HomeMy WebLinkAboutPermit Plumbing 1998-01-26.t
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BACKFLOU PREVENTIOI,I DEVICE PERMIT APPLICATIONCITY OF SPRINGFIELD
DUILDING SAFETY DIVTSION
225 FITTH STREET
SPRINGFIELD OR 97477 OIFICE:
INSPECTION LINE:
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726-37 59
726-37 69
JOD LOCATION:
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OUNER:
ADDRESS:
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TAX LOT II:
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STATE:
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BACI(rLOU PERMIT IS 515.00 + $.ZS ISTATE $.45 (ADl.trN. rEE) = $1.6.20
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CONTRACTOR
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CONSTRUCTION CONTRACTORS REGISTRATION I}:
BY STGNING TITIS PERMIT/APPLTCATIoN, r AGREE T0 CALL rOR AN TNSPECTTON ONCE TuE
BACI(FLOV PREVENTION DEVICE IIAS BEEN INSTALLED AND IS VISIBLE TOR INSPECTION(126-3769).STATI TIIAT ALL INTORMATION ON TIIIS PERMIT/^'&T'qU/rt1^,''
FOR OFIITCE USE
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DATE OT APPLICATION:
RECDIPT II:
TOTAL AMOUNT COLLECTBD:
JOD I}:
TSSUED DY:
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