HomeMy WebLinkAboutPermit Building 1987-09-04II ..RESIDENTIAL..
22 s North stlt streeAPPLrcATr,N
/PERIlr?
Spn'Lngfield, )regon 97477
Building Diuision
7 26- 37 53
SPRINGFIELE'
reJob lacaticn:OC)
Aesessors Map #lcz Lot # 4o-o e
Svbdilsision:
(a<Amen:u a
Address:o Phone: )Os
zip:ci
Describe l,loyk:
Date of Value
Vznzzz 4arz-Bz
,./az .3frnnrn
/qorEnc ,F aTarrFza-
e//
?7t-
Additian
RemoCeL
OO4, , a'a
9 e
tlll
l0(,
I /6U
I
c.c-
Date:
GenetaL
Coaetntctiotr Leder._... -g_
It i, tlte
fian the*Buildtng
L
L
'rceponeibility of tlc peadt hoaa'to aee that-all-inopections oe nad,e at the prop"n tine, t1at s44ft:,ursss is reac,l^ie"it1,iiu?#*,:"'!;**r"#*1,*"i:E*,rib:*[3;i"%;irryfAa:-
PP02EDUPE PoR rVsPEnroll .?qquEST"cALL 726-3769-(reeotder) state aou" city cesigza-ted job nttriber, job acFness, type of inspeelicntequested and ahen uou aiLL be t'eady fot inspection, ciil.li""- olr a,ners- nctte'otd phone mnb*. pequests receixed befcre ?:00 o:t:.iLL be nade the ei,te d.cg, "i"q""ili"i"i iiiu z,oo- *,,,titt i- nala) ,li.;;;:;;"L;n'Lr.
!our Desigr,ated Job llunber fs:82'o6 /2
aftet oR !:)wD
Lwk ie cotseted,
SNE INSPEC?TON:
ezcamation, but
' Io be rrude afterprtor tc set up of
naCe
and
to
)rJ
to
t4
fotne
trenches
)4
PTilAL PANABTNG
7;'q
PIIIAL MECHANICAL
vtA
PTNAL ELECIRTCAL
tr
MAS2NR! Steel Location, bond
beons, groutirtg ot, oetticals in
accotdance Lrith U.B.C. Section
24L5. 2 \J -a-I \,/l w)1DS?oI/E:lA @,rrpGtfi..
CURB & APPRCACH APPON: Aftet fottnsee etected but prior to pout-ing
conj?ete.
SfDEHALK & DRf\WAY: For all cott-
cr-ete patsing uithin st?eet r.ight-of-txy, to be nade after aLL e.cea-
uating canplete & forn tnrk & sub-
base rater.ial i,n place.
yequired oqor boz-iete oe in placebut before ory Lath, Wpslrn boaz,C ot,
ULL 9ooeting i,s applied, otd. before
any insulation is concealed.li
DRWALL TNSPECTION: Tcdfi6i-dtT@TTis in
but pnior to any taping.
Final - h\ten abarc t)tens ote ecnpleted
and uhen Cmclition is canq;Lete bt stntc-tuye moued urd. prettrtaes cleaneC up.
Sanitary seaer ccptped. at goperfu lit:e
Septic tank V.arped and filled ti.th gra;;et
Hcmes
Blocking otd. Set-up
Plunbittg connections -- aane? otd, uatet
Electrical Ccmnection - Bloeking, set-up
and._ plunbing connections nast bb oppoot'edbefote requesting eleclrteal inspeeiiol
Accessory- Building
be rrude
plaee,
V
a
To
INDERFLOOR PLUMBING & MECHANTCAL:
'1o be nad,e .prior to installation offloot ineulation ot deeking.
P-PF? 4N.O A.EAM: To be nade prLot toiistallatian of floor insuT,ation o?
deckittg. * ... r4i 4> 3i
ROUCH PLUIBTI\G. ELECTRTCAL &-MECH-
AN|CAL: Uoaffiw:til these inspections laue been
node crd. approtsed..
