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Home My WebLink AboutPermit Building 1981-01-26INSPECTION I,INE 726..376? CIIY OF SPRINGTIETD COMEINATION APPTICAIIONi PERMII INTORilATION TINE 7263753 '// ' ,- /-htlJob Address /1 o3) {sDe scripiion 5 .? Xt0 Volue of Work: ENERGY Heof Woter Heoler R -New --Add-Alter-ReP. --Fence-Demo-Chonge/ Use _ Orka, Sq. Frg. ,$oin 7- Z{ 5q. Ftg. Accerr' Sq. Frg. Other Owner LLAIG phon" 1764 ]o /iro( 1r)r^-,RAddresr Building Permit lnfo: Describe Work (i.e., Buiid Single Fomily Residence With Atloched Goroqe) I ovt .a<Construction Lender /1/[A .Aco L) C[) S*7719 -Add re ss Phone (nome)(o dd ress)(lics. no.)no.)DESIGN TEAM res) Electricol /- a^ o (1,,Plumbinq PLU^ABING Electrico I l-V CHARGE NO.NO. i FEE CHARGE NO.I FEEtl Eoch single fixture <-€.<u.Residence of -sq. fr. furnoceT'burner lo -BTU'S Relocoted building (new fix. odditionol) .4 New circuits, olterotionr or exiensionst c i*tat74 /s"Applionce venl sepqrole S.F. Re:idence (l borh)SERVICES Stotionory evop. cooler Temporory Consiruclion Vent fon with sinoie ductDuplex (l both) eoch Vent syslem oport from heotinq or A.C.Additionol both Amps. Mechonicol exhoust hood ond ductWoier lervice Wood rtove/ heoterSewer F EEDER SStorm Sewer Ampr. Heot Pump Air hondler to t0,000 cFM Air hondler over r0,000 crM d/* / a p,aa ( r/d fi4-,//-? <--\ 41 ISSUANCE OF PERMIT TOTAI CHARGESTOTAT CHARGES -- Cto<{J, WHERE STATE tAW REOUIREs thor thc Electricol work be done by the Eleetricol Contrqclor. tha electri<ol portion of lhis permit.:holl not bo vqlid unril o lqbel hor been rignad by on Elc<tricl Controdor ond ottqched to lhe electricol ponel. I HAYE CAREFUttY EXAMINED rhe completed opplicotion for permit, ond do hereby certify thot oll informqtion hereon is irue ond correct, ond I further certify thot ony ond oll wcrk performed sholl be done in occordonce wirh the Ordinonces of ihe City of Springfield qnd the Lows of the Stote of Oregon pertoining to the work de:cribed herin, ond thot NO OCCUPANCY will be mocie of ony structure without rhe permission ertlfy thot my regiskotion with the Euilder's Boord is in full force ond e{fect os required by ORS 70.|.055, lhot if exempt heron, ond thot only 3ubconirsctorr ond empioyees who ore in compiione wilh ORS 701.055 will be used on ihis proiect. TOTAT CHARGES ,1(5t). SfAu re / T. ,r,l el.lecC SIGNATURE DAIE /-ta-F( of ihe Building Division. I further the bosi: for exemption is noted Bosis for Builder'r Boord exemption: NAME (pleose print) FOR OTFICE UsE ONTY x Volue .a -Volue TOTAL VATUAIION <-a 9zz.Type/ Consr. -"uls Bge.'n xFtg. r'{oin occv Zone Flg. Access olue Flood Ploin torie:-Occy Loqd -5q. Grorp F- }' 5a. Fire Zone-Bedrooms Ftg. Other--- Syslems Development Choroe ( 1 -59'")/ j)€oBUITDING PERMIT Chorger ond Surchorges (aa Plon Ck. Comm/lnd Fee2.7. Per BI Plon Ck. Res 6t.=6Totol Comb. Permit PTUMBING PERMIT Chorges ond Surchorges 4e Az>Demo ( ELECTR PERMIT €ir o /, c SidewolkChorges ond Surchorger TOTAT "6.% MECHANICAI, PERMIT Chorger ond Surchorges Curb Cut Slructurol Mechonicol A{echo nico I no. ELECTRICAL MECHANICAL FEE "4 Fence COMBINATION APPLtCATIONz/PERn:r[ (CAp) l. Applicont to furnish A. Job Address B. Legol Description I. exomple-toxlot.l 00,-Lone County Mop Refere.2. exomple-Lot I. Block 3,2nd Addiiion to Spring C. Nome, etc. of owner qnd construction lender PERMIT VALIDATION CITY OF SPRINGFIETD CitY Holl Springfield, Oregon Deportment oI Public Works OFFICIAT RECEIPT No. B 55G66 Dote 4-a r9 Rec'd From Address Received For 2C c O Pt ( D. Energy Sources I. exomple-heot;'electricol ceiling./z. exompte-woter heoter,. electricol or forced oir io r5 or ( E. Squore footoge or rolrotioilIl]- F. Building permit informotion: I. exomple-construcf single family house wilh qn , goroge 