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Home My WebLink AboutPermit Plumbing 1981-01-06il, re INSPECTION tINE 72t3769 INFORIJIAIION TINECIIY Of SPRINGFIETD COMBINATION APPTICAIION/ PERIAIT 72U37s3 -o3ILegol Description Addresr Add ress -New --Add--Alrer--ReP., - Fence _Demo-Chonge/ Use lrzOthet - Building Permit lnfo: Describe Work (i.e., Build Single ENERGY SOURCES: Volue of Work: Woter Heoler Sq. Ftg. Accesr' Sq. Ftg. Other With Attoched Go Heot -_-.-..............-=-- Sq. Ftg. Moin Construction Addre ss Phone DESIGN TEAM (nome)(oddre ss)(lics. no.)(expires)(phone no.) Structuro I Primory Electricol Mechonicql (oddress)(lics. no.)(expires)(phone no.)CONTRACTORS (nome) 3 3Generol-t--e t 7Plum JElectrico I Mechonicol MECHANICATPTUMBINGELECTRICAT FEE CHA,RGE NO.FEE CHARGE NO.rEE CHARGENO. i furnocelburner lo --BTU'S i I Eoch single fixture Residence of sq. ft Applionce venr 5eporoteI I Relocoted building (new fix. odditionol) New circuils, olterotions or extensions Stotionary evop. @oler S.F. Residence (l borh)SERVTCES Vent fon with :inqle ductDuplex (l both) eoch Temporory Consiruciion Additionol both Amps. Vent syslem oport from heoting or A.C. Mechonicol exhou5t hood ond ductWoter cervice Wood slove/ heoterIs.-., ?tnnl()tD|'/6q /0.09 FE EDERSStorm Sewer Amp:. Heot Pump Air hqndler to r0,000 cFA,r Air hondler over r0,000 cfM I I I I I II ISSUANCE OF PER/IA|T WHERE STATE tAW REQUIRES rhst thc Electrical work be done by lhe Electricoi Conltsctor, lha clectricol portion of lhis permit rholl not bc volid unril o lqbel hos becn signed by on Electriccl Contractor qnd ottqched to the electricol ponel. I HAVE CAREFUttY EXAMINED the completed opplicotion for permil, ond do hereby certify thot oll informotion hereon is lrue ond correct, ond I further certify thot ony ond oil work performed sholl be done in qccordonce with the Ordinonces of the City of Springfield ond TOTAT CHARGESTOTAT CHARGES 2- Lows of the Stote of Oregon siructure without the permission the Building Division. I furtherde of ony s required bethedescribedworkondNOlhetwillOCCUPANCYheri n,topertoining effecfondmthottiostrowithnBuildethe5r'tsBoord ful fo rcetnreg Iertlf y Y ond otewho nI iihsndthosubconlroqtorscomplionceheron.only employees .055, rhot if exempt bosis for exemption is noted TOTAT CHARGES Bosis for Builder's Bcord exemption: NA,lviE (pleose print) wil on ihis 6o rOR OFFICE USE ONIY x lue Flood Ploin Type/ Const.Sq. Ftg. Moin Bedroomr ._ occy lood Sq. Ftg. AccessFire Zone Zone TOTAT VATUATION Group-Sq. Ftg. Other- x -Volue x -Volue Syslems Developmenl Chorqe (l.5olo) BUILDING PERMIT PIon Ck. Comm/lnd fee Plon Ck. Res Per FeeChorge: ond Surchorges Fence Toiql Comb. Permit /n.49Demo Chorges ond Surchorges PLUMBING PERMIT /0,o9 ,46 Sidewolk A/C Povinq Chorges ond Surcho rges ETECTRICAI PERMIT o Curb Cut TOTAT f/o,onMECHANICAL PERMIT Chorges ond Surchorge s o q oI N Ronoe ao?t(Lv etfr( h)*v Ph""3{i7-1?f D^rE/4/._ O coMBINATION AppLlcATtON/pERMtv :Ap) Applicont-Jo furnish .A. Job Address B. Legol Description I. exomple-tox lot I00, Lone County Mop Reference l7 03 432. exomple-Lot l. Block 3, 2nd Addition to Springfield Estores C. Nome, elc. of owner ond construction lender D. Energy Sources % s,neJS- h eo t /.J ugI1ggl5g! ng,/or f o rced o i r s o s e x o m p l e - w o