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HomeMy WebLinkAboutPermit Backflow Test 2000-9-20 . . I Job# 00-01413-01 I .. Page 1 of 2 TRANS#:01-0003260 DATE:SEP 20 2000 AHT RECD:2 $ 16.50 CHANGE: CASHIER:061 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01413-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 821 ROYALDEL Ln Spr Assessors Map#: 17032343 Lot: Block: Addition: Tax Lot #: 02102 Subdivision: River Glen Owner: Future B Inc. Po Box 7425 Phone Number: 541-744-2660 City/State/Zip: Eugene, OR 97401-0017 New Value: $0 Address: Scope Of Work: Backflow Device 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: 1 (VN) Wood Frame - Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Dwelling Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769, All inspectio~~C?el;~~fted before 7:00 a.m, will be made the same working day, inspections requested after 7:00 a,mr~iU 15e.mai:le:the\f6115Wi?i91E IFTHEWORK working day, AUTHORIZED UNDERTHIS PERMITlS NOT Backflow Device R dl t __.h._......._....-......"'.....,...lt"'\._"'l~r"rl"'\n equire nspec ions \"IVIVlIVI..., "''''......... _. I....... ........ .__. .__. _,. I Plumbing I ANY 180 DAY PERIOD. -After device is installed but before backfilling trench, Construction Types:(VN) Wood Frame Occupancy Groups:Dwelling # Of Buildings: # Of Bedrooms: Handicap Access? 0 rArea (Sq. Feet) Main: Accessory: Accessory Structure" TIEl\, -;,OI\J:Oreo"" ?" .:::)r'l' ;01' Ie # Of Stories: He!!l~Mf\l!!~i:.; adoptee uy LOe Oregon Utilli Current Units: P~Qp.!Ili!!!lcI;I.rii~iltel, Those rules are set for Census Code: New SF - detached OAR 952-001-001 0 through OAR 952-00" , u090. You may obtain copies of the rules iii Total: callingthecentel. (Note: the telephone ...",.,.,h",rfnrth" nrAnnn Ulilitv Notification Fee Paid On Receipt# Plumbing (",., . 09/20/2000 3260 ,. f:t3nTrnl. '_.' ""-"'~~1"",41. Value/Quantity' ", Fee Amount Minimum Plumbing Permit Fee $5,00 By signing this permit/application, I agree to cail 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 this pe 'application is true and correct. /" _/ ~. ~n3ture ~. ) . Job# 00-01413-01 Paid On Receipt# Plumbinll 09/20/2000 3260 09/20/2000 3260 09/20/2000 3260 Fee State Surcharge For Plumbing Permit Backflow Prevention Device Plumbing Administrative Fee Total Plumbing Grand Total . Page 2 of2 Value/Quantity Fee Amount 1 $1,05 $10,00 $.45 $16.50 $16.50 9-PltP --0 OJ Date