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Home My WebLink AboutPermit Building 1981-08-05INsPECIION TINE 72&37 69 CIIY OF SPRINGTIETD COMSINAIICN APPTICAIION/ PERIAIT INFONMAIION TINE t7h3ts3 P(ifrot,f ENERGY SOURCES: -OtherOwner R Heo t Sq. Ftg. Accerr. Sq. Ftq. OtherWoler Heoler .lob Addrerr De rcription Volue of Work: f o6-ao Sq. ttg. Moin -New -Add -Alter -Rep.. -tence-Demo-Chonge i Ure Addrerr qe{ ,// ,j q Ph"^.rf7qilq Buildinq Permit lnfo: Dercribe Work (i.e.. Build Singla Fomily Re:idence With Arro(hed Ggfgg.|_ $ N Con!?ruclio^ [ende. Addrer r Phone relDESIGN TEAM (nome)(oddresr)(lics. no.)(e e Sl.ucturol Eleoricq I ,\tcchonicol noneRS(nome)CONTR )i Plumbing ETECTRICAT A^ECHANICAL?tUMBING F'ECI-IARGE NO.CHARGE NO, r?a Electrico I l'{ethonicol iurnocel'burner toRe:idence oi - 'qi fr,ioch rinqie iirture I I Appiionce vent 5eporo te New circuilr, oileroliorrr or extenricnr Relocored building (ncw lir. odciirionol) Slolionory, evop. coole;SERVICES S.f. R:r'dencc (l both) Vent fon with :inqie duciTemporory ConrtructionDuoler rl both) eoch II I Vent syrlEm oporl from heotinq or A.C.AmprAciditionol borh i Mechonicol exhou:t hood ond ductWoter rcrvice I I Wood rtove/heoter 5:eSewcr I I I Heot PumoFEED E RSSlorm Se*er I Air hondler to I 0.000 cFAiAmpr. Air hondler over I0,000 crM ISSUANCE OF PERA{II lo.- WHERE TTAIE LAW REOUIRES rhor thc Electricol work bc done by the Elearitol Conrto€rot, thc :lectricol pcrtion of thir permit rhqll nor bc vqlid unril o lcbcl hor bcrn rigned by on Elactricol Controclor cnd ottoched fo tho clcctricol poncl. I HAVE CAREFUtty EXAf,{tNED the complcicd opplicolion for permit, ond do hereby certify thot oll informotion hcreon ir truc ond correcl, ond I furthcr certify thot ony ond qll work pcrformcd sholl ba done in occordqne with ,he Ordinonces of the City of Springfield ond the Lowr of the Slote of Oregon pcrroining :o rire work Ccrcribeci herin, ond rhot NO OCCUPANCY will bc mode of ony irrucrure without the permission of the Building Divi:ion. I furrher eaify rh-ot my .egirrrorion with rhe Euilder'r Boord ir in full fore ond effect os required by ORS 701.055, lhot if exempi the bo:ir for cxcmption is noted hcron, ond rhor Jnly tvbcontrocrors ond employcer who ore in complionce with ORS 701.055 will be used on thi: proioct. TOTAI. CHARGES DAIESIGNATURE (Bosir for Builder'r Eoord cxcmption: NArt{E (pleoso print) TOTAT CHARGES TOTAT CHARGES +) offrcE usE ON,.Y /FOR zon" R- / Typ.lcon*. *N unir, Fire Zona- Eedroomr ---_3ccY x Voluc x --Volucx -Volue TOTAI. VATUATION, illi,_r--ilccY Ftg. Accer5 Frg. OtherFlood Ploin Ftg. Aloin Sy5tems Development Choroe ( I .59'o) Plon Ck. Comm/lnd 65,|1 Bldo Per Fee Plon Ck. Res 30"6/ Eldq Per Fee j.to BUITDING PER[{IT Chorgcs ond Surchorger ?b la. nn Fence Ot>24Totol Comb. PermitDemo PTUMBING PERMII Chorger ond Surchorger Sidewoik I A/C Povinq I I Chorger ond 5urchorger ETECTRICAT PERMIT Curb Cut *<tpta Faa TOTAI. I I 'oo de'f,3-T- 5. MECHANICAT PERA{IT Chor-cer ond S urch or ger 4a lf,.'o 5; --BTU'SI I \a coMBtNATtON .AppLtcATtoN,'pERM|T (CAp) l. Appliconr. to furnish A. Job Address B. Legol Description PLANS REVIEWED BY, I. exomole-rox lot 100, Lone County Mop Reference lZ 03 432. eEmilE-Lor t. Btock 