Loading...
HomeMy WebLinkAboutPermit Plumbing 1980-07-15INSPECTIOPI LINE CITY OF SPRINGFIELD NFORMATION LINE 726-376 111111111 9 - „QMBIJATIOPI APPLICATION/PERMIT 726-3753 Job Address � � � �� ENERGIlY SOURCES: So. Ftq,, Main Heat `q. 17tg. Access. Legal Description lJater f{ r Sq. Ftq. Other z O Range' _flew Add.,-,..,Afterr�RepAL,. 71 a)?) q Q-90.�,y„ Fence emo Change/Use Value of Work. 0 r Owner •---`"" lop !Soo AddressPhone4 ,Built-;ina Perniit Info: Describe Work(i..e., Build Single CLFam.il !',esidence IJith A-.ttached Garage) Constructio er � Q Address Phone DESIGN TEAM (name) (address) (tics. no.) (expires) (phone no. Primary Structural E I e c t r 1* c a I Mec ha n i ca I CONTRACTORS (name) (I_i cs._no.(expires) (r)hone no.� General Plumbin Electrical Mechanical PLUMBING ELECTRICAL MECHANICAL NO. FEE CHARGENONOAF --- that all information - m0 . - MWER.— hereon F F C HAR�.F.FFE and correct, and I further certify that any R G E work nerformed shall be dare in accordance with the ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the Each singe fixture herein, and that Residence of OCCUPANCY will furnace/burner to of any structure without the permission -,CfIA the Building Division. I further certify that my registration SO* FTa with the Builder's BTU' s Board is in full farce and effect as required by ORS 701.455, that if exempt the basis for exemption is noted hereon, and that only subcontractors and emnloyees who are in Relocated building will be New circuits alts, Ir Floor furnace project. thew fix. additional) or extensions and vent S.F. Residence Recessed wall � ��t� SERVICES S.PaQe heater and v Duplex (Z bath) each � .,en Additional bath Temporary Construction Appliance vent se arate Water service Change in existinr� Stationary evao. residence cooker Sewer multifamily, comm. or Vent fan with Industrial sinole duct Of dent syste� apart from Storm Sewer — �m��, heating or A.C. COMM./IND. FEEDERS Mechanical exhaust hood and duct Wood stove/heater :Install/alter/relocate distrib. feeders 0f amps. I i ISSIJANCE OF pFR�IIIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vat i J until the label has been signed by an Electrical Supervisor and returned to the Building Division - - - - I HAVE CAREFULLY EXAMINED the completed r application i cats on for permit, and da hereby certify --- that all information - m0 . - MWER.— hereon is tree and correct, and I further certify that any and all work nerformed shall be dare in accordance with the ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full farce and effect as required by ORS 701.455, that if exempt the basis for exemption is noted hereon, and that only subcontractors and emnloyees who are in compliance with ORS 701.055 will be used an this project. NXNIE(Please print) /11 ty.SIj%� rlfAoS-0 I G'N A T U R E FOR.OFFICE LSF Zone TyDe/Const. Uni ts Sa Fire -BedroomsOce Load S Flood Plain StoriesOcey Grou DATE11 4w* 1,SJ K) P1L stn. Main x Value Fto. Access x Value Ftg. Other x Value TOTAL