HomeMy WebLinkAboutPermit Plumbing 2002-9-13
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Job# 02.Q11 04.Q1
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Page 1 of 2
TRANS#:01-0010604
DATE:SEP 13 2002
AMT RECD:l $ 60.00
CHANGE:$ 8.25
CASHIER:032
SPRINQFIELD
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-01104-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4622 Ivy St Spr
Assessors Map#: 18020513
Lot: Block: Addition:
Tax Lot #: 05100
Subdivision:
Owner:
Address:
Dowl Boles
4622 Ivy Street
Phone Number: 541- -
City/StatelZip: Springfield. OR 97478
New Value: $0
Scope Of Work: Backflow Device
Contractor Type
Landscape
Contractor
Grants Landscape Service
Po Box 221. Springfield, OR 97477
Registration #
10250
Expiration Date
9/30/2002
Phone
541-746,8482
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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
working day,
NOTICE:
ConstructiorH~~P,!!~RMIT SHALL EXPIRE IF THE WORK
Occupancy ~J?~,~sriIZED UNDER THIS PERMIT IS NOT
# Of Buildln~e:MMENCED OR IS ABAND~1Nerh's:
# Of Bedroo'wN 18QDAY PERIOD. Current Units:
Handicap Access? U Census Code: Does not apply
iArea (Sq. Feet)
I Main: Accessory: Total:
R . d I. .- -,... ..onn, _!:a\/\ ,;::l,nll1rA~ \fnll TI
equlre nspectlons . " , ,.,"
, follow rules adopted by the Oregon UII.i(Y
, "I Plumbing ,I Not;fication Center. Those rules are set lorb
-After deVice IS Installed but before backfilling trrr~~hAR 952-001-0010 through OAR 952-00'; -
-When all plumbing work IS complete, 0090. You may obtain co~ies of the rules b,
callina the center, (Note: the telephone
numb~ for the Oregon Utility Notification
C3i1teri~ 1-800-332-~344),
Backflow Device
Final Plumbing
Height (feet):
Proposed Units:
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Fee
Job# 02-01104-01
Paid On Receipt#
Plumbin!l
09/13/2002 10604
09/13/2002 10604
09/13/2002 10604
09/13/2002 10604
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Backflow Prevention Device
8% Administrative Fee - Plumbing
Total Plumbing
Grand Total
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Page 2 of 2
Value/Quantity Fee Amount
1
$31,00
$3,15
$14,00
$3.60
$51.75
$51.75
By signing this permit/application, 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 correc ,
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Date"
225 FIrrH STREET. SPRINGFIELD, OR 97477 . rH:(541)726-3753 . FAX: (541)726-%89
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CITY OF SPRlNGFIELD, OREGON
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Tax Lot n,-<)/ o-tJ
{Jowl /Joles
Addres. t/I?-~ 51/\/
City :5 P!Z- Jf\.&~;e I d
Phon..
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Zip
97 L/ 17
Stat..
BACKFLOW PERMIT IS $SI.7S (includes Permit Fee, State Surcharge & Administrative Fee)
Contractor Il1formatioll
Contractor {;,. e.4 AJJS' t-.<J Iv J ~A~ ~JE-V}Ce ~
Addr.... R<:J...1&,X ':J-~ I . Phon.. 7 t/ b.~tj~':d-
Cit:, <(i)(e-I~e td -, State /J e I Zip Cf7 t)( 7
Expires I () ;d ~
Construction Contractors Registration #
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By.signing this permit/application, I agree to call for an inspection once the backflowprevention
devise has been installed and is visible for inspection (726-3769). lalso state that all information on
this permit/application is correct.
Signatur"
~~~
0- ( 1/
Date
9f3/0?-
For Office Use
Date of Application
Checked for Delinquencie.
Checked for Historical Status
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