HomeMy WebLinkAboutPermit Backflow Test 2000-3-30
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I Job# 00-00487-01 I
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CITY OF SPRINGFIELD~ OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00487-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
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location Of Proposed Site: 1294
Assessors Map#: 17032344
Lot: Block:
Delrose Dr
Spr
Addition:
Tax lot#: 09100
Subdivision:
Owner:
Address:
Lester Kunkel
1294 Delrose Drive
Phone Number: 746-401-9
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
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Scope Of Work: Backflow Device
Ill....; '; , 1\","'\I.Ult:~YUfJ laW requires you l
Office Use -"Il~"i rules adopted by the Oregon Utili~y
. 'Iotlflcallon Center, T.h..c . I '
Quad Area: lan~ Use. I OAR 952-001-001 ~~f8U1 lIlhlfStsetfort,
# Of Units: Zonmg Code: J090, You may Obta~~g~~i~01'
Constr. Type: Bedrooms: calling the center ~r. ~~ 1!?e rules b)
Water Heater: Range: 'lumber tOrthe Ore' "10 e ,\et'fPho~e
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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
iArea (Sq. Feet)
I Main: Accessory:
Required Inspections
-After device is i~stal;e~ ~~ub:;~~gba~k~~Trmm:
THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 OA Y P.FR10D
Height (feet): '
Proposed Units:
# Of Stories:
Current Units:
Census Code: Does not apply
Backflow Device
Total:
Fee
Paid On Receipt#
Plumbinn
03/30/2000 1086
03/30/2000 1086
03/30/2000 1086
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Backflow Prevention Device
1
$5,00
$1,05
$10,00
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Fee
Plumbing Administrative Fee
Total Plumbing
Grand Total
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Job# 00-00487-01
Paid On Receipt#
Plumbinn
03/30/2000 1086
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Page 2 of 2
Value/Quantity Fee Amount
I
$.45
$16.50
$16.50
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Date