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Home My WebLink AboutPermit Mechanical 1981-03-18INSP€CIION I.INE 72(.3769 co, CITY- OF SPRINCf IEtDIAIIVi APP!ICAIIONIPERfrTIT TNFORMAIION TINE 72637s3 ENERGY SOURCES; Heoi - Woler Heoter nLegol 1 6zz -New -Add-Alter--Rep'-- -Fence--Demo-Chongef Use --Other Sq. Ftg. Moin 5q. Ftg. Accerr. Sq. Ftg. Other Addre ss Phone Volue of Work: ce Building Permit lnfo:Dercribe Work (i.e., Build Single Attoched Go Address Phone C,A5 No D (lics. no.)(phone no.)DESIGN TEAM (nome) Primo Structu.o I Mechonicol I Plumbi Electrico I Mechonicol PLUTlrBING ETECTR ICAT MECHANICAL No. i I FEE CHARGE NO.I FEE CHARGE NO.FEE CHARGE I I I Eoch single fixtura Residence of fr. furnocefburner to.=---BTU': Relocoted building (new fix. oddiiionol) New circuits. olterotions oa extensioh3 Applionce vent seporore S.F. Reridence (l both)SERVICES Stolionory evop. cooler Duplex (l both) eocir Temporory Conslruclion Yent fon with sinqle duct Additionol both Amps. Vent system oport from heoting or A.C. Woler rervice Mechonicoi exhoust hood ond duct Sewer Wood stove/heoier Slorm Sewer FEEDERS Heot Pump Amps. Air hondler to t0,000 cFM Air honciler over'r0,000 crM ISSUANCE OF PERMII WHERE SIAIE tAw REQUIRES thot lhe Elactricol work be done by thE Electrisal Controctor. the electricol porrion of this permit sholl not ba volid unril qlqbel hos brn :igncd by on Elactricol Controctor ond ottoched to the etectricol ponel. I HAVE CAREFUttY ExAMINED rhe completed opplicotion for permit, cnd do hereby certify thot oll informqiion hereon is true ond correci, ond I furrher(ertifr thot ony ond qll work performed sholl be done in qcordonce with the Ordinsnces of the City of Springfield ond rhe Lows of the itore of O;.;o;Pertoining lo ihe wqrk described herin, ond rhot NO OCCUPANCY will be mqde of ony siructure without rhe piermission of the guilJing Division. I furthercertlfy thot my regirtrotion wirh the Builder's Boord is in full fcre ond effect os required by ORS 70I.055, thot if exempt the bosis for exemption is- notedheron, on<i lhot oniy subcontroclors ond employees who ore in complione wiih ORS 70I.055 wilt be used on this proiect. Flood Ploin -storier-Occy Group-Sq. Ffg, Other-_-_-.--- TOTAT CHARGES DATENAME (pleose print) TOTAT CHARGES TOTAI. CHARGES Boris for Builder'r Boo Ftg. Moin FOR OFFICE USE OT{IY SIGNATURE Fire Zone-Bedrooms x Yolus x Volue x -Volue TOTAI. VATUAIION, Zone -fyps/ Conct. --Units lood -Sq. Ftg. Access Plon Ck. Comm/lnd 6596/Bldg per fee Systems Development Chorqe (1.5%) BUILDING PERMIT Chorges ond Surchorge:Plon Ck- Rer 309/./Bldg Per Fee Fence PI.UMBING PERMIT Chorge: ond S urcho rge s Demo Totol Comb. Permit Sidewolk ETECIRICAI. PERMII Chorges ond Surcho rg e s A/C Psvinq Curb Cut MECHANIC.AT PERMIT Chorges ond Surchorger l_b,QQ_ IOTAI.t6 bc 3tlob Address .cc Construcrion Lender t tl (oddress)(expirer) CONTRACTORS (nome)(oddress)(lics. no.)(ex pi re s)(ohone no-i U '\. COMBINATION APpL|CAT|ON,,,PEr .,T (CAp) + l. .Appliconr. to f urnish A. Job Address B. Legol Descriptionl. exomple-tox lot I00, Lone County Mop Reference I7 03 432. exomple-Lot l. Block 3, 2nd Addition ro Springfield Estotes C. Nome, etc. of owner ond construction lender D. Energy Sources l. exomple-heot,'electricol ceilingT'or forceo' oir gos 2. exomDre-woter heoter. electricol., or solor E. Squore footoge or voluotion, etc.t. g.g4p]g-!?10 .C.foor house, 50! sq. foot goroge 2. exfi;E-iT-iew