HomeMy WebLinkAboutPermit Backflow Test 2001-7-10
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I Job# 01-00699-01 I
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Page 1 of 2
TRANS#:01-0006098
DATE: JUL 10 2001
AMT RECD:2 $ 16.50
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00699-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 835 ROYAL DEL Ln Spr
Assessors Map#: 17032343
Lot: Block: Addition: 3rd
Owner:
Address:
FUTURE B HOMES
PO BOX 7425
Scope Of Work: Backflow Device
Backflow device
Contractor Type
Landscape
Tax Lot #: 10400
Subdivision: Riverglen
Phone Number: 541-744-2660
City/State/Zip: Eugene, OR 97401
New Value: $0
Contractor
Sato Landscape
83968 Cloverdale RD, Creswell, OR
97426
Registration #
12974
Expiration Date
3/31/2002
Phone
541-895-2955
Office Use
NTIOi\!'a.r^"'0-!1I~W rcquires you to
Land Use: ATTE I '# Of Buildings: Unity
. las .....c..nJl';l(l uy UIO '-'Iegon I
Zoning Code: follow ~u '" Occupancy Group: sDVoielllng
N f"catlOn Cen,,,.. ,.'v~_ l.:.__
Bedrooms: 0 HI Heat'Source:, OAR 952-001-
in OAR 952-001-vv ,- ,,,.--- b
Range: nO!lQ, You may ~!l:t!i!1Qt~ge:; 01, t~~_~~~: y
calling the centcr, \'~U''', ':'''' '';''-,'':''-';-
To request an inspection call the 24 hour recording at 726-3769. All i~,~P.!l8\!.9Q~lr!lquesteSl:befoi'e':7i~0~'''catlOn
a,m, will be made the same working day, inspections requested after 7:00 a."tC':'!!b!l!lJI1l~deJttie:tollowlng
working day,
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
1
(VN) Wood Frame
Required Inspections
VII"''"",
I Plumbing' . ,~. '''I
-After device is installed but beforerbackfililngtrehat. EXPIRE IF THE WORK
fill i ,"i,'I~Ll' UNDER THIS PERMIT IS NOT
C'",VI' ,W:i::D OR IS ABANDONED FOR
ANY 180 OAY PERIOD,
Accessory Structure
# Of Stories: Height (feet):
Current Units: Proposed Units:1
Census Code: New SF - detached
BackfJow Device
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
Minimum Plumbing Permit Fee
Total:
Paid On Receipt#
Plumbing
07/10/2001 6098
Value/Quantity
I
Fee Amount
$5,00
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Job# 01-00699-01
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Page 2 of 2
Value/Quantity Fee Amount
I
Fee
Paid On Receipt#
Plumbinfl
07/10/2001 6098
07/10/2001 6098
07/10/2001 6098
1
$1,05
$10,00
$.45
$16.50
$16.50
State Surcharge - Plumbing
Backflow Prevention Device
Administrative Fee - Plumbing
Total Plumbing
Grand Total
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
this permit application is true and correct.
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Signature V Date