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HomeMy WebLinkAboutPermit Plumbing 1981-4-13 :. JobAdd.... Q~~ HOY low RrL l.gol C.",;.,;o. . HAl r1 Qn :er R~ r;/)J); I7D3?..-b 12.'- Ow." Alfn VJ k!,.pPC). Or Add.... 1-l~ r::: {?~q, ' i4In-[qL\ L\- INSPECTION LINE 726-3769 Co~struclio" Lender Addren DESIGN TEAM (nome) Primary Structural Eleclricol Mechanical CONTRACTORS (name) Genllfol. Plumbinq ()1..DYl Q "If'"" Elecfrical Mechanical PLUMBING NO, I I FEE I CHARGE NO, 1 I I I I I I I 1 I I 1001 I I I I I I 1/09<0 Eoch sinqJe fixture RelocaTed building (new fix. additional) S.F. Residence (I bath) Ouolu Cl bOlh} each Additional both Water s.n;ce \ Sewer Storm Sewer I I r I TOTAL CHARGES I CITV", SP~NGFlElC COMBINAhcm APPLICATION/PERMIT . cA. - D' 0J (jI '" \ INFORMATION liNE 726-.3753 I ENERGY SOURCES: Hear Water Heater Ronqo Valve of Work: , Sq. fig. Main Sq. Fig. Ac~eu. Sq. Fig. Olher _Nllw _Add_Alter _Rep. _ _Fence-;--Oomo_Changel Use __Other Phone BuiTd-i-;';gP;-;;it-i~io; , Describe Work (i.e.. Build Single 'rr;;';di.)W;st~Jltpy ()W,npf tI1;~ Phone I {phone no.l (address) (lies. no.) (expires) (address) (lies. n~.) (expires) (phonll no.) ElECTRICAL MECHANICAL FEE CHARGE NO. I' FEE . CHARGE Residence of furnocel burner to I1TU's Appliance vent separate Stationary evap. cooler Vent fan with sinqle duct Vent system apart from heating or A.C. Mechanical exhaust hoad and duct .I Sq: ft. New circuits, alterations lOr extensions SERVICES Temporary Construction Amps. Wood stavel heater FEEDERS Heol Pump Air handler to 10.000 CFM Air handler over 10.000 CFM Amps. ISSUANCE OF PERMIT WHERE STATE LAW REQUIRES thaI the Electrical work be don. by the Electrical Contractor, the .Iectrical portion of this p.rmit shall not b. valid until a label has b.en signed by on Electrical Contractor and attached to the electrical panel. I TOTAL CHARGES TOTAL CHARGES I HAVE CAREFUllY EXAMINED the completed application for permit, ond do hereby cortify that' all information hereon is true and correct, and I further certify that any and 011 warlt performed sholl be done in accordann with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work de"ribed herin, and that NO OCCUPANCY will b. made of any structure without the permission of the Building Divilion. I further certify that my regisrrotion with Ihe Builder's Soard is in full forte and effect a s required by ORS 701.055, that if exempt the basis for exemption is. noted heron, and thar only subcontractors and employees who ore in complian~ with ORS 701.0.5S will be used on this project. . Basis for Builder's Soard exemption: NAME (pl.e.. .d.~L C- &1 N , Zon' Fire Zone Flood Plain Typel Canst Bedrooms ~Iorie' BUILDING PERMIT Chorgos and Surcharges PLUMBING PERMIT Charges and Surcharges II), on t1.0 ELECTRICAL PERMIT Charges and Surcharges MECHANICAL PERMIT' Chergllls an. Surcharges I .--------1 , ,'> -' ' f? ~ t.f? ~N~TURE &? L r: '!if f{ FOR OFfICE USE ONLY OATE~ t? 'C e Qe.r7 qn;ts ("'Itcy load Occy Group Sq. ftg. Main <;.... Ftg. Ac:c:eu Sq. FIg. Olher x x Value Valuo Value TOTAL VALUATION Plan Ck. Comm/lnd 65~:.1 BldQ Por Fee Pion Ck. Res 30%1 BldQ Per Fee Systems Development Charae 11.5%1 Fence Demo Total Comb. Permit Sidewalk I Ale Pa'f'inQ Cutb Cut \0.00- TOTAL , , .... ~-;-....- ..... -'---. . COMBINATION APPLICATION/PERMIT (CAP) . , I . ."""1 I. Appliea!\( ta furnish A. Jab Address B. legal Description 1. example-lax lot 100, lane County Map Reference 17 03 43 2. example-lot 1. Block 3, 2nd Addition to Springfield Estates C. Nome, etc. of owner and construction lender D.. Energy Sources 1. example-heat I electrical ceiling/or forced air gaS 2. examole.woter heater/electrical/or solor E. Square footage or valuation, etc. 1. example-1250 sq. foot house, 500 sq. foot garage 2. example-if new project, check new-if addition, check add. etc. F. Building permit information: 1. example-construct single family house with an attoched garage 2. example-remodel existing garage into family room 3. example-convert sin.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 avoid design or construction delays, Building Division Stoff must be able to contact appropriate persons regarding design informction or job 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 fill~in only the No. Boxes adjacent to the appropriate ilem{s) 10 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 hove been abbreviated 2. If the item(s) to be installed a~e not covered on the abbrevi- ated schedules you should consult the full schedules C. BUilDING DIVISION STAFF Will Fill OUT All FEES AND CHARGES ON THE SCHEDULES - III. Applicant to sign and dote Whenever possible, the initial application will be used os a worksheet only. Where possible, Building Division 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 ore 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 ore due and payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: J' Additionol Project Information: PLANS REVIEWED BY, name . ____ signatun'" "ERMIT VALIDATION '. Permit Clerk ..I,to Job Add,... a~ ~ H. ()0f \ OW R (~ l.gal Om,;.tia" ' HAl (i 0 ~& - tS:ri ~f)J) I7D3?.-b 12 - OW"., t:;. {" h Vl k:',-P P (').. 0 ~ Add,... '2-L~ r:::: F q.-. 14 '''1-IClL\ l\- I I I I I I I 0 uel> I I I I I I IOpijJ I TOTAL CHARGES INSPECTION LINE 726-3769 . Co~'truClion lend., Addre" DESIGN TEAM (nome) Primory Structural EI~ctriCQI Mechanical CONTRACTORS (name) General plumhinq (11 VI) Q V electrical Mechanical PLUM81NG NO. I FEE CHARGE NO. Each ,inClI. fi:Jllure Relocaled building (new fix. additional) S.F. R.sidence (1 bathl Duolu (1 both) each Additional bolh Wat., ,en';c. 1\ I I I I : I "I Sewer Storm Sewer TOTAL CHARGES '; . INfORMATION LINE 726-3753 C~1.Y~F.SP~INGFIElD COMBINATION APPLlCAJlON/PERMIT Phone cA I ENERGY SOURCES: I Sq. Fig. Mai' - Hear Sq. FIg. Aceen. D' I Wat.r Heater Sq. Fig. Olh.r r:::.. \ Ranqe _New._Add_Alter_Rep. .\ 'J I Value of Worle: 1__Fence_Domo_Change, Us. \.J' _Olh.r I BUilding Permit Info: D.scrlbe Worle (i.... Build Singl. f'- Fa~'l it!"') w'C:'o71 t?} (DYlnPf lI1,~ ~ Phone (address) (expires) (phone no.l (lies. no.) '" (addr.n) (expires) (phon. noJ (lies. no.) ElECTRICAL MECHANICAL FEE iCHARGE I I I I I NO. I CHARGE I I: I ,: FEE Residenc. of furnace/burner to Il;TU's Appliance vent seporote Stationary evap. cooler Vent fan with sinClle duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct H~: ft. New circuits, alterations or extensions SERVICES Temporary Construction Amps. Wood stovel heater FEEDERS Heat Puma Air handler to 10.000 CFM Air handler over 10.000 CFM Amps. ISSUANCE OF PERMIT I TOTAL CHARGES WHERE STATE LAW REQUIRES ,hal Ih. Elech'ical wark b. ciano by Iho Elutrical Contractor, Ih. electrical portion of this p.rmil .hall not be yalid ,until a label has bMn signed by an Elech'ical Contradar and attached to the .Iectrical panel. 