The URL can be used to link to this page

Home My WebLink AboutPermit Building 1988-01-09_ CITY OF SPRINGFIELD Department of Planning and De:..1opment Building Safety Divi.,on 225 North 5th Street Spri ngfi e1 d, 0regon 97 477 726-3753 (Bus.) 726-376e (rnsp.) SPRINGFIELDOCCUPANCY II.JSP'- TION APPLICATION DArE l-q-tt -k g4colh9 JOB ADDRESS: /4b/'a ha t tl< OWNER: OI']]\ERS ADDPGSS r-3O u 1rl APPLICANT:o APPLICANTS ADDRESS: /</(! /.Moh aalc }-OR ACCESS TO PROPERTY--PLEASE INCLUDE TELEP}IONE NUMBER:a - 0.s2G PROPOSED USE: A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME ^{ 0F APPLICATION ir\) THIS APPLICATION FORM MU!!BE SIGNED BY THE OIINER OF THE PROPERTY TO BE INSPECTED tI SIGNA P.E OF P PERTY OI{NER. FOR OFFICE USE ONLY RECEIPT NIN4BER I06 4r* DATE OF I}ISPECTION l-zto -Bt DATE OF REPORT:DATE PAID: DATE OF CERTIFICATE OF COI{PLIANCE 4oA ,1qoCI CO}O4ENTS DAIE: /-q-I -* ${tCob'JOB ADDRESS:'ha OWNER: OT,,INERS APPLICANT: ADDRESS:>r€1rf APPLICA}MS ADDRESS:'b /.M autlc 5 0 7 *d0 -rrttrY IrrrE L(J,ZZS NortSpringffeld 726-3753-(Bus. h t ) OCCUPAI{CY I}JSPECTION APPLICATIONth Strp-t regon - 17126-3769 (Insp. ) lll llig clrru utrvC tUp,ltr,Lfety DivisionBui I di ng Sa FOR ACCESS TO PROPERTY..PLEASE INCLIIDE TELEPHONE NT]MBER:4 r'?-o.G PROPOSED USE: A $ 35.00 TNSPECTION FEE IS REOIIRED AT TFIE TI}.[EOF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY TI{E OI.JIIER OF THE PROPERIY TOBE INSPECTED. /4 SIG}IA OF IY FOR OFFICE USE ONLY DATE OF I}ISPECTION: DATE OF REPORT: r 1os RECEIPT NTMBER. I aB4to DATE PAID:l-zb -tr(// DATE OF CERTIFICATE OF COI{PLIAI{CE: COMMEMS: I 3 Cofi\r. S rxr tct,fr I i I ,i I s x Ip $,- /"1 I ( Tr I (-., ba l-) BeRSrrrr. *ORAIr.r5 U\)vl elEdTllcnLs3 Er€c;rQ \ iI I '!.c x I f-'t ItI i V I s ,l' t : s- ). : ''t I I I 1 I : . a?Pr4.AL I4Ef'a lr'iJ ! w @.' , I l : I ! .. ^eGluired ln spec' '9n s .. IT IS THE RESPONSIBILITY OF TIIE PERMIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TII.IE, THAT EACII ADDRESS IS READABLE FROU T}iE STREET, AND THAT TIIE PER} IT CABD IS LOCATED AT TIIE FRONT OF THEPROPERTY. BUILDING DIVISION APPF.OVED PI,ANS MUST BE ON JOB SITE AT ALL II}IES. PROCEDURE FOR REQUESTING IIISPECTIONS: Ca11 726-3769 (recorder) state you CITY DESIGNATED JOB NtMBER,job address, type of lnspectlon requested and vrhen you w111 be ready for the inspection, Contractorsor owners name and rrhone number. Requests recelved before 7:00 amywlll be nade the same day, requestsrecelved after 7:00-am w111 be ur,ade tihe followlng work day. Your Clty Designated Job Number Is:#aa6g Job Address: Or,rner z>'4>. Contractor:_ Phone: SFB|I'(IFTIJD SITE INSPECTION:Affir ef;vatG;,To be made but prior to setup of forns. UNDERSLAB PLI.NBING, ELECTRICAL & ITECHANICAL: To be made before any tr'ork is covered. CONCRETE SLAB INSPECTION: To be ffitding service equipment, conduit, piping, accessories and other ancillary equipment items are in place but before any concrete is poured, FOOTINGS 6 FOUNDATIONS: To be made after trenches are excavated and forms are erected, all steel in place, but prior to pouring concrete UNDERGR0UND: Plumbing, Electrical, Gas, Sanitary Sewer, Storn Sewer, Water and Drainage lines. To be made prior to covering or filling trenches. UNDERFLOOR:, Plumbing, Electrical, ilecE;Icat. To be made Prior to installation of floor