2. exomple-remodel existing goroge into fomily r< 3. exo,npE-convert single fomily residence into iElTEIront (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structurol Specio Ity Code H. DESIGN TEAM AND CONTRACTORS To ovoici design or construcrion deloys, Building Di' Sloff must be oble to contoct cppropriote persons r design informotion or iob site correcticns, etc. Abbrevioted PIumbing, Mechonicol & Electricol Schedu A. Except where blonk spoces occur in the description of the Mechonicol ond Electricol Schedules, the cpp,, need fill-in only the No. Boxes odiocent to the oppr item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble of the Building Division 'I . To conserve spoce on the permit form the schedu hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on tl oted schedules you should consult the full schedu C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES, CHARGES ON THE SCHEDULES Applicont lo sign oncj dofe Whenever possible, the initiol opplicotion will be used < worksheef only. Where possible, Building Division Stoff prepore o typewrirten copy ond return it to the opplicor the time the octuol permit is issued for his signolure. I 2 exomple-i 250 sq. foot house, 500 sq. foot gorc eEmE-iT ",ew proiecr, check-new-ii oddition, {tkoa;, etc. ( ( ( ( ( ( f { ( ( e ( ( ( ( r e lil ( ( Amounl Received Permit Clerk RIZED SIGNATURE SHETION.TURNEULL FNIXTERS EUGENE OR 97'OI lV. Fees ond Chorget ( Plon check fees ore due ond poyoble ot the time of the , \'|' ond no plons will be processed until these fees ore poid.l;,. other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONTY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Pro[ect tnformotion: PLANS REVIEWED BY: nome 1:2&e tsignoturedote t ( -1 INSPECTION tINE 72$3769 CITY Of SPR,INGFIETD COMBINATION APPTICAIIONi PERMII INFORMATION lINE 726.3753 Legol Job Address /5OS klohOUlK eno^" 246 -?4t Building Permit lnfo: Describe Work (i.e., Build Single Fom Use f Volue of Work: Sq. Ftg. lrtoin Sq. Ftg. Access. -New -Add-Aller-ReP. Sq. Ftg. Other Goro ENERGY SOURCES: Woter Heoler Heot idd t'{ranalIn#r, t lt uo tc"to Conslruclion [ender s, eo m (^ T Addresr Phone (nome)(oddress)(lics. no.)(expires)(phone no.)DESIGN TEAM Primo ry Str ucfurol Mechonicol CONTRACTORS (nome)(oddress)(lics. no.)(expires)(phone no.) Generol Electricol Plum Mechonicol ETECTRICAT MECHANiCALPTUMBING FEE CHARGE NO FEE CHARGENO.FEE CHARGE NO. furnocelburner lo --BTU'r 2 Eoch sinqle fixiure /(,.o9 /o,"t Residence of -rq. ft. New circuits, olterqtions or extensions Applionce vent seporo te Relocqted building (new {ix. oddirionol) SERVICES Stolionory evop. cooler S.F. Reridena (l both) Temporory Conslruclion Vent fon with single ductDuplex (l both) eoch Amps. Vent syslem oport from heoting or A.C.Addilionol boih Mechonicql exhousl hood qnd ductWoler:ervice Wood sfove/ heoterSewer FE EDERS Heot PumpSiorm Sewer Amps Air hondler to _19,000 cFM Air hondler over 10,000 cFM ISSUANCE OF PERMIT TOTAL CHARGES / b,o9 TOTAL CHARGES O WHERE STATE LAW REQUIRES thor thc Elecricol work be dona by rhs Eleoricol Conlrsctor, the aleclricol portion of rhis permit sholl not bc valid until a lobel hos bacn rigned by on Elcctricol Controctor ond qttoched to the electricol ponel. IOTAT CHARGES O I HAVE CAREFULTY EXAMINED the completed opplicotion for permil, ond do hereby certify ihot oll informotion hereon is lrue ond correct, ond I further cerlify thot ony ond all work performed sholl be done in occordonce with the Ordinonces of the City of Springfield ond lhe Lows of lhe Stote of Oregon perroining io rhe work described herin. ond rhot NO OCCUPANCY will be mode of ony structure without the permirsion of the Building'Division. I further cerilfy thot my regi:trotion with the Builder's Boord is in