HomeMy WebLinkAboutPermit Plumbing 2002-05-22SPRINGFIELD
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of 2
Job Number: 02-00603-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot #: 03200
Subdivision : Levi Landing
225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 6680 Simeon Ct Spr
AssessorsMap#: 17023411
Lot: Block: Addition:1st
clTY oF SPRINGFTELD, OREGON
Owner: Sam Kamkar
Address: 6680 Simeon Ct
Scope Of Work: Backflow Device
lnstall backflow device
Phone Number:
City/State/Zip:
New
541-744-7085
Springfield, OR 97478
Value: $0
Contractor Type
Landscape
Contractor
Sato Landscape
83968 Cloverdale RD, Creswell, OR
97426
Registration #
12974
Expiration Date
2t28t2003
Phone
541 -895-2955
Quad Area:
# Of Units: 1
Gonstr. Type: (VN)Wood Frame
Water Heater:
Office Use
-
Land Use:
Zoning Gode:
Bedrooms:
Range:
#OfBruildings
Occupancy Group: Dwelling
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at726-3769.
a.m. will be made the same working day, inspections requested
working day
Required lnspections
Plumbing
Backflow Device -After device is installed but before backfilling trench.
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling Accessory Structure
ng
(
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(sq.
Accessory:
# Of Stories:
Current Units:
Census Gode: New SF -
Total:s
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
Minimum Plumbing Permit Fee 0512212002 9191 $31.00
Job# 02-00603-01
fo\
)cl-
before 7:00
"SC
$'
Main:
Job# 02-00603-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
State Surcharge - Plumbing
Backflow Prevention Device
8% Administrative Fee - Plumbing
TotalPlumbing
05t22t2002
05t22t2002
05t22t2002
9191
9191
9191
1
$3.1 5
$14.00
$3.60
$s1.7s
Grand Total
By signing this permiUapplication, I agree to call for an inspection once the backflow prevention device
his bLen installed and is visible for inspection (726-3769). I also state that all information on this
permit application is true and correct.
$51.75
-f'\:z -da
Signature Date