The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1982-4-15 (2) INSPECTION LINE 726-3769 . CITY OF SPRINGFIELD COMBINAlION APPLICATION/PERMIT . INFORMATION LINE 726-37S3 '-/.. Job Address ~~".....-r') aAr_~~JAV , C:-/0~"Yj.../ r7 ENERGY SOURCES: Sq. Ftg. Main Heot Sq. ftg. Access. Water Heat~A~ Sq. ftg. Other Range .....=1. t I ,r ' _New_Add_Alter-Rep. Valve,af Wn.a.. _fence_Dema_Change/Use _Other "0 ~ '" l.gol Description 4- Owner ~7 .;~"rr",-..7 """.:t Tbh_ /?L D"I-'-""~~ Building r-..rmit Info: Describe Work (i.... Build Singl. family R.sidence With A"ached Ga.aqe) -'r ~_./ .(I""...-76r Jj JJ "" I -~ 1 '" Address _~ ~ q-....- <);, "" )/.1 ,-:~t'IV;,J JIJ~nj ....<:hhan.?.eJ"'7 -/'fY/ / ?L'7/ #U~ hrf '772.,...- Construction lender Address Phone DESIGN TEAM (name) (add.eu) (lies. no.) (expires) (phone no.) Primary /rz.. 7 Y7 ",,' .~1 Structural Electrical Mechanical CONTRACTORS (nome) (address) (Iics. no.) (exgires) (ahone noJ General .K7A. J-yj ~ ,11 Plumbing Electrical " Mechanical PLUMBING ELECTRICAL MECHANICAL NO. fEE CHARGE NO. FEE CHARGE NO. fEE CHARGE Residence of furnace/burner to " 11,TU's Appliance y.nt seporot. Stationary evap. cooler Vent fan with single duct Vent system aport from heating or A.C. Mechanical exhaust hood and duct ;; Each sing I. fixture Relocated building (new fix. additional) S.F. Residence (1 both) .~. ft. New circuits, alterations or extensions SERVICES Duglex (I bath) each Temporary Construction Additional both Amps. Water service $ewer Wood stoye/heater Storm Sewer fEEDERS Heat .Pumg Air handler to 10.000 CfM Air handler oyer 10.000 CFM Amps. '- ISSUANCE Of PERMIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portian of this permit shall not be valid until a label has b.en signed by an Electrical Controdor and attached to tho eledrical panel. I HAVE CAREFULLY EXAMINED the compl.ted application for permit, and do hereby certify that all information hereon is true and correct, and'"1 further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the lows of the State of Oregon pertaining to the work described herin, and Ihat NO OCCUPANCY will b. mode of any structure without the permission of the Building "Oivisian. I further cartlfy that my registration witt. the Builder's Boord is in full force and effoct 0 s required by ORS 701.0.5.5, that if exempt the basis for exemption is noted heron, and that only subcantra.ctats and employees who are in compliance with ORS 701.055 will be used on this project. Basis for Builder's Boord exemption' NAME (please print) /.. "J. * ./ ,........,., /. /~,.d"1~.-? 7.L/ SIGNATURE/. .-'/".?"---- Ld<__~ DATE -!/A.r/<7? . , ,. ~ ... FOR OFFICE USE ONLY Zone Fire Zone Flood Plain Type/Canst Bedrooms '"tori.. I!nits n<::cy Load n,.,"Y Group Sq. Ftg. Main Sq. fig. Access Sq. ftg. Other x x , Value Value Value TOTAL VALUATION BUilDING PERMIT Charges and Surcharg.s Plan Ck. Comm/lnd 65%/ Bldq Per fee Plan Ck. Res 30%/ Bldq Per Fee Syst.ms Development Char<:1e (J .5%1 PLUMBING PERMIT Charges and Surcharges Fence J j, V'-o Demo I Total Comb. Permit ELECTRICAL PERMIT Charges and Surcharges Sidewalk lAIC PayiM MECHANICAL PERMIT Charges and Surcharges I ---------1 Curb Cut I TOTAl 1)/ g. t,."o 'r." . COMBINATION APPLICATION/PERMIT (CAP) I, Applicant to furnish A, Jab Address B, Legal Description 1. exomple-tax lat 100, lane County Map Referenc. 