HomeMy WebLinkAboutPermit Plumbing 1981-08-03INSPECTION TINE
72G3769
CIIY OF SPRINGFIETD
CO}IBINAIION APPIICATION/PERMIT
INFORMATION TtNE
7263753
Job Address
ENERGY SOURCES:
Heot
-
Woter Heqler
Ro
Sq. Ftg. Moin
Sq. Ftg- Access
Sq. Ftg. Other
-New-Add-Alter-Rep,
-Fence-Demo-Chonge/
Use
Other
tegol Description
Volue of Work:
Owner
^dd,"
* 4?A A - -fn, rz flfr y rrc^Z+€ -rz qa Building Permit lnfo: Describe Work (i.e., Build Single
FomilyJesidence With Attoched Goroqe)
%,e.qr,as Z
Construction Lender
Address Phone
DESIGN TEAM (nome)(lics. no.)(expires)no
Primo
cql
nicol
nerol
Plum
Electricsl
Mechonicol
PTUMBING ETECTRICAI.MECHANICAL
NO.rEE CHARGE NO.FEE CHARGE NO.FEE CHARGE
Eoch single fixture
Residence of
fr,
furnoce/burner lo
-BTU'S
Relocoted building
(new fix. odditionol)
New circuits, olterotions
or exlensions
Applionce vent
seporo te
S.F. Residence
(l both)SERVICES
Slolionory evop.
cooler
Duplex (l borh) eoch Temporory Conslruction
Yent fon with
sinqle ducl
Addirionol both Amps.
Vent syslem oport from
heoting or A,C.
Woler rervice
Mechonicol exhousl
hood ond duct
Sewer Wood stove/ heoter
Storm Sewer FEEDERS Heot Pump
Amps.
Air hondler to
r0,000 cFM
Air hondler over
10,000 crM
ISSUANCE OF PERMIT
TOTAT CHARGES TOTAT CHARGES TOTAT CHARGES
th6 Electricql work be done by the Eleclricol Conlroclor,the electricol portion of this permit shqll nol ba volid until o
WHERE ST'AIE rAw REOUIRES thol
oleclricol ponel.lcbel hos been signed by Electricol Conltoclol q nd attoched lo rhe
EXAMINED the comPleted
oll work performed sholl
opPlicotion tor permit,ond do hereby certify thot o ll informotio n hereon ls lrue ond correct,o nd further
I HA VE CAREFULI.Y occordonce with the Ordinonces of lhe
be mode of onY structure
effect os required bY ORS
City of
withoul
701.055,
be used
Springfie td ond lhe Lows of the Stote of Oregon
ce rtily tho t ony nd be done ln
the Pe rm I ssro n of the Build Division.I fu rther
the k described herin,ond ihot NO OCCUPANCY will ng
notedpertornrngtoforceondtholifexemptthebosiforexemptionts
certlfy lhot my regislrotion with lhe Bui lder's Boo rd ts I f ull this proiect,
ond thot nly subcontroctors ond employees who o re tn complione rh ORS 701 .055 will on
heron,o
Bosis for Builder's Boord 6c L
<l .--.,
SIGNATURE DATE
NAME (pleose Print)
FOR OFTICE USE ONTY
Zone TYPe/Const.Units Sq' Ftg' Moin 1 Volue
x Volue
y
-.-VolueTOTAT YATUATION
Fire Zone-Bedrooms Lood ...=.....---Sq. ttg. Access
Group-._...._-Sq. Ftg' Other-
Flood Ploin Storie
Plon Ck. Comm/lnd Systems DeveloPment
BUILDING PERMI]
Chorges ond
Surchorges
Per
Plon Ck. Res
Per
PTUMBING PERMIT
Chorges ond
Surchorges
Fence
Demo Totol Comb. Permit
ETECTRICAT PERMIT SidewolkChorges ond
Surchorges c
MECHANICAT PERrv{lT
Chorges ond
Surchorges
Curb Cut
TOTAT
on
COMBINATION APPLICATION/PE,-.f (CAP)
l. Applicont to furnish
A. Job Address
B. Legol Descriptionl. exomple-lox lot 100, Lone County Mop Reference l7 03 43
2. exqmple-Lot l. Block 3,2nd Addition to Springfield Estqtes
C. Nome, etc. of owner ond construction lender
D. Energy Sourcesl. exomple-heot/electricol ceiling,/or forced oir qog
2. exo nr p:lE-wote rTeoGi/elEEtEo I /"@-
E. Squore footoge or voluotion, elc.l. exomple-l 250 sq. foot house, 500 sq. foot goroge
2. exomple-if new proiect, check new-if oddition, check
odd, etc.
F. Building permit informolion:I. exomple-construct single fomily house with on oltoched
goroge
2. exomple-remodel exisling goroge into fomily room
3. @-convert single fomily residence into
restouiont (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Division
Stoff must be oble to contoct oppropriote persons regording
design informolion 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 instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building DivisionI, To conserve spoce on the permit form the schedules
hove been obbrevioted
2. lf the item(s) to be instolled ore not covered on the obbrevi-
oted sc,hedules 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 Ee us6d os o-.-_
worksheet only. Where possible, Building Division Stoff will
prepore o. typewritten copy ond return it to the opplicont ot
the time the octuol permit is issued for his signotuie.
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 the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS IO BE SATTSFIED BEFORE OCCUPANCY:
Additional Proiecr lnformqtion:
nome sig notu re dote
PLANS REVIEWED BY:
PERMIT VATIDATION
Permit Clerk
-