The URL can be used to link to this page

Home My WebLink AboutPermit Building 1982-02-10INTORiAAIION I'INE 72(F375tCIIY OT SPRINGFIEID cor^utN;itoN- liPrtclrtoH / PenurINSPECTION LINE 72{'3759 Rq ENER.GY SOURCES: Heot Woter Heoler , Fence-Demo-Chonge -Other X N"* / Use Sq. Ftg. Moin Sq. Ftg' Access Sq. Ftg. Other Volue of Workr nfot Wilh SingleDescribe Wor k (i.e., Bui Building Pe rmit I Phone Address @f\)ooF(rl Address Phone (lics. no.)(oddress) (nome)DESIGN TEAM no.) ntco MECHANICAT ETECTRICAT CHARGE PTUMBING NOCHARGE FEE Electricol Mechonicol furnoce/burner to Residence of fr Eoch fixture Applionce vent seporq leNew circuits, olterotions or extensions(new fix. oddiliono Relocoted building Slolionory evoP. coo lerSERVICESS.F, Residence Vent fon with single ductTem poro ry C!!:llYg,oI-eoch Vent system oPort from heoling or A.C.Amps.Addilionol both Mechonicol exhousl hood ond duct Woler service Wood stove/ heoter Sewer Heot PumpFEEDER.SStorm Sewer Air hondler to r0.000 cFMAmpr. Air hondler over r0,000 cFM ISSUANCE OF PERMIT TOTAT CHARGESTOTAT CHARGESTOTAT CHARGES benot unlilvolid oeleclricolthcofthisrhollConfroctor,permitrheElactricolbeworkdoneportioltthethqtElectricolby5T,,TEA REQUIRESr.AwWHERE the alectricollo ponel,chedondottsElectricolonContruclo?hqrlobel been signed by DATE certify thol ony pertoining to the of ony required Spri the thot oll informotion hereon ifor permit, ond do herebY ertifYI HAVE CAREFULTY EXAMINED the compleled opplicotion ngfield ondocordonce with lhe Ordinonces of the City ofsholl be done inond oll work performed structure without permissionnd thot NO OCCUPANCY will be modework described herin, o by ORS 701.055, lhot if axemPlBoord is in full force ond effect oswith lhe Builder'scerllfy thot my regislrotion wirh ORS 70I.055 will be ued on this proiect,s ond employees who ore in omPlioneonly subconlroctor NAME (pleose print) exemption: heron, ond thot , Bosis for Builder's s true ond correct, ond I furlher the Lows of the Stote of Oregon of the Building Division. I further the bosis for exemption is noted zrn" C 4 Typeiconsr. V-N Unirs 1 , 6.15 vot," x Volue x -Volue TOTAT VATUATION toR oFHCE USE 1 800Mcin Access Other tire Flood Ploin Bedrooms lood -- Grorp B4 Sq. Ftg. Sq. Ftg. Sq. Ftg. 166.11I Sr.t"-. Develooment $39.00 Pd 1-38-EZi"'n.rirz.i - Plon Ck. Comm/lnd 65?6/Blds Per Fee #857925Plon Ck. Res 30o/o/Bldg Per Fee ___$60.qq-BUITDING PERMIT 2.40 Chorges ond Surchorges Fe nce 62.40Totol Comb. PermitDemo PTUMBING PERMIT Chorges ond Surchorges ELECTRICAT PERMIT A SidewolkChorges ond Surchorges TOTAT $228"57 MECHANICAT PERMIT Curb CutChorges ond Surcho rges --,-- 1 1 -074.00 COMBINATION APPLTCATION/PE\-T (CAP) l\'r],c'1 ?l. Appliconr to furnish A. Job Address B. Legol Description I. exomple-tox lol 100, Lone County Mop Refere,nce l7 03,(3 2. ex;mFle-Lot I. Block 3, 2nd Addition to Springfield Estqtes C. Nome, etc. of owner ond construction lender PERMIT VATIDATION D. Energy Sources l. exomple-heot/electricol ceiling/or forced oir gos 2. exo mFlE-woterTIohl, e-lEctrico l, o@-- E. sq l. 2. uore foologe or voluotion, etc, exo rn '1250 sq {oot house, 500 sq. foot goroge exom new proiect, check new-if oddition, check elc. F. Building permit informotion: I. exoirPle-conslruct single fomily house wilh on otloched 9oroge Z. exomple-remodel exisling goroge inlo fomily room 3. ExEmpl-e'convert single fomily residence inlo ElGu?6nt (chonge of use) G. Volue of work os defined in Section 303 (o) of the Struclurol SpecioltY Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys' Building Division.- sLit mrsr U.iUi" to conloct oppropriote Persons regording design informotion or iob site corrections' etc' ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces o-ccyr-i1 the description porlion of thl Mechonicil oni Electricql Schedules, the opplicont i""aJitt-in onty ihe No. Boxes odiocent to the oppropriole item(s) to be instolled B. Full Plumbing, Mechonicol' ond Electricol Schedules ore ovoiloble or the Building Divisio-n l. To conserr" tp"i" "n thJpermit form the schedules hove been obbrevioted r L.- 2. lf rhe it.rnt,i-to'[i insrolled ore not covered on the obbrevi- oted sc'hedui;;you should consult the full schedules C. SUI.DINC DIVISION STAFF WILL FILL OUT AtL FEES AND CHARGES ON THE SCHEDULES lll. Appliconl to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheel ".|y. wl;;; p"ttiur"i'e'rldins Division Stoff will ;;;;;;; ryp6ntiii"n-tlpv ond re,tYrn it ro the opplicont ot ih.'ti|11" the octuol pe.mitis issued for his signoture. lV. Fees ond Chorges Plon check fees ore due qnd poyob-le ot the time of the opplicotion' ond no plons will;"-;;;;JJLntil these fees ore poid' All other fees ""a .nJtiJt;;;l;; ond povoble when the permit is issued. V. FOR OFFICE USE ONLY Permit Clerk PROJECI CONDIIIONS TO BE SAIISFIED BEFORE OCCUPANCY: Additionol Pro[ect lnformotion: PTANS REVIEWED BY: signolurenome \ li:-. -:;;Cl: i;; Corittii.ll. .:l-!.. i !Oi{/rE,:n,it INTORMAIION tINE 776-3753 Adr.i, -:s 757 North 12t Street Ie _D :,c_rir;ri1 __ 1 7 - 03 = Address MECHANICAL PERMIT Chorges ond Surclrotocs Phonc R Woler l{eotcr EI.IERGY SOUKCES: Hcot -}-New- Add- Alrer-Rcp. -Fence--Demo--Chon ge / Urc -Qths. __-- Sq. F19. Other Sq. Ftg. Acce:r. Sq. Ftg. Moin Volue of Work: Work (i.e., Build SinsleBuilding Permit lnfo: go PhoneAddress (lic. no.)DESIGN TEAM (oddress)(nomc) Primo S tr ucturol Electrico I NTR Electricol Mechonicol IAECHANICALETECTRICAT FEENO PTUMBING rEE CHARGE furnoce/ burner loRasidence oI -sq. ft.sl Applionce vent sePoro te New circuits, olterotionr or exlensionsRelocoied building (nerv fix. odditionol)Stotionory evop. coolerSERVICES S.F. Residence (l both)Vent fon with single ducfTemporory Co!t!M!!"!-Duplex (l both) eoch Venl sytlem oport from heoting or A.C.Amps.Additionol both Mechonicol exhoust hood ond duct !ervrcG Wood rtovc/heotar Sewer H;ol PumpTEEDERSSlorm Sawer Air hondlcr to 10,000 crl{Anpr..ri;' { 1/:;,1i(;1":_, r.< Air hondhr ovcr 10,000 cFM ,);.r\.t: ISSUANCE OF PERMIT TOTAT CHARGESIOTAT CHARGESTOTAT CiIARGES ountilrhicrhollYolidnotbcol.GtricslthcConlroclot,portion pcrmittheEloctricclbeworkdoneEtcctricalbythcREQUwthotIRES3TAEREtAIEWHlotherleciricoponel.olrd oltochedConlroclorElcctricolgnhobean5bybellorigncd cxcmplion:{orBosi:8u i lde r'r DATE NAr\{E (pleosc Print)'ii1' i,roR orFlcE usE Pd 1- 62.40Tofol lood - GrorpSL- Fee Demo Sq. 0 ' ,.rt!*'-r4:'; :.' #Bs 9 DcvelopmcntPlon Ck. Comm/lnd TOTAT VXUATION C 4 Typr/conrt.Jl=N------unitrZone ?ire Zone -Bodroomr flood Ploin .. st- 1. i. : Plon Ck. Res Per _-_$_q0.qg- 2.40 BUII.DII{G PERMIT Chorges cnd Surchorger PI,UMBING PERMIT Chorgcs ond Surchorgcs r ----Volrr Sq. ttg. Othrr x Volw -. J'tir.'i $228. 51TOTAT Sidewolk Curb Cur P ER/N ITELECTR ICAt Chorgcs ond Surclroroc r i l;Jr- Ftg. Ftg. of A/C Povino ,:,r i,.-\" . ,, t,' ..itc;'llpERMlT (CAP)Lu,,,r,rr!,.llv:\ .. l. Applicont to furnish A. Job Address B. Legol Description I. exomple-lox lol I00, Lone County Mop Reference.I 2. exoTpie-Lot j. tslock 3, 2nd Addition to Springfield E C, Nome, elc. of owner qnd construction lender D, Energy Sources l. exomple-heot,/electricol ceiling/or forced oir gos 2. exomFle-woterT6EE;7@A/". - E. Squore footoge or voluolion, elc. l. exomple-!2!9 rq.fool house, 500 sq. foot goroge 2. e x o mEIE-iTrr=Iw p roi c,ct, check iEi-if o dd iti on, ch eck odd, etc. F. Building permit informotion: l. exomple-construct sirrgle fomily house with on ottocl goroge 2. exomple-remodel existing goroge into fomily room 3. d;mpfe-convert single fomily residence into relT6'IlEnt (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 construclion deloys, Building Divisio Stoff must be oble lo contocl oppropriote Persons regol design informction or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description port of the Mechonicol ond Electricol Schedules, the opplicor need fill-in only the No. Boxes odiocent to lhe oppropri item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electiicol Schedgles ore ovoiloble ot the Building Division l. To conserye spoce on the permit form the schedules hove been obbrevioted 2. lf fhe item(s) to be instolled ore not covered on the< oted schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALT FEES ANI CHARGES ON THE SCHEDUTES {- lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Stoff will prepore o typewritien copy ond return it to the oppliconl ot the time the ocluol permit is issued for his signoture. r i_;..,iiGi:lELD City Holl Springfield, Oregon Doportmenl of Public Works OFFICIAI RECEIPT llo. B 58012 l9 /-.. r !, 'j r3 Address 9o et i' For: ,/ \o Amount Received .r/ AUTAORIZED SIGNATUiE txtltoN.tUiXau!! titiTti!. auctxf. oi tr40t ,PI // laSrt -a l lV. Fees ond Chorges Plqn check fees ore due ond poyoble ot the time of the oppticotion, ond no plons will be processed until these fees ore poid. All other fees ond chorges ore due ond poyoble when lhe permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDIIIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Proiecl lnformotion: PLANS REVIEWED BY: Permit Clerk nome Dan Smith signoture dote 2-8-82 f,i.; - !