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 ond 011 worlt performed shall b. done in accordance with the Ordinonr;es of the City of Springfield and the laws of the Slate of Oregon pertaining to the work described herin, and that NO OCCUPANCY will be- mode of any structure without the perminion of the Building Division. I further certify that my registration with the Builder's Boord is in full force and .rffed a s required by ORS 701.055, that if .....mpt tho basis for .....mption is - noted h.ron, and that only lubcontractars and .mploye.. who are in compliance with ORS 701.0.55 will be us.d on this project. " Basis for Builder's Board exemption: NAME {pl.ose prin~L t:,.. W , Zone Fire Zone Flood Plain Typel Consf ,Bedrooms C:',ri.' BUILDING PERMIT Charg., and Surchargu PLUMBING PERMIT Charge. and Surchorg.s __lQ~OQ__~ . ,?S; ("') ~.~n ELECTRICAL PERMIl Charges and Surcharges .fY r: -d? ~N~TURE (j L r::at IV FOR OFFICE USE ONLY OATE~ 12 -c e t:;2e.R 'nib n."Y Load n,.cy Group Sq. fig. M::.in Sq. Ftg. Ace... Sq. Fig. Other . Value Value Value TOTAL VALUATION Plan CIe. Comm/lnd 6S%/Bldq Per Fe. Plan C\.:. Res 10%/Sldt'l Per Fee I Systems Development Chorne 11.5%1 I I I Total Comb. Permit I I I I TOTAL \0.00 I Sidewall. ----------- MECHANICAL PERMIT Chor..,.. an. "...::..... '-Char".. I?~-"' .......:: 'M"'... c' ~__~-:i._' ;._.......".....: 1- Ale Pavinq Curb Cut ... - ~.~ ,. ".~. ..::.... ..i, - . COMBINATION APPLICATION/PERMIT (CAP) I. Appliconl ta furnish A. Job Address B. legal Description 1. example-lax lot 100, lane County Map Reference 17 03 43 2. example-Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D.. Energy Sources 1. exomple~heat I electrical ceilinglor forced oir qas 2. exomoJe-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. faot house, 500 sq. foot garage 2. examole-if new project, check new-if addition, che add. etc. F. Building permit information: 1. example-construct single family house with an otte garage ( 2. example-remodel existing garage into family roar J. exam,ole-convert single family residence into restaurant (change of use) G. Value of wark as defined in Section 303 (a) of the Struclural Specialty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or ccnst'ruc'ion delays, Building Divi~ ( Stoff must be able to contact appropriate persons ref design informction or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedule A. Except where blank spaces occur in the description p. of Ihe Mechanical and Electrical Schedules, the oppli. need fill.in only the No. Boxes adjacent to the appro item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedul hove been abbreviated 2. If the item(s) to be installed a~e not covered on th oted schedules you should consult the full schedu C. BUilDING DIVISION STAFF Will Fill OUT All FEES J CHARGES ON THE SCHEDULES III. Applicant to sign and date Whenever possible, the initial application will be used ( worksheet only. Where possible, Building Division Stoff prepare Q typewritten copy and return it to the applieal . 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 1'" ..._~ and no plans will be processed until these fees are poic _((I . -. ather fees and charge. are due and payable when the ~,. f is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY, I, itERMIT VALIDATION ...... ( CITY OF SPRINGFIELD City Hall Springfl..ld, Or..gan D..partment of Public Wark. OFFICIAL RECEIPT No. B I (I (] ( ( 56282(1 (. c OdDJ)j f1i1~1 ( ( R..ceived far: ~CZOHLQv 1t).W - qG!O .( .46 ,( ( ( / ( ( c ( C Amaunt Received .r fL_4 0 r ~ . ( r4J ---- -'- . ( 'I C.IIY --C_ Af'THO"IZED SIGN"TUItE ""t:ltO"'TU"".U'" ""'"TIE"". IEUOI"I[. 0" .7"0' ...".. ( c: '" t ..... Permit Clerk . .:~.~ I: I " j I I - . j Additional Project Information: PLANS REVIEWED BY: nom..... rignatura ...... -l....:. ,J. '~ .Jete ......, :;:. 1.... ._' f ~ ., '~:~...;-,~ ~ :., " - ' - . .. . . <.,.~ .... ;;. :., :,'1~_~.\~~' ,:tt~.: .,..~.............~"t'".... "._.....,.......