :iAP I: . j '7,020 5 z. '-I
01lNER: . \/, YIlt:::; H7I'rf1l" u '?t.I'.L~rJ>'l '\
ADDRESS: '? 0 R/))( 0-~1I
CITY:
F3u I, F:r? F:
STATE:
OFFICE: 726-37S9
INS<OvLAON LiNE: 726-3769
-------------------------
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TAX LOT I:
(I'''''<:..hvl\:h ,.,.rI
Ob '700
PHONE I:
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/(JPifl, -.::J.33~
ZIP: q 7l/()';)...
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BACKFLOV F3RHIT IS $15.00 + $.75 (STATE SURCIIAllGE) + $.45 (ADIlIN. FEE) .....$16.10 /~ sc
CONTRACTOF.: Sht_t? I c<'flfJ'){t<fU
ADDRESS: 93 Dl, /p r2. IffA"'[ rlrL PHONE I:
/
CITY: , 1hYlr'fwV1 t':t .j.., J STATE: 0IL
j
CONS'IRUCTION CONTRACTORS REGISTRATION I:' ~ ( q (,
.')2(/-'19';-20)7
ZIP: ~T~ J-t 1741-('1
J>Ac .....ES: 2 - / 'fj - c> r
BY SIGNINC nus PERKU/APPLICATION. 1 AGREE 'to CALL POB. AN INSPECTION ONCE 'tUE
BACKFLOV PREVENTION DEVICE BAS BEEN INSTALLED AND IS VISIBLE FOR INSu....~ON
(726-3769). I ALSO STATE THAT ALL INPORKATION ON THIS PElUIIT/APPLICATION IS
CORRECT .
r>I uYCt- J.--LA
~URE ~_.
FOR OFFICE USE
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bATh
------------------------------~-------------------------------------------------
DATE OF A?PLICATION: D9'05" c> D
RECE:n 11:
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ISSUED BY:
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