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Home My WebLink AboutPermit Demolition 1981-01-26CIIY OF SPRINGTIETD COMBINATION APPTICATION/ PERMIT INFON,MATION TINE 726-3753 Strrrcturo I Electricol Mechqnicol ZZ Address '1633 Legol Addres:ffiA-lrfsen\\n'nrP- de. ENERGY SOURCES: Heot - ri/oter Heoter -----.--.- Building Permil lnfo: Describe Work (i.e., Build Single Fom Reridence Ron Volue of Work: Sq. Ftg. Access. Sq. Frg. Orher -Other - New-Add-Alter-ReP. - -r.nr" B"^o-Chonge/Use Sq. Ftg. Moin ifiConstruction Lend). d E 6 Add re sr Phone (o ddress)(phone no.)(ex pire s)DESIGN TEAM (lics. no.)(nome) P rimo ry CHARGE NO,FE I:NO. furnoce/ burner loResidence of -sq. ft. MECHAS{ICALEI.ECTRICATPI.UMBINC.' le fixture FEEFEECHARGENO. toch Elect;i;s lvleil,orriccl ueneru: Applionce vent sepqrote New circuits, olterotions or extensions Relocoted building (new fix. odditionol) SERV ICES Stotionory evop. coo ler Vent fqn with single ductDuolex (l bolh) eoch (r both) S,F. Residence Temporory Construclion Yent sy3lem oport from heoting or A.C.Amps.Additionol both Mechonicol exhoust hood ond ductWo ler rervice Wood stove/ heoterSewer Heot PumpStorm Sewer Air hondler to r0,000 cFMAmps. Air hondler over r0,000 cf^ ISSUANCE OT PERMIT TOTAT CHARGES WI{ERE STAfE tAW nEQUIRES rhor the Electricol work be done by the Elactricol ContrsGtor, the elcclricol portion of thir permit sholl not ba valid until o lobel hos been signoC by on Electrirol Contrsctor ond ottoched to the eleclricol ponel. I HAVE CApEFUtty EXAMINED rhe completed opplicotion for permit, ond do hereby certify thot oll informoiion hereon is true qnd correct, ond I further certify thot ony ond oll work performed shoil be done in qcordqnce with ,he Ordinonces of rhe City of Springiield ond the Lows of the Stote of Oregon pertoining to tire work described herin, ond rhot NO OCCUPANCY will be mode of ony structure withoq? lhe permission of the Building Division. lfurther ce*lfy rhit my registrotion with the Builder's Boord is in full force ond effect os required by ORS 70I.055, thot if exempt lhe bosis for exemption is noted heron, ond thot only rubcontrqctors ond employees who ore in complione with ORS 701.055 will be used on this proieci' TOTAT CHARGESTOTAT CHARGES SIGNATUREDW N DATE l->c- Bosir for Builder's Boord exemption: NAME (pleose print)E-tv t t, b Fire Zone-Bedrooms occy lood Sq. Ftg. Access torier-Occy Group--Sq, Ftg. Other- FOR OFfICE USE ONTY -So. Ftg. Moin Flood Ploin x Yolue 1--Volue x -Volue TOTAT VATUATION. Tone -Type/ Consi, -Unils Systems Development Chqrge ( 1 .59ld- Plon Ck. Comm/lndBUII.DING PERMIT OO ----30%l Per Fee Plon Ck. Re: Chorges ond Surchorges Per Fee Tolol Comb. Permit PTUMBING PERMIT Demo Chorger ond Surchorges EI.ECTRICAL PERMIT Chorges ond S vrcho rges SiCqwolk Povi TOTAT oo MECHANICAT PERMIT Chorges ond Surchorges Curb Cut CONTRACTORS (no (phone nc.) INSPECIION tINE 72(}37.L9 s*-- - lun:qn"qSoonr \ -BTU'S FEEDERS coMBTNATTON AppLtcATtONipERMir'(CAp) l. Appliconr to furnish A. Job Address B. Legol Descriptionl. exompls-roxlot .l 00, Lone County Mop Reference I7 03 432. exomple-Lot l. Block 3,2nd Addition to Springfield EstotesC. Nome, etc. of owner ond construction lender D. Energy Sources I. 2. exom -heot or forced