proiecr, checkilew-ii oddirion, Jheck odd, etc. F. Building permit informotion: I. exomple-construct single fomily house with on ottoched goroge 2. exomple-remodel existing goi,oge into family room 3. @-convert single fomily residence into restouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of the Structurol Speciolty Code H. DESIGN TEAIA AND CONTRACTORS To ovoid design or construciion cjeloys, Building Division Stoff must be oble to contoct opproprioie persons regor.iing design informction or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules ,A,. Except where blonk spoces occur in the description porlion of the Mechonicol ond Electrical Schedules, the oppiicont need fill-in oniy the No. Boxes odiocent to ihe oppropriote item(s) to be instoiled B. Fuil Plumbing, A{echonicoi, ond Electricol Schecjules ore ovoiloble ot the Building Division I. To con-rve spoce on the permit form the schedules : hove been cbbrevioted 2. lf the item(s) to be instolled ore not covered on the obbrevi-. oled 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 onci dote Whenever possible, the initiol oppiicotion will be used os o worksheet oniy. Where possible, Builciing Division Stoff will prepore o iypewritten copy ond return it to the oppliconi ot the time the octuol permit is issued for his signoture. lV. Fees cnd Chorges Plon check fees cre due ond poyoble ot the time of the opplicotion, ond no plons will be processed until these fees ore poid. Ail other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED EEFORE OCCUPANCY: Additional Proiect lnformotion nome signotu re doteiF PLANS REVIEWED BY INSPECTION I,INE 72(F3769 Job Addre CITY OT SPRINGFIEID COM AIIO,. APPTICAIION/PERMII INFORMAIION TINE 72L3753 r-( I Dercri ( -New -Add-Alter--ReP'-- -Fence--Demo-Chonge/ Usa --Other - Building Permil lnio: Dercribe Work (i e., Build Single Volue of Work3 Fq Woter Heoter Accerl. Atto ched Sq. Ftg 5q. itg Sq. Ftg ENERGY SOURCES: Heot - Moin -_.--- Othcr - Phonerdd,",, S&l/Y\& 1A { Constrvction Lender *cr\o D Tl Addre s:Phone DESIGN TEAM (nomc)(oddress)(lics. no.)(expirer)(phone no.) Primo ry Slructurol Electricol Mechonicol (nom e)(oddress)(lics. no.)(expires)(phone no.)CONTRACTORS I Plumbinq 1V Electricol lr'.echo nico I EIECTRICAT MECHANICALPLUr'1BlNG FEE CHARGECHARGENO. I FEE CHARGE No. INo. i J FEE Residence of it. furnoce/ burner lo --BTU'S Eoch:ingie iixture Applionce vent 5eporole Relocoted building (new fix. ociciilionol) New circuits, olterolioos or exiensiont Slolionory evop. co o ler S.t. Reridence (I both)SERVICES Vent fon with sinqle ductDuolex (l both) eoch f emporory Construclion Additionol both .A,mpr. Yent system oport from heoting or A,.C. Woler rervice Mechonicoi exhoust hood ond duct Sewer i i Wood :tove/ heoter Slorm Sewcr FEEDERS Heol Pump Ampr. Air hondler to t0,000 cFM I I I A,ir honciler over 10,000 cFrri ISSUANCE OF PERMIT TOTAL CHARGES TOTAT CHARGES WHERE trAIE rAw REAUIRES thqt lhe Elecrricol work be done by the Eletlricol Conltoctoi. the electricol portion of this permit rholl not ba volid until olobcl hor bon rigncd by on Electricol Contrq(tor qnd sttsched to tha eteclricol ponel. TOTAT CHARGES I HAVE CAREFUttY EXAA'llNED the compleled opplicotion for permil. cnd do hereby certify thot oll informoiion hereon is irue ond correct, ond I further(eriify thot ony ond oll work performed sholl be done in occordonce with the orCinonces of the City of Springfield onci the Lows of the irore of Or.gonpertoining to ihe work dercribed herin, ond rhqt NO OCCUPANCY will be mode of ony rtructure without the plrmisrion of the Building Divi:ion. I furtherertlfy thot my rcgilhqrion with the Builder's Boord is in full fcre ond effect os requireci by ORS 701.055, tho, if erempt the bosir tr exemption is-notedheron, ond thot oniy subqonlroclor ond employeer who ore in complione wiih ORS 70I.055 will be ured on thir proiert. SIGNATURE DATE n:Boris catJ,.