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HomeMy WebLinkAboutPermit Plumbing 2001-11-9 Job# 01-01243-01 Page 1 of 2 TRANS#=01-0007223 DATE:NO'J 09 2001 AMT RECD:l $ 60.00 CHANGE:$ 8.25 CASHIER:003 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-01243-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 3053 Hayden Bridge Rd Spr Assessors Map#: 17021932 Lot: Block: Addition: Tax Lot #: 00202 Subdivision: Owner: Joanne Harris Phone Number: 541-746-0026 City/State/Zip: Springfield, OR 97478 New Value: $0 Address: 3053 Hayden Bridge Road Scope Of Work: Plumbing Backflow Device Contractor Type Landscape Contractor Grants Landscaping Service PO Box 221, Springfield, OR 97477 Registration # Expiration Date Phone 541-746-8482 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: I' i I I # 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) Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Minimum Plumbing Permit Fee State Surcharge - Plumbing Backflow Prevention Device Administrative Fee - Plumbing Total Plumbing Grand Total Paid On Receipt# Plumbing 11/09/2001 7222 11/09/2001 7222 11/09/2001 7222 11/09/2001 7222 Value/Quantity Fee Amount $31.00 $3,15 $14.00 $3.60 $51.75 $51.75 Job# 01-01243-01 Page 2 of 2 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are reque/s:ed ;; ~~~r~P2: a~. th ~at th pe P, roje~ address is readable from the street. A/L//fi-f ~~ \ // /9 /n I S~ture (- U Date" '/ - I