FIPEPT,AgE: Pm)or to plccirg faeingmaterlale and. before franing ZnepeZ-xlon. bFRAI,IING: lrtust be requested afterapproual of rottgh plwrbing, electni_q.L & neeltanieal. ALl, toofing
btactng e chinmegs, etc. rrust be
i umpleted. tlo uork ie to be con-._.cealed unti.L thie inspection ltaa'been nod.e anC apptooed.
4t
Aftet irctalTation ie
q/e
w
Pinal - After pcrches, skirting, decl<s,etc. ee cornpleted.
!EIl!!: Wen conplate -- tuotidegatee or mouable aections through
P.U.E.
ALL pnoiect conditions, such ae the installation of Itreet trees, conpletion of tietequired Landsecpirg, atc., rntst be satisfied befone the aurioiub |INAL ean be'rcquested.
*ALL MANHCLES AND CLEAIIOWS MIJS? BE ACCESSIBLE, ADJAST!{ENI TO BE MADE A? fiO COS? IO CI?Y
D, PrNAL BUTLDTNG:- ?h? Ei-nal Building. rnapeetion nuat be tequested aftet the Fitut ptwnbingY/ Electrical, od Necharicat tispZi,tiono 'tw)e i"iiia-"- ii- ippnoind.
I
Paqe 1 of,Z
IA
tr
z
\o
r--codJOB NO.g
Zone:
TotaL
SOLAR A"-?ESS REQ.-
)'l
Bedroone
Sourees
Ileat
Lace
-- Fees --
Date Paid:
Reeeipt #:
Signed:
f HAW CAREFALLy |XA|NED the eontpleted application for permtt, ald ilo
hereby certifg tlwt aLL infonnation heteon ie tz,ue anl. correct, and. f
further eertify that any ard aLL uork perfomted stnll be dane in aceot-
dance trLth the 1rdinances of the City of Springfield, atd, the La;s of the* State of )regon pertaining to the wrk Cescribed herein, ct1d. tlnt N0 1CCA-
- PANCY t'vill be naCe of any sttactu?e uithout perrnisaion of the Buildi,ng DL-lloision. f fi*ther "l""tl..i'g that only conttaitors ad, anplcyees who arZ in
.- cqnpliance uith oRS 701.055 uiLL be used on thie projectt7,
Lot Sq. Ftg.
I of Lot Cottetage
LOT TWE
_ fntetiot
_ Cora,er
_ Panhand,Le
CUL-de-sac
[-at Facee -
Df
{ of Stories
Iotal Ezight
Topogrqhy
ITEM F?G Y VaLue Building Volue & Permit
This per'ttnt is granted on the erptess condition tlat the said-constmtetionslnll, i,n aLL respeets, conform to the hdinance adopted b;y the City of
Springfield, including the Zonittg Crdirwtrce, regulating the ecnsttacticn
orl use of buildings, otd mag be suspend.ed or yeuokeC at cny time upon oic-
Lation of anA prcoisione of said 1rdinznees.
Lu€28 a4
TOTAL VALUE
s.D.c. 1..5 c uc.VE?,*
Bui,Lding PettrLt tG
-)
State -?a
Iotal Clwges 77zo *
fiEM NO FEE CHARGE Plumbing Permit
No pereon slla.ll eonstlaet, instal!, alter or elunge anA net cr esisting
plwrbing or drainage sAltqn in uhole or in patt, unless such person is tle
Legal poseessor of a oalid plunbetts License, escept tlnt a pe?son nay do
pltonbing uork to prope"tA uhich is orsned, Leased on opetated by the appli-
@nt.
Fi.ab*es
Resid.entia.L (1 bath)
Sa,sen
-C,
Pl,onbing Perqrtt €au r
State .fe
7
c)Electricol Permit
Whet,e State La requites tlut the electrLeal uopkbe ilone by an Eleett'ical
Cont?actor, the eleetrtcal portion of this permit slnll not be oalil until
the Label has been eigned by the Electrtcal Contractor.
