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Home My WebLink AboutPermit Building 1981-06-29INSPECIION TINE 7213769 CITY OF SPRINIJFIETO COA{EINAItCN APPI.ICATION / PERMIT ENERGY SOURCES: Heot - Ron INFORMAIION tINE 7283753 Sq. Ftg. Moin Sq. Ftg. Accerr. Woter Heoler Sq. Frs. Orhsr -New-Add -Alter-ReP.-,-Fence-Demo-Chonga/ Ure -Other TOTAI, CHARGES WHER.E STAIE tAw REOUInES thor th. Elccricol work bo donc by the Elertri<ol Conlroctor, tha aledri<ol portiort of this parmit :holl not be volid unril o lobcl hor bon rigned by on Ellctricol Conlro<tor ond ottoched to lhc elcctricol ponel. I HAYE CARErUL[y EXAMINED tha compleied opplicotion for permil, ond do hereby ceriify thot oll informolion hereon ir true ond correct, ond t further certify thot ony ond oll work pcrformed rholl be done in qccordonce with the Orcjinoncer of the Cily of Springfield ond lhe Lows of the Stote of Oregon pertor:ning to tia work de:<riixd herin, ond thot NO OCCUPANCY will be modc of ony sirucrure wilhout lhe pcrmir:ion of rha Building Divi:ion. I further ertify th-ot my.caitnotion with th. Builde/r Boord is in full force ond effect os required by ORS 70I.055, lhot if exempt the bosis for cxemption ir noted heron, qnd thor o;ly lub6ntroctor3 ond employeer who ore in omplioncc with ORS 701.055 will be used on lhis proiect. Eorir for Buildc/r Boord ercmption: NA.&IE (pleosc print)DATE \CI\ Addre [egol Dercri Addrerr Phone Voluc of Work:qrD.oo Building Permil lnfo: Deccribe Work (i.c.,8uild Singla Fom Reridence Wirh A e CJ(x Addrcrr Phone (nomc)(oddrerr)(lics. no.)no.)DESIGN IEAM (expires) Mcchonicol no.teress)CONT ETECTRICATPLUMBING Mcchonicol CHARGENO.r?,CHARGE furnoce/burner ioRe:idence of {i xlurcEoch New circuils, olterqlions or extensions Applionce ventRelocoted bvilding fix, odditionol) Stotionory evop. coolerSERVICES S.f. Re:idencc I both) Slr ie duct Vent fon with Con5lructio nI both) coch heori or A.C. Venl syslem oporl from Ao'ditionol both Mechonicol exhou:l hood ond Scwcr HeotFEED ER5Scwcr Air hqndler to I CFM Air hondler over I CFM tsstlANcE oFiPERAI|I TOTAT CHARGEsTOTAI. CHARGES FOR OTFICE USE Unilr -5q. Ftg. Moin -- x.----Volue x ---Y6luc y -Volue TOTAI VATUATION. tire Zone-Bedroomr occy lood 5q' Ftg' Acce:s tloodPloin-.------_.Jlorier-OccyGroup-Sq.Ftg.other- Zone -Typc/Conrr. Systemi Development Chorqe ( I .5?6) BUIIDING PERMIT OO 30.eLl Per Plon Ck. Comm/lnd 65111 Plon Ck. Rer Chorgcr ond Surchorges fotol Comb. Ptrmit PTUMBING PERMIT Demo Chorge: ond Surchorgcr ELECTRICAT Chorge: ond Svrchorger c Sidewoik TOTAI. MECHANICAT PERMIT Curb CutChorqer ond Surchorger Ufrr4,ffi 5 2'o MECHANICAT (r't1'gtJo an K v)on- l srGNAruRE t/ ,0r) COMBINATION APPLICATION,'PER,- (CAP) l. Appliconr. to furnish A. Job Address B. Legol Description l. exomole-tox lot t00, Lone County Mop Reference'l 7 03 43 2. exo-pr"-Lot l. Block 3, 2nd ,Addition to Springfield Estotes C. Nome, etc. of owner ond construction lender D. Energy Sources l. exomple-heolu'electricol ceiling/or forced oir gos 2. e-x o-fr-"G-,ro t.. TIITE?IEGEE1|ior@- E. Squore footoge or voluotion, etc. L exomole-1219 ,q. foot house, 500 sq. foot goroge 2. 6xffi;E-iTn-Iw proiect, checkil:ew-ii oddittn, check odd, elc. F. Building permit informotion: l. exomole-construct single fomily house with on ottoched goroge 2. exomole-remodel existing goroge into fomily room 3. 