HomeMy WebLinkAboutPermit Plumbing 1998-04-15SPFlINGFIELf)
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BACKFLO1I
225 FIFTH STREET
SPRIT:GPIELD OR 97477
V{ORK
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FOR
JOB LOCATION: IS 01 '4
ASSESSORS I.iAP S:I 103 25 3'l
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ADDRESS: Z3SA O*urJ4 "(pHoNE t, L(&f-rf7 tt
CITY: &I,L€NG STATE: OreE ztpz ?7,b I
BACKFLOU PERMIT IS $15.00 + $.75 (ST.'.TB SURCHARGE) + $.45 (ADMIN. FEE) = $16.20
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ADDRESS: /S-2 rS- ( A* ,,.-t G KO PHoNE *z 689^ | <t4lf
GITY: €t-t€aue STATF,z Dt(6 ZIPz 77+o
coNSTRUcTIoN coNTRAcToRS REGISTRATIoN *, ( 76?f EXPIRES: e/?,
BY SIGNING THIS PERMIT/APPLICATION, I AGREB TO CALL FOR AN INSPECTION ONCE TTIE
BACKFLOV PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION
(726-3769). r ALSo STATE TrrAT ALL INFoRMATToN 0N THrS PERMTT/APPLICATIoN rS
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FOR OFFICE USB
DATE OF APPLICATION:
RBCBIPT II:
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ISSUED BY:
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TOTAL AHOUNT COLLECTED:-)n
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