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HomeMy WebLinkAboutPermit Building 1980-10-8 (4) ) .. ,') ,... ~.:Sv,d I /,,; i;ISPECTIO" LlI.E 726.3769 CITY tlf SPRInGFIELD COMBI NATION APPll C~,T1011/PERI11 T Job Address 95'0 W. FA/RV/SW l/;p ~A:"?' l.e9al De;cription 17-<:J?-77. ~I 7'L.~, ::ro/ "ICJe:> r I - " , ~6~ 7t!>O,?a/ ~':2 111 ~. owne((name/address/Phone) .'P.....NN.I ~ WA4cS'k 9~o W. FA.lPV.lF.:W i::>ii? ~rl'?/ ,y~F/c:="P. I ~.- Vent system apart from I heat;na or A.C. 158~~ Mechanical exhaust I hl"lod nnd rllJrt , I I I ~lood stove/heater I n I n I n nl COMN,/INO, FEEDERS Install/alter/relocate .d..i..s1J:jh. fppf'lprc:. Of '. amps.1 New circuits. alts. I ..o.r.....ext.en".5rnc: M~B';.tf: ~Q' 1,..,- ~_.c l '-;OP;Dt..V Y'" ...,...., I I SSUArlCE Of PER!1lT I I I I ..JJ' ."."..,,~ TOTAL CHARGES TOTAL CHARGES W' :;0,..." that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division. Construction lender (name/address/phone) UI:.~Hiil ItA/1 ,(name I Primary 13'7<A;"c.# Structural 6;0<::.,,; ~!.:b~/~ E1 ectrica 1 /1echan;cal CO!lTRACTORS enamel General Plumbino Electrical ~'echanica 1 I FEF [HARCF i NO I I I I I I Sewer /8oo'<€~' 1/.!b.~ ~ Storm Sewer ';lQ:l ~ ~4i>' M"I!JIL~ HoMe 1',....- Hoe>k'lJ~ V;J. ar I - I PLUllB lUG 1':0, Each single fixture I Relocated building (new fix. additional) "s. F. Res i dence {1 bathl IDuplex (1 bath) each Additional bath ~!a ter serv i ce I- I TOTAL CHARGES WHERE STATE LAW REOUIRES shall not be valid until the I 8:;5" p~ NFORl!A II Oil LIIIE 726.3753 l"Energy Sources: /Sq. rt. maln&accsy, bldg.' heat . \ Hater heater Lnew _add _a I ter _rep. ~. ranC'f'\ ____ [~.~ fence demo 1 Hion 1 -fk-tc::: I -;:';";"':lbc';hangeTuse other ..a ue 0 war: ~..:llr-'. lA.....LI. L...:::::::.-.~ _-=-__ _._, C. ~Ulldin9 pennit info.: describe work (~e.. bulld -, ; kinQle fam. res. with detached ouaael ~ 'I~ . '\ 1;() 1-/1 A h .tJ.i) , \ .......J. I U 7;t!(;-680"3 I I I' J rr.;f.l ~-t:-u:)V"\ Dl ~_'r--f--- . e , . -, tI , (address) (lics. no.] (exoiresl /c:;S 'Q n ~-r, ~'-'.I7tS :2-,8 /W;-c::::5~ \ \ \ (ohane no. I , (addrpsc; 1 (l ice;. nn.) (".xoirp<:. , (ohnn". nn_) \ \ I MECHANICAL ELECTRICAL <<L'~\ \ furnace/burner to BTU's l~~1=" I r~ .HP I I New circuits alts. or extensions I SERVICES I Res i dence of SQ, FT. I Floor furnace and vent Recessed wall Sn~l'"'" h".~t"'r ~nr1 v".nt Appl iance vent c;eoarate Stationarv evan. cooler ~ . I Vent fan with sinole duct I I I I ITemporary Construction IChange in existing 1"''''~j1Pn'''e I mult i fami 1y. corrm. or TnnlJ<:.trial Of amps.1 I HAVE CARE FUll Y EXAl-1ItlED the camp 1 eted app 1 i ca t i on for penni t. and do hereby cert i fy that all i nfonnat ion 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 pert,aining to the work de~scribe herein. and liha NO OCCUPANCY will be made of any structure without the permission of the BuildinQ Division. .' , J J I !1 / IIAI'IE (please print) _/),~ ,.i ;,;'/5 ,B ()JL) J. p ~JSIGNATURE .'.. 41-1'U.{J ,t{)c:tlkd'& IOI<::;,;,e--, ,___..,1-" , ,," , ..' , / Zones ;:zm- .MNP Flood Plain Bdrms Type Const. Oeey L~3d. O~cy Group - Sto~ Units :3")( A L [ U U rl r S U 1-1 ~1 A R Y Plan Ck. Comm/lnd 6Sr./Rldn Ppr F".". Plan Ck. Res 30%/Blda Per Fee Fence BUILDIrlG PERI'llT Charges and Surcharges __n.:27J. eo I 'i .8'1 ';;;>0 CO "'co ____Si!..'_iti'...!.___ :1'2.:10 ____~2'q~~.:__ 1~(j;O PLUI,IB IIIG PERI1lT Charges and Surcharges ELECTRICP,L PERllIT Cha rges and Surcharges IIECHANlCAL PERMIT Charges and Surcharges fOR OFfiCE USE OIlLY Sq Ftg. Value ~'7~/UNI7'Vnluc /S'~,~.