lull force ond effect os required by ORS 701.055, thot if exempt the bosis for eremprion is noted heron, ond thot only rubcontrqslors ond employees who ore in omplione with ORS 7OI.055 will be used on lhis prolect, z^21-t ( DATE Bosis for Builder'r Boord exemplion: NA}{E (pleose prini) FOR OTFICE USE ONLY x Yolue x -Volue x -Volue 47AZoneL-2 Sq. Ftg, Access TOTAT VATUATION Flood Ploin Slorier-OccY Fire Zone - Bedrooms Type / Const.nils -Sq. Flg. l{oin 5q. Frg. Other- Lood -- croup R-? Systems Development Chorqe (.l.5%) Plon Ck. Comm/lndo Fee Plon Ck. Res Per BUITDING PERMIT Chorges ond Surchorges Tolol Comb. Permit /r\+cIut PTUMBING PERMIT Chorges ond Surchorges Demo SidewolkoEI.ECTRICAT PERMIT Chorges ond Surchorges TOTAT MECHANICAT PERMIT Chorges ond Surchorges / 0.4!,tCurb Cut() io, COMBINATION AppLICATION/PErtrrlT (CAp) Appliconi ro furnish A. Job Address B. Legol Descriptionl. exomple-tox lot .l00, Lone County Mop Reference I7 03 432. exomple-Lot l. Block 3, 2nd Addition ro Springfield Estotes C. Nome, etc. of owner ond construction lender D. Energy Sources ceili /or forced oir gos 2 co L/o r solor E. Squore fooroge or rolrotion]lil-I. exomple-1250 sq. foot house,500 sq. foot goroge2. exomFIE-iTIEw proiecr, .ire.[ .'e*-ii oddirion, Jheck odd, etc. F. Building permit informotion:t. gI"rylg-conslruct single fomily house with on ottoched gqroge 2. exomple-remodel existing goroge into fomily room 3. exomFle-convert single fomiiy residence into restouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of the Strucrurol Speciolry Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to contoct oppropriote persons regording design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Elecrricol Schedules ,d. Except where blonk spoces occur in the description porfion of the Mechonicol ond Electricol Schedules, the oppiicont need fill-in only the No. Boxes odiocent to the oppropriote item(s) lo be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve spoce on the permit form the schedules : hove been obbrevioted 2. lf the item(s) to be instolled qre nol covered on the obbrevi-. oted schedules you should consul, rhe full schedules C. BUILDING DIVISION STAFF WILL FILL OUT AtL 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 Stoff will prepore o typewrifien copy ond return it to the opplicont ot the time the octuol permil is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the fime 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 permit is issueci. V. FOR OFFICE USE ONIY PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SAIISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: PLANS REVIEWED BY; nome signoture dote IN5PECTION TINE 72(..3769 INFOIMAIION IINE 72C3753 CITY Of SPRINGTIELD COMBINAIION APPIICATION/PERMIT Job Addre:s K Phone Building Permit ln{o: Dercribe Work (i.e., Build Singlc fomily Residence With Attoched Goroge) Volue of Work:- *Fence. 4o,h.,- -Demo-Chonge/ Use 5q. Ftg. Accesr. -New -Add-Alrer-ReP. Sq. Frg. Olher Sq. Ftg. ir{oin r { ranalIn4f, tlt no tt tts a-dd Construction Lender s uou (^ J Addre sr Phone (noma)(oddress)(lics. no.)(e x pi re:)(phone no.)DESIGN TEAM Primory E lectrico I Struclurol Mechonicol re lumbi Electrico I Mechonicol MECHAN iCAti."1",ELECTRICATPTUMBING FEE HARGEFEECHARGENO. IFEECHARGENO. furnoce/burner lo --BTU'I //;.o9 /o,"9 Residence of --tq. ft.2 Eoch single fixture Applionce vent 5eporole New circuiis, olterotions or extenrions Relocoted building (new {ix. ocidirionol) Stotionory evop. coo lerSERVICES S.F. Reridence (l both) Venr ion with sinqle ductTenrporory ConslructionDuplex (l borh) eoch i! Venl syslem oport from heorinq or A-C.Amps.Additionol both Mechqnicol exhousl hood ond ductWoler rervice Sewer Wood rtove/ haoler Heot PumpFEEDERS Air hondler io