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Home My WebLink AboutPermit Electrical 1981-04-02CIIY Of SPRINGTIELD COMEINAIION APPTICATION I PERAATT INFORAAATION TINE 72&i753INSPECTION TINE 72&3769 14 5 tegol Description o Ron Woler Heoter ENERGY SOURCES: Heot *Sq. Ftg. Moin 5q, Flg. Accesr. Sq. Ftg. Olher -New.-Add -Alter--ReP. - -Fence--Demo-Chonge/ Use -426il.., . Volue of Work: Bui Permit lnfo siCence Describe Work (i.e., Build Single ched GqPhoneAddre rs stl/ uctio 0s c gl 00 W PhoneAddress hone no.)(lics. no.)(expires)DESIGN TEA^A (nome)(oddress) Mechonicol Mechonicol Plumbi PTUMBING ETECTRICAT MECHANICAL No. i FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE I Eoch sinqle fixture I Residence of ---sq. ft. furnoce/burner to -_--_BrU'rRelccoted building (new fix. ociditionol) New circuits, qlterotions or exlensions Applionce vent sepo rq le S.F. Residence (l both)sERVrcEs c-/La/h q.L /6,a9 /a,g Stolionory evoo- cooler Duolex (l bqth) eoch I I //u Temporory Construclion Vent fon with single duct Additionol both i I ,dmpr. Yent system oport from heoting or A.C. Woler rervire Mechonicol exhoust hood qnd duct Sewer s toYe Storm Sewer FEEDERS Heot Pump Ampr, Air hqndler to Air honciler over 10,000 cFM SIGNATURE DATE P"bo-n I comple hereby certifycertilyperformed correcr,Springfie Oregonerllty furtherheron, notedproiect. I HAVE CAREFUTTY EXAAIlNED rhe ted opplicotion for permit, ond dothot ony ond oll work lhot sll informotion hereoshoii be done in o n is irue ondccordonce wiih ond I furthertheOrdinsncesof the Ciry ofpertqining to the work dercribed ld ond the Lows oherin, qnd thot NO OCCUPANCY will be mode f the Stote ofof onyihot my registrotion with siructure wilhout ,he peihe Builder,s Boqrd rmission of thais in full Iore ond effect os Building Division. Iond thot oniy su required by ORS 701bcontroctors ond employees .0.55, thor if exempt lhewho ore in complione bqsis for exemption ;swith ORS 701.055 will be used on thisBosis for Builder,s Boord exemption: ,E99r L TOT AL Hc ARGES ATTOI.o6CHARGESo AITOT CHARGES (_).HEREw A5T TA,TE REQU I RES lhqt rhc Etectricol bework oone theby Elactricol Conlro thelqbelctoi,electricolhorbeerned ofporlion thistigonbyEleGtricqlnrroCo parmit shollo(tor nd no,bcqltochedto volid unriltha oelertricslpunel. NAME (pleose prinf) ISSUANCE OF PERMIT FOR OTFICE USE ONIY TOIAI. YATUAIION x ueLood -i So.G.orp K Q, 5o. 5q.Ftg. Aioin Flg. Accsss Ftg. Oiher Flood Ploin - Srorie Fire Zone Eedroom: Zone Type/ Const. x Volue x Volue Comm/ lnd Fee Fee PIon Ck. Res 30o/ol BUILDING PERMIT Chorger ond Surchorges Systems Deve lopment o, ?sPTUMBING PERA^IT Chorges ond SurchqTggg DemoIIChorges ond Surchorges Curb Cuf Sidewoli< oo O,4 (s0PermitIotolComb. PERAl IT IOIAI 0,69 ddre i--_ S truclu ro I Electricol Per Plon Ck. L.qkl fe< (1 ond COMBINATION APPLICATION/'PER, l. Appliconi. to furnish A. Job Address B. Legol Descripfion exomple-heot ,/electricol ceil2. e]ffiElE-wot er eoter colE. Squore footoge or voluoti on, etc g. foot house. (cAP) or forceo' oir oos ,/ or solor 500 sq. foot goroge new-if oddition, check c D I. exomple-tox lot .,00,_Lorre.County Mop Reference i7 03 432. exEmiG-rot l. Brock'3, inl;;ii;;';isprinsfierd EsroresNo-"*r.. of owner ond construction lender Energy Sources proiect, check F. Building permit informotion:l. exompie-construct single fomily house with