Loading...
HomeMy WebLinkAboutPermit Mechanical 1982-10-28 - -...... - Job Address 112/ /' /.~r-, '- /"-'HTdf \ov/.I~ l-~~ legal De<cription ('?'07.7l-.:J. -ex,., C> ::7,.t-,'0/ CITY OF SPRlilGFIElD COIIBHIATION APPLICATION/PERMIT EilERGY SOURCES: Heat ~'Iater Heater , INFORIIATION UNt 726-3753 Sq, Ftg, l'lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter ~ep. -Fence Demo Change/Use Other- - .~ 1:::: D ~ IIIISPECTIOII LIIIE. 726-3769 Owner 5H?/~F/e.cD /NVC:57/77ch'T ~. Range ValuE. of Hark: Address Phone Bul101no Pemlit Info: Describe Work(i.e., Build Single Familv Residence With Attached Garaae) Address DESIGII TtAl1 (name) Phone (address) "-f\\ ~cu))J' 51- \) ~Slf~llt (Dhone no.\ (1 ics. no.) (exoires) Construction lender Primary c< c.---'. '7-~.5 /1. //74Y&"R' /~) #4# :5?: 6~6; ciTE 5S1'6-- :37// Structura 1 Electrical Hechan; ca 1 CONTRACTORS (name) (address) flie,,_ .no.) (plmirps) {ohnnp. nn l Genera 1 Plumbina Electrical ~'~c:hanieal P~Gr/.?G"R :S:4cE7 ~r<::::, PlUllBlIIG ELECTRICAL MECHANICAL NO. FEE CHARGF NO FFF rHARr,F NO. SQ. FT. furnace/burner to BTU's FFF rHAor.F ,/. Each single fixture Residence of Relocated building (new fix, additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence 11 bath) Duplex (1 bath) each Additional bath SERVICES Recessed wall So~~P hp~tp.r ~nrl vPot Storm Sewer Of amps. Appliance vent seDarate Stationary evap. cooler Vent fan with sinole duct Vent system apart from I heatina or A.C. Mechanical exhaust hood and duct Sewer Temporary Construction Change in existing r€l~idpnc€l multifamily, comm. or Industrial ~Ja ter servi ce amps. I I -'. I ~ I /TL-TC?j'" ,. ~'.c:::;; r~ .(;bC7we>h4' I I I Wood stove/heater CO~1./INO, FEEOERS Install/alter/relocate di,trih. fppdprc; Of G<>.o I SSUANCf OF PFR!lIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L\H REQUIRES that the Electrical work be done by an,.Electrical Contractor, the electrical portion of shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXN1INED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work oerformed 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, and that NO OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 7nl.055 will be used on this project. /0. C>O /6- c:>"" thi s permit IIAI-IE(please print) Zone L:. C Fire Zone Flood Plain TYDe/Const.~<<' -/ hL;!? -Units Bedrooms Occy Load Stories Occy Group S IGI1ATURf FO" QFFT~: USE OIll..Y Sq. Ftg, Ilain Sq. Ftl]. Access B- ;> Sq, Ftg. Other DATE x x x Value Value Value TOTAL VALUATION BUILDING PERMIT Charges anc Surcharges Plan Ck. 65t/Bl dn Plan Ck. 30t/BldQ ____________1 Fence I DemQ I Sidewalk ------------1 A/C Paving _n_.L~':~nl Curb Cut . C. r I Comrn/Ind Ppr Fp~ Res Per Fee Systems Development CharQe tl,5r,) . PlU11BING PERMIT Cha rges and Surcha rges ElECTRICP,l PERI:IT Cha rges and Surcharges IIECHANICAl PERMIT Charges and Surcharges TOTAL 10. ':;::0/ /b .C;r Total Comb. Permit "... -. ~ COMBINATION APPLlCATION/PER.'IlT (CAP) ! III. V, FOR OFFICE USE ONLY - ( CITY OF SPRINGFIELD . (; CllyHall Sprlngflald. Oregon Department 01 Public Works ( , OFFICIAL RECEIPT, No. B 59909( ( Date 0......,. :::?&. 19 B~ Rec'd From ,4,UE tll L. <j n /.1 '< 7'/ ~ cle'S.5/<-9C. .c:/ h< c. c- Address ~-z;,I='e::>.Jl?.b ~. ( - ( ( I ( i~ ( ( ( ( ( ( Received For: .d'7 cc:../f . T-~~ /(;', 00 ..61 ItS-6'~ I. Applicant to furnish A, Job Address B. Legal Description I, example- Tax Lot 100. Lane County Map 17 03 43 2, example- Lot I. Block 3. 2nd Addition ( Sprlngtield Estates C. Name, etc. of owner and construction lend. D. Energy Sources 1. examole~ heat/electrical ceilin~/or f. 'd 2. examole- waterheater/electrical/or so E. Square footage or valuation. etc. - 1. examole- 1250 sq. foot house. 500 sq, 2. example. if new project. checknew -' adr check add, etc. F. Building permit information: 1. example - construct single family hou: attached garage ( 2. examole ~ remodel existing garage intI 3. examole - convert single family residl. restaurant (change of use) G, Value of work as defined in Section 303 (; (If Structural Specialty Code H. DESIGN TEM1 AND CONTRACTORS To avoid design or construction delays. BJ Division Staff must be able to contact apl ~.~i persons regarding design information or jr corrections. etc. II. Abbreviated Plumbing, Mechanical, & Electrica' A. Except where blank spaces occur in the de: (p.t portion of the Mechanical and Electrical ~ the applicant need fill-in only the No, Bl to the appropriate item(s) to be installel B. Full Plumbing. Mechanical, and Electrical (eo. are available at the Building Division 1. To conserve space on the permit form : have been abbreviated 2. If the item(s) to be installed are no' t', the abbreviated schedules you should f full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL CHARGES ON THE SCHEDULES ( . 0, As noted on the CAP. the label must be de' electrical contractor for signature by hi~ supervisor. The general contractor is.n01 to sign the electrical label. - ( Applicant to sign and date '; \ Whenever possible, the initial application wi.... _~ '__n __ . a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his Signature. lV. Fees and Charges Plan check fees are due and payable.at the time of the application. and no plans will be processed until these fees are paid. All other' fees and charges are due and payable when the penmit is issued. / /f7jiq L joT-5#: 8<. /0 <::7/ /'#cc~'#2 // !!!.....if' . ~d , '..... /6.6T ~~-P~/r. - ; AUTHORIZEDSIG~TURE"""'- \~.... BRIGGS "RINTIERS/LITHOGRAP'HlI!:RS. lI!:UQlI!:NIE. ORlI!:GON Amount Received ..~.-..........,.. Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signatured~ ~~~e . " /0 -::?t?-S~; . _._..,1 ....:.::-:-.;:: ~..c:..-;':-"':';:'::~-:":.:=-'''::::!,,':':'~'': :.~....;.:: ~.:.:;'~' _~;_:-;:;7~~.-_:;~::::.;: :: .. :~~:. :=':";::':::-',=j,-:'l>':~~~:. ~ :~::~'.::.""::.;s.~--.. :::.:.~....::-,:::'",;:::,::,,-=~:~~'.:~=--~:::::=:i'=...~__..-. d a ~J