The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1985-3-1 V'll" Df Horkj .B .Sl.o '+ Phone Bui16ina Permit Info: Describe Work(i~e.t Build Single 3,-(?'-fS((} ~~v0es~W~:;Jr~~~r L.:"~ ~\\.r J/ JfA..,'_C ~ " . .-, JrlSPECTlOrl LIrlE 726-3769 CITY OF SPRIrlGFIELD COMB illATION APPLlCATlON/PERMIT EIIERGY SOURCES: Heat t~ater Heater Job Address 4/'f- 'f({, j11 /1A'n c) I- So~;j( ( r ~". I Legal DescriptiDn tA....r ~ ,'~ \ I ~.c...,,,, RanQe Owner ~~ 'f W 0"1 +0 ""- Address L (J I ~rJW~'" f..!-$ O--...r;, . 'f ~ tZ.M2 Construe on Lender Address Ut~ tliN I tAr., Phone (address 1 lname) (lies. no.) Primary Structural Electrical Mechanical CONTRACTORS (namel (addrpss) 11 ir:c;._ no. \ Genera 1 Plumbina ~~...,.. ~~:JJ ~.~"J oj -:iJt4-v:,) I lAJn~q", lA j~....An.... E1 ectrica 1 ~'echani ca 1 PLUI1B J NG ELECTRICAL -.!!Q.."I Each single fixture INFORllATlON LI~c 726-3753 So. Fto. 1,Iain ~q. Ftg. Access. So. Ftg. Other New Add Alter PeD. Fence_Demo _Change/Use _Other r6 f'- .......... \\) ~ (exo;res) (ohone nO.l ..~ (pxn;rpc;.) lohnnp nn I MECHANICAL I FFF I rHI\Rr.F ~JO I I l:"~~ rl:!AB.G.E' Nn I Residence of furnace/burner to SQ. FT. BTU's 't't'LI..t.tiAR.G.E..1 j I I I I j I /~.-,I TOTAL CHARGES hJ. TOTAL CHARGES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pemit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXN1INED the completed ap~lication 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 pertaining to the work described herein, and that UO OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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. SIGtlATUREn;J,rf {J~~ FQ~, Q'FICE I!~~ 011LY Sq. Ftg. t1ain Sq. Ftg. Access Sq. Ftg. Other Relocated building (new fix. additiDnal) ~ New circu~ts alts. or extenSlons __ ':l P7Q "-'ft::>I'f", SERVICES Is- IS.F. Residence C1 bath 1 IDuplex (I bath) each IAdditional bath I ~Iater service I Sewer \Storm Sewer I b:::A.P on: b/~~ . j I I I I I I Temporary Construction jChange in existing rp'l j rlynl"P Imultifamily. COlml. or Induc;tri~l /LP.- IOf ICOMH,!IND, FEEDERS 1 Install/alter/relocate dic;trih_ fppflprc; amps.1 Of amps. I I I I~.~ TOTAL CHARGES WHERE STATE L~H REQUIRES shall not be vali1 until the IWIE(please print)~/.J ~, lJM~O"'" Zone Fire Zone FloDd Plain Tvpe/Const. Bedrooms Units Occy load Occy Group Stories BUILDING PER/lIT Charges and Surcharges I Plan Ck. COll11l!lnd < 65t:/Bldfl Ppr Fpp Plan Ck, Res 30%/Bldo Per F"e /t!:? '*c:> Fence ____J_4__'____ . ,/0 I 0000 IG: CO I Sidewalk -------~6~-1 A/C Paving I Curb Cut ------------1 PLU'lBlrlG PERMIT Charges and Surcha rges ELECTRICAL PERr:IT Charges and Surcharges Floor furnace and vent Recessed wa 11 ~n~rp hp~tpr ~n~ vpnt Appliance vent c;el)ar~tp Stationary evap. coolar Vent fan wi th sinola duct Vent system apart heatino or A.C. Mechanical exhaust hood ~nd durt from Hood stove/heater " ISSUANCF OF PFRIHT DATE 3- /- \1 '(" , Value Value Value , , TOTAL VALUATlO~1 SystemsOevelopment CharQe (1.5~) 11ECHAN I CAL PERMIT Charges and Surcharges ITotal Comb. rermit I I TOTAL I "2 b. oPe> ::?G~.e>t> . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION J, Applicant tD furnish A. JDb Address B. legal Description 1. examp.le- Tax lot 100. Lane County Map Reference 17 03 43 2, exa~le- Lot I, B1DCk 3, 2nd AdditiDn to ~prlngtield Estates , C. 'Name. etc. of owner and construction :lender D. Energy Sources . 1. examele- heat/electrical ce;lin~/or forced air qas 2. example- waterheater/electr;cal/or solar E. Square footage or valuation. etc. .------ J. exam~le- 1250 sq. fDot hDUSe. 500 sq, fDot 'garage 2. example. if new project. check new - if addition, check. add. etc. F. Building pennit information: 1. example - construct single family house with an a ttached garage 2. examele - remodel existing garage into family room 3. examole - convert single family residence into' restaurant (change of use) G. Value Df work as defined in SectiDn 303 (a) of the Structural Specialty Code H. OESIGN TE~I ANO CONTRACTORS To avoid design or construction delays, Building ~ivision Staff must be able to contact appropriate persons regarding design information 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 ND. Boxes adjacent tD the apprDpriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building ~ivision 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) tD be installed are not..cDvered Dn the abbreviated schedules YDU should consult the full schedules C. BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEOULES D. 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. --- III. Applicant tD 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 penmit is issued. J?;;l bC/3 D ~ fJ 3J/ts' " V. FOR OFFICE USE ONLY Permit Clerk M 1 PROJECT CONDITIONS TO BCSATISFIED BEFORE OCCUPANCY: " Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date '.