9r#Fl-.-convert single fomiiy residence inio restEuront (chonge of use) G. Volue of work os defined in Seetion 303 (o) of the Structural Speciolty Code H. DESIGN TEAM AND CONTRACTCRS To ovoid design or construclion deloys, Building Division Sldff must be oble lo contoct oppropriote persons regording design informction or iob site corrections, etc, It. AbLievioted PIumbing, Mechanicol & Eleciricol Schedules A. Except where blenk spoces occur in the description portion of the Mechonicol oncj Electricol Schecjules, the oppiicont need fill-in only the No. Boxes odiccent to the oppropriote item(s) to be instolled B. Full Plumbing, Mechonicol. ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve spoce on the permii form the schedules .: hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on the obbrevi- oted scheciules'7ou should consult the full sihedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the iniriol opplicotion will be used os o worksheet only. Where possible, Building Division Stoff will prepore o typewritten copy ond return it to the opplicont ot the lime the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the opplicotion, qnd no plons will be processed until these fees ore poid. All other fees ond chorges ore due ond poyoble when the permit ir issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION Permit Clerk PROJECT CCNDITIONS TO BE SATISFIED -SEFORE OCCUPANCY: ( Additionol Proiect lnformqlion: nome signoture dote PTANS REVIEWED BY: Owner Volue of Work: ing Permit dence With Darcribc Work (i.o', B uild Singla tomiPhoneAddrcrr fe c-) (\ PhoncAdd rc rr no.)(oddresr)DESIGN TEAM (nomc) nicol EIECTRICATPI.UMBING Mcchonicol MECHANICAL FEENo.cl-lNo. Ii FESl furnocc/ burncr !o --BTU'T ReriCence oi fr.Eoch rinqlc fixrvrc Applionce vent !e Porq teNew <ircuiis, ollerotionr or exlanrion:Ralocorcd bvilding (new fir. odditio^oll Stotionory evop. coo ie rSERV ICESS.f, Reridcn<r (l both)Vent fqn with rinqle CuctTempororY ConitrucrionDuplrr (l both) coch Vent 3yttem oport from heotinq or A.C.Ampr.Additionol borh Mechonicol €xhou!l hood ond duct Wotar rcrvicc Wood rtove/ heoter Scwer Heot PumorEED ERSStor-m Scwcr Air hondler to t0,000 crMAmpr. Air hondler over 10.000 cFMI TOTAT CHARGESTOIAT CHAR,GES ( I .516) DevelopmcnlSyrtemr ChorqeBUILDING PERTAIT Demo 309',./Per Fee PIon Ck, Comm/lnd Fee65:;l Plon Ck. Rer Chorger ond Surchorger PTUMBING PERMIT Chorger ond Surchorgcr PermitTolol TOTAT A^ECHANICAT PERT^IT rcAt Sidewolk Curb Cut Pqvi Chorger ond Surchorger Chor-oer ond Surchorgc r INSPECTION IINE 72L3t69 De tion CIIY OF r,'rltlGirEtD COM8INAtICN APPI.ICATION / PERMIT INTORMATION !INE 72&3753 Sq. F19. Moin Sq. t19. Othcr -Ncw-Add -Alrcr-RcP- -. -f ence -Damo-Chongcl'U te rhe boris for cxcmPtion ir notcd. DATE 1. Voluc x Volur a Voluc ENERGY SOURCES: Heo I !!Wol.r Heoler Ro -Olhcr lssl.lANcE oFiPERA\lT TOTAI CHARGES wHErE SIAIE IAT' BEOUIn Ei thot thc Elctlrical wo.k b. donc by thc Elarlricol Conlrocror, ihr clectricsl Po'tio" ct thir parmit rholl nor bc volid unril o labrl hor boo rigncd bY on El.Gtri(ol Conlrdcto? ond ottochcd to thc cbctricol Poncl. I HAVE CAREfULT'Y EXAA{INED lhc comPleted oPP licotion for Permi t, ond do herebY cerlifY lhot oll informotion