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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: [ftSHiER:059 225 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: $O qofl Quad Area: # Of Units: Constr. Type: Water Heater: 1 (VN) Wood Frame Land Zoning Bedrooms Range: # Of Buildings: Occupancy Group: Dwelling . -ftl \SO Heat Source: oN Sq. Footage: 1,.,1-, To request an inspection call the 24 hour recording a1726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required lnspections Plumbi Backflow Device -After device is installed but trench. "i$\*'l ,so\oQJ ^cO' 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 //,0.^, $16.50 €-/s -rc DateSignature