3, 2nd Addirion iJSprinsfield Esrores Nome, etc. of owner ond construction lender Energy Sources l. exomple-heotu'electricol ceiling/or forced oir gos2. eEmE-', o re r IET6I?Efi.J I ;;rfr ,, Squore fooroge o. rolrotioil[_- I =+E'EsO rq. foot house.50O sq. foor sorosel. exompre.ii new proiecr, checki-ew-if oddition, cieckodcl, elc. F. Building permit informorion:l. exomole-<onstruct single fomily house with on ottochedgoroge 2. exomoie-remodel existing goroge info fomily room3. exfiEG-conven,;"gle fJ.;ily .l.iJ"n"" intorleliET?Ent (chonge o] use) G. Volue of work os defined in Section 303 (o) of theStructurol Speciolty Ccde H. DESIGN TEAM AND CONTRACTORS I:_:,""]d iir,ni or consrru*ion cjeloys, Building Divi (. )totf must be oble to contoct oppropriote persons redesign informotion or iob site .o.r.iionr, .r.. It. Abbrevioted plumbing, Mechonicol & Electricol SchedulrA' Excepr where blcnk spoces occur in the description o. of rhe Mechonicol ond Electricol S.l.J"Lr,lfr5';;;i;need fill-in only the No. Boxes cd[ocent to the opproitem(s) to be insrolled B. Full Plumbing, Mechonicol, ond Electricol Schedulesore ovoiloble ot the Building Divisionl. To conserve spcce on the-permit fo._ the schedul,hove been obbrevioted2. lf rhe irem(s) to be insrolled ore not covered on th,. oted schedules you should consult rf.," frii*f.r1ariC. BUILDING DIVISION STAFF WITL FILL OUT AI.L FEES ACHARGES ON THE SCHEDULES lll. Aoplicont to sign oncj dote Whenever possible, the iniiiol opplicofion will be used q:worksheet only. Where possible, 'arifli^g Division Stoff rprepore o typewritten copy ond return iito the oppliconrthe time the ocruol permit is issued ioi t,i, signoture. lV. Fees ond Chorges Plon check fees ore due ond ooyoble ot lhe time of the oond no plons wirl be processed inrirlhese feer ore ooid- :tL"-:.I.:'ond chorse: ore due ""J p;t;bt;;;; il;;,ts t33ued. V. FOR OFFICE USE ONIY PERMIT VALIDATION CITY OF SPRINGFIEI.D Ciry Holl Springfield, Oregon Deporlment of Public Works OFFICIAT RECEIPT l{0. B 57 A27 l9 c. D. E. ( Rec'd at,( ress ( Received For: (" c ( L ( ( ( (- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPA Amount Received BY _(, H AUYHORIZED SIONATURE SXCLTOI.IUaiaut( atrtTERS - EUCENE OR eTaOt lt lr !.4 fIf- Additionol proiect lnformotion: C) nome ure dole g-tt I ( ( I /2 \ 55"C L INSPECIION TINE 72t3769 S lructuro I ,\lechonicol Plumbi Electricol l'{echonicol t Legol De:criprion Job Addresr ENERGY SOURCES: Heo, - Woier Heore.Sq. Ftq. Other -New'--Add -Alrer -Rep.- . -tence--Demo-Chong:/' Urc -Other R Sq- Ftg. Accerr. Sq. Ftg. Moio Vqlue of Work: f 06-aoo-n., fi@ /lt1 LL t). t/4 fl,' ,( Tn J Addrerr ? Q ,; .// .j q ?h"^" ?+7q53q Building Permit lnfo: Dercribe Work (i.c., Build Singlc Fomrly Residence Wilh Aroched Goroge) y'^+t ,,")l )/., ^ -;* :r O %--=7^)l-," ;;-4';Conrlruclion tendcr 0 dPhoneAddrcr OSSIGN TEAM (nome)(oddress)(licr. no.) (expires)(phona no.) I P.;6otY no meONTRACTORS NO :E iCHARGE NO. PLUM EING Fal CHARGE Re:iience oi sq. ft iurnoce/burner lo ___3TU',sioch rinqle firlure I I Applionce vent 5eporole New <ircuilr. olterotiorrs or exrensicn: i I Relocotcd building (new fir. odciirionol) Stotionory, evop coo le;SERV ICE5 I I I I S.F. Relcien<e (I both) Vent