Neu/Ectend Circuits
Seruice
a5
Stcte /-aa -4
*Iotal 3
NC FTO CIIARCE
(.
O
6 a5
6aa-
Mechonicol Permit
6 f?
;
bltalat Hoo,l.
llcodstotte
Vent Fa
Pemrtt fssuotce
Meclwnical Pennt
State
.- ENCROACEMENT --
Seatt'ity Deposit
Storage
l,b,intetunce
Permit
-?6',Cvtbeut
:
/3-7a6?/Sidandlk ?o.a I
E7-ectt tcal 3 .70
Mobile Horne
TOTAL AI,IOUN? DUE:1 flvzr.=r Date
Vcfar
*
.oence
225 Fitth Street
Springfield, 0regon 97 477
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
sFErxcrrelD
Off i ce:
INSPECTION LINE:
726-3759
726-3769
CITY OF SPF OREGO'V
Job Location:5LI S Ll+t
Assessors Map #-. l8' D?- 05 -
ownen S. cil*t Laurtq- K C ,,,J u,rlctl
Tax Lot #:D45oo
L
Address: \\ 5'{ 5 q Lt+k Phone #: aL{b'Llb2
City:
Value of Fence:
Contractor/I nstal I er :
Address z ll 5L{
Statet I K
Fence Permit is $5.00
Zi p:Qlqtl
$seo
0,^t 0(
s. ,/|lL Phone * 711- JV AZ
By s'igning. this permit/appliqq!i9!r-l agree_to call for an inspect'ion once myfence has been constructed (726'3769). -I also state that all information on"this application/permit is correct and that I was provided w'ith the Springf.ield
Development Code requirements for fence standards.
/-c?- 57
City:State
Construction Contractors Registration #:
a re
FOR OFFICE USE
W:p,24lKZi
Ex pires:
a e
Job #:Date of Application:
Receipt #:4
Total Amount Collected, 6rDD
Issued gy : y\,\-lilWU,L,
1-
Checked for Delinquenc'ies:l/Checked for H'istorical Status:
^.ilA
leceiot I
Job Locaticn:
Aesessons Mao #'o?
Subdittision:
0tmer:
Address
uL
Addition
Date of AppL ieaticn //-6-a4
Ceneral
Phntbing
Car,v4cer<
O,yazv y'o P v
SPRINGFIELD
Pnva<y?
.. REslD."^_ .,f lAL..
22 s North stt, itonnAtPPLrcAT
r,N /PERttrr
Spn'Lngfield, )regon 97477
Buildtng Diuision
726-37 53
&a '|-
Tc,s lat # O
a
Phone:
zip:
Describe llork:
Value
4
TI ftffi<<./ ZaBSnE-7/6*
/6"/ ? // ut7b4A4' feY to 4#.3/rF
2 5 76v7 Signed
Date
Electrical
I,lechanicaL
I^t ie tlu reepons'ibi_Lily of tlre pendt ltotd* to eee that alt inspectiotts ee nade at lhe p?oper time, tLat eceh addrees is reas-'^ie
f.y,l-tJr-" attee-t, atd tltat the_perftit-card ie laated at the fuoi of the Woperty.tauildi.w Nuiciot apprw^ed plot slall remain on the Bunlding site 'at aLL' tihes.-
PI?)C9DUPE- FoR. I\SPE2?I)U ,WytSr.'CALL 726-3769 (z,eeorder) state yout, City Cesignated job ntmber, job aCitess, type of insoec=icn
neQu.ested ar.d ulzen gou ttLL be ready for inspeetion, cont?aetars o,-r anzets-nane Lnd pTane nunbet.- aequests rccei.i:bd b'efcre- ?:0C ant'iLL be nnde the sante dcy, "equests made afta.r ?:00 Gn rtLLL be nade the ne.tt:nrki$ day.
Constmtctiott Lendet
Reauinerl Iour City Desigr,ated Job Nunbe? Is:%776
I
ANDERSLAB PLAI4BTNG, ELECTRICAL &
MECH!.\IICAL: To be nade befote ang
tlot'k is cooet,ed.