insulation, decking or floor sheathing. POST G BEAI\,I: To be nade prior to instaltation of floor insul ation, ATTIC DRAFT STOPS 6 CURTAIN I{ALLS. FIREPLACE: Prior to placing facing materials and before framing i inspection. INSULATION 6 VAPOR BARRIER: TO be made after all insulation and required vapor barriers are in place but before any lath or gypsum board interior wal1 covering is applied. FR MING: To be made after the roof, a-ff-?ilrning, fire blocking and bracing are in place and all pipes, chimneys and vents are complete and the rough electrical, plumbing and heating wires, pipes and ducts are approved. FIRE 6 qr!484I!-qN ILL!: Located 6 ccnstruatad according to plans. LATH /ND/0R GYPSIjM B0ARD INSP.ECTION I fo 5e maae after all lathing and IAL INSPECTIONS: In with on Building Code a special lnspector shall be ernployed by the Owner/ Contractor during construction of the fcllowing work. A copy of the special test ing reports sha1l be furnished to the Divis ion.ilding STRUCTURAL CONCRETE: In excesS of 3OOFS]I.-1306;.r)- STRUCTUR{L WELDS: Preformed on thei6-olii-il- HIGH STRENGTH BOLTING: During all - iolt-iGtil.iit13n and tighting operations (306 a.5) *,{ | tr decking or floor sheating'. FLOOR INSULATION G VAPOR BARRIERS: ot, decking or floor sheating. MASONRY: Steel location, bond beams FilTI-ng or verticals in accordance witn u.B.C. Section 2415. ROOF SHEATHII'lG AllD NAILING: Priorffi*))?. I:-71 RoUGH PLUMBING. ELECTRICAL 82lliffiuntil these insPections have g)? is sum board, interior and exterior, in place but before any plasteri is appliedjcints and finished ' or before gypsum board fasteners are taped and wooDSTO\rES: After installation is aompGtea: SIDEWALK DRIVEWAY Required for all concrete paving within street CURB AND APPROACH APRON: After forns are ereEted but Prior to Pouring concrete. PARKING LOT: After gravel is in tGce6inrior to Placing asPhalt or concrete. SPRAYED ON FIREPROOFING: (U.B.C.ffi SPECIAL GRADING. EXCAVATION AND @oa.tt FTfrE:ter zs) GLU-LAM BEAI{S: Inspection Certificate Uy an approvea agency, furnished to the Cityts Building Division before beams are placed. (250l-U.B.C. STDS' 2S-10,11). right-of-way' to be made after all ex-avating comPlete I form work & sub-base material in Place. * In addition to the insPections specified hereon, the Building oificiat nay make or require other inspections of anY construction *o.i to ascertain comPliance with the Building, CitY or Zoning Codes' clTy's SITE PLAN REtr'IEW BOARD IX!!!!TIoN: Must be requested 2 days in advance of the date yot' suchaslandscaping,parkinglotstriPlngetc.must be complited before requesting this inspectlon' \elK FINAL BUILDING: Must be requested after the final Plumbing, Electrical' Illechanical and Fire mi;#r#ffi"=rpectiins are made and approved. No occupanc| of.the prenises can be.made until a certificate of occupan"y rrut been issued by the Builiing'Divisicn and posted on the prenise: I covered been lE K _l iE ?rt FIN.qL PLUMBING '4q FINAL ELECTRICAL FINAL I,IECHANICAL uq FINAL FIRE DEPARTMENT *ALr, MANHoLES AND CLEANOUTS MUST BE ACCESSIBTE, ADJUSTIIENT To BE MADE AT NO COST TO THE CITY' made and approved. 4/1L DE*74 PZfi<{??)