oir gos exom "oiJoJorE. Squore footoge o.,rolrotion]"rcI exomple-l 250 sq. foot house, 500 sq. foot goroge exomple-if new proiect, check new-if oddition, check aaa;tc. F. Building permit informotion: 1. exomFle-construct single fomily house with on otloched goroge 2. exomple-remodel existing garoge into fomily room 3" 9*#FE-convert single fomily residence into restouront (chonge of use) G. Volue of work os defined in Seclion 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be obte to contoct oppropiiot. purro-n, regording design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only the No. Boxes odiocent to the oppropriote item(s) to be instolied B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division 1. To conserve spoce on the perrnil form the schedules hove been obbreviofed 2. lf the item(s) to be instolled ore not covered on the obbrevi-' oted schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Sroff will prepore o lypewritten copy ond return it to the opplicont ot the time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the opplicotion, ond no plons will be processed until these fees ore poid. All other fees ond chorges ore due ond poyoble when ihe permif is issued. V. FOR OFFICE USE ONLY PROJECT CONDITTONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Proiect lnformolion: nome signoture dote PLANS REVIEWED BY: -PERMIT VATIDATION Permit Clerk I lDercription Addres: ner PhoneAddre sr Primo Ron Building Permil lnfo:Describe Work (i.e , Build Single ENERGY SOURCES: Heot Woter Heoler Yolue of Work: Sq. Ftg. Accesr. Fomi W;th A INFOR.MATION tINE 726-37s3 INSPECIION I.INE 72&31 59 CIIY OT 5PRINGFIEID COMEINATION APPTICATION/PERTAII Sq. Frg. Other -_-.-- -New-Add-Alter-ReP'- - -F e nce -de mo-Cho n ge / U se -Other Sq. Ftg. Moin -- DESIGN TEAM ne( lics.(oddress)(no me) tcs.re5 Ele tfricol CONTRACTORS Mechonicol Plumbin PTUMSING FEE I CHARGECHARGE MECHANICALETECTRICAL NO.FEE Eiectricol Mechonicol CHARGE NO.No.FEE fvrnoce/burner to ,sResidence of --sq: fr.Eoch:ingle fixture Applionce vent seporo te New circuirs, olterotions or exten5ions Relocored building (new {i:, ocidilionol) Stolionory evop. coolerSERVICES S.F. Residence (l both) Vent fqn with single ductTemporory ConstruclionDuplex (l bqth) eoch Vent syslem oport from heoting or A.C.Amps.Additionol both Mechonicol exhqust hood qnd du(tWoter rervice Wood stove/heoierSewer Heot PvmpStorm Sewer Air hondler to r0,000 cFM F EEDERS Amp:. Air hondler over 10,000 cFM ISSUANCE OT PER}AITt WHERE SIATE LAW REAUIREs thor rhe Electriccl work be done by the Electricol cont.octor. the elcslricul Portion of thir permit. rhall not ba volid until o I HAVE CAREfULty EXAMINED rhe completed qpplicotion for permit, ond do hereby certify thot oll infomotion hereon is lrue ond correct. qnd I further certify thot ony ond oll work p"rfor-"j rhoil be done in ocordonce with rhe ordinonces of the cily of springfield ond lhe Lows of the stote of oregon pertolning to tire work de:cribed herin, ond thor No ocCUPANcY will be mode of ony 3tructure withoqt the permission of the Building Division. lfurther errlfy th-ot my regirtrotion with the Builder's Boord is in full force ond effect os required by ORS 701.055, thot if exempt the bosis for exempiion