* I *(,rl FOR OTFICE UsE ONIY ocry Lood Sg. Ftg. Accars -Srorirr Occy Group_Sq. Ftg. Other....---- ti -So Ftg. Moin Flood Ploin TOTAT VATUAIION Zone - fypc/Const. f ire Zone- Bedroomr x VoJue x Volue x _-lqlgE Plqn Ck. Commf Ind Fee Systems Oevelopment 8UI[DING PERAlIT Chorge: ond 5urchorges Plon Ck. Res Per Fee Fence PTUMBING PERA,\IT Chorger ond 5urchorger fotol Comb. Perm it Sidewolk II Chorger ond Surchorges Curb Cut MECHANICAT PERMIT Chorger ond Svrchorger TOTAI.t5 bc I | (\r10 cc L( 1 NA.lvlE (pleose prinr) (l _5?l) Demo A/C Pcvino COMBINATION APPLICATION,,/PE .IT (CAP) l. Applicoru. to furnish A. Job Address B. Legol Description I. exomple-tox lot 100, Lone County Mop Referenc2. exomple-Lor l. Block 3, 2nd Addition to Springfie C. Nome, etc. of owner ond construction lender D. Energy Sources I. exomple-heotr'electricol ceiling/'or forced oir oosz. exomote-woter heoter eleciricol,/or solor E. sqrilTiJoee or rotrotioflil I. glg11plq-1250 sq. foot house, 50! sq. foot gorogr2. exomilE-iFiEw proiecr, checkE-w-ii oddiri'on, c-h odd, etc. F. Building permit informotion: l. exomple-construct single fomily house with on oti goroge 2. exomple-remodel existing goroge into fomily roor3. gIgjlpE-convert single fomily residence into restouront (chonge of use) G. Volue of work os defined in Section 303 (o) of rhe Structurol Specio Iry Code H. DESIGN TEAIA AND CONTRACTORS To ovoid design or construciion deloys, Building Divi: Stoff must be oble to contocl oppropriote persons re( desiEn informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedule A,. Except where blonk spoces occur in the o'escription o< of the Mechonicol ond Electrical Schedules, rhe oppli< need fill-in only fhe No. Boxes odiocent to ihe opprol item(s) to be instolled B. Fuil Plumbing, A{echonicoi, ond Electrical Schedules ore ovoiloble or the Building Division I. To conserve spoce on the permit form the schedule hove been cbbrevioted 2. lf the item(s) to be instqlled ore not covered on fhe. oted scheduies you should consult rhe fuil schedulr C. BUILDING DIVISION STAFF WILL FILL OUT,ALL FEES AI CHARGES ON THE SCHEDUTES lll. Agplicont to sign onci dote Whenever possible, the initiol opplicotion will be used os worksheet oniy. Where possible, Builcjing Division Stoff v prepore o iypewritten copy ond return it to the opplicont the rime the octuol permit is issued for his signoture. PERMIT VALIDATION CITY OF SPRINGFIELD Clry Holl Springfield, Oregon Deportment of Public Works OFFICIAT RECEIPT fsr C C ( { r ( ( ( (: 8e, ( \ ( { ( (; I{0. B 56096 Dote l9 For: Amounl Received BY r) ( ( (, ( ( 1-------- Iffi 5IGNATURE I t*a.ro* ruJ,auLr FRrNrEis EUGETE on st.o!lr lV. Fees cnd Chorges ( Plqn check fees cre due ond poyoble ot the time of the cp ond no plons wiil be processed until ,hese fees ore poici. AII other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATTSFIED SEFORE OCCUPANCY: Additional Proiect lnformotion: dotesignoturenomea PTANS REVIEWED BY: