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Home My WebLink AboutPermit Mechanical 1982-05-13( { { ( INFOR'\AAItON I.INE 72(-3753IN5PEC*ON LINE 7263769 Job .+ ENER.GY SOURCES: Heci Woter Heoler -New -Add-Alter Rep. Fence Demo-Chonge/ Use Other - Sq. Ftg. Moin Sq. Ftg. Access, Sq. Etg. Other Volue of Work: & Owner Address Building Permit lnfo: Describe Work (i.e', Build Single Fo Re Address Phone (phoneDESIGN TEAM no.)(oddress)(nome) Primo Slructuro I Plumbi Electricql Mechonicol MECHANICATETECTRICATPTUMBING NO.FEE CHARGE NO.FEE CHARGE furnoce/burner to -BTU'S Residence of ft.le fixtureEqch Applionce vent role New circuits, olterotions or extensions Relocoled building fix. odditionol) Stotionory evop. coolerSERVICESI S.F, Residence Vent fqn with le ductTemConstructioneoch Vent syslem oport from or A.C.Additionol bqth Mechonicol exhousl ondWoler service Sewer Heot PumFEEDERSStorm Sewer Air hondler to I CFM Air hondler over I CFM ISSUANCE OF PERMIT TOTAT CHARGESTOTAT CHARGESTOTAT CHARGES WHERE STAIE tAW REQUIRES rhot the Electricql work be done by the Eleclricsl Conlroclor, the eleclricol portion of lhis permit sholl not be volid unril a label hos been signed by on Electricol Controclor qnd ottached to the electricol ponel. I HAVE CAREFUIIY EXAMINED the compleied opplicotion for permil, ond do hereby certify lhot oll informotion hereon is lrue qnd correct, ond I further certify thot ony ond otl work performed sholl be done in qccordonce with the Ordinonces of the City of Springfield qnd the Lqws of the Stote of Oregon pertoining to the work described herin, ond thot NO OCCUPANCY will be mode of ony structure withoul the permission of the Building Division. I further cerrlfy rhot my registrotion with, the Builder's Boord is in full force ond eiffect os required by ORS 701.055, thot if exempt the bosis for exemption is noled heron, ond thot only subcontroctors ond employees who qre in complionce wirh ORS 70I.055 will be used on this proiect. SIGNATURE DATE Bosis for Builder's Boord exemplion: NAME (pleose FOR OFFICE USE ONIY Zone-Type/Const.-Units-Sq.Ft9'/r{oinxYolue Sq. Ftg. Other Occv Lood So Ftg. Access x - VolueFire Zone-Bedrooms TOTAT YATUATION Flood Ploin tories-OccY GrouP x -YoJue s DevelopmentPlon Ck. Comm/lnd Per Plon Ck. Res Per Fee BUIIDING PER vtlT Chorges ond Surchorges Fe nce Totol Comb. PermitDemo PTUMBING PERMIT Chorges ond Surchorges Sidewolk ETECTRICAT PERMIT Chorges ond Surchorges Curb Cut MECHANICAI. PERMIT Chorges ond S urcho rge s TOTAI. ___a,il t. CITY OF SPRINGFIEID COMBINATION APPTICAIION/PERMII Conctruclion Lender cst t-)ts \ Eleclricol {l FEE CHARGENr) Amps. Wood stove/ heoler Amos. tt /ttrhfl ^ rt t x! iot t ,l <n ttt td.^a) 4'z/g^ (1 .50/"\ #s.os.M coMBtNATtON AppLtcATtoN/pEh. ..r (cAp) I. Applicont to furnish A. Job Address B. Legol DescriptionI. exomple-tox lot I00, Lone County Mop Reference I7 03 432. exomple-Lot I. Block 3,2nd Addiiion ro Springfietd Esrotes C. Nome, etc. of owner ond construction lender D, Energy Sources I . exo m p !S- h ""t/"_lggrygJ_Sgj.! ng,/or f o rced o i r go s 2. exo m p lE-wo te rl-eo GiTEllctri co l / "r tdS: E. Squore footoge or voluotion, elc.l. exomple-1250 sq. foot house, 500 sq. foot goroge 2. exomple-if new proiect, check new-if oddition, check odd, etc. F. Building permit informolion: I. exomple-construcl single fomily house with on ollqched gqroge 2. exomple-remodel existing goroge into fomily room 3. examF[e-convert single fomily residence into restotrront (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structuro I Specio lty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to contocl oppropriote persons regording design informotion or iob site correclions, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A,. Except where blonk spoces occur in the description porlion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only the No. Boxes odiocent to the oppropriole item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot lhe Building Division L To conserve spoce on the permit form the schedules hove been obbrevioted 2. lf rhe item(s) to be instolled ore nol covered on lhe obbrevi- oled schedules you should consull the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL 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 Stoff will prepore o typewritten copy ond relurn it to the opplicont ot the time the octuol permit is issued for his signolure. 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 o.re due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VATIDATION Permit Clerk PROJECT CONDITIONS IO BE SATISFIED BEFORE OCCUPANCY: Additional Proiect lnformolion: dotesig noturenqme PLANS REVIEWED BY INSPECIION lINE 72('3759 CIIY OF SPRINGTIELD COMBINATION APPTICATION / PERIAII INFORMATION I.INE 726-3753 ( ( r/q legol Description ENERGY SOURCES: Heot - Wqter Heoler - Ro Sq. Ftg. Moin Sq. Ftg. Accesr. Sq. ttg. Other -New Add-Alrer-ReP. - -Fence -Other nge/ Use c^ tJt: -+Volue of Work: x ?/0 aO c, Addre:s Building Permit lnfo: Describe Work (i.e., Build Single Fomily Residence With Alroched Goroge),////ecz/ fib Stti-ztI Conrlruction Lender Add ress Phone DESIGN TEAM (nome)(oddress)(lics. no.)(expires)(phone no.) Primory Strucluro I E lectrico I ) RACToR( (qome)0 (oddress\ I (lics. no.)(expires)(ohone no,) P Electricol Mechonicol PTUMBING a EIECTRICAt MECHANICAL NO.FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE Eoch single fixture Residence of -sq. ft. furnoce/burner to ,s Relocoted building (new fix. odditionol) New circuits, olterotion: or exlensions Applionce vent sepqrq te S.F. Residence (l borh)SERVICES Stotionory evop. cooler Duplex (l both) eoch Temporory Conslruclion Yent fon with single duct Additionol both Amps. Vent syslem oport from heoting or A.C. Woler service Mechonicol exhousl hood ond duct Sewer Wood slove/heoter Slorm Sewer FEEDERS Heot Pump Amp:. Air hqndler to I0.000 cFM Air hondler over r0,000 cFM u/n.Ahir. a ailia,ut U ,1. <t> I tt lssuANcE or PERA{IT lD.&1) TOTAT CHARGES TOTAT CHARGES TOTAI. CHARGES tt),,<]) WHERE STATE tAW REQUIRES thot the Electricol work be done by the Electricol Conlroclor, the clectricol porlion of this permit sholl not ba vqlid until o label ho: been signed by on Eleclricol Controclor ond ottoched to the eleclricol ponel. I HAVE CAREFULIY EXAMINED the completed oppli€otion for permit, ond do hereby cerlify thot oll informotion hereon is true ond correct, ond I further cerlify thol ony ond oll work performed sholl be done in qccordonce with the Ordinonces of rhe City of Springfield ond the Lows of the Stote of Oregon pertoining to the work described herin, ond thot NO OCCUPANCY will be mode of ony slructure without the permission of rhe Building Division. I further certlfy thot my registrolion with, the Builder's Boord is in full force ond effect os required by ORS 701.055, thot if exempt the bosis for exemption is noted heron, ond thot only subconlroctors ond employees who qre in complione with ORS 701.055 will be used on this proiect. Bosis for Builder's Boord exemption: NAME (pleose SIGNATURE oar4tSf-62-- FOR OFFICE USE ONI,Y Zone -Type/Const. ls Sa Ftg. Moin x Volue x -lqlgg 1-{qlss Fire Zone-Bedrooms Occy Lood Ftg. Access FloodPloin-stories-occyGroup-Sq.Ftg.other- TOTAT VATUATION BUITDING PERMIT Chorges ond Surchorges Plqn Ck. Comm/lnd 6596/Bldg Per Fee Syslems Development Choroe (I.5%) Plon Ck. Res 307o/ Blds Per Fee PTUMBING PERMIT Chorges ond Surchorges Fence Demo Totol Comb. Permit EI.ECTRICAT PERMII Chorges ond Surchorger Sidewolk A/C Povino MECHANICAI. PERMIT Chorges ond Surchorges -t450 Curb Cut TOTAI.g ( coMBTNATTON AppLrCATrON,/PERMTT (CAP) l. Applicont to furnish A. Job Address B. legol Description l. exomple-tox lol I00, Lone Counly Mop Referenc 2. exomple-Lor I. BIock 3, 2nd Addition to Springfiei C. Nome, etc. of owner ond construction lender D. Energy Sources CITY OF SPRINGFIELD CitY Hall Springfield, Oregon Department ol Public Works OFFTCIAL RECEIPT No' _l -r- $, (. ( (( {. ( B ss!35 'l 2. E. Squore footoge or voluolion, elc. l. exomple-l 250 sq. {oot house, 500 sq. foot goroge 2. exomple-if new proiect, check new-if oddition, chr odd, elc. F. Building permit informotion: I. exomple-construct single fomily house with on ott goroge 2. exomple-remodel existing goroge into fomily roor 3. exompE-convert single fomily residence inlo restouront (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 conslruction deloys, Building Divis Stoff must be oble to contoct oppropriote persons reg design informotion or iob sile corrections, etc. Abbrevioted Plumbing, Mechonicol & Electricol Sc,hedule: A. Except where blonk spoces occur in the description po of the Mechonicol ond Electricol Schedules, the opplic need fill-in only the No. Boxes odiocent to the opprop item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ol the Building Division I. To conserve spoce on lhe permit form the schedule hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on the oted schedules you should consull the full schedule C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AI' CHARGES ON THE SCHEDULES exomple-heot/electricol ceiling/or forced oir gos e-io-iiElE-wo te rT-eo G7@! /o r soiE r- - Date t3 1s tz Hec'd From Address ti.*s Beceived For: h,4-l* g zo rlg / (t I lrn ( ( ( ( { /f o o 0 l0.oa ,s8 (l (t (l r'l I (t I oo Amount Received .& t{.ov e.l lll. Appliconl to sign ond dote Whenever possible, the initiol opplicotion will be used os worksheet only. Where possible, Building Division Sroff w.-, prepore o typewritten copy ond relurn it to the oppliconl ot the time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due qnd poyoble ot the lime of the opplicotion, ond no 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 p itntgog PRtxtER3/IITHoGRAPHERS' EUGENE' ohEGoN Permit Clerk / PROJECT CONDITIONS IO BE SATISFIED BEFORE OCCUPANCY: Additional Proiect lnformotion: PLANS REVIEWED BY: dotesignolurenome ( (. ) t