is noted heron, ond thot only iubconrrqctors ond employees who ore in complione wirh ORS 701.055 will be used on ihis proiect. Eosis for Euilder's Eoord exemption: TOTAL CHARGESTOTAL CHARGES ->-b -OATESIGNATURE lobel hor been :igncd by on Electricol Conlroctor ond ottoched lo the cleclricol ponel' TOTAT CHARGES NAME (pteosa ,,nrl F LV A l, ? RD W N FOR OFFICE U5E ONLY Flood Ploin Storier----Occy.Group--Sq. Ftg. Other- x Volue 1-Volug a -Yolus TZone occy lood Flg. Access TOTAT VATUATION ype/Con:t.-Units __.--._-Sq' Ftg' Moin Fire Zone-Bedroomr Plon Ck. Comm/lnd 65"/!.lBldg Per fee Systems Developmenl Chqrqe (l ) Plqn Ck. Re: 3O%/Bldg Per Fee OOBUII.DING PERMIT Chorges ond Surchorges Fence foiol Comb. PermitDemo Chorges ond Surchorges PTUMBING PERMIT Sidewolk A/C Povinq PERMIT Chorger ond Surchorges Curh Cut TOTAL oo MECHANICAT PERMIT Chorges ond Sur cho rge s ( ,4 g PERMIT VATIDATION OF SPRINGFIETD Ciry Holl Sprlngfield. Oregon Deportment of Public Works OFFICIAT RECEIPT No. B 55658 1' exo m Pls-i""11'Hiffi,*lis",:;.$$uss:/. exomple-v E. Squore footoge o. ,rolrotionll-l. exomple-13 .q.f"ot houlu-, 500 sq. foor gorogGz' exEmpTe'iTo=& proie*, .t'"ir. "i*-ii oddirion, <heck;e-J=rc. F. Building permit informotion:l. exomFle-construct single fomily house with on oftochedgoroge 2. exompie-remodel existing gctrqge inlo fomily roomr. exomEfe-co.nvert sinste fIr;ity .l.iJ.i.fir;;'"""' resrouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of theStructuro I Speciolty Code H. DESIGN TEAIY1 AND CONTRACTCRS To o-void design or construction deloys, Building DivisionSroff must be oble to contoct opp.op.iot" p".ro-n, ."go;;ingdesign informolion or iob site corrections, ;t.. - - ll. Abbrevioted plumbing, Mechonicol & Electricol SchedulesA. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, rh; ";pi;;;; ' neeci fill-in only rhe No- Boxes odiocent r"-tr,. "fp-ropri"r.item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedulesore ovoiloble ot the Building DivisionI. To conserve spoce on the perrnit form the scheduleshove been obbrevioted 2. lf the item(s) to be instolled ore not covered on the obbrevi-. oted schedules you shouid corrsult the full schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ANDCHARGES ON THE SCHEDULES lll. Applicont to sign ond dore Whenever possible, the initiol opplicotion will be used os oworksheet only. Where possible, building Division Stoff willprepore o typewritten copy ond relurn it to the opplicont otthe time the octuol permit is issued for his signotuie. lV. Fees ond Chorges Plon check fees ore due ond poyobre ot the rime of the oppricotion,ond no plons will be processed until these fees ore p"U. ,Cii -- other fees ond chorges ore due ond poyoble,"t"n it," p"i-itis issued. V. FOR OFFICE USE ONLY coMErNAT|oN APPLICATTON/pERMlilcAp) t. Applicont tgfurnish A. Job Address B. Legol Description i, ffi,ff J :il:?'.:T. iH,,,, # ?t,[..1:;.,[ i.C. Nome, etc. of owner ond construction turra".D. Energy Sources rTc3clTY E1!Olel ( C ( ( e d lr aived For: ( ( ( I (l (t (l rount Received AUTH ax€Liox.ruix6uL! PililEls s EU6ENE OR 97'O! ( ( Permit Clerk PROJECT CONDITTONS TO BE SATISFIED BETORE OCCUPANCY: Additionol Proiect lnformotion: PLANS REVIEWED BY: t,a nome signoture dote (