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Home My WebLink AboutPermit Fence 1981-03-26"a5 N NU Volue of Work:cc ing Permil lnfo: (nome) 4L ''*J e Z Addrerr Phone o Phone h (p(oddres:) tionDercrip :3, With Arro(hed Go Dercribe Work (i.e., Evild Single ENERGY SOURCES: Woler Heolet Heo t Sq. Frg. Orhcr DESIGN TEAM Addrerr Con:tr Sq. Ftg. Accesr. Sq. Frg. Moin INFORMATION TINE 72G3753INsPECIION I.INE 72C3769 CI?Y OF SPRINGFIETD c'.)r48lilA i.oN aPPUCATIoN/PERMIT --Othcr -New. -Add-Aher-ReP. - -Fence--Demo-Chonge/ U se Mechonicol (oddrers)(lics. no.)(ex pires)(phone no.)CONTRACIORS (nomr) Plumbinq Elecrricol Mechonicol MECHAN ICALETECTRICATPtU}^BING NO. i rEE I CHARGENO. I FEE CHARGENo. i i rEE I CHARGE Resicience oi --rq. ft. furnocel burner to I I I I Eoch rinqle iixtura Applionce vent seporole Reiocoted buiiding (now fix. odditionol) ! I New circuits, qlterolions or extentionr SERVICES Sfoiionory evoo coo ler 5.F. Reridence (l both) Vent fon with sinqle ductDuolex (l borh) eo<h I I I I Temporory Conriruclion Vent syrlem ooort from heotinq or A,C.Additionol both Ampr. Mechonicql e.xhourt hood ond duclWoler rervice Wood srove/'heoter I I Sewer Heol PumoSlorm Sewrr FEEDERS Air hondler to r0,000 cFMAm pr. Air honciler over I0,000 cFMI ISSUANCE OF PERMIT TOTAI CHARGESTOTAT CHARGES WHERE SfAIE LAW REQUIRES thor rhc Elactricol work be done by thc Elestricgl Conlroclor, thc clectricol pottion of thir permit rhall not ba valid unril o lqbel hor beca rigncd by on Electricol Controclor ond ottoched to lhc electricol panel. TOTAT CHARGES I HAVE CAREFU1IY EXAMINED lhe completed opplicotion for permit, ond do hcreby certify lhot oil informqtion hereon is lrue ond correcl, ond I further certify thot ony ond oll work performed sholl be done in ocordqncs with lhe Ordinonces of the Ciiy of Springfield ond lhe lows of th6 Stole of Oregon pe.toining to the work dercribed herin, ond thot NO OCCUPANCY will be mode of qny srructure without lhe permission of rha Building Division. I furlher ertlfy ,hot my regirrrorion wirh th€ Euilde/: Eoord is in full fcre ond effecl 03 rcquired by ORS 70I.055. lhot if exempt the bosir for exemption i: noted heron, ond rhot oniy subontrostorc ond employees who sre in complione wiih ORS 701.055 will be used on this prolecl. 8f *mexcmPtion: Lkt€ Anc!SIGNANA,UE FOR OftlcE USE OItlLY FloodPloinSloriel-OccyGroup-Sq.Fr9.olher- x --Vqlue x -Volue x -Yolue IOTAT VATUATION --O ccv lood -----Sq. Ftg. Accer:Fire Zone-Bcdroomr Zone -fype/Conrr. nits ---.--Sq. Ftg. Moin Plon Ck. Comm/lnd Sy:lems Devclopment r Fee Plon Ck. Rer Per Fee BUIIDING PERMIT Chorge: ond Surchorger lo cc folol Comb. Permit PLUMEING PERMIT Chorge: ond Surchorge: Demo ETECTRICAT PERMIT Chorger ond Surchorger Sidewolk MECHANICAI. PERMIT Chorger ond Sur cho rg e r Curb Cut TOTAT /o, oc 24t) t! f .Y* \ BTU'T 3-;3e&- Boris for Builda/: Charnc /I 5'i) Fence A/C Povina coMBtNATtON AppLtcATtoN,,. MtT (cAp) l. Appliconr. ro furnish v A. Job Address B. Legol Descriptionl. exgmole-tox -lot .l 00, Lone County Mop Referenr2. exE-ilE-Lot l. Block 3, Znd adJit'ion ro SpringfieC. Nome, etc. of owner ond construction lender D. Energy Sources CITY OF SPRI NGFI ETD Ciry Holl _ Springfield, Oregon Deporlment of public WorksOFFICIAL RECEIPT -rl- F PERMIT VALIDATION ( ( t. 2. E. sq l. 2. exomple-h eot./ electricol ceilin ./or forced oir gos exomDle -woter eoter.,e col,io. sdEi--_ uore foologe or voluoti on, erc, exo e-l 250 s q. foot