2. example-Lot 1. Block 3, 2nd Addition to Springlie C. Name. etc. of owner and construction lender D, Energy Sources ,-' 1. example-heat/electrical ceiling/or forced air qas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq, foot house, 500 sq, foot gara~ 2. example-if new prol'ect, check new-if addition, c add, etc, C F. Building permit information: 1. example-construct single family house with an ( 2. ~:~:g~e-remodel existing garage into family rc ( 3. example-convert single family residence into restaurant (change of use) (' G. Value 01 work as defined in Section 303 (0) 01 the Structural Specialty Code "H, DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building r (iC' Staff rr:!ust be able to contact appropriate persons design infor~otion or job site corrections, etc. II. Abbrevioted Plumbing, Mechanical & Electrical Sche' A. Except where blank spaces occur in the descriptic 01 the Mechanical ond Electrical Schedules, the a need fill-in only the No. Boxes adjacent to the af , item(s) to be installed .- B. Full Plumbing,'Mechanicol, ond Electricol Sched, are available at the Building Division ". 1. To conserve space on the permit form the sch : . have been abbreviated ,,2, lithe item(s) to be instolled ore not covered '....' '" ated schedules you should consult the full sc! C. BUILDING DIVISION STAFF WILL FILL OUT ALL F, CHARGES ON THE SCHEDULES (.' ~p ( CI'iOF SPRINGFIELD , City Hall Springfield, Oregon Department 01 Public Works ( OFFICIAL RECEIPT I No.8 58893 ( 'I c ( 4-, I~- 19 gL Rec'd From 4ctT./ow.t ;1;;' /; A ' A l......Ln-Y AF ~aa.., Address 3 39f ~ UJ iku~l.-fr ~--_ aiM- " -; Date (" ( Received For: ~,(-r.'-_ ~ ilL ,~ ,-J, l74-' . - - ____"'"UA,. ,t/:- R~ -?;j.() ''f// t. Uti ( ( .( .c 'c. tJ It. 1/'-0 .( Amount Recelved_p A .J~_ C. ~ ,IV, Fees and Charges ",,,,,. ."" " ' ." Plan check fees are due' and payable ,at the time of the application, , ,,' and na plans will be processed until these fees ore paid, All ',".; : other fees and charges are due and payoble when the permit. .~-:;,-.isissued. ',';~"':';'~", ~.~" ".~ .>.' ':.. . ..-., (ul, ~'" '.,,- ,._,. '111. Applicant to sign ~nd dote , ..:....~ .Whenever possible, the initial application will be used as a . ":":, worksheet only, Where possible, Building Division Stoff will . prepare a typewritten copy and return it to the applicant at :.:"\. the time the actual permit is..issued for his signature. V. FOR OFFICE USE ONLY '. ,,' '.. .'. "," ~ . ". PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .' .,' ~ .~;..;\ . '. ,". :.-"';~ 1". 'f- . :':.-'. '. Additional Project ,Informotion: P', " PLANS REVIEWED BY: name signatur.... .' u:. ....;,. II k~ ..".'- sY.' ~revi- '...... . ( ( ..,ooa I"RIHTIlRS/UTHOGlU.PHIlRS .. '.' . ,~.. . . _ . .', '.'".. . 0'" '. GIlNIl.ORI:GON .... . AUTHORIZED SIGNATURE ( :j- "-'. . " .,' '. '.~...' - :;'-;," ..: . '.: ~; .', "r' ......~ " .:., . :{ . ~ "" ,..',' ';,.. :'~;;.. . ,i';. .~' :.,:i " , '''-''.'.. Permit Cler~ ..... ._..:i:.;.:_<'. :.:~:'. ;t, .. . .. ...':':f/~ .,. '''~' '-.I ".:, ;"' 'Co.,' :!~. ~ . ....' , "::'. !.-. ..~ -.~" , '..:;i:::.::::~~k', .,\,...., , "";i,.1 ' ~. ,". , ......,-.' . :' :::';. ~. i. ~", _".;,. ~.,.. .... ...\.'. .1..,..., I~' ....,'-.1,. -,.;. '. .". " .. , " ";.';'..,.'_,';J.." .....: .....1... :-::;'t': ..:..::.-;;.....0'..,', . ';.:... ~...,,:.:.,' .:'.';i;;.I+", "..J,."' . "J' .:~.': , ''-' . :.:~ '.:,.. .' " .:.. "". ...,'. . .