hereon it lruc ond cottecl, ond I furthcr o ll work Pcrformcd sholl bo done in qc@rdonce with ,he Ordinqnces of the CilY of Springfield ond the Lowr of th. Stote of Oregon Gertify lhot onY ond of rhc Building Divirion. I further Pettoining lo tho work dcrsriixd herin. oad thot NO OCCUPANCY will bc modc of cltli{y thot my regirtrotion wi th thc Euilde/; Boord ir in {ull {orcc ond effccl o s rcqui hrron, ond thot onlY :vbonlroclort ond emPloy.e3 who ore in emplioncc with ORS 701,055 will be uscd on ihis proiect. Eorir for Builda/r Boord cxcmption: NArt\E (phorc Print)J K o)o*SIGNATUREd Om toR oFrlcE u5E Zone TYPe/Conrr'Unitr Sq' Ftg' Moin firr Zonr-&droom: o ccy Lood Sq. Ftg. Acce:r flood Ploin --Jlorirt OccY Group Sq. Ftg. Other ony rlructure without lhe pcrmilrion ireci by ORS 70t.055, thot if exemPf \ TOTAT VATUATION -- 5 ?-o ..-. ., - l* ..- -.:-{. OOF<--1 COMBINATION APPLICATION, PEh-,T (CAP) l. Applicoru to furnish A. Job Address B. legol Description l. exomole.tox lot 100, Lone County Mop Referenc,2. e-GffiE-Lot 'l . Block 3, 2nd Addiiion ro Springfie, C. Nome, etc. of owner ond construction lender D.. Energy Sources l. exomole-heotz'electricol ceiling/or forced oir gos z. exomore-woter heoter, eleclncol/ or solor E. Squore foologe qr voluotion, etc.l. exomo!e-1250 sq. foot house,500 sq. foot gorogr 2. exomoie-if new proiect, check ne*-if oddition, cl";&., t,. F. Euilding permit informorion: l. exomole-construo single fomily house with on ot 9oroge2. exomole-remodel existing goroge into fomily ror 3. ffiFE-convert single fomily residence into EiEEEnt (chonge of use) G. Volue of work os defined in Seciion 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction cieloys, Building Dir Stoff mus, be oble to contoc, oppropriote persons rr design informotion or iob site corrections, etc. ll. Ab6revioted PJumbing, Mechonicol & Electricol Schedu A. Except where blcnk spoces occur in the description of the Mechonicol onci Electricol Scheciules, the opp need fill-in only the No. Boxes od[ocent to the oppr item(s) to be insrolled B. Full Plumbing, Mechonicol, ond Electricol Schedule, ore ovoiloble ot the Building Division I. To conserve spoce on the permil form the sched hove been obbrevioted 2. lf the irem(s) to be instolled ore not covered on ored scheciules you should consull the full schec C. BUILOING DIVISION STAFF WILL FILL OUT ALT FEES CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the iniriol opplicotion will be usec worksheet only. Where possible, Building Division Sro prepore o typewrirren copy ond return it lo the opplic the time the ocruol permit is issued for his signoture. PERMIT VALIDATION {., ctTY oF SPRTNGFTEID Ciry Holl Springfield, Oregon Deporlment of public WorksOFFTCIAT RECEIPT llo. B 56800 C ( ( ( ( ( (i. fti( ( ( F r: ( ( ( ( ( ( ( fiL tV. Feer ond Chorges Plon check fees ore due ond no plons will be pr, other fees ond chorges, is irsued. V. FOR OFFICE UsE ONLY , ond poyoble ot the time of t#opplicotion, ocessed until these fees ore poid. All ore due and poyoble when the permit Amount Received sxEt Permit Clerk AUTXOiIZE O SIGNATUREautt PRrttaR3 EUGETa oi 97aot ! a !I,A ( (o BY ( ( ?ROJECT CCNDITTONS TO BE SATISFIED BEFORE OCCUPANCY: ( Additionol Proiect lnformorion: PLANS REVIEWED BY: nome signo ture dote ( ( (