^/}--26 INSPE 726-3 COHB I NATI ON APPL I CATION/PERI.IIT Job Address Legal Description 6^CfA lrater Heater EIIERGY SOURCES: Hea t c\n er(aHDo.u (,owner n^f (Ay lNVESTM6^J-TS Value of llork:/5a."' Sq. Ftg. Access._ Sq. Fts. 0ther J{ew Add AlferlPEE- _Fenc e_Demo_C ha n ge/ U se -other- n scribe Work(' hpd Garaoe .e., Build Sing'leAddress Z?o oA(cvroNsr wY +B?t9 Eurc€ru6. o({. q.)qo I Construction Lender Addres s Phone s" \ \ UT,sIGI{ TEAI.I name ( addre s s ex ol rPs (ohonp no- Primary Grr 14anStructura l ,l v'o'21 E l ectri cal I Hechani cal nhnnc nnCONTRACTORSname General -1wttEIcal PI NI-T t, ,l c\ oN ELECTRICAL MECHANICALPLUIIBI NG FFFFEECHARGENOFFFC}IARGF N0- q Each single fixture 7,9 379 Residence of FTsQ furnace/burner to BTU' s z-F Floor furnace and vent Relocated building (new fix. additional)4 New circuits alts. or extensions S.F. Residence(l hathl SERV I CES Recessed wal I Soace heater and vent Duplex (l bath) each Apol iance vent spne ra tpAdditional bath Temporary Constructi on Change in existing re< i dpnce Stationary evap. cool erl.later servi ce multifamily, corm. or I ndrrsf ri a I Vent fan with sinolp ductSewer Vent systenn apart fron heatino or A^C-0fStorm Sewer Mechanical exhaust hood and ductCOMH./IND. FEEDERS llood stove/heaterI nsta l I /a I ter/rel ocatedistrib. feeders 0f amps. ISSUANCF OF PFRI'IIT TOTAL CHARGES2-:PTOTAL CHARGES32.5aTOTAL CHARGES I.,HERE STATE LIl.l REQUIRES that the Electrical work be done by an shall not be valiC until the ]abel has been signed by an Electrical Electrical Contractor, the e'lectrical portion of this penait Supervisor and returned to the Building Division S IGNAl{Al.tE ( p lease pri nt ) for permi t 'formed the permi nd effect f exempt .055 wil' onsdi I n9 701 AS certify that alI information is true, and do in accordance with the Ordi of the Cityand al] work per shal land correct, and I further certify that any of Springfield and the Laws of the State of wlll be madeoertaining to the described herein, and that ll0 with the Builder'sDi vi si on further certify that my regiof any structure without ssion of 0regon the Buil is noted hereon, and thatthe basis forBoard is in full force a as required by ORS .0s5 I be used on this project.only subcontractors and employees who are in compliance wi oRs 701 e/ec\^P-r Y Ftg Ftg FtgFlood PIain Stori es ue x I Fire Zo I ne/ Val l,lai n__-_-_____x Va ToTAL VALUATIoil_ zon"-4r.2.-B-- -type/Const. ?X/ un:ts Access. 0ther ,//'./ '/2.?S Svstems Deve' Clrarqe (1.51 opmentPlan Ck. Corm/lnd 65%/8ldo Per Fee Plan Ck. Res 30%/Bldq Per Fee Charges and Surcharges .2:; +BUILDING PERI.IIT Fence DEsto PLUIIBING PERI{IT Charges and (Surcharges J -_?_zSa__ Stdewal k Total Comb. Permit Charges and Surcha rges v\2z-:5> 7 ELECTRICAL PERI|IT A/C Paving Curb CutI,IECHA}IICAL PERHIT Charges and Surc harges TOTAL /25{/ au tr onc FOR OTFICL lue colr8lilATI0N AppLTCATI0N/PERmIT (CAp) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map ReferenceIIT3*:T3 2 examo I e- Sprl ngf r Lot l. Block 3, Znd Addition toeld Estates Name, etc. of owner and construction lender Energy Sources c. 0. E. r gas ra9e ion, II. III. f. Building permit information:l. example - construct single family house with anattached garage ?. example - remodel existing garage into family roomJ. example - convert single family residence into_ restaurant (change of use)G. Value of work ai defined in Section 303 (a) of theStructural Specialty CodeH. OESIGN TEAM AND CONTRACTORS To avoid leslqn or construction delays, Building0ivision Staff must be able to contalt appropriitepersons.regarding design information or job iitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Hechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjiient_ to the appropriate item(s) to -be installed8. Full Plumbing, l'lechanical, and Electrical Schedulesare available at the Building Divisionl. To conserve space on the permit form the scheduleshave been abbreviated?. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF I{ILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by his ei"ii.iiai'-supervisor. The general con[ractor ii.not authorizedto sign the electrical labelApplicant to sign and date llhenever possible, the initial application wi.l.l be used asa.worksheet only. lthere possibtL, suilding Diviiio;-aaai;wil'l.prepare a type written copy ind returi it to theappllcant at the time the actuii permit is.issuea ior tissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, .and-no ptans wiii-be proceiied until thesetees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY IV v PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: exempt from registration with the Builder,s Board because:Permit appl icant Additional Project Information: PLANS REVIEWED BY: name date /'z?-se,i gna ture Job Address lrlater Heater EIIER6Y SOURCES: Hea tLegal oescription Construction Lender Y T +7 \r!, Owner Address Value of llork: --Ga.* sg. Ftg. AcceF--- A Ftg. 0ther . Ftg.tn Descrn t{i re., Build Single Address Phone GAFess'exDI res (phone nol RS name addres s lics- no.exoi re<ohone no- PLUI{BING ELECTRICAL FFF CHARGE NN FFF THAPNF NO FFFgEach single fixture 79 379 Residence of sq. FT furnace/burner to BTU' s z-D Relocated building (new fix. additional)4 New circuits alts.or extensions FIoor furnace and vent S.F. Residence(l bath)SERV ICES Recessed wall Soace heater and vent Duplex'(l bath) each Additional bath Temporary Construct i on Appl iance vent seDa rate Ilater service Change in existing rpq i dpncp Stationary evap. cool er Sewer I ndustri a I multifamily, corm. or Vent fan with sinolp drrct Storm Sewer 0f Vent system apart from heatinq or A.C. COMH./IND. FEEDERS llechanical exhaust hood and rlrrct I nsta I I /a I ter/rel ocatedistrib. feeders llood stove,/heater 0f 5. TOTAL CHARGES 3?.so -72-c<>TOTAL CHARGES Plan Ck. Conm/lnd 65%/8ldo Pcr Fee /6.?S Svstens Deve Charqe (1.51 oprmtEUILOING PERI'IIT Clrarges and Surcharges .25; 4-?, Plan Ck. Res 30%/Bldq Per Fee FencePLUI4SING PERI,IIT Charges and Surcha rges __?_zSa__ Demo Sldewal kELECTRICAL PERIIIT Charges and Surcha rges -?z-:;> 7 A/C Paving Total Comb. Fermit Curb Cut 4/<z_ DE&r4 PAfi<<-27)^6l--26t| "r, tI Prima Structura I El ectri cal l'lechan i ca I C-T IIHERE STATE Llll'l REQUIRES that the Electrical woshall not be valiC until the label has been signed COHBI C\n ON e t! t{ECHANICAL ISSUANCE OF PFRIIIT TOTAL CHARGES app ca on permit, and do ta n rmation and all work perfomed shall in accordance with theoertaining to the described herein, and that ll0 done by an Electrical Contractor, the e'lectrical portion of thls permltElectrical Supervisor and returned to the Buildlng Division 7 ?ta llec ding Division fu rther certify that m.y regis 1vtL4L is trueof the Ci ty madewlll be bn uith the Builder'sis noted hereon, and that rk be by an INED thE comp and correct, and I further certi fy Y of Springfield and theof any structure withou t the permission of Laws of the that any State of 0regon the Buil Board is in fu'll force and effect as required by ORS 701.055only subcontractors and employees who are in compliance wi 0Rs e/ec.