PO1:IINC & F0UNDAT|CN: ?o be raCeAfier tz,enc6az,e ercaated and
forns ate erected, but pz,iot, to
pou?LnS ccncrete.
SnE INSPECTfON: ?o be made after
eicauation, but priar tc se! up of
fonae.
TNSULATTON/VAPOR BARRTER il]SPICTION
Io be made aftet, aLL insulaticn a".d.
DRWALL fNSPEC?r1N: ?c be nade
after all, CryuaLL i,s in place,
but prior to any taping.
tutASONRI: Steel Location, bond
beons, gz,outing ot oerticals in
aceordstce tLth U.B.C. Section
2415.
W0ODS?01'E: After installation is
anpLeted.
Sanitary seser captped ct ptoperQ; litce
Septic tank pryed and. fi.Ll,ed trith gta:;el
linal - I{hen abctse itens are ccnoleted
oid uhen CarcLition is conplete br stntc-
ture moued ord. prenises eleanei up.
requined oapor bez,ie?s @e in place
but befoz'e ory l.ath, ggpsurn baotC or
wLL cooering is applied, attd. before
oty iraulation is eoncealed.
X
fi uvlsacpoulo pLUM!V,__gswE!2_jrArE&'z)
.Litq trenehes.
n uwtBrtooR pLUr.EttG & r,tEcllANrcAL:itof
flooz, insul,ction or decking.
, I POS? AND BEAI4: ?o be nade prLor to
-)
ffiiaiGiTcn ot iloon insu-raxion ot
&cking.
-4 ROUGH,.?LAETXG, ELECT?ICAL e MECH-|/\l ANICAL: No uotk is to be eotset,ed
-
w:tiL these inspectiors ltaue been
nade and, aooroued..
fl rrpser,ac.li wto, to plceir4 faeing'' - | mcterials and before frating inspel-tion. 6 q45frla<a
\l frut:tnc: Wst be requested aften/\l dppz,oual of nough plwr,bing, electri-
a,L & nechanical. ALt roofing' bracing A chinmegs, etc. rrust be
. cornpleted. Ilo ucrk is to be con-.. cecled until this inspecti,on las
'been nale anC approoed.
T
E
E-t
l'lobile Hcnes
w
tr
CURB & APPR1ACH APPON: Aftet formsce eteeteC but prLor to pouring
cottcrete.
SfDE$IALK & DRf',EIIAY: For aLL eon-
cz,ete patsing uithin atteet right-of-tx!, to be mode after aLL etea-
oating eanplete & font tnrk & sub-
base material in pla,ce.
PTilAL PLUIIBIIIG
FINAL I,IECHANICAL
PINAL ELEC?RICAL
IENCE: hlhen conplete -- ProoiCe
gates o! mooable sectians through
P.U.E.
ALL pnoject conditions, such as the i.nstallation of slr,eet trees, conoletion of the
requined Landsecping, etc., rmtst be satisfied before the BUILDING FIIIAL can be reqtested.
PINAL BAfLDfNc: The Final Building fnspection naet be tequested cfter the ,iiral Plunbing
Electrical, and Meclnnical fnspections lqtse been made and approoeC.a
Blocking otd Sex-up
I
Plunbing connections -- salre? otC aaley
Electtical Ccmnection - Bloeking, set-ut
and plwnbing conneetions rn;st be qprc"-el
before requesting electrical inspeclio:t
Aceessory BuilCing
Pi.tnl - Aftar lctches, skirting, decl<s,etc. ate conple'-ed.
Page 7 of 2|ALL |4ANHCLES AND CLEAN1.)?S UUST BE ACC1SSTBLE, ADJUSTyiiE TO BE |IADE r'.? ilO CSST tO Cny
to\
I )\.
T
JOB NO.
