HomeMy WebLinkAboutPermit Plumbing 1999-02-16J
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APRI,{C :IELD
BACKFLOS PREVENTION DBVICE PERMIT APPLICATIC I
CITY OT SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTH STREET
SPRINGFIE::,D OR 97477
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IFFICE:
INSPECTIC; LINE:
726-3759
726..3769
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EXPIRE IF THE WORK
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CITY:STATB:
BACKFL0IJ PERMIT IS $fS.00 + $.75 (STATE SURCTTABGE) + $.45 (ADl :N. FEE
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FOR OFTICE USE
DATE OF /.PPLICATION:q J0 tt:
RECEIPT I.:)ISSUED BY:/)
TOTAL AHOUNT COLLECTED:
STATE:08
CONSTRUCTION CONTRACTORS REGISTRATION *, JO, &AS P B 3XPIRBS ,5.3T'13
BY SIGNING THIS PERHIT/APPLICATION, I AGRBE TO CALL FOR AN IN: :)BCTION ONCII TIIBDACKFLOU PREVENTION DEVICE HAS BEEN INSTALLED-AIIP TS VISIBLE. )R INSPECTI()N(726-3769) ' r ALso srATE TIIAT ALL rNroRuAiion- du utrs pERHrr \pplrcATroN rsCORRECT.
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