on ottochedgoroge 2. exomple-remodel existing goioge into fomily room3. exo;;G-converr slngle fir;ily rlsidence into restouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of theStructurol Speciolry Code H. DESIGN TEAIN AND CONTRACTORS To ovoid design or construciion Celoys, Building DivisionStoff must be oble to contoct opproprioie p"r.o-n= regordingdesign informction or [ob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electriccl Schedules A, Except where blonk spoces occur in the description oortionof the Mechonicol ond Electricol Schedules, the oppiicont need fill-in oniy the No. Boxes odiocent to the oppropriote item(s) to be instolled B. Fuil Plumbing. Alechonicoi, ond Eleciricol Schecjules ore ovoiloble ot the Building Division l. To conserve spoce on the per.mit form the schedules : hove been obbrevioted 2. lf the item(s) to be insrolled ore not covered on the obbrevi-. oted scheduies you should consult the fuil schedules C. SUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Appliconf to sign onci dote Whenever possible, the initiol opplicotion will be used os o worksheet oniy. Where possible, Builciing Division Sroff will prepore o type\ /ritten copy ond return it to ihe opplicont ot the time the octuol permit is issued for his signoture. lV. Fees cnd Chorges Plon check fees ore 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 exomple- l 250 s eEmElE-;T n& odd, etc. PERMIT VATIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect Informotion: signotu renome dote* PTANS REVIEWED BY: CIIY OF SPRINGFIELD COTAEINATION APPI'ICAIION / PENA{II INFORMAIION TIilE 72C3753INSPECTION tINE 72&.3769 Woler Heoter ENERGY SOURCESI Heot - 0wner Sq. Ftg. Moin ..-New.-Add--Alter--ReP' - -Fence--Demo-Chonge/ U se -4zl|th", - Volue of Work: Fo mi SingleDercribe Work (i.eing Permit lnfo: riCence WithPhoneAddre:r <,/-sJ(-l/ Cons PhoneAddress (nome)(oddress)(expires)(phone no.)(lics. no.)DESIGN TEAM PTU&18ING CHARGEFEE ETECTR IC,AT ARGEFEE MECHANICAL NC EE IEochsingle fixturc Residence of --rq. ft, tur Ourner to tRelccored building new fix. ociditionol) New circuits, olterotions or extension3 Applionre vent S.F. Reridence (l both)SERVICES ChAINAL /6.oe /0,q ) eo<hDuolex Temporory Conrlruction le duct Vent fon wifh ,dmps.heotin or Vent syilem oport from Slorm Sewer FEEDENS t Pum Ampr.Air hqndlcr to 1 Air honciler over I CFM IOTAL CHARGES TOIAI. CHARGES 60 SIGNATURE DATE Springfield ond the permission hereby certify ond further Gartlly Oregon heron,further notcd L o- -(J- I HAVE CAREFUI.TY EX AMINED rhe completed opplicotion for permit, ond do<ertify thot ony ond oll thot oil informotionwork performed shoil hereon is truebe done in occordqnce wirh lhepe.toining to the worl OrCinonces correci, ond Iof the City ofdescribed herin, qnd thot NO OCCU PANCY will be mode the Lows of the Stote ofthot my of onyregirtrotion with thc siruclure withou,Builder's Boord is in full of thefore ond effecl osond tho t oniy rubcof,troqtors required by ORS 7OLO55. r ORS 701.055 will be used Building Divirion. Iond employeer who thot if exemptore in complione wiih the bo ris for exemption ison this proiect.Bo:is for Suilder/: Boord cremplionr ', the clectrical poriion of fhis permit shqll not be volid until o WHERE ST ,IE tA'REQU IR E5 thot ths workElectricql be done theby calElactti Cont?oGlolhoslqbelboonncdtt9obyEloctricqctcrControqndoro<hed to thE cledricol Psnel. NAI\\E (pleose prinr) TOIAI. CHARGES ISSUANCE OF PERMIT FOR OFTICE USE ONI.YZone Eedrooms o"ay -So Sq. Sq ryp"/ Corsr. Fire Zo flood Ploin - Srorie Flg. Other TOTAI. VAI.UAIION Lood 'i Gr"rp N. Q, Fig, Auin x Volue x Volua x _ Volue Syslems Deve lopmcnl Per PIqn Ck.Comm/ lnd PLUA,IB NG PERAlIT qChorges nd Plon Ck. Res Surcfi6lEq, BUILDING PERMIT Chorger ond Surchorger .