- ~'I/. IS" Storm Sewer Connec. Other Other Sprinkler System Other Demo. I Total SDC Comb. Permi t I ::>Cc; e:.I't r".,...,."Y r;<;,'V "l7"r~H-~p. U=> ~H" ~~939. ~ A/e Paving Curb Cut ,',' jt). CO ~.~ I TOTAL . Sidewalk6&>O -e ee . ' ;, CO:,:BWATlG:1 APPLlCATlOrl/PER:,lIT (CAP) 'I CITY Of s-p-iii N G FIE L 0 ( City Hall Springfield, Oregan Department 01 Public Works OFFICIAL RECEIPT No. B Dote 10 - <2., 19 <nO Rec'd From Oflnnl'S U mt.pn AddressqS() Jo i h /JI j) J) D.Jr I. Applicant to furnish A. Job Adaress B. legal Description 1. eXdmole- Tax lot 100, lane County Map 11 OJ "J 2, e"."le- Lot 1. Block 3. 2nd Addition Sprlngfield Estates C. flame. etc. of owner and construction lendel O. Energy Sources ( 1. eXJ:'!':oJe. heat/electrical ceilinQ/or fOI . 2. eX~~3Ie- wJterheater/eleCtrlcal/or s~ E. Slluue footage or valuation. etc. - 1. examole. 1250 sq. foot house. 500 sq, f '9 2. eXfI..'7::lle- if new project. checknew - if ~,..j~ C;l'2Ck add, etc. F. Building pernit information: 1. eX~r.l::l1e - construct single family house" ,en att~cned gararye ~ 2. exa~:lle - remodel existing garage into 3. eXd~~le - convert single family residen. restau~ant (change of use) G. Value of work as defined in Section 303 (a) '.tl Structural Specialty Code H, OESIG:I TEAI'I AriD CONTRACTORS To avoid design or construction delays, Buil [g, Division Staff must be able to contact apprc ~ persons regarding design information or jab corrections. etc. II. Abbreviated ?luffioing. Mechanical, $ Electrical S ~~ A. Except ~here blank spaces occur in the descr ~n" por:ion of the Mechanical and Electrical Sch the ap~licant need fill-in only the No. Saxe to the appropriate item(s) to be installed (, B. Full Plumbing, :-lechanical, and Electrical Scl tlF are available at the Building Division 1. 70 conserve space on the permit form the have been abbreviated ~ 2. If the ite:n{s) to be installed are not cc ~ecf the abbreviated schedules you should con~ full schedules C. BUIL~I;;G OIVISIOlI STAFF WILL FILL OUT ALL FEE ." CHARGES Qij THE SCHEDULES (, O. As noted on the CAP, the label must be delive electrical contractor for signature by his el suoervisor. The general contractor is not au to sign the electrical label. - Applicant to sign and date . Whenever possible. the initial application will bl . a worksheet only. Where possible, Building Divis' , will preoare a type written copy and return it to ~ applicant at the time the actual permit is issued signature. +-. IV. Fees and Charges Plan check fees are due ~nd 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 permi t is issued. ( ( \ ( S4842( ( Received For: 'it%pr a/iJ SX.0 Y/ ~, pp,' , ~()G,OO - 37 :1..0 3'1 l ,00 IL\-. <fA 3dn.06 I~ ,tr,(l l?H ' U5 70. CO Received t q ::l1. ,...-t4 ~P:_= ( ( 4,01n 1- jeJP L\Ob y/r i\OIO pC y: CD'Y\Wl ~L / .CJj) Amount ,', ( ( (, \ .. 1 , ( , I I 1. , , ~'~ \ r uQ""o "OHAW" ....(~~ON.TU....U~~ ."INU.. . "'uc;;...(. O. .,.0' ...".. (.. , 'v, FOR OFFICE USE GNLY Permit Clerk .. . -..". . ...... -- ~ -...... '."- .", ..... ,-,.,... -..-....--, PROJECT CmlDITIONS 'TO BE SATISFIED BEFORE OCCUPANCY: j- ~z::?:: ~A;;rc.~5 A-Ee z;.. ~ A/P'> , Sr.::..";' h-;:;>~r /5 ~7'A/~='7> Lz- #0 ~c ....;!:>~A/,....~< .!!"/~6"""" L-l:.'!".:-:..... I I 'f C::CJ''f A:: <=-" c.~ I I I I, 1 tv1,,~ ( " ..,..1 1 )'-4~25'/<::"E' ' d 'J": ~ 5~;<::> k-"v-==-</,;t:X'oS- Additional Project Information: PLANS REVIEWED BY: na~e LoPN!E /2t!?'-=. ",:,,' Signature~~ , - - v ~ --............--.....-..-.__ ...... ."... ...., I.,.... 0.. "_"""_ ... . date /e>-,b-/9, I ,...-,...., :" '.',_ .::, , - ,..,:,..,..__.J