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Home My WebLink AboutPermit Plumbing 1981-7-7 f ~..t..- 'of;; - , - ........... ,--v-..... I JNSPECTION LINE 726-3769 I Joh Add,... 2/,f/i - &-;,; /'E /IJAI /.4 L CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT INfORMATION LINE 126-3753 I ~ ~ G ~ ~'ln -:5r~tJ~r'\~%oO OW"" #C J4/8L.L.:'; hle/f/.<<;7L1A9,,;:' r-' .. A ~I/....../?n Ir' BUlldmg PermIt Info Descnbe Work (I e, Budd Single Address2l.9 J.2. - /-/ ~ Th /"iY e Phon~~~7 c-~~ Fomlly Residence With Attached Goroge) llLi/LJ Ilegol Descnptlon I ,J Construction lender Address DESIGN TEAM phone (nome) (address) Pnmary Structural Electncol Mechanical CONTRACTORS {nome} (address) General Plumblnj:l #A/7:JELJa/A/~e Electrical Mechonlcal PLUMBING NO FEE CHARGE NO I Residence 0+ Each $1n1=l1e fixture Relocated bUilding (new fix additional) 5 F Residence (1 bath) sq ft New ClfCUlts, alterations or extensions SERVICES Duplex (1 bath) each Temporary ConstructIon AdditIonal bath Amps Water servIce Sewer Storm Sewer FEEDERS Amps TOTAL CHARGES;{J't?~~ TOTAL CHARGES I ENERGY SOURCES Heot I Water Heater Ranoe I Val~e of Work Sq Ftg Main Sq Ftg Access Sq Ftg Other _New_Add_Alter_Rep _Fence_Demo_Change/ Use _Other :S:!ilt/c~ ~,,(?/A/~ -n, /:fg LE'"".PL1S.e.D IfAJn ;:hLJP'ek?L y ,{!kP.,&/'-eF.D (IICS no) (expires) (phone no ) (lIcs no) (exPires) (phone no ) ElECTRICAL MECHANICAL FEE I CHARGE NO FEE I CHARGE I I , furnace/burner to I\TU's ApplIance vent separate Statlonary evap cooler Vent fan WIth single duct Vent system apart from heating or A C Mechanical exhaust hood and duct " ./ Wood stovefheoter Heat Pump Air handler to 10,000 CFM Air handler over 10000 CFM . " ISSUANce OF PERMIT TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrICal portion of thiS permit shall not be valid until a label has been signed by an Electrical Contractor and attached to the .lectru:"al panel I HAVE CAREFUllY EXAMINED the completed application for permit, and da hereby certify that Clll informatIon hereon 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 pertaIning to the work described herin, and that NO OCCUPANCY WIll be mode of any structure Without the permiSSIon of the Building DIVISion 1 further cerHfy that my regIstration WIth the Budder's Board IS In full force and effect as reqUired by ORS 7010S5, that If exempt the baSIS for exemption IS noted heron, and that only subcontra<:tors and employees who are In compliance WIth ORS 701 055 WIll be used on thiS prolect Bam for Budder's BoardMAm~IG.A F< E T l!... NAME (please pnnt) ~'1J~.." V HeAlsro..t= (w'e..,:::.J c:.IGNATURE ~~ FOR OFFICE USE ONLY h ,~DAT?h/?/ 10nr- Type/ Const "nlts Fire Zone Bedrooms n..cy load Flood Plain '"toner Occy Group BUILDING PERMIT Plan Ck Comm/lnd Charges and 65~o/ Bldg Per Fee Surcharges Plan Ck Res 30%/ Bldg Per Fee PLUMBING PERMIT Charges and Fence Surcharges Demo ElECTRICAL PERMIT Charges and SIdewalk Surcharges AI C Pavm~ MECHANICAL PERMIT Charges and Curb Cut Surcharges -------- Sq Ftg MOln Sq Ftg Access Sq Ftg Other x Value Value Valul x TOTAL VALUATION Systems Development Cho(~e (1 5%) Total Comb Permit TOTAL ,- COMBINA nON APPLlCA TION/Pt"MIT (CAP) I Applicant to furnish A Job Address B Legal Description 1 example-tax lot 100, Lone County Mop Reference 17 03 43 2 example-Lot 1 Block 3, 2nd Add,t,on to SpringfIeld Estates e Name, ete of owner and construction lender o Energy Sources 1 example-heat/electrical ceiling/or forced air gas 2 example-water heater/electrIC:al/or solar E Square footage or valuation, ete 1 example-1250 sq foot house, 500 sq foot garage 2 example-If new prOlect, check new-If addition, check add, ete F BUlldmg perml1 mformatlon 1 example-construct single family house with an attached garage 2 example-remodel eXisting garage Into family room 3 example-convert single family residence Into restaurant (change of use) G Value of work os defined In Section 303 (a) of the Structural SpecIalty Code H DESIGN TEAM AND CONTRACTORS To avoid deSign or constructIon delays, Building DIvISion Staff must be able to contact appropnate persons regarding deSIgn mformatlon or lob site corrections, etc II AbbreViated Plumbing, Mechanical & Electrical Schedules A Except where blank spaces occur In the deSCription portion of the Mechanical and ElectrICal Schedules, the applicant need flll-m only the No Boxes adlacent to the appropriate Item(s) to be Installed B Full Plumbing, Mechanical, and Electrical Schedules are available at the Budding DIVISion 1 To conserve space on the permIt form the schedules have been abbreViated 2 If the ltem(s) to be Insta\led are not covered on the abbreVI- ated sohedules you should consult the full schedules C BUILDING DIVISION STAFF WILL FILL OUT All FEES AND CHARGES ON THE SCHEDULES \II Applicant to SIgn and dote Whenever pOSSible, the initial appltcatlon Will be used as a worksheet only Where pOSSIble, Budding D,V,SIon Staff WIll prepare a typewritten copy and return It to the applicant at the time the actual permit IS Issued for hiS signature IV Fees and Charges Plan check fees are due and payable at the time of the application, and no plans wtll be processed untd these fees ore paId All other fees and charges are due and payable when the permit IS ISSUed V FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY Additional Prolect Information PLANS REVI EWED BY nam" <:'lgnaturp PermIt Cler~ ~ - .~ -"<&'7*' PERMIT VALIDATION '""""tr:- - v........