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HomeMy WebLinkAboutPermit Plumbing 1980-12-11 B~iTding:-Perl,:,it .Into: Desc;ibe Work (i.e., Buil~ Single \ -.::::: Fomil Res;rl"'"~" Wjth Attochp.d Goro(1el ' ~--..J J1 Jjl y (()"y,\ np, ( Jt;)(jn I C'). .\,'(,D.-~/H:r'f1//,;H,6U./kJJ(j-y , bU.-' (?1/Xibl '~1;,0jat!.LV {liqi)no.l ' (expir,{) (phone no.) urLl-.,..7a-:, i '-j I I i I ( Nor--=-: , ' INSPECTION LINE 726-3769 O';:Yf/'I!;.r f :--.;;; r ,- I. CITY OF SPRINGFIElD , COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 - . / 11 (." ,~ ...5tl.!tifct y --Ie; D (J;/I./ U -) .. JQb Arl,.{res' :<.':z,1Q ._~ Sq, ftg. Me;n \ U (1( ~ Sq. FIg. Access. Sq. Ftg. Other __New._Add_Alter_Rep, __Fence _Demo_Chonge/ U Sit Other (')w V- V UL- V\I /7_n7:-:?7-1 Hoat Woter Heoter' .? (J/J :.ILL:/' , legol Description 7Z.. - /./;0 '2- Ranqe Value of Work: L.of f3- 11~ gqD Owner f".... Kpl~ ~~_C' Addren qZLI e ",,--~'!.n ' Ci.J&eNe, I"J~ <?7/{o.. ?n \ ~\\^ '2,0 Phone LI Construction lender &:A~ l.I/I=!C-r" Address ~'-rutuN ..c:;::v,cPHp OESIGN TEAM . (name) \ Phone Primary <=:Tl4'L-~ \ ~~,.,,;: &zIrtl./-o/~1 $tr...ctur.,1 Electrical \ Mechcnical CONTRACTORS (nome) (address) (phone no.) (lics. no.) (expire:) G~nerol ~.::. ""'~T" I;?vGi:'EN~ PLu.....RINA- ~1'" P-i<<=.-no:l,c:..... &;; J~~ ~,.u ~'/1!1!tJ .P'0S-E1!1: r7U7 -".x.~' Plumbi!"!Q ~ I Electr;cal I Mechanical I I NO. I I I I ., I II I j I I PLUMBING ELECTRICAL MECHANICAL FEE NO, FEE ! CHARGE r NO. CHARGE Residence of furnace;burner to BTU's Appliance vent separate Stationary evop. cooler Vent fan with single duct . .-Vent system.opart from. .,' he~ti~q'~'':'A.C:' ".. .-~, Mechanical exhaust hood and duct ~.: -, '.. \q: ft. Eoch sinol!? fi:ll;ture Relocated building (new fj:>:, additional) S.F. Residence (l bOlh) New circuits, alterations or extensions SERVICES Duplex {1 bcth} each Temporary Construction I I I I I I 'Wood stove/healer I Additional both Amps. W..ferslE!r...;ce s':~:;~' ~f,~~ '~',,7jJC ,~:.: ~:(! I.\~~ ;" (\lJe I (,J{) i'~ ,'1 StOlm Sewer FEEDERS Heat PUmD Air handler to 10,000 CFM I Air handler over ," .', '10,000 CFM Amps. HI I I .;. '.',' . ~.-~- .1 I I I I I <, . ISSUANce OF PERMIT TOTAL C10fARGES r: ii or} TOTAL CHARGES /,c. . TOTAL CHARGES C>Q a --. ~ .1 FEE I CHARGE i I. / i I I '. I .. '". ,.," I ./. I I I I I I j,'. WHEi:E STATE LAW REQUIRES that the Electrical work' be done by the Electrical Contractor, the electrical portion of this permit ,hall not b. valid until.a label has been ,igned by an Electrical Controdor and attached to the electrical panel. I HAVE CAREfUllY EXAMINED the completed applicotion for permit, and do hereby certify tnot all information hereon is true and correct, and I further . certify thaT arrY 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 thot NO OCCUPANCY will be mode of any structure without the permj~sjon of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect' os required by ORS 701.055, that jf exempt the basi, for exemption is noted heron, and that only subcontractors and employee, who are in compliance- with ORS 701.055 will be used on this project. Basis for Builder's Boord exemption. ~AME {please Printf t!... /\:';:-I"'T'I-J (I .~;(;/tz~. OAT'f... /Z-/I-f?O SIGNATUR~ FOR OFFiCE USE ONLY fJ.K=rz" Zone P I Fire Zone Flood Plain Type/Const,~l Bedroom, .-- Storie' .j- x Units ""'ccy lo'od Dccy Group C-:. Ftg. Main Sq. Ftg. Acceu Sq. Ftg. Other x Value Value Value "' r.J ('co. '- TOTAL VALUATIOt' BUILOING PERMIT Charges and Surcharges I Plan- Ck. Comm/lnd 65%/8Ida Per Fee I Plan Ck. Res 30~~J BldQ Per Fee I Systems Development Chorae 11.5%\ L\loe~ I;:)'{',q-j ,~l'\*) ts"O?