~.' ::: ".. ". ',~F.. ". ...~. 1~:::::,...:. ,'. .... . ... -:' -.. , ~. ' '...., 0 ....: , ' ., .J,'," ",' 'p. .f.. ~ .'. . .'.'0 ":, "'.' "'.,... __,. . ."!,o,..." -... .,..',,1" ..Jot"" . - -,-~._. ---- .. .. ." ......, '" , :-,... .... ,,~., ",.'w.. '$ . '}' '~;;':": .~ >~"';:"'f'I~.n~,;;,,', t CITY OF SPRINGFIELD CDMBIilATION APPLICATION/PERMIT t INFORlIATION LINt 726-3753 Sq. Ftg, 1.lain ~q, Ftg. Access, ""'<>'1 ~ Sq, Ftg. Other J..J Hew Add A'ter Rep. Ranqe -Fence Demo Change/Use ~ ValuE of Work: Other- - ^' c;:/"?//(? /1'.\ BuilulnQ Permlt Info: Describe Work(;.e.. Build Single ~ Family nesidence Hith .A.ttached GaraQe) .. () fi,',./ 'p~__~,~.4'N..M=:~ =~;'..l~1 /1 I , ~ <Vf'A1~ _ /7 A'-r_ ,<;;:,/..do? ~~",;o~.d 4-...Q /11 f'..! -/ a jJ~) (lies. no.) I INSPECTION LINE 726-3769 Job Address ~ ~ ~tQ' r3LJ TY Legal Description 1:7.. "" /1 /".1/9(-,1 11 E!IERGY SOURCES: s.;;.p"'~"f~;T.,.1 Heat . oteE: Hater Heater tL/.44/ 7.1"'" /7-<:;:,-2.'2-;:ZO. ;r.e... /;?.:>C:> .0:.",..,,,.< Owner .3'"' __ 'T~,7 77..1 r/ &.J "Y1 A 1. Addr's~ ~q-;- <:.;.;J r.: L1b' /7~rll/: P,. }.4~ eHI~ n-d) ~/'~c;,'; ~ 7C Construction Lender Address Ut>IGN TEAM Structural Primary /!Jt:;,TY7<"A' (name) , El ectri ca 1 '., Mechanical , CONTRACTORS {name} Genera 1 A h,./ ~ tlf _ Plumbina NO. j;fF / Each single fixture :7-'L8 i'f VHTc;1<{ H. RelOcated building I (new fix. add~tlonal) I each I I I I I I I I I I I . El ectri ca 1 , ~'echani ca 1 S.F. Residence (1 bathl Duplex (1 bath) Additional bath IWater service I Sewer I Storm Sewer I I I I PLUI,IBI NG TOTAL CHARGES , WHERE STATE L\lj REQUIRES shall not be valid until the I HAVE CAREFULLY EXAMINED 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 Derformed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon !lertaining to the work described herein. and that UO OCCUPAI~CY will be made of any structure without the penmission of the'Building Division. I further certify that my registration with the Builder's 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 ORS 7rn.055 will be used on this, p~oject. ,~) ;;?9?-/<g-// ,(r!trJ1r4~.( ;z,,#,~ f"17d,/:// rWIE(please print)/A 7u<J./~ I. l-Jr1,-v7L ')o:"u7y' SIr,r1ATURE,4.../~~n.L~......4~~DATE -?'/~~ez. Foh OFFICE USE DilLY Sq. Ftg. Sq. Ftg. Sq, Ftg. Zone <. ~ '/ Fire ZonE" Flood Plain BUILDING PERI-lIT Charges and Surcharges - PLur~BING PERMIT Charges and Surcharges ELECTRICAL PERlm Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges "'36. .",c. P~;~B~~~ ------------ ~ ,; Plan Ck. /. '7 'I 30%/B1 da _____Q-;~__ Fence .?-tfP TYDe/Const. :tZ:- N Bedrooms Stories Phan~97_/S'7, Phone (addressl texoir€!sl (Iln('ll'lp n(l (address) {1 ice;. no. 1 (pxoiresl (ilhnnp no, ~ _ _...--...._.~c~~..- ELECTRICAL MECHANICAL I, rlJAllliE. ! ./ rHAPr,F Nn ~ ..cJ::!At)r.~ NO <<< Residence of furnace/burner to BTU's s;- SQ, FT. New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wall So~rp hp~tp~ ~nrl vpnt I ITemporary Construction IChange in existing re~ j ~e.rH'p Imultifamily. comm. or Industrial 10f amps.1 ICOMM,/IND, FEEDERS IInstall/alter/relocate 1 rli~trih_ fpprlpr~ 10f amps. I I I I Appliance vent SPOilrat.p I Stationary evap. cooler I Vent fan with sinale duct I Vent system apart from I heatino or A.C. I Mechanical exhaust hood and duC"t I ~lood stove/heater II I I I 1 ISSUANCE OF PFRrlIT '- ' $":- TOTAL CHARGES TOTAL CHARGES that the Electrical work be done by an,'Electrical Contractor. the electrical portion of this pernit label has been signed by an Electrical Supervisor and returned to the Building Division / Units Occy Load Occy Group #/-/ 1 Value , Value, bt9= x Value TOTAL VALUATIDN.t"?