HomeMy WebLinkAboutPermit Plumbing 2002-07-18SPRINGFIELD
Job# 02-00854-01
RESIDENTIAL PERMIT
Gity Of Springfietd
Community Services Division
Building Safety
Page 1 of2
Job Number: 02-00854-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00101
Subdivision:
225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2473 00014th Pt Spr
AssessorsMap#: 17032433
Lot: Block: Addition:
crTY oF sPRtNcFtELD, OREoON
Owner: Homer & Beth Payne
Address: 247314thPlace
Scope Of Work: Backflow Device
Sprinkler System
i-|i'ir';-rr f#[if Nqmbqr: s41-740-s023
n u ii bii r iE ,j,HfrffiW*ffiJfi^Hffi#ffi$ o R e7478
C0MlvlENCE84ff lS ABANDofrl[p ggptui: $o
ANY 1BO DAY PERIOD.
Contractor Type
Landscape
Gontractor Reqistration # Exoiration Date
Meadow Landscape services ooJs -tfiffis
1755 Clearwater Lane, Springfield, OR
97478
Phone
541 -726-9903
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office -Ug676gr52a0i -0010 th'ougl'i ilAF !,i52 't,'
Land Use:
Zoning Gode:
Bedrooms:
Range:
0090. You maY obtain cqp6t
calling the center. (N
Footage:
nurnberforthe Oregon
Center ir i -8lf.t-
To request an inspection call the 24 hour recording at726-3769. 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
Plumbing
Backflow Device -After device is installed but before backfilling trench.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq. Feet)
Main:Accessory:
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee 07t18t2002 9975 $31.00
I
a:
Job#
Fee Page 2 of 2
State Surcharge - plumbing
Backflow prevention Device
8% Administrative Fee - plumbing
Total Plumbing
Paid On
07t18t2002
07t18t2002
07t18t2002
Receipt#
9975
9975
9975
1
once the backflow prevention devicestate that all information on this
Date
Fee Amount
$3.1s
$14.00
$3.60
$s1.7s
$s1.7s
Grand Total
Signature
/t
-
SPFIilGFIELD
BACKFLOU PREVEMION DBVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTII STREET
SPRINGFIELD OR 97477
OFFICE:
INSPECTION LINE:
726-3759
726-3769
CITY OF SPFINGF'ELD, OREGO'U
JOB LOCATION:K
ASSESSORS MAP *:t1o1 2c+ S 3 Frc-:tn I TAX LOT *I
OIINER:
ADDRESS:fA.
crrY: SP?r-ru 6.,F-cgz \ SrArE:
DATE OF -/( -a o
RECEIPT S:ISSUED BY:
L{>
PEoNE *, )Ll6^ &ld.5
ul\:(Jregorr lavl
e Ore
Those gon Utitity
50
00;
l-l
')/
THIS IHIS in copies of the rules bote: the tel,
ADDm$6 :l PHONE
crrY: SRaz-^ e STATE: <T<zrp,9 )g 7&
CONSTRUCTION CONTRACTORS REGISTRATION T:6,62I EXPIRES:c:ol/c,:<
By SIGNING THIS PERMIT/APPLICATIoN, I AGREE T0 CALL FoR AN INSPECTIoN oNCE TttE
BACKFLOII PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION
(726-3769). I ALSo STATE THAT ALL TNFoRMATIoN 0N THIS PERMIT/APPLICATIoN IS
CORRECT.
FOR OFFICE USE
TOTAL AI{OUIT COLLECTED:,5/.a{
JOB *:0)