Permi,t
dtrbeut
Plumbing Pemtit
Tctal
PermLt
-- ENCROACHMEIIT --
IotaL
-22/?,f,
SO LAR ESS REQ.-L-co d
Bectoons:
Date Paid:
Receipt #:
Sigred:
Plumbing Permit
No person shaZl construct, instal!, alter or ehange GnA neu cn e:isting
plutnbiilg or dtainage sVstan in alole or in pott, unless such person is the
Legal possessor of d oalid phtnbet,ts Lieense, eceept tha.t a pe?son na'g do
pltnbing uork to property uhich is ormed, Leased or operated by the appli.-
ccnt.
Electricol Permit
Wet,e State Las requires th,at the electyical uork be done by an Eleetrieal
Conttaetot, the eleetrteal portion of this permit slnll not be ualiC until
the l.abel ha.s been signed by the Electrical Cont?acto?.
t
r{
//-<-84
Date
I HAW CAREEULLy SXAILINED tle cornpleted aopLication for permit, crd. do
hereby cettify that aLL itfotmation hereon is tnue and. cotrect, cnC I
futther eettify that any ard aLL uork perfor-ned sVnLL be done it aceor-
dance rrith the ordinances of the City of Sptingfield, and. the Lr;.,l.s of the* State of )r,egon pertaining to the uork Cescribed herein, cnd tial*- N0 )CCU-
^ PAIICy tvLtl be nad.e of anA st?ucture uithout permission of the Suilding DL-/ uision. I further eertifE that only cont"acto"s o;d enplcyees dho are in
,. canplianee uith 2RS 701.055 ui.LL be used on this y,oject
Sideualk
?ence
Eleetnical tabel
Mobile Hcne
bt sq. Fts. 7467
Z of Lct Cotserage /9,6
# of Stories
Iotal Hei.ght
lopogrqhy
LCT TWE
_\ tntericn
2
-2tq./
O-z7e
Come?
Panhand,Le
CUL-de-sac
L.House
Lot Faees -
-- Fees --
Building Volue & Permit
This pertntt is granted, on the erp?ess cond.ition tlnt the said.-eonsttwction
slaLl, in all r,:espeets, eonforn to the Ordirnnce adopted 6;y the City of
Springfield, including the Zoning CYdinance, regulating the ccnsttacticn
and, use of buildings, otd may be suspended ot, reuokeC at c*y tzne upon oic-
Lation of atly prcuisione of said 1rdir,attces.
Value
TOTAL VALUE
F?C x
/Ye
j
E
TTEI,I NO FEE
S.D.C. 1..5 d
Building Penrit
lotal Clanges
Fi,zb*es
Resil.zttti.a.L (1 bath)2-.) t 7nv
SaniLetg Seuer
ilcten
ii).FEE
Res. So. fte./1-//
Nets/Ertend. Circuits
!rycroy Serwice
,/aE
i?.T LL
1
Mechqnicql Permit
llcodstotle
Veat Fot
bhant llooC
rs
t.
Permit fssucnee
Mechanicel Petnrtt
State
/d/> /%,tVaE
TOTAL AITIOU}]? DUE:'/bE Signed Date
,P[glEcaniner ' /-4&a-D
,?a
ITEi,l
/
See,rit?l Deposit
leeeipt #.. RESIDE*[IAL..
Zzs North stt, itrnlPPLrcArr,N/PERI,rr
SprLngfield, )regon 97477
BUL Ldlng D7.u1-slon
726-s7 53
Job Locaticn:&
SPFIINGFIEI-D
?c,s Lot # O
Pl",one
zip:
Aesessore Map #-o?
Subdioision:
Asner:
Address:2
a
a\4 Ne")
Describe l,/ork:
Cor.rP.nr= 5-n SEro?#z rZzWr*s<f
u,y?rv y'-bFa=/*// v r*m<<,q ZaBS/ad-7/D*'ti/f f //v//22?,4A7 'lgf * '?4#;F2 5 7zv7
Addition
RenoCel
Signed:
Date:
Value ed
GeaeraL
14echanicaL
consj"rct'io, Jender_ - _
It ia the reeponeibility o! the pernrtt holder to see that alt inspectiotts ee nade at the Prope? tine, that acch,;ddreas is reafubie
frcn tle atreet, atd tltat the petttrit catd ie lacated at the fro* of tle property*auilding Dir,ticion appro"^ed plan sttcll temain on tlp Building Site at aLL times.
PRoCgDUpE FoR INSPEC?IO\\ R17WST.'CALL726-3769 (reeotdet,) state you? City desigrated job ntmber', job aCi.ress' lAPe-of inspee=icn
eadyfot,inspection'confudetcrso|anne?snanecndpionenunber.Pequestsreceitedbe!cr,e7:00c:ir'ill be nade the eane dag, ?equests made after ?:00 an tiLL be nade the nert'eorking day.
%?76
#
I
fr uwEacp)utD pLuuttuc, sswEp. I^/.trm,
'.i I onatttnE: To be maCe prior to fil-Lirq trenehes.
7 uaompLooR zLUIETNG & r,rEclIANTcAL:,lof
floor insu1,ation or decking.
:--1 P1sr AND BEA\|: To be nade prior to
) m;"i-AAo| iloot, insulation ot,
deckiztg.
._.-71 ROUGH PLT]1,!BI:1G. ELECTRICAL & UECH-t^l
uritLL these Lrzspectlons hnue been
mad.e and aoorotted..
, Y I FIPEPLACE: Pt'tor to placirg fceing'/\ | Ar;;i;I; and before'froniig ir"pnl-
tion. 6 q45Q1/4<,A
T fwtttlc: ltust be tequested aften
A "pp""rr"L of rough plurbing, eiectri-
cal & mectnnical. ALL roofing
braeing & ehinmeys, etc. rrust be
. eompleted. Ilo ucrk is to be con-
. cealed until this inspeetion lns
'been made anC approted.
T
E
E
l
SruE INSPEC?T)N: To be made afterq;aoatton,-rut pt iot, tc set up of
forne.
ANDERSLAB PLUI4BING. ELECTRICAL &WCrulIAl: ?o be made befoz,e angwrk is cooet,ed.
PC1TING & F1UNDATICN: Io be naCe
4t;;ffies are ereaoated and
fotns ate erected, but ptiot' to
pourlrq ccncrete.
FTNAL PLUI{BIIIG
FTNAL I,ITCHAI'IICAL
FINAL ELECTRICAL
TNSULATTON/VAPOR BARRTER IIISPEC?IOII :
Io be nade after aLL insulaticn avd.
required oapor berie?s @e in Placebut before ory lath, Wps?ltn bcarC ot
rnLL cooeting is applied, and before
oty insulation i.s concealed.
DRYWALL INSPECTT)N: Ic be made
aftet, aLL dtyuaLl is in place,
but prior to arLU taping.
!!/!9Nt!: SteeL Location, bond
beons, grouting or oerticals in
accozdotce Llith U.B.C. Section
2415.
WOODS?11,/E: After i.nstallation is
anrpleted,
w
tr
CURB & APPRCACH APPON.
ee ereeteC but pr"ior
After fortnsto pourtng
concrete.
SIDE\IALK & DRTIEWAY: For aLL eon-
c"etenaofrAtffi street right-
of-dcA, to be made after aLL e*ca-
oating conplete & fotn tsotk & sub-
base rm.terial in place.
IENCE: h4ten conplete -- ProuiCe
gates or nouable sections through
P.U.E.
ALL project conditiow, sueh as the installation of slreet trees, conoletion of the
requined Landsccping, etc., rmtst be satisfied before the BUILDfilG FMAL ean be requested.
fiNAL BUILDING: The Final Buildirq Inspection mtst be requested cfter the Pinal Plunbing
Electrical, anC Mechanical Inspeetions hque been nade and appt'oveC.
X
DEilOLTT-OR BUILDI;]CS
Sanitaty seuer eaptped at ptoperfil Lit:e
Septic totk p;.t".ped and filled rrith gra:sel
Final - h1ten abcoe'Ltens ate carpleted
and uhen Cenclition is eornplete o? st?uc-
ture mooed atd g,etrLses cleanei up.
