HomeMy WebLinkAboutPermit Backflow Test 2001-3-21
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I Job# 01-00276-01 I
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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
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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
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Date