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Home My WebLink AboutPermit Building 1981-09-09CITY Of SPRINGTIETD COMEINAIICN APPI.ICAIION / PERMIT INTORMAIION TINE 72137 53IN5PECTION IINE 77G3769 ringfield,0R2119 N. 15th St, SJob Addresr Sq. ttg. Olhlr -New -Add -Alter-ReP'- -[encc-Demo-Chongei Use -Other r c ENERGY SOURCES: Volue of Work: Heo I Sq. Ftg. Accerr. Sq. FrE. Moin Ron Artoched Build Singles Reside nceFomil Bui i-;;, Dercribe Work (i.e.,Owner Addre:r coPO(r)(o N) PhoneAddrarr ne no.)(expire r)(lig. no.)(oddrerr)DESIGN IEAM (nome)( rvi ce Structurol Electri co I Mecho RACTORS no nerol 0atman ElectricElectrico I Plum ETECTRICATPLUMSING FE Mechonicol A^ECHANICAL CHARGE NO.NO.FEECHARGENO. t t F?t 25.00 furnoce/burner lo --BTU'S 1 *"i'duo" "*_,o: ,r.Eoch ringle fixturc Applionce vent sepo ro le New <ircuits, olteroliolls or extensions Relocored building (new fix. odciitionol) Stolionory evop. cooler25.OC SERVICESX S.F. Reridenge (l both) 300 5-00Vent fon with sinqie duct10.00 21Temporory ConrlruclionDuolex (l both) eoch I Vent sy5rem oport from heotinq or A.C.Ampr-Aciditionol borh 450Mechonicol exhourl hood ond ducr1Woter rerYica Wood stove/ heoter10. 005cwer1 I Heot PumpFEEDERSSbr.m Sewer Air hondler ro 10,000 cr,fiAmpr. Air hondler over r0.000 cFM TOTAT CHARGES 2fr^sfLTOTAT CHARGES 35-!OTOTAT CHARGES DATE Units plionr ?- tood .--..-Sq. crorp R3 sq. notrholl Yqbc untilIid oclectricolthaolthisConlrocror,permilE!ertricqlbeworkdona porlionthewthctElectricqlbylhaEREWHAsr,!A R EOUIRESTE lhe ele crri cq Ilo ponel.ottothedondncdnConltoctorElactricolhorlobclbccnrtgby City of withoutiony, to the of ony required lthereon ondiruc ond furtherIinformoiioncorrecl,thot olldoondcerlifycolionIherebyforEXATl1INYtheEDleiedpermil,HAI CAREFULI.com p OPPVE the ofStotetdthecndLoofofthengfi,herh nqOrdi nce 5tndoneonceoccordktshollbecerlilhondolperformedfy Oregon furtherofnrhaIDivision. Spri thestruclure BuildingpermissioYDEwillmodethotondOCCUPNO,ANC' Ce rcriwork her i n.Deopertoi ning noteditlhotexembothetsIor515701oRs.055,Pt exemPtiono3etleclbyforeful I ondBuilder't5Boord tnthotistrotionlhewilhcertifymyre9 701 .055 I usedbe rhion 5owilh proiecl.RSqrewhotnondntroclorsomplionceondthot:ubco employeeronlyheron, Borir for NAr\{E (pleose Zone Type/ Conrt, FOR OITICE UsE ONIY IGNA Fire Zone ---_-i- Bedroomr Flood Plqin IllH,,188&--:EI:[: Frg. Orhcr-1 -Volue TOTAI VATUATION. 61q ?OPlon Ck. Comm/lnd 659'"lgldq Pet fee I Syitems Development Cho roa { I -5?'"} #q67n648 - g0 nd 6-'l 2-8Plon Ck. Res 30%i Bldq Per Fee ?oITemo. Elec. I ahrFence 283-10Tolol Comb, PermitDemo PTUMEING PERMIT Chorger ond Surchorger ___-r5--0q BUITDING PERMIT Chorger ond Svrchorges 7 R6,Sidework 76-63 A/C Pqvinq Chorger ond Surcho rge r ELECTRICAL PER,MII 11.80Curb Cut 18t $q02. 50 TOTAI MECHANICAI. PERMIT B2 20. 50Chorger ond Surchorger Leqol Dercriptiot LOt 1. Bird Plat 17- Phone 746-4?69 IssuANcE oF PERI IT 1 0 - 00 ?E nr ._-_J-q3,-00--- 6.52 1. 40 -___35-_0tr-- 1.40 Additionol Pro[ect lnformorion: signoturenome dote COMEINATION APPLICATIONiPERAIIT (CAP) l. Applicoru. ro furnish A. Job Address B. Legol Description I. exomple-tox lot I00, Lone County2. e-xomiG-Lot l. Block 3, Znd Additi C. Nome, etc. of owner ond construclion D. Energy Sources lectricol ceili /or PERMIT VALIDATION ' Mop Reference I7 03 43 on to Springfield Estotes lender forced oir gos 2 eoter ct col,/orJolET E. Squore footoge o.,rolrotioil.