HomeMy WebLinkAboutPermit Building 1984-2-21 (2)
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I IrISPECTION LIIIE CITY OF SPRINGFIELD
726-376g C0I1BIHATION APPLICATION/PERMIT
...4 ,.I' ,,/ EilERGY SOURCES:
Job Address 8(/$ /,/#/j .Sf- _~/./".Jt.l-'/I/17 Heat Fhr_
Legal .Qe5cription/?_~3_~~2. "7d~ C7/~ I~ater Heater /,j~r_
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INFORllATION LIN. l
726-3753
Sq. Ftq. 1,Iain
~q. Ftg. Access.
Sq. Ftq.~ ,~cz,.,g
--11ewJ(Add__Alter-O~ep.
Fence Demo Change/Use
, --Other -- --
Owner d;/.~.-J.~.h#'Qf~'t/ /.f~k<1
, , I
Address t!?a.J' /JiJ/,,) ~'h~ /a,.,,/ Phonc'~q:
~ J'wOH?%;.eYb4";ill y- $~P?i .:> /"7"
Construction Lender Nt?#i>
Ranqe
ValuE of 1,lork:
/~5" I)" t!J
Bui lGin~ Pennit Info: Describe Work. ( i ..e..
Family ~esidence With Attached Garaoel
Build Single
~
'"
vt
IN
I
Primary
(namel
b...';' &A'$(
I
Phone
(address l
65'/ N,t'.!/. -/Aot'S/'A/
-4,:/<<.~;;tI"~" .,f ,f/ .?/d1/'t#/
,ti&/;~...i:; h~/~~
/
<,-'~
Address
Ul:.~ tliN II:.AI~
flies.
&/?,/~/;;;,
no. 1
{exoiresl
Cohone no.
Structural
7SV- ?zca
Electrital
Mechanical
CONTRACTORS (name 1 (address 1 (1 i r~. nn. 1
General /t"";h,nnl AI. <?dIll' ;;~Nj ,.?~_? ~,./j _,7- +#/"';"/--1//
~M'~.Mp $:".I'R~'NAU&Q I
, --
(pxoil"pc:l
(ohnnp nn_ \
~.#'7-?5?,I./
,
Electrical
"echanic'al tf" ....W^'PA T J::'L61N' ~n-< '
PLUi1BING
ELECTRICAL
MECHANICAL
110,
Each single fixture
FE, I rHARr"
;)'- 1tP,-
Nn
<F,
rHM.IiE. NO,
FFF
rfJARliE.
:2
Residence of
SQ. FT.
furnace/burner to
BTU's
Relocated building
(new fix. additional)
~ New circuits alts.
~ex~~E'
SERVICES
ISQC
Floor furnace
and vent
,
S.F. Residence
11 bath 1
Duplex (1 bath) each
Additional bath
V ~Iater service
iI"
Temporary Construction
Change in existing
rec;..i rly.oce
multifamily, comm. or
Tnrlll"triill
Of amps.1
COr~I./INO. FEEDERS I
Install/alter/relocate I
rli"trih. fppder" I
Of amps.l
'Zs;-a
Recessed wall
SOilrp hp~tpr ~nrl ve~
'I I/Y~<' Vh/7S G,.oP 7,{--
- Appl iance vent I
s@oaratp
Stationary evap. "
cooler
Vent fan with I
sinale duct
Vent system apart from I
hea t i no or A. C.
I Mechanical exhaust
hood ilnd durt
I Hood stove/heater
I~ r~hG
I
I
I
I
i
I
I
I
I
I
I~.-
I
I
A;?-
Sewer
v' Storm Sewer
6-
-:: :: -::,::::
TOTAL CHARGES ?:S."'" TOTAL CHARGES ~.:o.. TOTAL CHARGES -:::?~, -
WHEnE STATE L\I/ REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this permit
shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division
I HAVE CAREFUllY EXJ\flINED 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 oerformed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Ore~lOn pertaining to the work described herein, and that NO OCCUPAI~CY 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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project.
SIr,il^T~4/~....,u></ ,;'/./?
Fon OFFl CE USE ()ilLY
Zone t:;t'::, Tyoe/Const. 3-N Units Sq, Ftg. l1ain .4'0/> 7~~S '1' value~85''1'-
=~ -
Fire Zone Bedrooms Occy Load Sq. Ftg. Access PA1"P:>N Value I t?~ _
Flood Plain Stories Z, Occy Group8~/.i/II.'ISq. Jt'l,:, Othe ~('.. '1//7//1 Value 8()t;,,!!
N"",,: F""N~Ap<AN-./"E/JJS#.Ir /,f$CJCD ?-':n'-6'f p"r ~.R<:' TOTAL VALUATION/. '/ ~ ..,
1$ /N<u...>,7/~.o /N 77/'/,$ .""7:::;-:~./T: oJI=/n?Wn?, (YUOI
BUILDING PERfIIT ~/8 etQ I Plan Ck. COIllll/lnd ~LAO ~ r:..ll_rsystems oevilopment I /002 9,,-
Chargesan~ ___;;;!!P~ ....:.._. 6Sf:/BldoPJ?rFpp r,-,... (; Charqe(1.5,.) IttIlP€.
lis rCM.r~es&9.1i;'P, ~ / IJ '72 Plan Ck. Res B.+.~EP CIV' V.(i.Ul5' C~'"
_.I~_,-;rdii>.- ". _ 30%/Bldo Per Fee A ""~2&.. ./9Y.
-, ,
PLU!lBING PERMIT ......... ~4:a Fence
Charges and - - - _.i'~ III
Surcha rges / . 'i c:> Demo
ELECTRICAL PERi~1T ____ U~".. "0 I Sjdewalk"?'A'~>r'
Charges and ~
Surcharges I . 6<:> A/C Paving I
rlECHANICAL PERMIT 2' 00 I
Charges and ______!JP-l,____ Curb Cut
Surcharges /. (:) Sf I
IlAl,IE(please prin~hd-' ~--;;'f'F4'/'..,I /.t/.J:.~<'
DATE ,;,0/ /.!I-'/
~ ....e.
.lTotal Comb. Permit
I
I TOTAL
f9-s1.7G
2'387.67 I
PROJECT CONOITIONS TO BE SATISFIEO BEFORE OCCUPANCY:
Permit appl icant exempt from registration with the Builder's Board because:
Additional Project Information:
"
PLANS REVIEWEO BY:
name _L c2.N,r: n ~<;. ~
Signatur~~
,.
~-j--",
{ ----- -'
,IV
.--.
date
,
S;".,2-,8y
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BILL
HUTCHQS
VICE.PRESIOENT
(5031 747-3374
"(Whate<7e< Ut CTake,"
9TH
8< MAIN STREET
SPRINGFIELD.
OREGON 97477
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