HomeMy WebLinkAboutPermit Plumbing 2000-8-28
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I Job# 00-01304-01 I
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Page 1 of2
TRANS#:01-0003037
DATE:AUG 28 2000
AMT RECD:2 $ 16.50
CHANGE:
CASHIER:061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01304-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1343 Lawnridge Ave Spr
Assessors Map#: 17032522
Lot: Block: Addition:
Tax Lot #: 04800
Subdivision:
Owner:
Eileen Turner
Phone Number: 541- -
City/StateIZip: Springfield, OR 97477
New Value: $0
Address: 1343 Lawnridge Ave
Scope Of Work: Backflow Device
backflow device
Contractor Type
Landscape
Contractor
Harris Irrigation
po box 1297, Springfield, OR 97477
Registration # Expiration Date
Phone
541-746-6444
Office Use
Land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: Heat Source:
l-T- ..T" ,,~.. "..ocr; ;allv a'4ulle:, you ,.
Range: "'. _.tSq.'.!.?~~~~bnhvthaOre!!onUtilit\
'oJ:I~.. f._,__ r T)~ rules are sel 101 "
To request an inspection call the 24 hour recording at 726-3769. All inspectidAllI~'1l~~m(\lr' U hOAR952-o01
a.m. will be made the same working day. inspections requested after 7:00 a.ml Qalf6~!?iI'~\Y;P~~'t ~~s of the rules b\
working day. J090. youmayo I(N te.thetelephone
calling the C81 n~!':~r~ 1';;)1'1' I\Intifil'.ation
Required Inspections numut:' 'v. , .~ _,eo- -
C~",,,.;' . 'l"",""".?~44).
I Plumbing I" ~
-After device is installed but before backfilling:t~el)ch;
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Backflow Device
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. F", I, ------
I Main: Accessory:
Total:
Helgtrtlfllet)::
Prqp!>~ec!:UhitsSHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 1 RO DAY PERIOD.
# Of Stories:
Current Units:
Census Code: Does not apply
Fee
Paid On Receipt#
Plumbing
08/28/2000 3037
Value/Quantity
I
Fee Amount
Minimum Plumbing Permit Fee
$5.00
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Job# 00-01304-01
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Page 2 of 2
Fee
Paid On Receipt#
Plumbing
08/28/2000 3037
08/28/2000 3037
08/28/2000 3037
ValuelQuantity
Fee Amount
State Surcharge For Plumbing Permit
Backflow Prevention Device
Plumbing Administrative Fee
Total Plumbing
Grand Total
1
$1.05
$10.00
$.45
$16.50
$16.50
By signing this permit/application, I agree to call for an inspection once the backflow prevention
device has been installed and is visihle for inspection (726-3769). I also state that all information on
this~~:on~rt:=t. 3-28- OD
~~t~re 0 ( . (}l Date
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SPRINGFIELD
BACKFLOV PREVENTIO~ DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTH STREET
SPRINGFIELD OR 97477
OFFICE: 726-3759
INSPECTION LINE: 726-3769
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JOB LOCATION: l3lf-3 t-t\Wf\..l f2-IDGC
ASSESSORS MAP tl: I 70.3 25 z. '2- TAX LOT tl:
OIINER: 1'5/ L.k5'~;-.j .,-;'..... ~11..s:1L
ADDRESS: 1"2..f+~ LA1...J 10 (2.. \ 'f) 6~ PHONE tl:
CITy:~....c-:--r, ~ -t' STATE: r-....(l-
BACKFLOV PERMIT IS $15.00 +1.05 (STATE SURCHARGE) + $.45 (ADMIN. FEE) =$16.50
CYi &'00
ZIP: 17177
CONTRACTOR: 1-/.VJ.//U1/) W.fll GAT){)N
ADDRESS: PI) &'?'K. /7.t:f /
CITY: So IZ / IV ~ t='i GSl~)
V
CONSTRUCTION CONTRACTORS REGISTRATION tl:
PHONE tl: 7 rfh t, tfV4
1
STATE: () 11 ZIP: 9 7 't:J 7
0<:1 -? '=? EXPIRES: '3/"51/ ()j
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BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE
BACKFLOV PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION
(726-3769). I ALSO STATE THAT ALL INFORMATION ON THIS PERMIT/APPLICATION IS
CORRECT.
3~
~ -Z~- 00
DATE
FOR OFFICE USE
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DATE OF APPLICATION: O~/z..g-I 0 0
RECEIPT tl: '~C:>3 7 ISSUED BY:
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TOTAL AMOUNT COLLECTED: () ~
JOB 11: DO -0/30'-(-o)
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