-I]-I. exomple-t,2Ig ,q. foot house, 500 sq. foot gorogez. ex.o.mpte-rt new proiect, check new_if oddition, checkodd, etc. F. Euilding permit informotion:l. exomple-construct single fomily house wirh on ottochedgoroge 2. exomple-remodel existing goroge into fomily room3. &;;Fie-converr single fornily rlsidence inro restouront (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 construction cieloys, Building DivisionStoff must be oble ,o contoct oppropriote purrJr,, regordingdesign informction or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicor & Erectricor schedures A. Except where.blonk spoces occur in the description portionof the Mechonicol ond Electricol Schedules, the oppiicont need fill-in only rhe No. Boxes od[ocent to the oppropriote item(s) to be insrolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot rhe Building DivisionI. To conserve spoce on the permit form the schedules .:hove been obbrevioted 2. lf the irem(s) to be insrolled ore not covered on the obbrevi-. oted schedules you should consult the fuil schedules 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 oworksheer only. Where possible, Building Division Stoff willprepore o typewritten copy ond return it lo the oppliconi o,the time the octuol permit is issued for his signotuie. lV. Fees ond Chorges Plon check fees ore due ond ooyoble or the time of the opplicotion,ond no plons will be processed until these fees ore poid. ellother fees ond chorges ore due ond poyoble when ihe permitis issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit Clerk PLANS REVIEWED BY: CITY Of SPRINGFIETD COMEINAIICN APPI.TCATION / PERMII INFORMATION TINE 72h3753INSPECTION TIHE 72(..3769 21t9 N. 15th St, SPringfield, 0R tionOe Addrerr Sq. F19. Orhcr -New.-Add -Alter-ReP.- Fencc-Demo-ChongeiUre _ .L ^- Volue of Work: cRo Fl ccfr a ENERGY SOURCES: Wo ler H Heo t Sq. ftg. Accel. 5q. Ftg. l^oin tto<hed b.r..ib" Work (i.e., Build Singla Fo mil Bui rmit lnfo: dence ng RePhoneAddrer r o* Co^ !lru(tion @ O(,(o l\) Addrerr Phona r)(lic:. no.)(oddresr)nome)DESIGN TEAM (phonc o dd res(nomc) 687 2-0 q3 5tr ucturo I Electricol Mechon EI.ECTRICATP!UMEING CHARGE NO.I l-E!NO. r I F:E i CHARGELNO. 25.00 furnoce/burner to --BTU'S 1 *"i'880" "' ,o: u.Edan rrnola lrxlua? Applionce vent re poro te New <ircuils. olteroliottr or exlenSlons Relocqred building (naw lir. odciitionol) Slotionor.y evop coolerSERVICES25.0Cx Vent fqn wilh sinqie Cucl 3-0010. 00 2iTemporory ConttructionDuolex (l bolh) coch S.f. Reridengc (l bo Vent Jystem oporl from heoting or A.C.Ampr.Additionol both Mechonicol exhourt hood ond duct1Woter r"rYicr Wood siove/heoterI0- 0r'l Sewer Heol PumoTEEDERSSlor.m Se-er Air hondler to I0,000 cF,fiA-P,. Air hqndlar ovcr 10,000 cFM rOTAt CHARGES 35.00TOTA! CHARGES ?5 0n Syrrems Developmenl Choroe (L591,) BUII.DING PSRMIT Chorger ond Surchorger ___1_6,3-_Q0__651',"1e Per Fee 30%i Btd,Per Fee Plon Ck. Comm/lnd Plon Ck. Rer 48-90 od 6-1?