house, 500 sq. foot gorogexdmnew proiect, check new-if oddition, cl r\o , elc. r:rtr te F. Building permit informotion:I. exomple-construct single fomily house with on ogoroge 2. exomple-remodel existing goroge into fomily ro3. t;;;G-convert single fomily r-esidence intoElliTT6nt (chonge of use) G. Volue of work os defined in Section 303 (o) of theStruourol Soeciolry Code H. DESIGN TEATA AND CONTRACTORS To o-void design or consiruciion deloys, Building Di.Sloff must be oble to contoct oppropriote persJns rdesign informction or iob siie corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedu A, Except where bionk spoces occur in the descriotion of the Mechonicol ond Eiectricol Schedules, the opp need. fill-in only the No. Boxes odiocent ro the oppr item(s) to be instolled 8. Fuil Plumbing, Alechonicol, ond Electricol Schecjule ore ovoiloble ot rhe Buiiding Divisionl. To conserve spoce on the permit form the sched ho.ve been obbrevioted 2. lf the item(s) to be instolleo' ore no, covered on oted scheduies you should consult the fuil schec C. 3UILDING DIVISION STAFF WILL FILL OUT,ALL FEES CHARGES ON THE SCHEDULES Amount Rece ived lll. Applicont to sign onci dote !Y Whenever possible, ihe initioi opplicotion will be usec Iworksheet oniy. Where possible, Builciing Division Sto rtprepore o iypewriren copy oncj return it to the opplic (.,, the time the ocruol permit is issued for his signoture. p lV- Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the opplicorion,ond no plons will be processed until these fees ore poici. allother fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY SHEL S IGN ATU RE EUGaNC Oi tTaol Permit Clerk I PROJECT CONDITIONS TO BE SATISFIED EEFORE OCCUPANCY: Additional Proiect lnformorion: nome signoture dote a PLANS REVIEWED BY: JIo. B 5S167 t (_ ( ( (( ( ( ( INSPECTION TINE 72C3769 CI:Y OT SPNINGf IETD C.]IE:JII.IA r ION APPTICAIION / PERMIT INFORIAAIION IINE 72e3753 11) 2- Job Addr*r I L-J rY, . Lego I (Lolz, bLLL Ken-L-( '' P t€, HOwner €u PhoneAddre:r -New. -Add -Alter--ReP.-- -tence --Demo-Chong"/ U rc --Other -=..=--_=-- Building Permit lnfo: Describe Work (i.e., Build Single Fomily Reridence Wiih Attoched Goroge) t Volue of Work:oo Sq. trg. Moin 'z_40 Sq. Ftg. Acccsr. Sq. ttg. Othe. 4</4-4q30 T€tt P, o rot)nd renroi Ant)s-e, Qt ParnDLxldJ-Construclion Lender 5ucfiLt:n or-i Ll u)(brrproF "^6 t-\N b Addrerr Phone DESIGN TEAM (nomc)(oddrers) S truciur o I Electricol Mechonicol CONTRACIORS (nome)(oddress)(lics. no.)(expires)(phone no.) Plvmbing EIe<frico I Mechonicol ETECTR ICAI.PIUI^8ING MECHANICAT No. I FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE I i I Eo<h sinqle fixiure Residence of --sq. ft, furnoce/burner to ----BTU'SRelocoted building (new fix. odditionol) New circuils, olterolions or extention; A,pplionce vent sepo rore S.F. Residence (l bqth)SERVICES Slolionory evoo. cooler Duolex (l borh) eoch Temporory Conrlruclion Vent fon with sinqle duct A.mps.Additionol both Vent syslem oport from heoting or A.C. Woler rervice Mechonicol exhoust hood ond duct Sewer Wood slove/ heoier Slorm Sewer FEEDERS Heot Pump Ampr. Air hondler to 't0,000 cFM Air hon<iler over 10,000 cFM ISSU,ANCE OF PERMIT TOTAI. CHARGES TOTAI. CHARGES WHERE SIAIE IAW REQUIRES thqt lhe Electricol work be done by the Eletlricol Controclo?, thc clectricol portion of this permit rholl not bc valid unril a lobel hor been signcd by on Electricol Contrqctor ond ottoched to lhe electricol