HomeMy WebLinkAboutPermit Plumbing 2002-10-8
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City of Springfield
Plumbing Permit
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: PLM2002-00102
ISSUED: 10/8/2002
APPLIED: 10/8/2002
EXPIRES: 4/8/2003
SITE ADDRESS: 824 River Knoll Way
ASSESSOR:S PARCEL NO.: 1703234311100
Springfield
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TYPE OF WORK:
TYPE OF USE:
New
PROJECT DESCRIPTION:
Backflow device
Residential
Desc rintion
PLUMBING CONTRACTOR:
DECKER LANDSCAPE AND IRRIGATlm
PO BOX 87
ALVADORE OR 97409
CCB # 6746 f~fJPe: 20/3/9/30
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1).\01\\1'" ,. ,:>I-\f>.\.\. t..- ':> ?'t."'''''' \ - 0.
Amount'l'aj!l. ot."'~:Ite,P"id\\ i\\\ "f"\.~hQINumber
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3.15 f>.\l,\\Q"'\l'r~~~lJo5J f>; 1200200000000000025
14.00 C.Cl\'JI\'JIt.~ ~~'i). 1200200000000000025
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541-746-6965
OWNER/APPLICANT:
STEVE RUPP
824 RIVER KNOLL WAY
SPRINGFIELD OR 97477
Cashier
+ 7% State Surcharge
Backflow Device
Minimum/Adjustment Plumbinj
+ 8% Administrative Fee
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Backflow Device
Minimum/Adjustment Plum
+ 8% Administrative Fee
+ 7% State Surcharge
$14.00 10/08/2002 :00000000000025
$31.00 I 0/08/2002 ~00000000000025
$3.60 10/0812002 ~00000000000025
$3.15 1 0/08/2002 ~00000000000025
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To Request an inspection call the 24 hour recording at 726-3769.. ~J((m~~~ioi\~~~!IeSt'ea~~~ore 7:00 a.m. will be made
the same working day, inspections requested after 7 :00 a.~,~ill~il:ti!!a'rl.e!~ 'fdllij\f.!!!g?~~i.!ig:day.
Reauired InsDections: ,,,,\ \ v' ~\l\esO'-~\e~' \ "\~~o\l~" 0\\'(\"" ~0'(\6 '
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1 Backflow Device: Prior to coveriI\g and~p~yia:?'a~cppy'6'(\the:t~~t'!.epoR#n'~ite at the time of inspection.
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City of Springfield
Plumbing Permit
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: PLM2002-00102
ISSUED: 10/8/2002
APPLIED: 10/8/2002
EXPIRES: 4/8/2003
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certifY that all
information hereon is true and correct, and I further certifY that any and all WOlk performed shall be done in accordance with
the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certifY 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 requested at the proper time, that each address is readable from the
street, and that the approved set of plans, if applicable, will remain on the site at all times during construction.
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Date
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CITY OF SPRINGFIELD, OREGON
225 FIITH STRHT . SfRINGFIELD, OR 97477 . fH:(541)726-g75g . fAX: (541)726-g689
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City Job Numbp' PLM1 200 Z r 00102-
Job Locatior ~d-l{ ((.,'vtr K \1'1-' II
170 3,Z31{"3
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BACKFLOW PERMIT IS $51.75 (includes Permit Fee, State Surcharge & Administrative Fee)
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By signing this permit/application, I agree to cal~~~~\~~~i?on once the backflow prevention
devise has been installed and is visible for inspecl1~~d2'l?-3769), I also state that all inf!lrmation on
this permit/application is correct e"'''\O~\),\{\''\ ~
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Checked for Historical Statu<
Contractor Information
Contractor 1),e Cj( ~r
Addrf'<< ~O. 730 x.
CityJ AjlJe. J&r{
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Construction Contractors Registration #
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Shared Drive (f:)IBuilding FonnslBacldlow Preventionl-02.doc