CFMAmpr. .l Air hqndler over I crM ISSUANCE OF PERA{IT thsl thc Elacfricol work be done by rhe Eleclricol Conlroctor, the eleclricol portion of this parmit rholl not bo vqlid DATE tion:tr 09 TOTAT CHARGES City of without Springfield ond the permission n hereon lrue don ond Idqnooqllf hot nformo correcl,tiotorl,certifyPermiherebypplicotion ofnceS rhenwirhqcordqnceOrdinorhebedone be demo of !lruclurethoNOtwillOCCUPANCYonyndoheri n. thot itndqoeffectoRs70t.055,the BooBui lder's t5rd f ulltn fo rce required by exempt owith 701RS will.055 usedbe lhisonorewhonInce proiecl,ndo omplioemployees NAjilE (pleore Eosir for Builder'r O TOTAT CHARGES Elcctricol Conlrd.tor ond ottoched to thc electricol ponel. TOIAL CHARGES WHERE 5TATE TAW lobel hqr bccn I HAVE ollceriify thot o pertcining to rhe work ccrli{y thot my heron. ond thot only FOR OFFICE USE ONIY Flood Ploin Fire Tone Zone x Yolue x -Volue x -Volue TOTAI, VATUATION Ftg, Acce:rlood --Sq'c,oup R-? sq.Frg. Other-- Consf.-Unit: --Sq. Ftg- /r{oin Systems Development Chorqe (1.5?'") Plon Ck. Comm/lndBU ITDING c B Per Fee Plon Ck. Rer Per Fee Chorges ond Surchorger Totol Comb. Permit PI.UMBING lo,Fence Demo Chorges ond Surcho rges EI-ECTRICAL PERMIT o C Povin SidewolkChorges ond Surchorger TOTAT MECHANICAT PERMIT Chorges ond Surchorger Curb CulO fsit Mahautk {iirS resol pe:cripti"" TL 3? OO - ,'7- O.?'-e,<-3q_ EN€RGY SOURCES: Wo ter Heo t Owner -*{rt tn klrt r rc/ i I I fil o o t5the sholl coM8tNAT|ON AppLtcATtoN,i|_MIT (CAp) l. Applicont ro furnish .A. Job Address B. Legol DescriptionI. exomple-tox lot .l 00, -Lone .Counry Mop Referen.^ - 2. exomple-Lor I. Block 3, 2nd Addiiion ro SpringfiC. Nome, etc. of owner ond construclion lenderD. Energy Sources exomple-heot/electricol ceiling ,/or f orced oir go:eEmEG-wo te r rr "oTE7EGiJiilo I i o ;;io. - PERMIT VATIDATION oF SPRINGFIELD ( Ciry Holl Springfield, Oregon Deportment of Public Works OFFICIAT RECEIPT No. B 55926 1a d, /r, 2 c clrY ( ,,( ( ( E. Squore footoge o. rolrotioil[-l. exomple-.l,Zgg rq.foot house, 500 sq. foot gorogz. exompte-rf new proiect, check new-if oddition, clodd, etc. F. Building permit informorion:l. exomple-conslruct single fomily house with on o.goroge 2. exomple-remodel existing goroge into fomily roc3. @-conver, single fi,;iiy risidence inrorestouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of theStrucrurol Speciolty Code H. DESIGN TEAM AND CONIRACTORS To ovoid design or conslruction deloys, Building DiviStoff musr be-obte tr.".r".i "pfiolriot" persons redesign informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol ScheduleA. Except where blonk spoces occur in the description pof the Mechonicol ond Elecrricol Schedules, rhl "ppiineed fill-in only ihe No. Boxes odiocent to ihe opproirem(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Divisionl. To conserve spoce on the permit form the schedul,hove been obbrevioted 2. lf rhe item(s) to be instolled ore nof covered on thr. oted schedules you should consuli the fuil schedul,C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ACHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used o:worksheer only. Where possible, 'Building Division Sroff tprepore o typewritten copy ond return it to the opplicontthe time the octuol permit is issued for his signofuie. Dore e-AZ Ie al Rec'd From 5*.t, 14 €tl(" Address Received For: ( Q/nb", /o,oeJ 47o ( (i ( (n ( ( Amounl Received BY 0 49 GNATURE dr1,vrlAUTHORIZEO 5XELION.TUXRIUI! PRINTEiS . lV. Fees ond Chorges ,. Plon check fees ore due ond poycble ot the time of rhe o ( ond no plons will be processed until lhese fee, o.e p.U. +..other fees ond chorges ore due ond poyoble ,rh"n'rh. fu.iitis issued. V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: nome signoture dote PLANS REVIEWED BY (t