HomeMy WebLinkAboutPermit Building 1981-01-08,
INSPECTION I.INE
7263769
MECHANICAT PERATIT
Chorges ond /
Surchorges
CTTY OF SPRINGFIETD
COTABINATION APPTICATION/ PETMII
INFORiAATION lINE
72C3753
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Lot 2, BurneII Park
Job
legol
6556 Thurston Road
ENERGY SOURCES:
Heot
-
Woter Heoter
TL 1003 fi a.34 10l4a Volue of Work:
I ,500.00
Sq. Ftg. A{oin_--
Sq. Fts. Access. ?16
-Add-AIter_Rep
-tence-Demo-Chonge/
Use
-orher-StOEa-O€
fl' Fts.
'-l-New
Other
Address 6556 Thurston Road Phone 726-5673 BuildinEi Permit lnfo: D"r.rlb. W*k C,.- Build Single
fomily Residence With Aroched Goroqe)
Sprfngffeld, Oregon 97471 Storage Shed
Consiruclion Lender
Addres:Phone
u7
ccO
N)orh)
DESIGN TEAM (nome)(oddress)(lics. no.)(expires)(phone no.)
Primory 0lrmgf
Slr ucturol
Mechonicol
(nome)(oddress)(lics. no.)(phone no.)CONTRACTORS (expires)
Generor 0wner
Plumbing
Eleclrico I
l'{echoniol
PTUMBING EI.ECTRICAL MECHANICAL
NO.rEE CHARGE NO.FEE CHARGE NO.FEE CHARGE
Residence of
fr.
furnoce/burner lo
---BTU'SEoch single fixture
Relocoled building
(new fix. oddirionol)
New circuits, olterotions
or extensions
Applionce veni
sepo ro te
S.F. Residence
(l both)SERVICES
Stolionory evop.
cooler
Duplex (I both) eoch Temporory Conslruciion
Vent Ion with
single ducl
Additionol both Amps
Vent sysiem oport from
heoting or A.C.
Woler rervice
Mechonicol exhqust
hood ond duct
Wood stove/heolerSewer
Slorm Sewer FEEDERS Heot Pump
Ampr.
Air hondler to
10,000 cFM
Air hondler over
I0,000 cFM
ISSUANCE OF PERMIT
TOTAI. CHARGESTOTAI. CHARGES TOTAT CHARGES
WHERE STAIE tAW REQUIR.ES thot rhe Elcctricol work be done by the Electricsl Conlroclot, lhe clcclriccl porlion of this permit sholl not be vqlid unril o
lobcl hor bern signed by on Electricol Controctor ond ottsched to lhe eleclricol panel.
I HAVE CAREFULIY EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is lrue ond correcl, ond I further
certify thot ony ond oll work perforred sholl be done in occordonce with the Ordinonces of rhe City of Springfield ond the Lows of the Stole of Oregon
pertoining io the work desrribed herin, ond thot NO OCCUPAN,CY will be mode of dny structure without lhe permission of rhe Building ,Division. I further
certify thot my registrotion with the Euilder's Boord is in full force ond effect os required by ORS 70I.055, thot if exempt the bosis for exemption is noted
heron, ond thot only subcontroctors ond employees viho ore in complione wilh ORS 701,055 will be usd on this proiect.
NA}{E (pleose prinl) SIGNATURE
i
DATE /-3-ft
Bqsi: for Bdit{er's Boord exemplion:.\
Type/Const.-2T6
.60 4.50 PD 12-30-
Fire Be drooms flli"frr-;:ffi;:i::
Flood Ploin
Plqn Ck. Comm/l nd
Per Fee
TOR OFFICE USE ONTY
Developmenl
Ftg. itoin
Sq. Ftg. Access
Plon Ck. Res
Per fee
TOTAI. VATUATION
:.BUII"DING PERA{IT
. Chorges ond
Surchorges
Sq. Ftg, O$er-x
-Yolue
Htc 55483 by Pr illip Clifton ^'
il ;l)i.: '1 4.1i,i:i,'i
..4..'.. -.'i, '-
.. -j .'i.-.- : i'..' ir;
. ;.':i"-i':d irj-i'Totol Comb, Permit
PI.UMBING PERMIT
€horges ond
Surchqroeslc-,
fe nce
Demo
Chorges ond
Surchorges
ELECTRICAT PERMIT
Sidawolk
C Povi
Curb Cut 15.60TOTAI.
lloverowner Ga'l gn
l-
j
Electri col
COMBINATIO* O"'''OTION/PERMIT (CAP)
l. Applicont to furnish
A. Job Address
B. Legol Description
l. exomple-tox lol I00, Lone County Mr'^ o-'-
2. exomple.Lot I. Block 3, 2nd Addition d.C. Nome, etc. of owner ond construction ler r.
D. Energy Sources
L exomole-heot,/electricol ceilino,/or for
2. exomple-woter heoleru'electricol/or so (
E. Squore footoge or voluotion, elc.
I. exomple-1250 sq. foot house,500 sq.1
2. exEmFE-iT nEw proiect, check-new-if o ficodd, etc.
F. Building permit informolion:
I. exomple-construcl single fomily house , r, .
goroge
2. exomple-remodel existing goroge into I
3. exompl-e-converl single fomily residence
i,ilidUiont (chonge of use) ,,
PERMIT VALIDATION
CITY OF
.i
SPRINGFIELD (
CirY Holl
*rlll,?i;i l'*",,1";" err A
t{0. B 555ri3,
-P"r9 I
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G. Volue of work os defined in Section 303 (o)
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Built
Stoff must be oble to contocl oppropriote pe
design informotion or iob site correcfions, et,
ll. Abbrevioted Plumbing, Mechonicol & Electricol .l
A. Except where blonk spoces occur in the descr
of the Mechonicol ond Electricol Schedules, tl
need fill-in only the No. Boxes odiocent to thr
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schr
ore ovoiloble ot the Building DivisionI. To conserye spoce on the permit form the s
hove been obbrevioted
2. lf the item(s) to be instolled ore not covere(
oted schedules you should consull the full s
C. BUILDING DIVISION STAFF WILL FILL OUT ALL
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, lhe initiol opplicotion will be u
worksheet only. Where possible, Building Division I
prepore o typewritten copy ond return it to the opp
the time the octuol permit is issued for his signoturr
lV. Fees ond Chorges /
Plon check fees ore due ond poyoble ot the time of the
ond no plons will be processed until these fees ore poio. arr
other fees ond chorges ore due ond poyoble when the permit
is issued.
V. FOR OFFICE USE ONLY
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THORIZEO S TGNATURE
SHELTOil''URiBULL PFINTENS' EUGEN€'
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BY
Permit Clerk
PROJECT CONDITIONS IO BE SATISFIED BEFORE OCCUPANCY:
Additi,onal Proiect lnformotion:
PTANS REVIEWED BY:
. TOM SHEIRBON 1 -5 -81nomesignotdote
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