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HomeMy WebLinkAboutPermit Plumbing 2001-5-1 .. \ ~ I Job# 01-00444-01 I . Page 1 of 2 TRANS#:01-0005113 DATE:MAY 01 2001 AMT RECD:2 $ 16.50 CHANGE: CASHIER:061 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00444-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 811 Royaldel Ln Spr Assessors Map#: 17032343 Lot: Block: Addition:3rd Tax Lot #: 02102 Subdivision: River Glen Owner: Future B Inc Po Box 7425 Phone Number: 541-744-2660 Address: City/State/Zip: New Eugene, OR 97401-0017 Value: $0 Scope Of Work: Plumbing backflow device Contractor Type Landscape Contractor Hunter Irri9ation 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 recordin9 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. Backflow Device Required Inspections I Plumbinq I -After device is installed but before backfilling trench. Construction Types:(VN) Wood Frame Occupancy Groups:Dwelling # Of Buildings: # Of Bedrooms: Handicap Access? D [Ar~a (Sq. Feet) _ Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Accessory Structure Height (feet): Proposed Units:l Total: Fee Paid On Receipt# Plumbinll 05/01/2001 5113 Value/Quantity I Fee Amount Minimum Plumbing Permit Fee $5.00 . ~ .., "\ . Job# 01-00444-01 . Page 2 of 2 Fee Paid On Receipt# Plumbing 05/01/2001 5113 05/01/2001 5113 05/01/2001 5113 Value/Quantity Fee Amount State Surcharge - Plumbing Backflow Prevention Device Administrative Fee - Plumbing Total Plumbing Grand Total 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 reques"t th:..vroper time and that the project address is readable from the street. ~/~ \F/-<6/ , ! Sigl'lature Date 1 $1.05 $10.00 $.45 $16.50 $16.50