~%, PLUMBING PERMIT Charges and Surcharges "'['-leg /'- ..., . ~::6. Fence Demo Totol Comb. Permit elECTRICAL PERMIT Charges and Surcharges Sidewalk I'~~. ~~;,~, ...A; (), -'..- .MECHANICAl PERMir--- Charges and Surchargu AI C Pavin.. Curb Cut ..t( ~().g2 TOTAL 1 I. Applicant ~ furnish ',A. Job Address . "8. legal Description' ;t :-; 1. example-t~x lot 100, Lane County Map Referenc ,.r- 2. example-Lot 1. Block 3, 2nd Addition to Spring fie '" . C. Name, etc. of owner and construction lender. D. Energy Sources . 1. example-heat/electricol ceiling/or.forcel'air qo", (. -.r,.'; , 2. example-woter heater/electrical/or solar E. Square footage or valuation, etc. - 1. exomple-1250 sq. foot house, 500 sq. foot garage ( 2. example-if new project, check new-if addition, ch<< odd, etc. . F. Building permit information: ILL (~. 1. ~ample-constr.uct sj.ngl~ f~~i y ~louse w.itn a~ attl garage '1.,., 2. exol""lple-remodel ex (sting garage into family, roo." 3, example-convert si~gle family residence into (' restaurant (change of use) G, Value of work as defined in Section 303 (a)'of the, Structural Specialty Code > ' H, DESIGN TEAM AND CONTRACTORS"';"'!" .To ovoid design or construction delays, 'Building Pivisi- . Stoff must be able to contact appropriate .persons reg( (,'" . design' information or job .site corrections,~#tc:: II. Abbreviated Plumbing, Mechanical & Electrical Schedules A. Except where blank spaces occur in the description pOl (' of the Mechanical and Electrical Schedules, the applicc need fill.in only the No. Boxes adjacent to the approp' item(s) t!J be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division . 1. To conserve space on the permit form the schedules have been abbreviated, / ' \; 2. If the item(s) to be installed are not covered on the I ated schedules you should consu'lt the fLiIl schedules'.' 'c.- BUILDING DIVISION STAFF WILL'flLLOUT ALL FEES ANI'::: (,;_.:;-'~~:;: ,~- CHARGES ON THE SCHEDULES' ,\' _ Amount III. Applicant to sign and date Wh.enever possible. the initiol opplic:ation 'wi~1 be used as c (. .. wO'rksheet only. Where possible. Building Division Staff wil 'prepare a typewritten copy and return it to the applicant a the time the actual oermit is issued for his signature. . . " . ," Fees and Charges .P)gn..ch~ck..fees,9_re ~::lu.e.qnd payable at the.timeof the opp-lu~ullon, ,'1 --' and no plQns will be processed until these fees ore paid. All . other fees and charges ere due and payable when the permit is issued. COMBINA TION ~PPlICA T10N/.N~(CAP) IV. ,.", V.' FOR OFFICE USE ONLY /: PROJECT CONDITIONS.TO BE SATISFIED BEFORE OCCUPANCY: .Additional Project. Information: .;'1:,\- .., -' . PLANS REVIEWED BY, 'nam'" r,ignatur":,, .. " " " PERMIT VALlOATIOIi.r-:,'; ,. .. ': . . . .. . -- ,~'"' . ~~- :~.!:I ... ......:;....,: '.....;- 1. ::~.'~- .,~". S~RI'NGFIElD '\ I :.~"..-. k'!':o ;".;,. I CITY ,OF (, . City ,Hall. :., ',' , Springfield, Oregan: ' ,:,' - 'Oepai;tme,nt_af Pu~lic..Wark., OFFiCIAL RECEIPT ..':"'-, <J'n ~,.,. -~~ ~~.~'\~~tf;';: . (.: ~.- -~,~ -~ c. ... Yr'. ...... S5352( No. B Dote I Z - ) I 191--0 Rec'd From (, ' k:.pi t-h f-) -\( p '(:,C'" AddressCl'Z.4- ~ A-3vrL.,,5"t '. eel '( Received For,: '019, - -, ,"" .qz:~o::' , .4'. ~,,..: -,";;,:;.. '-. " (I '. 'l!).DO:':' , '.'/ "':'00" - r'I,v ~". ); .' 'i-,t,:'l..' :.-. '. ,.'. '(I ( CI (I ;, f\ '0,A<r> Ire, ::-' (I Recei~~d L( !..~._~ (..~..; t..S."..~ ,'" _- ~" , r r2"~",~o "omu", ':: >, ' SH(L.O....TU~...ULL .....'...T(~S: IICUGE"'E, Oil .,,.0,, . 5&5."'& :'.:\ . .( . (I ..k, , '. , 5 c " . . "--~ ,0 '-' ..,..... '::' : ',.:~~- '. " Permit Clery I ;,.'!< " '/ " '-;'.' ," - .~ ..late " "