fon with sinqie duclTemporory Con:lruclionDuoler ll borh) eo<h Il Ampr- Vent !yilem oport from heoting or A.C.Aciditionol borh Mechonicol exhourt hood ond ductWo ter tcrvice I Wood rtove/ heoter I I Scwcr rEED ERS Heot Pumo Ampr. Air hondler to 10,000 CFrri Scwer Air hqndler over 10,000 cFM IOTAT CHARGES IOTAT CHARGES FOR OTFICE UsE ONTY x ----Voluax -Voluc 1-Volue Sq Sq tt-:Ir Sa Ftg. Moin z p-/ . I ypcl Lontl. fire Zonc-Bedroomr ccY tood Flood Ploin lC-N TOTAT VATUATION itg. Acce:s Ftg. Othcr- Zone Syrlems Developmcnt Chorqe ( I.5",'") C-24fotol Comb, Permit Ploo Ck. Comm/lnd:Fla.'n j.-o Btd Per Fee fence Demo Plon Ck. Re: Per Fee309',o BUIIDING PIRMIT Chorger ond Surcho rger PTUAAEING PERT^IT Chorger ond 5urchorger ICAI PERMII Sidewoik c Chorger ond Surcho rge r MECHANICAI. PERMII Chor-ocr ond Surchorgcs lf,.'o Curb Cut 4a D.E Faa TOIAI ^- -r -Ef P 1'o" CITY OF SPRINGTIETD COAIEINAIION APPI.ICATION/ PERMII INTORMATION TINE 7263753 $ N no.te no.) ETECTRICAT MECHAN ICAL ISSUANCE OF PERIAII /e.nqt'i TOIAL CHARGES WHERE SfAIE tAW REOUIRES thot tho Elcctricql work ba done by the Elcrtricql Conttscrot, tha clectricol portion of lhi: permit rhcll not bo valid unril o lobcl ho: been rigned by on Electricol Controclor and ot oched to thc clodricol ponel. I HAYE CAIEFULLY EXAI INED rhe compleicd opplicotion for permit, ond do hereby certify thol oll informolion hereon is iruc qnd correct, ond I further certify lhot ony ond oll work performed sholl be dons in occordonce wilh rhe Ordinoncer of lhe City of Springfield cnd the Lowr of tha Stote of Oregon pcrtoining ?o the work Ccrcribeci herin, ond rhqt NO OCCUPANCY will bc mode of ony tlruciure without the pcrmisrion of rhe Building Divirion. I further errify thot my regisrrotion with the Euilder's Boord ir in full {orce ond effetl os required by ORS 701.055. thot if exampl lhe borir for cxemption is notcd hcron, ond rhot only :vbconlroctors ond employee: who ore in complionce with ORS 701.055 will be used on ihir proie(t, Borir for Builder'r Eoord exempiion: SIGNATURE OAIE 5t FFENO- r NAr\{E (pleorq print) - coMBtNAT|ON AppLtcATloNi PERMIT (cAp) l. AppliconJ ro furnish A. Job Address B. Legol DescriptionI. exomple-rox lot I00, Lone County Mop Reference I7 03 432. exompie-Lot I. Block 3,2nd Addirion to springfierd EstotesC. Nome, etc. of owner ond construclion lenderD. Energy SourcesI. exomple-heot,/electricol ceilin g/or {orced oir gos2. eEmole-woterl-il tio. rffiE. Squore fooroge or rolrotioi]II]- I. exompjs-1250,q.foot house,500 sq. foor goroge2. e 1o.m p i e - i f rr e w p r o i ec r, c h ec k -n e w- i i o d d i tion,-ci ec kodd, erc. F. Euilding permit informotion:l. exomple-construct single fomily house with on oltochedgoroge 2. exompie-remodel existing goroge into foniily room3. exompie-converr single fomily rlsidence into restouront (chonge of use) G. Volue of work os defined in Section 303 (o) of theStructurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction cieloys, Building DivisionStoff must be oble to contoct oppropiioru purro-r,, regordingdesign informotion or lob sire corrections, etc. ll. Abbreviored Plumbing, Mechonicol & Electricol SchedulesA. Except where blcnk spoces occur in fhe description porlionof