HomeMy WebLinkAboutPermit Plumbing 1999-03-03BACKFLOIJ PREVENTION DEVICE PERMIT APPLICATIO)I
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTH STREET
SPRINGFIE:.,D OR 97477
JOB LOCATION:
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DATE OT /.PPLICATION:
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BACKFL0U PERUIT IS 515.00 + $.75 (STATE
PHONE S:
CONSTRUCTION REGISTRATION *:
BY SIGNING THIS PERHIT/APPLICATION I AGREE TO CALL FOR AN INSPECTION ONCI] THE
BACKFLOIT' PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE ].OR INSPECTI()N
726-37 69 I ALSO STATE THAT ALL INFORHATION ON THIS PERMIT,'APPLICATION IS
rOR OFFICE USE
TSSUED BY:
TOTAL AHOUNT COLLECTED:2-D
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