HomeMy WebLinkAboutPermit Plumbing 2001-09-13Job# 02-01103-01
RESIDENTIAL PERMIT
Gity Of Springfield
Community Services Division
Building Safety
Page 1 ot 2
SPRII\lGFIELD
*
225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 236 Smith Lp Spr
AssessorsMap#: 17023231
Lot: Bloik: Addition
Job Number: 02-011 03-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 01917
Subdivision:
ctTY oF SPRTNGFTELD, OREGOA'
Owner: Tonya Nawalanic
Address: 236 Smith Lp
Scope Of Work: Backflow Device
Gontractor Type
Landscape
4U
Number:
p:
I
541-741-8630
Springfield, OR 97478
Value: $O
/F
Contractor
Decker landscape and irrigation
PO Box 87, Alvadore, OR 97409
04 v 0q /6
6746
Phone
541-688-7991
Office Use
-
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
i17
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
before 7:00
be made the following
I J/ou
To request an inspection callthe 24
a.m. will be made the same working day,
working day.
Backflow Device
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq. Feet)
Main:Accessory:
.iti/ilr.,by
Required lns
Plumbing
-After device is installed but before backfllling trench.
# Of Stories: Height (feet):
Current Units: Proposed Units:
Gensus Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee 09t13t2002 10602 $31.00
8tv
the
Job# 02-01103-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
State Surcharge - Plumbing
Backflow Prevention Device
8% Administrative Fee - Plumbing
Total Plumbing
0911312002
o911312002
09t13t2002
1 0602
10602
10602
1
$3.1 5
$14.00
$3.60
$51.7s
Grand Total
By signing this permiUapplication, I agree to call for 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 is true and correct.
nature Date
$51.75
/3- o )-