HomeMy WebLinkAboutPermit Plumbing 2000-09-28SPRINGFIELD
Job# 00-01464-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
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At'iT RE[il:L $ Iil.00
IHANEE:$ ].50
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 3301 Parker Dr Spr
AssessorsMap#: 17021943
Lot: Block: Addition:
Job Number: 00-01464-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 01800
Subdivision : Ambleside
ctTY oF sPRtNcFtELD, OREGOTV
Owner: Jeff Sindt
Address: 1190 Dondea Street
Scope Of Work: Backflow Device
backflow device
Phone Number:
City/State/Zip:
New
541-744-2681
Springfield, OR 97478
Value: $O
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
1
(VN) Wood Frame
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group: Dwelling
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording a1726-3769. 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.
Backflow Device -After device is in
Construction Types(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings:
# Of Bedrooms:
Handicap Access?
#
Proposed Units:1
(sq
Main Accessory:Total:
Current Units:
Census Code: New SF - detached
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Backfl ow Prevention Device
0912812000
0912812000
0912812000
Plumbin
3325 $5.003325 $1.053325 1 $10.00
Job# 00-01464-01 Page2 ot2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing Administrative Fee
Total Plumbing
09128t2000 3325 $.45
$16.50
Grand Tota!
By signing this permiUapplication, I agree to callfor 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.
$16.50
?2s=t-
Date