HomeMy WebLinkAboutPermit Plumbing 2000-05-18SPRINGFIELD
Job# 00-00748-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
TRANSil:01-0001?84
DATE: I,IAY 1E 2OOO
AHT RE[D:2 $ 16.50
CHANGE:
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2411 0001sth St Spr
AssessorsMap#: 17032433
Lot: Block: Addition
Job Number: 00-00748-01
Office:726-3759
Inspection Line: 726-3769
Tax Lot#: 02100
Subdivision:
crTY oF SPRiNGFIELD, OREGON
Owner: Ann and Joe Polanuk
Address: 2411 15th St
Scope Of Work: Backflow Device
Backflow- pressure vacuum breaker '"rrrrsl,I$
Phone Number:
City/State/Zip:
Alteration
Springfield, OR97477
Value: $O
qofl
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
1
(VN) Wood Frame
Land
Zoning
Bedrooms
Range:
# Of Buildings:
Occupancy Group: Dwelling
. -ftl \SO
Heat Source:
oN Sq. Footage:
1,.,1-,
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.
Required lnspections
Plumbi
Backflow Device -After device is installed but trench.
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,so\oQJ
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Gonstruction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buitdings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:Accessory:
# Of Stories:
Gurrent Units
Gensus Code: Does not apply
Total
n?'
(feet)
Proposed Units:1
Fee Paid On Receipt# Value/Quantity Fee Amount
Plum
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Backflow Prevention Device
0511812000
0s/18/2000
0511812000
1784
1784
1784
$5.00
$1.05
$10.001
a Job# 00-00748-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing Administrative Fee
Total Plumbing
05/18/2000 1784 $.45
$16.50
Grand Total
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$16.50
€-/s -rc
DateSignature