HomeMy WebLinkAboutPermit Plumbing 1985-12-3
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1 JrISPECTIOtl LIIIE
726-376g
.Job Address
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INFORlIATION L1t!<
726-3753
Sq. Ftg. 1,Iain
~q. Ftg. Access.
Sq. Ftg. Other
Ilew Add Alter Rep.
--Fence Demo Change/Use
Other - -
~
Legal Description
Owner HIA/UA j /Lat/t..,
Address, <)??tJ -1n~
Address
Ut:::dliN II:N1
Phone
(address)
BU11Gina Permit Info: Describe Work(i.e., Build Single
Familv nesidence With Attached Gara~el
~ pj"/PL/~ R ...fur
~A- ;!/lj!.u. ~~/-"~
tJ
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-
~
(;J
Construction Lender
lnamel
(l(~OireS)
(ohone nO.l
Primary
.~
'{f
Structural
Electrical
Meehan; ca 1
CONTRACTORS
(namel
(addrpss)
(lice:; no.'
(pxnirp,,\
lohnnp nn_ 1
General
Plumbina
f1t./ftJ..PA-l
Electrical
"'ec:hanir.Cll
I., .
Each single fixture
SQ. FT.
! MECHANICAL
1OELJ..cJ:IARGE ..JlU...1
I furnace/burner to
BTU's
I Floor furnace
and vent
I Recessed wa 11
Sn~rp hp~tp~ ~nrl vpnt
I
r"~
PlUllB ING
ELECTRICAL
...Jill.....
F>F
rHI\Rr,F
"n~
Residence of
I App 1 f ance vent
seoarat_p
Stationary evap.
cooler
Vent fan with
s;nole duct.
I Vent system apart from I
heatino or A.C.
I Mechanical exhaust
hood "'nd durt.
I \-Jood stove/heater
1
I
I
im
I
I
I
I
1
I
,/
/Re10cated building
(new Fix. additional)
IS.F. Residence
(] bath 1
louplex (1 bath) each
IAdditional bath Temporary Construction
1'~later service IChange in existing I
rp~idJ'nrp
I Sewer Imultifamily. COIl11l. or I
Tnn""tri<ll
I Storm Sewer I I Of amps.j I
10)1 JiL 0-1,11/ aJ I CDMlI,IIND. FEEDERS I I
I 0- A ",,-+- I IDI Install/alter/relocate I I
/) ~j/~J; ()C) rli"trih fpprlpr"
I I I 10f amp,,1 I
I /1'% I I-'lV 1 I
I I I I I
1 1 1 I I I SSUANCf OF PFRIIlT
TOTAL CHARGES ID ,10 TOTAL CHARGES I TOTAL CHARGES
WHERE STATE L.'1I REQUIRES that tile Electrical work be done by an,'E1ectrical Contractor. the electrical portion of this pernit
shall not be valij until the label has been signed by an Electrical Supervisor and returned to the BUilding Division
jNew circu~ts alts.
or extenslons .
I SERVICES
Fire Zone
I HAVE CAREFULLY EXAMINED the completed aprlication for permit, and do hereby certify that all information hereon is true
and correct. and I further certify that any and all work ~erformed 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 IW OCCUPAUCY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
Board is in full force and effect as required by ons 701.055. that if exempt the basis for exemption is noted hereon. and that
only subcontractors and employees who are in compliance with ORS 7Ql.055 will be used on this project.
SIGIIAT~~'.. ~~,~ DATE (;)-3 -,ts-
FOP. OFFICE USE DIlLY
Sq. Ftg.
Sq, Ftg.
Sq, Ftg.
LEWIS
IlAllE(please print)C. LAt2.~ c...
Zone
Tvpe/Const.
Bedrooms
Stories
Units
Occy Load
Occy Group
f1ain
Access
Other
x
Value
Value
Value
x
Flood Plain
x
TOTAL V AlUA TI 0/1
BUilDING PWIIT
Charges and
Surcharges
Plan Ck, Comm/lnd
65%/Bldo Per Fpp
------------ Plan Ck. Res
30%/B1do Per Fee
jO.CO I Fence
----- --:-10-1 Demo
hidewalk
I A/C Paving
I Curb Cut
------------
I
Isyste.ms Development
Charoe t1.5~) ..
PLUt1BING PERMIT
Charges and
Surcharges
I
I
ELECTRICAL PERI:IT
Charges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
ITotal Comb, Permit
I
I TOTAL
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