Loading...
HomeMy WebLinkAboutPermit Plumbing 2000-9-5 .. u ., I Job# 00-01339-01 I . 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 . 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 . 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 .. ~ . ." ~. .. . elT 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 ------------------------- c:...,~/rl I'M' TAX LOT I: (I'''''<:..hvl\:h ,.,.rI Ob '700 PHONE I: /?!'C /(JPifl, -.::J.33~ ZIP: q 7l/()';)... ,., 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 <?~2rr-DO bATh ------------------------------~------------------------------------------------- DATE OF A?PLICATION: D9'05" c> D RECE:n 11: -----;(0 '-! ISSUED BY: bs;-c J . TO'rA:' AHO:JNT COLLECTED: :be JOB I: 0 0 - 0 I 53 7~~ - ;:0 ..... :z: l'T'll'T'l c.o n"4* "=" Otr.:l.. ::I> ..,..,,0' c.o "'-0..... ::t: I l-t C") t4 .0 0 ,..,,:1: Ole ;::O:D~ 10 ,,:z:o-l'.)(.oI om- o~ O"rr1Oloo ~1_OO.p..