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Home My WebLink AboutPermit Plumbing 1981-4-21 . INSPECTION LINE 726-3769 Job Addren (.;.()!J t.. ~~ P~Rk legal Description ~ )r[;c<(l'. CITY OF SPRINGFielD COMBINATION APPlICATlON/pERMIT INfORMATION LINE 726-3753 . H I ENERGY SOURCES: Sq, Ftg, Main 755 W arldCU Heat Sq, Ftg, Acceu, .5frlJ1'\irt..Ic' Water Healer Sq, Ftg. Other J Ranqe _ _New_Add_Alter_Rep, Velv. ef W/t'~ ""^ ___F"",,_D.mo_Cheng./U.. '--t:::1 I) _Other - -B~iidi-ng Permit -Inf~:- -- D;~cribe Work (i,o,. Build Single Fcmil'f Resident"ft Wilh Att<:1chod Garaoe) cP' - g CJl \1. f)~G.-"d.1\ h-D t. J,J IHAMI1b4J1J? fJ/lll::5 c:::.PFI ^ f).n \~3 Ph en. Owner , Addreu Construction Lender --if Addren (nome) Primary Structural II Electrical I' " Mochonical CONTRACTORS (name) f), 57. '1 L4'1.' 10lA C' 1'1 \J ~\ \J \ /V0] Phone (address) (Iin, no.) ce' c... Pl"/A...g tJ (phone no,) Lf71,)"-73 &5 (expires) I 'i'!~ PeCl(" { (addreu) (liu. no,) (phone no,) (e:o:piresl 7/0 fI6UE({Or{ M,.q.- ?~6 ;;;t Plumbinq " '/--A.8.tiFEt...fr "!PilI/LIt ~ /III/ iJ(,.. fC(j(..E filii Gll'!neral elp.ctrical II WAg[) Fc.2.,:s7 Mechonical " PLUMBING NO, i FE!: I CHARGE I I I I I I I I S.w" ~'I Slolm S.w" P7'.-.l,.c- l,c_ - ( =~fi:l' I A"P 11?B/~r/~A/ Each single fi:o:ture RelocaTed building (new fix, additional) S,f. Residen~e (1 balh) Duoln (1 bath) each Additional balh Water service ~.a6 ~,"'" ,~ r I TOTAL CHARGES I ELECTRICAL MECHANICAL. NO I i/ CHARGE CHARGE NO. FEE FEE Residence of furnace/burner to BTU's Appliance vent separate Stationary evop, cooler Vent fan wilh sinqle duct Vent system aport from heotinq or A,C, Mechanical exhaust hood and d~ct Sq: ft, New circuits, alterations or extensions ISO"' SERVICES Temporary Construction Amps, Wood slave I heater FEEDERS Heat Puma Air handler to 10,000 CfM Air hondler over 10,000 CFM Amps, ISSUANCE OF PERMIT '1'5". G.oI TOT At CHARGES WHERE SlATE LAW REQUIRES thai the Electrical wor~ b. done by the Elertricol Cantroctor, the electrical portion of Ihis permit shall not be valid until a label has" been signod by on "flectrical Contractor and attached to the electrical panel. L" ...... 10' TOTAL CHARGES I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further certify Ihat any and 011 work performed shall be done in accordance with the Ordinances of tho City of Springfield and the Laws of the State of Oregon pertaining to the worle described herin, and that NO OCCUPANCY will be mode of any structure without the permission of the Building Division. I further certify that my registrotion with the Builder's Boord is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is nohtd heron, and that only subcontractors and employees who are in compliance with ORS 701.0.55 will be ulOd on this project. Basis for Builder's Board exemption: J!.o+ ~J{efJ rOI!.. ':>'f!.. tI PA(j~'I<"'" ./7 // NAME (please print) --.t:J it{)r fu.:rs..n ~ SIGNATURE ~Mb t . ~ Zon" Fire Zone flood Plain Typel Canst. Bedrooms C,torie" BUILDING PERMIT Charges ond Surcharges PLUMBING PERMIT Charges and Surcharges 'fSCO I.S. ~ ...~ I.J. ELECTRICAL PERMIT Charges and Surcharges 6D MECHANICAL PERMIT Charges and ,Surcharges I .--------1 DATE -y /::<{ jog I fOR OfFICE USE ONLY Unih ("lecy Load Occy Group Sq. Ftg. Main Sq. Ftg, Access Sq, Ftg. Olher Value x Value x Valua TOTAL VALUATION Plan CIe, Comm/lnd 65%/ Blda Per Fee Plan Ck, Res 30%1 Bldq Per Fee Systems Development Chara. {I,5%\ Fence Demo Total Comb, Permit Sidewalk I U-.,:;)C- .,.::> . I I -I TOTAL <?'f. ,/0 ~z.- AI C Pavina Curb Cut . COMBINATION APPLICATION/PERMIT (CAP) '!. Applicalll, to furnish A. Job Address B. legal Description 1. example.tax lot 100, lone County Map Reference. 17 03 43 2. example.Lot 1. Block 3, 2nd Addition to Springfield Estates C. Nome, ete, of owner and construction lender D.. Energy Sources 1. example-heat/electrical ceiling/or forced oir gas 2. example-water heater/electrical/or solar 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 on attached garage 2. example-remodel existing garage into family room 3. example-convert single family residence into restourant (change of use) G. Value of work os defined in Section 303 (0) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delaysl Building Division Stoff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbrevioted Plumbing. Mechanical & Electrical Sched~les A. Except where blank spaces occur in the description portion of the Mechanical ond Electrical Schedules, the applicont need fill.in only the No. Boxes adjacent to the appropriate i.tem(s) to be installed B. Full Plumbing. Mechanical. ond 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 ore not covered on the obbrevi- aled schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES III. Applicont to sign ond 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. IV. Fees and Chorges Plan check fees ore due ond payable at the time of the application, and no plans will be processed until these fees are poid. 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: ~ , Additional Project Information: .', PLANS REVIEWED 8Y: .... ". nama ",ignatura . PERMIT VALIDATION ~ro't ~. ~ ~3 3 Lv \J%.). \ OOA I"-=t 4010 ptmb 496 ~ . ...,\'. ,..., '. 3~ ,00 \~. 0-0 . (s; () Y'S..oO I . <6'0 94:40 CJ: . ,/ ..1' ." ~+CO/~g'J -. , " ~. ;- Permit c'eMiMJ . , . - . .Jate.