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HomeMy WebLinkAboutPermit Building 1984-03-26I'i9IlttED CITY Of SPRINGFIEID coMBtNATloN lppt tcartox / pelmtr TNFORIAAIION LINE 726.37StlNs?tcroN lrNE ,2t-3r69 713 Water Street Ro SOURCES; BE ENERGY Heo t 17 03 35 ?2TL 1040i,LcAol Volue of Work, 6 ,000. 00 - Fence - Demo-Chonge/ Use Other -Other -Rap. ad.l X ^t.-, Sq. Ftg. Accesr' Sq- Ffg. Moin Sq. Frg. X N"* Robert & Can ace Steele Residence Euilding Permit lnfo: Describe Work (i.e., Euild Single Phone 343-5159Addre rr L977 }ak Street [ender ga+a€ffidwetj-in @Ho lJ @5 PhoneAddrets DESIGN TEAM res)(lics. no.)(nome) I E Electrico I Mechonicol PTUMBING ETECTRICAT MECHANICAL FEE CHARGE NO.FEE CHARGE Eoch fixture 1 TI,25. 00 furnoce/burner lo --BTU'S Relocoted buildinq f ix. New circuits, olterotions or exlensions 1 Applionce vent rq le 3. 00 1 I S.F. Residence 00 SERVICES Stotionory evop, cooler I eoch Conslruclion 2 Vent fon with le duct 6. 00 1 Additionol both 0. 00 rt fromVent syslem o heoti or Wqler rervice Mechonicol exhousl hood Sewer Storm Sewer FEEDERS Air hondler to Air hondler over CFM rssuANcE OF PERA,ilT 10. 0 TOTAI. CHARGES TOTAL CHARGES 25. 00 TOTAL CH.ARGES 19.00 WHERE STATE LAw nEeUtRES lhot rh. Etedricot worklc donc by rhelqb:l hos beon signed by on Electricol Controcto, ond>ottoched to-the Elactricol contr6cto?. ,he .lcctricol portion of thir permit rhall not bo votid until oclectricol ponel. I HAVE cAREFUttY EXAMINED lhe completed opplicotion for permit, ond do hereby <eriify thot oll informotion hereon is true ond correct ond I furthercertify thot ony ond oll work performed sholl bo done in ociordonce with the oidinoncs of the city oi Springfield ond the r.o-r-or the Stota of oregonpertoining to the work described herin, ond lhot No occUPANcY will be mode of ony structure wit'hou, tie iermission.i tf,. irifai.g,Division. lfurther@rtlfy thot my registrotion with' the Builder's Boord is in full fore ond effect os requirej by oRS 701.055, rhor'if .r"-pr ir," r"Jr'r", exomption is notedheron, ond thot only subconfroqlors ond employees who ore in complionce with ohs 7Ol.Ot5 wiu be used on ihis proiect. Eorir for Builder's Boord exemptioni 3' zq5{eel<_R" 6 erf SIGNA DA' NAI{E (pleose TOR OFFICE USE ONI.Y .Typ./Conrr. V-N Unirs 1 Sq. Frg. ^toin x Volue x -[sls6 x -Volue R-1 Sq. Ftg. OthetGroup Otv Iood P So Ftg. Access Flood Ploin Zone TOTAT VATUATION Fire Zone-Bedrooms Plon Ck. Comm/lnd DevelopmenlBUITDING PERMIT Chorges ond Surchorges 36.00----Tnq-Plon Ck, Res Per fee 0.50 PD 3-16_8 Label Fee .20 PI.UMBING PERMIT Chorger ond Surchorger 35. 00 ----T.40- Demo Totol Comb. Permii Sidewolk PERMIT Chorger ond Surchorger 25.00----T.Uo- Curb Cut rrq wMECHANICAT PERry{lT Chorges ond Surchorger 19.00 T6-TOTAT l Woter Heorerf-J gct==-=-- Owner ?Occv ,rd 2 J ;i8l tlji!- i-.'. 1'"j ., . .3 ili y_r CoMBINATION APPUCATION/PERMIT (CAP) l. Appliconl to furnish A. Job Address B. Legol Description I.-exomple-tox lol 100, Lone County Mop-Refere-nce- , 2. ero-ph--tot I. Block 3, 2nd Addition to Springfield C. Nome, etc. of owner ond construclion lender D. Energy Sources or forced oir osIexoe-heot electricol ceil 2.or PERMIT VATIDATION CITY OF SPRINGFIETD Cily Holl Springfield, Oregon Deporlment of Public Works OFFICIAT RECEIPT { No. B 56148 ( I /T 1l Received For ( f: ( { E. sq l. SBS:CiI uore ri foot go o elc. iF. Building inf ormotion: l. exomple-conslrucl single fomily house with on ollo( goroge 2. exomple-remodel existing goroge inlo fomily room 3. exomFG-converl single fomily residence into i6IIEuTiint (chonge of use) G. Volue of work os defined in Section 303 (o) of the Slructurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or conslruclion deloys, Building Divisi< Sloff musl be oble lo conlocl oppropriote Persons rego design informotion or iob site correclions. etc. tt. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description por of the Mechonicol ond Electricol Schedules, the opplico need fill-in only the No. Boxes odiocent lo the oppropr item(s) to 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 rhe item(s) to be instolled ore nol covered 9n the oted schedules you should consult the full schedule: C. BUILDING DIVISION STAFF WIIL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULES Amounr Received tlq ?\o ( K- C ( ( (' (s ( ( (' ( ( ( ( q ( C lll. Applicont to sign ond dote Whenever possible, rhe initiol opplicorion will be used--os ( worksheel only. Where possible, Building Division Stoff w prepore o typewritten coPy ond relurn it to the opplicont ' ih"'ti.. the octuol permit is issued for his signoture' ( IV. Fees ond Chorges !- Plon check fees ore due ond poyoble ot the time of the.oPPlico'ion' ond no plons will be processed until these.fee3 ore poid' All . other fels ond chorges ore due ond poyoble when the permit is issued. V. IOR OFFICE USE ONIY BY TXORIZEO SIGNATURE ( Permit Clerk INSURE THAT IT COPIPLIES TO APPLICABLE CODES. Addilional Proiect lnformotion: 3-1 9-81 \ dote3l9nolureHESIBON---> | (P ino.lrcr coNDtrtoNs ro BE sATlsFlED BEFoRE occuPANcY: t I .: