HomeMy WebLinkAboutPermit Plumbing 1998-03-23BACKFLOII
SP]lINGFIELD
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OFFICE:
INSPECTION LINE:
225 FIFTH STREET
SPRINGPIELD OR 97477
726-3759
726-3769
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BACKPLOI.I PERMIT IS $15.00 + $.75 (STATE SURCHARGE) + $.45 (ADMIN. FEE) = $16.20
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CONSTRUCTTON CONTRACTORS REGISTRATION #:EXPIRES:
BY SIGNING THIS PERMIT/APPLICATION, I AGRBB TO CALL FOR AN INSPECTION ONCE THE
BACKFLOV PREVENTION DEVICE HAS BEBN INSTALLED AND IS VISIBLE FOR INSPECTION
(726-3769). I ALSo STATE TrrAT ALL INFoRMATIoN 0N THIS PERMIT/APPLICATIoN IS
CORRECT.
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FOR OFFICE USB
DATE OF APPLICATION:
RECEIPT {I:
TOTAL AMOUNT COLLECTED:
TSSUED BY:
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