\ 20 b0TotolComb. PERA4 IIChorges ond Surchorges O Demo SidewoJk Curb Cur ITPERAT IOIAI o,69 cr L/ qr 0.r W Primo Eleclrico I Electricol Mechonicol Slolionory evoo. cooler Additionol both Woler reryire Aiechonicol exhouit hood ond duct Sewer Wood stove/ heoier I Lc(&l fe< coMBrNATroN AppLrcATroN,,pEr ^,. (cor) PERMIT VATIDATION BUITDING OWNER'S EL ECTRICAT I.ABELBU!tDING DlVlSlON-Ciry of Springfield-946 MAIN S l. dpplicoru. to furnish A. Job Address B. Legol Descriotion l. gomeis-.tox_lot.l 00. Lone County r!z. exomoie-Lor I. Block 3, 2nd AdditionC. N";l;;of owner ond consrruction leD. Energy Sources - i' ffi:I""1:,'#fff#.J, i:,1E. Squore footoge o. rolrotio - l. exomple-.1250 sq. foot house, 500 sqr. elomote-if new proiect, check i&-ii odd, etc. F. Building permit informotion:I. exomple-construct single fomily housgoroge 2. exomple-remodel existing goroge inlJ. exomole-ccnvert single fomily reside resrouront (chonge of use) G. Volue of work os defined in Section 303Structurol Speciolry Code H. DESIGN IEAIA AND CONTRACTORS To o-void design or construciion deloys, ISloff mus, be oble ?o contqct opproprioi design informction or iob site .o...lrion 72&3753 72t3769 r. Ns a187 B Signoture of OwnerBuilding (Must be providad energizing or connecling electricol Print) of Premises Dcrcription of Work: Additionol Servica ll. Abbrevioted Plumbing, Mechonicol & Eleor ,A. Except where blonk spoces occur in the description porlion of the Mechonicol ond Electricol Schedules, the oppiicont need fill-in oniy the No. Boxes oCiocent to the oppropriote item(s) fo be instolled 8. Full Plumbing, Alechonicoi, ond Electricol Scheciules ore ovoiloble or the tsuilding Division l. To conserve spoce on the permit form the schedules j hove been obbrevioted 2. lf lhe item(s) to be instolled ore not covered on the obbrevi-. oted scheduies you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ANID CHARGES ON THE SCHEDULES lll. Aoplicont to sign onci dote Whenever possible, the initiol opplicorion will be used os worksheet oniy. Where possible, Builciing Division Stoff v prepore o typewritten copy ond return it to the opplicont the time the octuol permit is issued for his signqture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the o1 ond no plons will be processed until these fees ore poid. , other fees ond chorges ore due ond poyoble when lhe pe is i;sued. V. FOR OFFICE USE ONLY INSPECTED BY DATE . IoB No. serving ogency lo connect ond energize lheTAEEL IS ACCdMPANIED BY A RED APPROVAT CITY OF SPRINGFIELD CitY Holl Springfield, Oregon Deportment of Public Workc OFFICIAL RECEIPT Itlo. B 56213 C,19(Jl oo 4q^n 4a 2>o Bol&'7 Received f., >Jfi^- ( (r (l il (r iJ t ( ( ,4 t PROJECT CONDTTIONS TO BE SATISFIED BEFORE OCCUPAI Received For ( t Additionol Proiect lnformolion: PLANS REVIEWED BY: ,t- t t- \l H (l Q ( (o Amount A'T'O''Z'O SIGNATURE SHELION.TURXBULL PiISTERS EUGENI OR 97'OI t a nome a signoture BY dote ( q lobel)