-R'#q6706 Temo. Elec. Labr Totol Comb. Permil PTUMBING PERMIT Chorger ond Surchorgcr -___-i5--9q- Demo ELECTRICAL P Chorger ond Surcho rge r I c ___35-_00__Sidewolk 8011 TOTAT MECHANICAT PERMIT Chorqer ond 5urchorger 82 20.50 Curb Cut 18' 4--82 Plumbi Wal I Etedricol 0atman El gctri c l'\cchonicol AlECHANICAL ISSUANCE OF PERrr{lT TOTAI. CHARGES WHERE SIAIE tAW REOUIRES thor thc Etrctricql work br donc by thc Elcdricol Conlrocror. thq rlectricol portion of this pcrmir rhsll not bc vqlid unril o lobal hor becn rigncd by on Etoctricol Contro<tsr ond oltoshcd to thc clestricol pcnel, t HAVE CA,REtULl,y EXA;,{1NED rh: compleicd opplicotion for permil, ond do hereby certify thot oll informoiion hereon ir lruc ond correct, ond I furthcr <errify thot ony ond oll work pcrformed sholl ba done in occordonce with the Ordinonccs of the City of Springficld ond the lows of the Slote of Oregon pertoining ro tie work Cercriixci herin, ond rhot NO OCCUPANCY will bo mode of ooy tlruciure without lhc permisrion of iha Building Divi:ion. I further errify rh;t my rcAisrrotion with the Euilder't Eoord ir ia full fore ond effect or required by ORS 701.055, lhot if exempt the bo:ir for cx:mption ir rroted heron, ond rhot only subonlroctorr ond employecr who cre in omplionce wiih ORS 701.055 will be uscd on this proicct. Borir for Buildcr'r Boord excmption: NArt{E (pborc prinr) SIGNATURE - OAIE FOR OFFICE USE ONIY So ff lll*r82&-X :==n-Y" "' -3ffi*8- [ood Sq G'o'P R3 Sq' Ftg' othcr-;.r^. r^.*I,:[-m;l: 6.52 1 .40 1CC 1Zone Fire Zone - Ecdroomr Flood Ploin - coMBtNAflON AppLlcATtoN,.pERMF (cAp) l. Applicont to furnish A. Job Address B. Legol Description I. exomple-rox lot .|00, Lone County Mop Referer2. erffiiG-Lot l. Block 3, 2nd Addirio. iJ Spa.siC. Nome, etc. of owner ond construclion lender D. Energy Sources I. exomole-heoti._lsglr5sljslinEt /or forced oir gcl. exomote-worer heoter. electricol.. or solor E. Sqro.. floroge or rolrotioi]]f,]- I. exomole-!259 ,q. foot house, 500 sq. foot goror2. eEEFiE-i?;;w proiecr, che.[i-e*r-ii oddition, todd, etc. F. Building permit informotion: l. exomole-construct single fomily house with on cgoroge 2. exomple-remodel existing goroge into foniily ro3. exfiFG-converr single fornily residence into restouront (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 construction cieloys, Building Div Stoff must be oble to contoct oppropriote p"rron, .. design informotion or iob site corrections, etc. ll. Abbreviored Plumbing, Mechonicol & Electricol Schedul A. Except where.blcnk spoces occur in the description I. of the Mechonicol ond Electricol Schedules, the oppi need fill-in only the No. Boxes cd[ocent fo the oppr< irem(s) to be insrolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Divisionl. To conserve spoce on the permit form the schedu hove been obbrevioled 2. lf the irem(s) to be instolled ore not covered on tl. oted schedules you should consul, the fuil schedu C. BUILDING DIVISION STAFF WILL FITL OUT AtL FEES I CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the iniriol opplicotion will be used c worksheet only. Where possible, Building Division Stoff prepore o typewritten copy ond return it to the opplicor: the time the octuol permit is issued for his signotuie. ,, clrY Dole Amounl Received Permit Clerk . PERMIT VALIDATION OF SPRINGFIELD Ciry Holl Springfield, Oregon Deportmenl of Public Works OFFICIAT RECEIPT No. B 572*8. -?/ oo ck it ( C ( so I togo (b, BY AUTHORIZEO 9IGNATURE SHaLTOX-YUirEUIL PArrrais ' EUCENE Oi tTaO!35 ! r-6 / +- lV. Feer ond Chorges Plon check fees ore due ond poyoble ot the time of the oppricotion, ond no plons will be processed until these fees ore poid. all other fees ond chorges ore due ond poyoble when ihe permitir issued. V. FOR OFFICE USE ONTY PROJECT CONDTTIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: PLANS REVIEWED BY: I & t E nome signoture dote Address \qru, 111ortn , [\ge (' ( (. ( Ct Ut,l ! {tr- ) L