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