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HomeMy WebLinkAboutPermit Backflow Test 2001-3-21 I ( \. . I Job# 01-00276-01 I e::. Page 1 of2 TRANS#:01-0004733 DATE:MAR 21 2001 AMT RECD:2 $ 33.00 CHANGE: CASHIER: 003 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00276-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 783 Old Orchard Dr Spr Assessors Map#: 17032343 Lot: Block: Addition: Tax Lot #: 02102 Subdivision: Owner: FUTURE B HOMES PO BOX 7425 Phone Number: 541-744-2660 City/State/Zip: eUGENE, OR 97401 New Value: $0 Address: Scope Of Work: Backflow Device Contractor Type Landscape Contractor Hunter Irrigation and Landscape 25226 Strawberry Lane, Veneta, OR 97487 Registration # Expiration Date Phone 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. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ,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 03/21/2001 03/21/2001 03/21/2001 03/21/2001 Value/Quantity Fee Amount Minimum Plumbing Permit Fee State Surcharge - Plumbing Backflow Prevention Device Administrative Fee - Plumbing Total Plumbing Grand Total 1 $5.00 $1.05 $10.00 $.45 $16.50 $16.50 ~ > > " L I Job# 01-00276-01 I . Page 2 of 2 By signing this permiVapplication, I agree to call for an inspection once the backflow prevention device has been installed and is visible for inspection (726-3769). I also state that all information on thisper . ;~i?;;cect. S' !uiture . s~,;U~p/ Date