panel. TOTAI. CHARGES I HAVE CAREFUTLY EXAMINED tho completed opplicotion for permil, ond do hereby csrtify lhot oll informotion hereon is lrua ond correct, ond I further certify thot ony ond oll work performed sholl be done in occordqnca with the Ordinoncer of rhe City of Springfield ond the Lows of the Stote of Oregon pertoining to lhe work dercribed herin, qnd lhot NO OCCUPANCY will be mode of ony struclure without the permission of tha Building Division. I further certlly thot my regi:trotion with rhe Builder's Eoord is in full forca ond effect os required by ORS 701.055, thot if exempt the bosis for exemption it noted heron, ond thot oniy subcontroctors ond employees who ore in complione wiih ORS 701.055 will be used on this proiect. SIGNATURE AP--QttunNAME Bo ris EH€ ArA exemplion: FOR OfFICE USE ONTY Zone -Type/ Const. -Units -Sq. Ftg. Moin x Volue x Voluo x -Yolue IOTAT YATUATION, Fire Zone-Bedroomr occy Lood Sq. Fig. Accers FloodPloin-5torier-occyGroup-Sq.Ftg.other- Systems Development Choroe ( I .571,) lo oo PIon Ck. Comm/lnd Per Fee BUITDING PERMIT Chorge: ond Surchorger PTUMEING PERMIT Chorges ond Surchorges Totol Comb. Permit Chorger ond Surcho rge: ELECTRICAI Sidewolk MECHANICAL PERMIT Chorgc: ond Surchorger Curb Cut TOTAI./o. oo ENERGY SOURCES: Heot - Woler Heoter -- ool- to I 3,;&olL Plon Ck. Res 3096/Bldo Per Fee Demo A/C Pavina coMBtNATtON AppLtcATtoN/,p,ltT (cAp) l. Applicoil. ro furnish v A. Job Address B. Legol Descriptionl. exomple-tox lot 100, Lone County Mop Reference iZ 03 432. exompie-Lot I. Block 3, 2nd Addition to Springfield Esrores C. Nome, etc. of owner ond construction lender D. Energy Sources I. exomple-heot./ 2. e-i6ilEG-woter electricol ceili or forceo' oir gos eoter.,eci col or solor E. Squore foologe or voluotion, etc.t. glg-p!g-1250 sq. foor house,500 sq. foor soroge2. exEmEiE-iTGew proiecr, checkiE-w-ii oddition, c-heck odd, etc. F. Building permit informotion: I. exompie-construct single fomily house wifh on ottoched goroge 2. exomple-remodel existing goroge into fomily room3. exEm;Ie-convert single fomily residence into relJEITont (chonge of use) G. Volue of work os defined in Section 303 (cr) of the Strucrurol Speciolry Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construciion deloys, Building Division Stoff must be oble to contoct oppropriote p.rson, regor.ding design informction or iob siie corrections, etc. ll. .A,bbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description oortion of the Mechonicol ond Electricol Schedules, the oppiicont need fill-in oniy the No. Boxes odiocent to the oppropriote item(s) to be instolled 8. Full Plumbing, Mechonicol, ond Electricol Schecjules ore ovoiloble ot the Building Division I. To conserve spoce on the permit form the schedules : hove been obbrevioted 2. lf the item(s) ro be instolled ore not covered on the obbrevi- ored schedules you should consult the fuil schedules C. sUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initioi onplicorion will be used os o worksheet oniy. Where possible, Builcling Division Stoff will prepore o iypewritten copy ond return it to the opplicont ot the time the octuol permit is issued for his signoiuie. 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 poi<i. all other fees ond chorges ore due ond poyoble when ihe permit is issued. V. FOR OFFICE USE ONLY PERMIT VATIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: nome signo tu re dote a PLANS REVIEWED BY: