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Home My WebLink AboutPermit Plumbing 1991-12-10. CITY OF SPRINGFIELD TOMBI NATiON APPL ICATION/PERMIT 7?6-3753 Job Address o t^l ( l-ega1 Description /3 t o6ge EIIERGY SOURCES Hea t llater Heater Ranqe Sg. Ftg.n Sq. Ftq. Access._ Sq. Ftg. Other-_ _l{ew_.Add_A1 ter_PeP . Fence Demo Change/Use :0 ther- s )N CI+"Vai ue of l,lork 0wner U x)o cAL- Address /oo N l/*,*tsoA.gr#zz-t Ph"^e443-1trz Builtiinq Permit Info: Desc Farni I y Res i dence lli th Attac ri be hed i llor( Ga raqe i.e- Auild Single ) 9urrue, u/4 ?gil 1 ,fl;-zztnz'E Dlztst -z .frx7i Construction Lender Addrcss l)honc DES I GN TEAI{name addres s exr,t res ohone no Pri ma ry Structura I Electrical Hechani ca l CONTRACT RS n ame (address exDt res (phone no. ) Genera.l ( g,z) PE 283-2IS Electrical l'lechani cal PLUI1B I NG EL ECTR I CAL 14ECHAN I CAL NO FEE CHARGE NO FFF CHARGF NO FFF CIlAPGF Each single fixture Residence of SQ FT furnace/burner to BTU' s Relocated building (new fix. additional ) New ci rcui ts al ts or extens i ons Fl oor furnace and vent S. F. Residence ( l hath)SERV ICES Recessed wal I Soace heat-er and vent Duplex (l bath) each AdditionaI bath Temporary Construct ion Apol iance vent seDa ra t-e l,later service Change in existing res i dence Stati onar-v evap cool er Sewer multifami1y, conrm. or Industrial Vent fan with sinole duct Storm Sewer 0f amps.Vent system apart from heatino or A.C. COMI'1./IND. FEEDERS Mechanical exhaust hood and duct I ?*9H'T2,,K)^?in/D /5.6',I nstal I /al ter/rel ocate distrih. feeders l,lood stove/heater t* <tRt/tct- E4l 0f ISSUANCF OF PFRI1IT TOTAL CHARGES /5r'TOTAL CHARGES TOTAL CHARGES I^IHERE STATE Llt'l REQUIRES that the Electrical work be done by an Electrica'l Contractor, the electrical portion of this permit shall not be vaiid until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE and correct FULLY EXAMINED the compl ted apnlication for nermit, a nd do he re b.y CE rt I fy t ha t a I I I n f rma t 'I on he reon I s true and I further certif-v that any and ll work nerformed shall be done in accordance with the 0rdinances of th Ci tyof Snr.ingfield and the Laws of the State of 0regon Dertaininq to the work described herein, and that NC 0CCUPANCY wili be madeof any structure without the permission of the Buildinq Division. I further certify that m.y re-oistration vrith the Builder,s Board is in full force and effect as required by ORS 701.055, that if exempt the baiis for exemption is noted hereon, and thatonly subcontractors and ernployees who are in compliance with OllS 701.055 r,rill be used on this pro.ject. I'lAl.lE(please pri nt)S IGIIATURE DATE -/0 - Tone Typelconst. Un 'i ts So Sq . Ftg ' Ftg . Ftg l'la i n xr Val Fire Zone Rp d ro oms Load :Access. 0the r xr Val ue Val ueFlood Plain es Occ.y Group x ToTAL VALUATI0N_ Stori BUILDING PERNIT Clra rges and Su rc ha rges Plan Ck. Conrn/Ind 65%/8ldq Per Fee Sys Cha ter,ls opmen e 7 .5,E Plan Ck. Res 30%/81dq Per Fee PLUI'4BING PERMIT Charges and Surcha rge s /5, ,7{ Fence Dgmo ELECTRiCAL PERI1IT Charges and Surcha rges Si dewa I k A/C Paving Curb Cut Total Comb. Permit IiIECHAI'IICAL PERMIT Charges and Surc ha rges TOTAL /f ,7s- PERMIT VALIDATION ")-LPermi t Clerk ? # s3ra /z-*/ S -*t/// s.? s- COMBINATION APPLICATION/PERMIT (CAP) II Applicant to furnish A. Job Address B. Legal DescrjPtion l. example- Tax Lot 100, Lane County Map Reference 17 03 43 ?. example- Lot 1. Block 3, Znd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources I . exampl e- hea r,/ e I ectr i ca l ce i 1_pg/o r _fo-rcS!_g:f_S!_!-2. exarnoTa- waterheater/electrical/or solar E. Square footage or valuation' etc. 1. example- 1250 sq. foot house, 500 sq. foot garage 2. exatele- JTnew project, check new - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. Example - convert single family residence into resTi-urant (change of use) G. Value of work as defined in Section 303 (a) of the Structural SpecialtY Code H. DESIGN TEAI'I AND CONTRACTORS To avoid design or construct.ion delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. Abbreviated Plumbing, Mechanical, & Electrical Schedules A, Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules' tfre applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you shou)d consult the fulI schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the labe'l must be de'livered to the electrical contractor for signature by his electrical supervisor. The general contractolis not authorized to sign the electrical label. Applicant to sign and date Whenever possibie, the initial application will be used as a worksheet on)y. Where possible, Building Division Staff wil'l prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signature. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed untjl these fees are paid. All other fees and charges are due and payable vihen the permit is .issued. FOR OFFICE USE ONLY III IV. PROJECTCoNDiTIONST0BESATISFIEDBEF0RE0CCUPAI.ICY: eb ac Su eerdrdSBoahtBtheu'tt n0 w'leritSraftr0mCjnae+gatempePrm'l pp Add jti onal Proiect Informat'ion: PLANS REVIEWED BY da tes i gnaturename II - r\IltrRESS- 1657 HTJHAhJH N[:5[R: REHOTIEL -OIJNER- UN ION O IL I]O P0 trtlx 7b SEATTLE' tlA 98111 - INFO- REPA IR CO},iT,IERC IAL 530CI OO l-OO?-BU ILI' INE PERi-t IT OO.:-OO4..ELECTR I[AL OO3-OO6-i.IECHAN ICAL OO4-OO1-PLAN f,HECK EEE OOl-016-PROGRESS IUE OO3-O 1 6.PROGRESS IUE PTIILBINft NIUI$ION JOB* 8?OE^{ .LEIJAL* LOT EILOIT{ r INAL -VALUE_ ?50 0 900? 12 TERI4 38 T00313 TERH 3S 1 703:53 I 05800 8907I't I t]00x 1? -EI.IERGY- .STATS* I{EAT 1- 3. BLBIJ U ONE CCH3O. STOR IES TLOONPLA INRANfiE- BETIRH OCE ERP B1 UN ITS $A EEET CONSI TYPE 5N -CONTRACTORS- 6ENL.AC SCHLE I$TER CONTRAf,TOR PHONE-74?-4944 PLI'IB- ELECT- I.tEEH. NESffN- NT:PT CAT TE31 SHQ-REAUIRHTI PEE}.JITS_.-*---*---EEE.SURCHAREE-t'ATE-EECEIPT-PERI',IIT*--_----UALUE.-- 68.50 ':1'f ri r-\ 15.00 44.53 NO PROfiRE$$ 8907 I ? 8907 r? 8907 I 3 8907 1 ? 3.43 1.13 0.75 0.00 1 4374 I 4374 I 4374 L437 4 $ $ s $ 7r500 0 o 0 {iTJN-.H IN II'1UI-I INSPEf,T IONS + HETIU IRHIIENTS--.-..- -----EXP NATE.--ACT NATE. OOl_04?.ROU6H ELEITRIC OO?-O31.EOUGH MECHANICAL 003-006.-EnAl,iING OO4-O09- IN$ULAT IfiN OO5-049-E INAL ELECTR ICAL OO6-039.T INAL I,IECHAN ICAL 0O7-064*E INAL F IHE NEPT OOS-019-T INAL EU ILTI INfi sEn*- INSPHCT ICINS----.---C0l'ti"lENTs-- "-----nATE*--*AESULT-- INsP*-.-