the Mechonicol ond Electricol Schedutes, th; ";pi;;;;need fill-in only the No. Boxes odiocent to the oppropriote item(s) ro be insrolled B. Full Plumbing, Mechonicol, snd Electricol Schedulesqre ovoiloble ot the Building Divisionl. To conserve spoce on the permir form the schedules .:hove been obbrevioted 2. lf the irem(s) to be instolled ore not covered on the obbrevi-. oted schedules you should consull the full schedulesC. BUILDING DTVISION STAFF WILL FILL OUT ALL FEES.AND CHARGES ON THE SCHEDULES lll. Appliconr to sign ond dote Whenever possible, the iniiiol opplicofion will be used qs oworksheet only. Where possible, 'Building Division Sroff willprepore o typewritten copy ond return it to the oppliconl otthe time rhe octuol permit is issued for his signoruie. lV. Fees ond Chorges Plon check fees ore due ond ooyoble ot the time of the opplicotion,ond no plons will be processed until these fees qre poid-illother fees ond chorges ore due ond poyoble when ihe p..iitis issued. V. FOR OFFICE USE ONTY PERMIT VALIDATION Permit Clerk PRoJEcr coNDtrloNs ro BE sATrsFrED BEFORE occupANCy, Additionol Proiect lnformorion:a a, PLANS REVIEWED BY: nome ture dole a-€-tr IN5PECTION I.INE 726-.3769 CITY OF SPRINGTIELD COMBINAIICN APPI'ICAIION/ PERMIT INFORMAIION TINE 72e3753 Legol Descri on Sq. Ftg. Other -New -Add -Alter-ReP.Fence -Demo-Chongei Ure Other Ro ENERGY SOURCES: Heot Sq. Ftg. Accesr. Woler Heoler 5q. Ft9. Moin Vqlue of Work: f o6-ao Add re rr Phone Buildinq Permit lnfo: With AttoFomilRe: i Describe Work 1i.e., Bui ld Single lio^ Le $ N Addrerr Phone res)lics. no.)(odd ress)(nom e)DESIGN TEAM (phone P Structuro I Electri cq I ne no. ,l1echo no meR Plumbin MECHANICALETECTRICATPtUMEING CHARGECHARGE RGI:E NOl.lO.r l?E Electri co I Mechonicol furnocel burner lo --_3TU',r Residence oi =---- rq. ft.-och ringle iixture I ! Applionce vent 5e po roie New circuiis, oiterqliotts or extensicnsRelocoted building (new 1ix. odciitionol)Slolionori, evop, coolerSERV ICES S.F. Reldence both)Vent {qn with :inqie duclTemporory Con!lruclionI both) eochDuolex {Vent syslem oport from heoting or A.C.Ampr.Aciditionol borh Mechonicol exhourt hood ond ductWoter rervice 5:eWood stove/ heoterI Sewer Heol PumpTEEDERS Air hondler to 10,000 craAmpr. Stor.m Sewe r Air honciler over 10,000 cFr IsSUANCE OT PERMIT /o.- I HAYE CAIEFULLY EXAMINED the compleied oPPlicotion for permit' ond do h Gertify lhot ony ond qll work performed sholi be done in qccordonce wilh th p..toining to lire work Cescribecj herin, ond rhot NO OCCUPANCY witl be mo ceaify rh-of my regi3troiion with the Euilder's Boord is in full fore ond effect o h"ron, ond rhot Jnly subcontroctors ond emPioyees who ore in omplionce w ereby certify lhot oll informotion hereon is lrue qnd correcr' ond I furlher e Ordinonces of the City of Springfield ond lhe Lqws of lhe Stqre of Oregon de of ony slructure without thE permission of thc Building Division- I further s requirei by oRs 70I.055, thot if exempt the bosis for exempiion is noted irh ORS 70I.055 will be used on this proiect. TOTAI. CHARGES Type / Conrr. DATE il.i,ullFlood Ploin --Stoti"t OttY Eedroomr occY shol bcnot untilvalid oelectricoth.rhiso{the cqlElerrri nlaq(rot.portion parmitCobcworknedoRESthethotElactri