^PT AS llAtlE(please print)€:f< Zon"A.2B -Jyoe/Const. ?X,/ Units Sq Fire Zone Bedroons Occy Load Flood Plain Stori es TIECHANICAL PERHIT on this project. Ftg. l|ain x Va lue . Ftg. Access x Val Val t if exempt the basi 701.055 will be used 5 for Charge Surcha s and rges -e/ ToIAL VALUATIoI_ Group Sq. Ftg.0ther TOTAL /2{{/ ue e t{ork{ Ga ra op t CITY OF SPRINGFIELD v' Cl$ Hall SPdngfrcld' Otegon Otlice ol Gommunily and Economic Development oFFrcrAL REcErPr i. il i-l S 8 ( coMErNATror{ APPLTCATI0N/PERmIT (CAP) ( I. Applicant to furnishA. Job AddressB. Legal DescriPtion1. example- Tax Lot 100, Lane County Map Referenc" ( Irft-{3 C 2 d a ?examol e- 5prr ng t r Lot l. Block 3' Znd Addition to eld Estates Address Received For: C. Name, etc. of owner and construction Iender0. Energy Sources1. example- heat/electrical ceilinq/or forced alr qa 2. ffii]-e- waterfrETGiTEIectFi?E'TZor s6TiF-E. Square footage or valuation, etc.l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add. etc. f. Eullding permit information:1. exarnple - construct single family house wlth an attached garage2. example - remodel exlsting garage lnto family roor3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. OESIGN TEAM AND COI,ITRACTORS To avoid design or construction delays, Building 0ivision Staff must be able to contact appropriate1 persons regarding design information or job site corrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrlcal Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate ltem(s) to be installed8. FuIl Plumbing, Mechanical, and Electrical Schedules are available at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult thefull schedulesC. EUILDING DIVISION STAFF I{ILL FILL OUT ALL FEES ATID CHARGES ON THE SCHEDULES0. As noted on the CAP, the label must be dellvered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is.not authorizedto sign the electrical label.Applicant to sign and date tlhenever possible, the initial application will be used asa worksheet only. Where possible, Euilding Division Staffri'll prepare a type written copy and return it to theappllcant at the time the actual permit is issued for hissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wil'l be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY 4m@'1 5t ,: 7-7 7z 5o ( ( ( ( / -/32s- II. III. 44*/25 Amou nt Received (r (.) flUntEf susrless FoBMS, lNc {503)342 8149 I 587 IV v Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information PLANS REVIEI.IED BY: name date /^??-aei gna ture IN o NYmber . i.:. ./ y'':.' Ir ) I t? r BUILDING DIVISION oil0Fs RINGFIT"D 726-3753 THE PREMISES NAMED HEREIN AND SUB)'tr\lo40 )fiArN STREST WE HAVE INSPECTED THE ELECTRICAL WIRING AND EQUIPMENT INSTALLED BY YOU AT THIS FOR YOUR RECORDS.OWNER OR TENANI TO LOCATION OF JOB tr] WIRING APPROVED FOR COVER n APPRCIVED FOR SEB/ICE [] WIRING INCOMFIEIE E WTRING COVERED WIT'HO{'[T INSPECTION E Dt E TO THESE PREMISES BEING Locl(ED AN lltsPECTlON n DUE TO NO ON,E HOME AN INSPECION COULD NOT BE MADE [] wlRlNG APPROVED FOR COVERING ErcEFT THE FOIJOWING E A PER,MIT lS REQUIRED fl HEAT CABIE AFPROYED FOR COYER E I,NDERGROIJND APPROVED FOR COVER E COtlDulT SYSTEM AFPROVED FOR COVER COLll,D tlOT BE MADE r),l); t. * 3 n€.. ucpot LlllcilL ur rrdillrlilg dllu ucvctuplllcrlL Building Safety Division 2?5 North sth Str''tSpringfield, 0regon -.477 726- 3753 (Bus. | 7?6- 3769 ( Insp. ) OCCUPAI{CY I}ISPECTION APPLICATIC\ 5FF(ltY(JrlELc, i^.4.:. E. .2 li9DAIE,1 ?:8f -h ffi c 0 JoB ADDRESS: /4/" / l.la hd u tlt OWNER: OI'INERS ADDRESS:r-3O 1rf APPLICA,NT: APPLICAIES ADDRESS: aFOR ACCESS TO PROPERTY.-PLEASE INCLIIDE TELEPHONE NIIMBER: PROPOSED USE: 7, , - Wa.kJ- A $ 35.00 INSPEcTION FEE IS REqUIRED AT THE TIME OF APPLICATION TIIIS APPLICATION FORM MUST BE SIGNED BY THE OI.INER OF TIIE PROPERTY TO BE INSPECTED.rI SIGI{A OF FOR OFFICE USE OMLY DATE OF I}ISPECTION:RECEIPT NIIMBER:I aB4 to DATE OF REPORT:DATE PAID:l-zto -rS DATE OF CERTIFICATE OF COMPLIAIiTCE: COMMEI{IS: k 2))'c4YY L a SPBINGFIELt' "[E5*'318HVgJgI]4L" 225 N. sTH STREET SPRINGFIELD, OREGON 97477 RALPH ST I BUILDING TNSPEfOR OFFTCE HouRs 6:OO.9;OO A.M. 4: OO. E: OO p.M, TELEPHONE 726-3-r59 STRUCTURAL INSPECTION REPORT JOB ADDRESS ,r4)1 ),//,DATE PHONEOI.INER e ADDRESS TENANT oR occuPANr .4 f,O a Lr-)E 4. .Bz,ilz TYPE OF INSPECTION: HOUSING i OCCUPANCY COMPLAINT FIRE DAMAGE '42c ,// \ Ii'ISPECTOR a drR,raAu 2 BeR,Srrrr. ?ConnP. S rrtr (-,, k2*l-> J+ I{ I I i i I s x If- it I {rr I .t, w& " trlLsORAIuj U\,ul A-6atat$f tt6<.'rQ \liitt { I I i SATE RiicrEvEo /-zB-#JoB ml?. -..,o:cu PAr'rcY GRoUPZ<;.tr e tJ ": t":j ,f. I : s- )x : ',t ;6 x S Un I g OccuF/.HC'i LoAD I E: a,' N. qT 7,*^.__ j: ''. : . l.i. ". //6/ Ha/.fw4 Bzrc-^,47Zr? /drnzraffi.,---i 'l',r:: a..: ','.:i.,1'r'5 t{t ri:I Cr:,, lr:'. = t,:11:t: P!'Jl;\rJED, Vr"T}'l l.i-r:t:r'irSrIri IND:lr.Iil ilD ltl i.i:i !'i:lliCr f:r'NCiL. CH \NriES (-h r : ic n-.\;t::',!5 I"iAD9 ;r,1 -it CA] [ [:;-LL]W Si{rr.LL EE .AFp:.1L.!,ED tst "fitE EUtLe;N.l CFF!c'inL. C:T'T CF SPRINGFITLD, ORTGON ay,p516,rsi1 !i:tse l' I i I,Ii, i r'*rl ucpor Llllcll L u I r roilil I ng dilu ucvg I uplilgil L Building Safety Division 2?5 North 5th Stree* Spri ngfi el d, 0rego n 97 7 7?6-3753 (gus. | 725-3769 (Insp. ) DAIE l-9-9P JOB ADDRESS: /4/" / l,la ha u t OCCUPANCY I}JSPECTION APPLICATIOI.; 5FFiltY(,rlELl:l 2Frh -hg4coh, OWNER: OI,INERS ADDRESS:>36 1rl APPLICANT: APPLICAbITS ADDRESS: /4b t. M oh antlt FoR ACCESS To PROPERTY--PLEASE INCLUDE TELEPHONE NIIMBER: ar'?-052G PROPOSED USE: A $ 35.00 u''TsPucTIoN FEE Is REoIIRED AT TIIE TIME OF APPLICATION 1TIIS APPLICATION FORM MUST BE SIGNED BY TIIE OI.'NER OF THE PROPERIY TO BE INSPECTED. S OF FOR OFFICE USE ONLY 14 DATE OF I}ISPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIAIiICE: COMMEMS: * RECEIPT NTIMBER:I aB4 t" DATE PAID:l'zb -rs 5 : I t t S ( .s J, : ln(w, NJ xs : !.,I xs ii\i\ I t 1 i UL"'€ {S,rr,erre Srr IUUO E- >,{lSBdB el rQ "--.; t I ;*! IJ' J $ ?t ,, \6f!4 >rN, s 'd\^rOpE -)ty'?tUl" ; I E I i T 1 47 1.DEfur4 FLrfz- <. 