Le ilcmes
Blocking otd Set-up
r
Plunbing connections -- aeue? ud. uatet
Electrical Connection - Blocking, set-ut
and plunbing eonnections rrust be dpprcr;ed
before requesting eleclrical inspeclion
Accessory- BuilCing
Pinal - After pcrckes, skirting, decks,
etc. an,e eotnpleted.
Pege 7 of 2*ALL \4ANHCLES AND CLEAN)UTS MUST BE ACCESSTBLE, ADJaSTltZtlT T0 BE MADE A7 lJ1 *Sr T0 CI?y
Ioto Ci,tA Desi,gr.ated Job Nwnbe! Is:
Date of eppliootio, //-6-%
a
soLAR '^:Ess REe.-dJOB NO.L-CO
Bedtoons:
Building Volue & Permit
Ihis perrn t is granted on the eepress eondition tlnt the said. eonstructionslnll, in all respects, conform to the Ordinance adopted 6iy the City ofSptingfield, includtng the Zoning Crdinance, regulctittg the ccnsttubticn
otd _use of buildings, otd may be suspend.ed ot, reuokeC at cnA time upon oic-'l.a.tion of 6nA prctsisions of said Oydir.nnces.
Aeeess.
-- Fees --
?OYAL VALUE
FEE .UI D'D
Sounees
x Value
DCLUC /Ye
fE
NO
S.D.C. 1.5 o
DT ilouse
tot Faees -
Lace
toxe
NEM
I'lain
Building Pe"ftLt
?otal Clnrgee
State
LCT ?WE
_f, nterict
_ Cor.ner
_ Panhand.Le
CUL-de-sae
Lot sq. ttg. 742?
Z of Lct Couerage /85
# of Stories 2
Total Eeight _?3 t
?opogrqhy O-Z7o
Eistut,es
Residetttial (1 bath)a2-,) t Trff
Scnitarg Sewer
,latey
CiIAP,GE
2€
jto FEE
Res. sq. ft". /6//
Il a,t / Ect end. C ir cui t s
Tanpcrog Sertsice
" fuEt,
I?314
Pw-tnee ETU'S
khanet HooC /
Vent Fot /
llcodstoite
o 1<€rt6 F.n
,/aE
-- ENCROACHMENT --
Secaritlt Deposit
Plunbing PelrrLt
State Su,cl^arge
cal Permit
Total
PermLt Issucnee
Mechanical Petmtt
Pentrtt
Tatal Chcraes
Cutbcui -22 /
Date Paid
Receipt #
Sigxed:
Plumbing Permit
No pereon sttall consb.-uet, instal!-, alter ot, change anA ned cr eristing
plunbirq or drainage systan in uLale or in patt, unless such person is the
Legal possessot, of a oalid plunbet,'s License, escept th,at a person nay dopltnbing uork to ptopert7 uhich is ouned, Leased ot, operated by the appli-
cant.
Electricol Permit
Were State La requires that the eleetrieal uork be done by an Electtical
Contractoz,, the eleetyLcal portion of this permit slwll not be ualiC untilthe Label. ltas been signed by the Electrical Cont?actol,.
Mechqnicol Permit
Z-?-G
.ne?
I HAW CAREFULLy EXAILINED the eornpleted applieation fon permit, cnd do
hereby cettify that aLL infotrnation hereon is ttue and eowect, aruC f
fut,tket, certify that any ard aLL uork perforned shall be done in accor,-
danee rrtth the 1ydinanees of the City of Springfield, and. the Lc";s of the
State of Oregcn pertaining to the wrk Ceseribcd herein, cnd ti,ut N0 OCCU-
P/.NCy tLlL be nad.e of any st?uctute uithout pernission of the Suilding Di-uision. I furthen certify that onLy eontracto?s and etrplcyees uho oxe in
conpliance uith ORS 701.055 ui.LL be used on this project
SideuaT.k
ELee L
Mobile Hone
//DEtVaE
TOTAL AMOUIIT DUE:'/bE Date
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