cql byEWHERTSTAIAREOUI toched cleclri cslrhaandConlrdctotqlto ponel.Eloctti(olqnho;lobel been rignod by Bo:ir {or Builder'r Boord exemPlion: NAfiE (pleose prinr) TOTAI. CHARGES TOTAT CHARGES FOR OTFICE USE ONLY SIGNATURE Ftg. Accest Zone 5q. ftg. Moin Ftg. Other-x -VoluE TOTAT VATUATION , Volue 1----VolueFire Zone- Sy:tems DeveloPmenl Chorqe ( I .59'.) Plon Ck. Comm/lnd Demo ?b la.nn 65";o BI.Per 3096/ Bl Per Plon Ck. Rer BUITDING PERMIT Chorges ond Surcho rger PI.UMBING PERMIT Chorges ond Surchorger O.>26Tolol Comb. Permit Sidewoik A/C Povinq I I Chorger ond Surchorger ETECTRICAL PERMIT Curb Cut ,>ar?EA F6 TOTAT tre.,a- .J. .E oo MECHANICAT PERMII lf,.'o 1o Chor_oer ond Surchorge: 55 FFE .G} a.-o Additionol Proiect lnformotion: e, E. coMBtNATION AppLtcATtoN/pERMtT (CAp) l. ApplicorU. ro furnish A. Job Address B. Legol DescriptionI. exomole-rox.lot,l 0!,-Lole.Counry Mop Reference I7 03 43 - 2: &ffi'F.iE-Lor I. Block 3, 2nd Addition ro Sprinsfield EsroresC. Nome, etc. of owner ond consfruclion lenderD. Energy Sources PERMIT VALIDATION CITY OF SPRINGFIEI.D City Holl Springfield, Oregon Deporlmenl of Public Works OFFICTAI RECEIPT J{0. B 5-i A27 l. gxomph-heotz'electricol ceiling/o, forced oir gos2. exo m p, e-,ro rer nEEJFEEffio l./o.EE?- Squore footoge o. "olrotioi]If,-I =+F-.8r9 tc. foot house.500 sq. foor sorosel. exqmpre-if new proiect, check nEi-if oddition, cieckoctd, etc. F. Euilding permit informorion:l. exomole-construct single fomily house with on ottochedgoroge 2. exompie-remodel existing goroge into fomily room3. Exo;Fi-e-co n verr si n g le f i.;ilyii.lJ".,." inrorETEITo-nr (chonge o1 use) G. Volue of work os defined in Section 303 (o) of theStructu rol Speciolty CcdeH. DESIGN TEAM AND CONTRACTORS To o_void design or construclion deloys, Building Divi ( Stoff must be oble to contoct oppropriot. persons redesign informorion or iob site ."r."iionr, ur.. ll. Abbreviored plumbing, Mechonicol & Elecrricol SchedultA' Excepr where brcnk spoces occur in the descriprion oof the Mechonicol ond Elecrricol S.l.,"a"f.r,lfr;;;;i; ,1:3 1'11-,1 onty rhe No. Boxes odiccent to the opprortem(s) to be insrolled rl, Full Plumbing, Mechonicol, ond Electricol Schedulesore ovoiloble or the Building Division (I. To conserve spcce on the permit form the schedul,hove been obbrevioted2. lf the irem(s) to be instolled qre not covered on th, aLoted schedules you should consult rhe fuil *f.,"ari f- BUILOING DIVISION STAFF WILL FILL OUT AI.L FEES ACHARGES ON THE SCHEDULES lll. Appliconr to sign oncj dote Whenever possible, the iniriol opplicotion will be used orworksheer only. Where possible, building Division Stoff iprepore o typewrirten copy ond return it,o the oppliconrthe rime rhe octuol permii'is issued foi hi, signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ol lhe time of the oond no plons wirl be processed Lntir these fees qre ooid-other fees ond chorges ore due "na p"y"Ui.;;;; ;h;;,is issued. V. FOR OFFICE UsE ONIY B. c Rec'd Add Received For: ?70 /2o ( ((3 F Amount Received fficPROJECT CONDTTIONS TO BE SATISFIED BEFORE OCCUPA PLANS REVIEWED BY: BY !6!r!-6 (r a AUTXORIZED SIGNATURE SBEITOT.YUTN'ULL PiI(IEIS EUGERE ON 9"O!rt.l- nome noture ao,u 8- s- t/ (. ( ( ( (