t e r Ee-o G rGIEcr r k-r ko l i o iTol o r E. Sguore footoge or voluotion, etc. exom Ie-l2501 2 sq. foot house, 500 sq. foot goroge proiect, check new-if oddition, checexomnew o . elc F. Building permit informolion:l. exomple-construct single fomily house with on ottoched goroge 2. exomple-remodel existing goroge into fomily room 3. exoma]A-convert single fomily residence into iSsG!?Ent (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 Stoff must be oble lo contoct oppropriote persons regording design informotion or iob sile corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only the No. Boxes odiocent to the oppropriole irem(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division I. To conserve spoce on the permit form the schedules : hove been obbrevioted 2. lf rhe item(s) to be instolled ore not covered on the obbrevi-' oted schedules you should consull the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT AtL FEES.AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Sroff will prepore o lypewritlen copy ond relurn it to the opplicont ot the time the ocluol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the opplicotion, ond no plons will be processed until lhese fees ore poid. All other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY k .* ERMIT VATIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .f?mu /nreor( /- 7..1 / /-tarz €Additional Proiect lnformotion: F,lnLo ).rdr / PLANS REVIEWED BY, nome signoture dote (/ c 4. INSPECIION tINE 7?63769 CITY Of 5PRINGTIETD INFORAAATION TINE 72t37s3COMSINAIION APPTICAIION / PERMIT Add [egol Detcriolion I -oJ ENERGY SOURCES:Sq. Ftg. ,lioin Heot Sq. Ftg. Accesr' Sq. Fts. Orher -New --Add --Alter---Rep. - -Fcnce---Demo-Chonge/ Use j.Z.Orhet Volue of Work: -Building Permit lnfo: Desrribe Wcrk li.e.,Sing le ed Go ^)a Addrcr:Phone DESIGN TEAM (nomc)rers)no.)(ex nc no.) Ii c:.s)ne Gene 3 -7 Plum ta 7 Electrico I J l'techo nico I PTUMSING ELECTRICAT MECHANICAL NO. I FEE I CHARGE NO.FEE CHARGE No. I FEE i CHAROE I I Eoch rinqle fixtura Residence of -sq.'ft. furnocelburner lo -jIU'I Relocoted building (new {ix. odditionol) New circuits. oltcrotions or extensions Applionce venr seporo le S.F. Pe:idence (l both)SERVtCES Stolionory evop. cooler Duolex (l bothl eoch Temporory Conslruclion Vent fon with singie duct Additionol borh Ampr. Vent lyslam oport from heoting or A.C. Woler rcrvice Mechonicol exhoust hood qnd duct I s.-,, ArnlUIlrb,/6 0!/0.09 Wood stove/heoter Slorm Sewcr FEED ERS Heoi Pvmp Air hondler io 10,000 clrM Air hondler over 10,000 cFM Ampr. I I I I I ISSUANCE OT PER,\TIT TOTAL CHARGES 6 o IOTAT CHARGES TOTAI CHARGES WHERE STATE tAW REOUIRES lhot tha Electricol work be done by tha Electricol Coarraclor, thc rlectricql portion of rhis permit shall not ba valid until olobel hos becn rigncd by on Elcctricol Controclor ond ottachsd !o the cleclricol ponet. I HA'VE CA R EfU LI Y EXAMI N ED the compleled opplicotion rmed sholl be done ir for permit, ond do hereby Gertify thot ll informotion hereon i lrue ond correcl,ond I further cetrif y thot o ny ond o I k per fo n occordon CE irh the Orcii non 5 of rhe City of Springf ield on d Low:of the Stote of Oregon Perroining lo the work described herin, ond thot NO OCCUPANCY will be mode of ony rfructure without lhe permisrion lhe Building Division, I furthererilfylhotmyregirtrotionwirhtheBuilder's Boord t3 tn f ull fo rce nd effect 5 req uired .055,thot it exempt bo srs for exem plion t5 noted hero n,qnd tho only 5U bconlro slo rl ond employees who ore tn complionce wilh on ,hi ct. Bosir for Builder'; Boord exemption: NA.