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HomeMy WebLinkAboutPermit Backflow Test 2000-1-26 ,~ \ . . .1 Job# 00-00113-01 Page 1 of2 TRANS#:01-0000366 DATE:JAN 26 2000 AMT RECD:1 $ 16.50 CHANGE: CASHIER: 059 ~ CITY OF SPRINGFIELD, OREGON PUBLIC PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00113-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 1010 Main St Spr Assessors Map#: 17033541 Lot: Block: Addition: Tax Lot #: 05200 Subdivision: ~ Owner: Phone Number: City/StatelZip: Addition Value: $0 Address: Scope Of Work: Backflow Device Lane Regional Air Pollution Authority Contractor Type Plumbing Contr Contractor Barnes High Tech Plumbing Inc 2787 Olympic SI Ste 27, Springfield, OR 97477 Registration # 83311 Expiration Date 2/17/00 Phone 541-726-9854 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. 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. Backflow Device Required Inspections I Plumbing I -After device is installed but before backfilling trench. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 [""Area (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# Plumbing 01/26/2000 366 Value/Quantity Fee Amount Minimum Plumbing Permit Fee $5.00 \ . I .- Job# 00-00113-01 I Paid On Receipt# Plumbing 01/26/2000 366 01/26/2000 366 01/26/2000 366 Fee State Surcharge For Plumbing Permit Backflow Prevention Device Plumbing Administrative Fee Total Plumbing Grand)O~ a~/. )~~ Signature . Page 2 of 2 Value/Quantity Fee Amount $1.05 1 $10.00 $.45 $16.50 $16.50 /~~o Dite