_~";> ~!::~; c~ syste, J:\S Development > l:,;I,:L.....n 4-/"'-82 Charoe tl. 5~) "'G:'. <:00 r ' , I I I I I I I Hain Access Other 5"0 'T Co",,1I nd PJ'r F'pp Res Per Fee Demo ISldewa 1 k ------------1 Ale Paving I Curb Cut I ITotal 1- I'OTAL '1'2.. t5</ \ ~ I "J 2..G 'f", Comb. Permit " , '- I r' . -. CI'~OF SPRINGFIELD City Hall , Springfield, Oregon DapartmentOl,publlc Works OFFICIAL RECEIPT No~B 58899:1 ( Ii .. COMBINATION APPLICATION/PERMIT (CAP) ( I. Applicant to furnish A, Job Address B. Legal Oescription f.' I. example- Tax Lot 100, Lane County Map Refe, , 17 U3 43 2. exam~le- lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources I. examole- heat/electrica I ceil inolor forced Received For: 2. examyle- waterheater/electrlcaf/or s~ (' E. Square footage or valuation, etc. ------ I. exam~le- 1250 sq, foot house, 500 sq. foot 2. example- if new project, check new - if ac cneck add, etc. (, . F. Building permit information: 1. example - construct single family house w; attached garage 2. examole - remodel existing garage into far 3. example - convert single family residence to restaurant (change of use) G: Value of work as defined in Section 303 (a) 0 Structural Specialty Code H. OESIGN TEAM ANO CONTRACTORS To avoid design or construction delays, Build Oivision Staff must be able to contact approp persons regarding design infonmation or job s corrections, etc. ( II. Abbreviated Plumbing, Mechanical, & Electrical Sc A. Except where blank spaces occur in the descri portion of the Mechanical and Electrical Schf the applicant need fill-in only the ,No, Boxe, ~ja 'to the appropriate item(s) to be installed B. Full Plumbing; Mechanical, and Electrical ScI are available at the Building Division 1. To conserve space on the permit form the have been abbreviated 2, If the item(s) to be installed are not c the abbreviated schedules you should con full schedules C. BUILOING OIVISION STAFF WILL FIll OUT ALL FE ,CHARGES ON THE SCHEOULES 0, As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical label, --- Applicant to sign and date Whenever possible. the initial application will be used as 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. IV, 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 permit is issued, Date t/.-/!f c 19 ,P '} Rec'd From -A,1fth 1.' Aff i.-., ". () ,,0-.(", ~dI4,_ Address 3') '1('- ,;5.-[{) L.J. A' I ~,:4. '<~ ./ or a......., <l -. 'Au 9 ~~~:;+ '-fJ;u -I'" j,-<--'~ :t .I.Ju't< ;:;. 1/ ~/) , '.4hA"A./dhl--lj~ "v . > _ U J.,?/" t'iJ I. '/-i/. ,L;"': 1'0 .~ I/[), h o (I c ( ( .( .. ---'- J ',.. (11- /;/3:2.6'1 Amount Received = ./ ~. ~e( ( ~" ~ . AUTHORIZED SIGNATURE ./ \, ( . .... .RIQQS PRINTI:R8IUTHOGRAPHER8. EUGENE. OREGON -.,> III. V. FOR OFFICE USE ONLY Pennit Clerk . . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .~.- , Pennit applicant exempt from registration with the Builder's Board because: Additional Project Infonnation: 1r'....."II.'...'.r ":_Jt'~- ' a""~:~: !.,__ -.,..V~' -lin~ ,*~1( PLANS' REVIEWED BY: -name ~#E '"::':::> .d ~ ""<~_'~ignature ~~/ ___~_!l""'" _ r- . ,,~ ,I date '1-/ fie-fa:Z. .