HomeMy WebLinkAboutPermit Plumbing 2000-03-30SPRINGF!ELD
Job# 00-00493-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
TRANSS:01-0001098
DATE:llflR 30 2000
Al,lT REED:1 $ IO.OO
IHANGE:$ 3.50
IASHIEft:05?
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1779 Yolanda Ave Spr
Assessors Map#: 17032434
Lot: Block: Addition:
Job Number: 00-00493-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00317
Subdivision:
ctTY oF SPRINGFfiELq OREGON
Owner: John and lrene Carlile
Address: 1779 Yolanda Ave
Scope Of Work: Backflow Device
Phone Number:
City/State/Zip:
Alteration
541 -9BB-3869
Springfield, OR97477
Value: $0
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
office use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group
Heat Source:
Sq. Footage:
To request-aninspection call the 24
a.m. will bd$GltdGESame workins
WOrKiNg dAHIS PEBIUIT SHALL EXP
hour recording a|726-3769. All inspections requested before 7:00
day, inspections requested after 7:00 a.m. will be made the following
II]E IFTHET/VORK
lnspections
COI\4MENCEDoRIS Plumbin
Backflow ES01cB0 DAy pgt+$tr. device is but before backfilling trench
Area (Sq.
Main:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
N:Orcgon resyou to
On Receipt#Value/Quantity Fee Amount
lOn 1 098
1 098
1 098
$5.00
$1.05
$10.00
Fee
03i30/2000 1
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? !
Job# 00-00493-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing Administrative Fee
Total Plumbing
03/30/2000 1098 $.45
$16.50
Grand Total
r Lnuttb 6^l,lo
$16.50
Signature Date
CITY OF SPRINGFIELD, OREGO'U
SPR16lGFIELO
BACKFLOI,I PREVEMION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTH STREET
SPRINGTTELD OR 97477
OFFICE:
INSPECTION LINE:.
726-37
726-3769
JOB LOCATION:0
ASSESSORS MAP *:TAX LOT *:
OVNER: Trh^*Irotno- Cqt"l;lt
ADDRESS: I
_i -7 1 \olo fru, -.PH0NE #: olq f, -386q
CITY:STATE: OR zw: 1 -74-7
7
BACKFL0W PERMTT rs 915.00 + i.05 (srATE suRcHARGE) + $.45 (ADMrN. FEE) =$i6.50
CONTRACAOR:
ADDRBSS:
CTTY:
CONSTRUCTION CONTRACTORS REGISTRATION #:
PHONE #:
STATE:ZIP:
EXPTRES:
BY SIGNTNG THIS PERMIT/APPLICATTON, T AGRBE TO CALL FOR AN INSPECTION ONCE THEBACKFL0V PREVENTTON DEvIcE HAS BEEN INSTALLED-er,ln rs vIsIBLE FoR rNspBcTIoN[]frf;|li', r ALSo srArE tHai arr. rNFoRHAiior,r on rurs pERuirTa-ppr.rcArroN rs
o-o
POR OFFICE USE
DATE OF APPLICATION:JoB *:
RECETPT #:ISSUED BY:
TOTAL AMOI.INT COLLECTED:
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