[{E (pleose print)2-SIGNA DATE FOR OTTICE USE ONLY zono R ? Type/Conrr. Unirr - Sq. Frg. Moin x ------Voluax Volue a -Volu6 TOTAT VAI,UATION, fire Zone - Eedroomr Lood Flg. Access Flood Ploin - Srorie Group-Sq. Ftg. Other- EUITDING PERMIT Chorger ond Surchorger O Plon Ck. Comm/lnd 651"lgldg Pe. fce Systemr Oevelopmenl Chorqe (L5?'") Plon Ck. Rer 309i,i Bldq Per Fee PIUMBING PERMIT Chorges ond Surchorges _ /0.?___ '46 Fence Demo Totol Comb. Permit 4c ETECTRICAI. PERMIT Chorgcr ond Surchorgcr o Sidewolk A/C Povinq MECHANICAT PERMIT Chorge: ond Surchorgcr o Curb Cut TOTAI.fl/o,og 1q G q N Ronqe I Ph."3{.G7rrrAddre:r e2?t (r,r.e*ih:{ L)*v ?timo(y Structurol Electrico I Mechonicol CONTRACTOzS )-t-it COMBINATION APPLICATION/PERI^- (CAP) l. Appliconl-Jo furnish A. Job Address B. tegol Description l. exomple-tox lot 100. Lone County Mop Reference 2. e*fi;E-Lot l. Block 3, 2nd Addiiion ro S.-' ( CIT Y OF SPRINGFIELD HollC. Nome, etc. of owner ond construclion lender D. Energy Sources l. . exomple-heot/ eleclricol cei Iinq,./or f orced <z. exomote-woler heoter eleclricolr'or solor E. Squore footoge o. rolrorioilll- I. exomple-l 250 sq. foot house, 500 sq. foor g 2. exomple-if new proiect, check new-if odditi,;ae=r. F. Building permit informotion: I. exomple-construct single fomily house with c 17 03 ,t', 1 CitY { SPringfield o"';llillo"l Oregon Public Works RECEIPI t{0. B 555 4=c, 9 t ( Fgoroge 2. excmple-remodel exisfing goroge into fomily 3. ;xfiFE-converl single fomily residence into iEll&r6nt (chonge of use) G. Volue of work os defined in Section 303 (o) of thr Struclurol Speciolty Code H. DESIGN TEAAA AND CONTRACTORS To ovoid design or construction deloys, Building D, Sloff must be oble to contocl oppropriote persons r design informotion or [ob site corrections, etc. ll. .Abbrevioted PIumbing. Mechonicol & Eiectricoi Schedu A. Except where blonk spoces occur in the descripiion 1 of the Mechonicol onci Electricol Scheduies, lhe oppl need fill-in only the No. Boxes odiocent to the oppro item(s) !o be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve spoce on the permit form the schedule hove been obbrevioted 2. lf the item(s) to be insfolled ore not covered on the oted schedules you should consuil the full schedules r' C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULES lll. Applicont to sign onci dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Stoff will prepore o typewritlen copy ond relurn it to the opplicont ol the time the octuol permit is issued for his signoture. lV. Fees ond Chorges . Plon check fees ore due ond poyoble ot the time of the opplir ond nc plons will be processed until these fees.ore poid. All other fees ond chorges ore due ond poyoble when the permit' is issued. V. FOR OFFICE USE ONLY PLANS REVIEWED BY: n€tme ( ( (ro,U ay 4 Qt' <"7 :1-N U 3IGNA.AURE ( il ,,1 () (( ( Gn Permit Clerk t- PROJECT CONDITIONS TO 8E SATISFIED BEFORE OCCUPANCY: /-7. I/I CAdditional Proiect lnformolion: ---r signoture dote - PERMIT VATIDATION ( ( ( F