26 WAddress rl Descrlptlon ff Y NV ies 3 LJ ;tructlon Lender "ess rary TS Da*vbL --I \r.,+ Phone c0HBI ITLICA EIIERGY SOURCES: Hea l.later Heater 06 Yalue of llork: tg. I'lain_ Sq. Ftg. Access._ Sq. Ftg . Other Sq. F scrnrmn r€.r BulId Slngle name addre s s (l lcs- no-exol res (ohone no. rc tura I trical ranlcal trl (\^oN P ?t<lobB w. 6urr-er.r€ Nrrlcal Oal f?rcL'S tLECrPr -l?l C ro<t-88 ?vtzlta PLUI,IBII,IG L CHARGES r.lHERE STATE L,1t{ REQUIRES that the Electrlcal work be doneI not be vallC untll the label has been slgned by an EIec b.l, .l Electrical Contractor, the electrlcal portlon of thls pertrlcal Supervlsor and returned to the Bulldln! Dlvlslon ISSUANCF OF PFRIIIT TOTAL CHARGES ELECTRICAL I,IECHANICAL Each slngle flxture Residence of FTsQ furnace/burner to -_ BTU's bu dtedocaRe n9flnewxaddIt Iona )4 New clrcuits alts. or extenslons Floor furnace and vent .F. Residence SERV ICES wal IReces Duplex (l bath) each Additional bath Temporary Construct I on Appl ance vent l.later service ln exlstlngChan tat onary evap. Sewer mul ti faml Iy, conm. or Vent nw s Sewer 0f system apartVe c01.i.r./IND. FEEDERS usthanca nstal I /al ter/rel ocate Ilood stove/heater 0f TOTAL CHARGES t comp e appl and ca on for pe Derfo , dll certlfy that all lnformat on reon s truecorrect, and I further certlfy thatorlngfleld and the Laws of the State any of 0regon all work pertalnlng to the rmed shall descrlbed hereln, and that tlO ln accordance wlth the ,ry ,Ji structure wlthout thes ln full force and e isslon of the Buil dl Dl vl slon further certlfy that m.y regis s of the Cltwlll be mad as requlred by ORS n9 701 055 lf the basls for exempt ls noted hereon, rnd tha wlth the Bullder's subcontractors and employees who are ln compllance wlt oRs 701. 'exempt 055 wlll be used on this proJect. ereo^p-r As perm ffect (please print O\r' t.Its . Ft9. llaln Zone Bedrooms . - Occy Load Ftg. Acces I Plaln _ Storles_gccy Group Sq. Ftg LOING PERI.IIT rges and €e TE ) *d'8 -s Value Val ile Val ue Plan Ck. Conm/lnd 65flBldq Per Fee l.5rtems oprcnt . 0ther ToTAL VALUATIoil_ L Li i I UT 5PRli',IbrIL.LU Department of Planning and Development Bui'lding Safety Divis'.rn 2?5 North 5th StreeSpringfield, 0regon 97477 726-3753 (Bus. ) 726-3769 (Insp. ) DATE /-9-93 OCCUPANCY II.JSPEC'TION APPLICATION SPRINGFIELO -k$gcolb9JOB ADDRESS: /4/, / l4a hautlt O!'INER: OI,INERS ADDRESS:>3<n 1rl APPLICANT:c o APPLICANTS ADDRESS: /4b / M oh rtttlr FoR ACCESS To PROPERTY--PLEASE INCLUDE TELEPIIONE NITI,IBER: Ay'1:052G PROPOSED USE: A $ 35.00 INSPECTIoN FEE IS REqUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY TIIE OITNER OF THE PROPERTY TO BE INSPECTED. SIGNA OF PERTY FOR OFFICE USE ONLY tI DATE OF I}ISPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF CO}{PLIANCE: COMMENTS: RECEIPT NI]MBER:I oBLl t" DATE PAID:l- ztn -fS robNumber EIOO fo 8'INSPECTOR c_DATE I A1 r CITY OF S INGFIEtt) BultDlNG DtYlsloN 346 MAIN sTREET 726-3753 WE HAVE INSPECTED THE ELECTRICAL WIRING AND EQUIPMENT INSTALITD BY YOU AT THE PREMISES NAAAED HEREIN AND SUBMIT THIS FOR OWNER OR TENANTTO LOCATION OF rJoB I E WtRtNG A,PPROVED FOR COVER E A PERMIT lS REQUIRED E APPROVED FOR SERVICE E HEAT CABL'E APPROVED FOR COVER E WRTNG INCOMPIEIE E UNDERGROUND A,PPROVED FOR COVER E W,[R1'NG COVERED WlTtlO,UT I].ISPECTION n CONDUIT SYSTEM APFROVED FOR COVER E DUE TO THESE PREMISES BEI'NG IOCIGD AN lttsPECTloN courlD NoT BE itADE E DUE TO NO ONIE HOME AN I,NSPECION COULD NoI BE MA,DE , . E WRING APPROVED FOR COV'ERING'B0CEPT THE FOLIOWING o'\,,\,-l rL-? -;l^ | ) L ei0l,q -a- A.q.aiJ I I