HomeMy WebLinkAboutPermit Plumbing 1980-10-29yy 1
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1�JHE�?� STA�t LAW REQU� RE S that the �� ectr� cal ti�ork be done by a� Electrical �.antractcr, the el ectr� ca } nor �i ren of this permit
shall not be vat i ;i until -[.-he label has been si qned by an Electrical Sunervisor and returned to the Building Division
I HAVE CAREFULLY �XA�"ii�GD tie completed application for permit, and do hereby certify that all information his true
ana correct, and T furthev-% cert fy that: any and a� � ��r�rk nerforme� shall be dine in accordance with the Ordinances of she City
of SDringflelld and theLaws of -the State of Orenon oertai ni ng to the work described hev,,-4ein, end that i��G OCCLIPA14CY will be made
of any structure without the permission of the Buildinq Division. i further certify that my registration with the Builder's F'
board is in fforce and effect as renu i �'ed by OPS 701.055, that i � Exemot the basis for exemption is noted hereon, and ghat
oniy subcontractors and emQl o,yees who are in comol i once with 0R5 7nl.055 will be used an this pro,]*e'�t-.
P.
", � �-- - � G�°J�',TL�RE .�.z.L,,.�..� DATE��A��E�p�ease �ar�nt} � IV �
7
F 0 0 F F I L�5� �p�LY��
Zone TYr)e/Const. Units 5o. Fta. �Iai n x Val ue
Fire Zane _ M Bedrooms Occv Load Sq. Ftp. access c Val ue
PEs
Flood Plain Stories Occy Croup Sq* wtgv ether x Vallue
%Tn7rni WnI tlRT?C?h! �
I
A
COMBIWNTICN F,PPLICATION/PEP.f4IT (CAP)
AOR OFFICE USE ONLY
PERMIT VALIDATION
CITY CSF SP-R.INGFIELD
city Hall
Springfield, Oregon
Department of Public Works
:,,OFFICIAL RECEIPT
Date
Recd From
No.
19 C.�J
Received For.:
a
y_
Amount ReceivedPE
- 11, M,
AUTHORIZED SIGNATURE
HFETOR-TUR BLA.L PRINTERS - EUGENE. OR 97401
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
385X1-8
AoP1
icant to furnish
Aa
Job address
B.
Legali Description
1. exp 1 - Tax Lot 100, Lane County Miap Reference
17 13 4+3
2 4P a l- Lot 1. Block 3, 2nd Addition
Dri L L
C.
0
Name, etc. constructi-on lender
D 10
tnerqv Sources
1* examol"e- heat/electrical ceiliqi/or forced
1 l ~
20 e rr l � � solar
Square lu i , et'c..
1. o,l - 1215110 sq. foot house, 500 sq. foot
2. exar,.D I S new Project. check new if add
-
�. j< and, etc.
F
Building permit -information:
examole c,.onstv,,%uct singlefamily hoose wit
h�qaraQe
2.6 l remodel exist -'Ing garaca. into 11arni
3. m l r: single family residence i
r � u (change of use)
G.
Value of work as definedin Section 3.03 (a) of
Struc-"Zl-ural Per 1 l ty Code
H.
D."r.6SIrGJ1%` TEA-.!'AtA111i'r-)
I '.d ,o avodimsian oC-1 c n s t- r u ct-ion delays, Suildin
i i i L t 1 L be ableconpact appropri
.
persons regarding designinformation job s
c o r r e. c,11" P o n s ;2, r c
I ' e ] P111mbing McLchan -' , Electr4cal Sche
_A.�
Ai
�.0 2. r s+`i r e !)lank sQaces occur in -sheipti
r cn o-;' tho Me
r, chani(-,al U,nd '.1ectriC'a1 Schedu
t.ne, apoticant need fiII-in only the No. Boxes
f
";a .ne 3..0.pr1t1J,%ori ate item(s) to be installed
_
..0
F NU I I P 1Wind i n (3 "IechanilrZal and Electr'p'cal Schell
are avai i able at t' -he Building Division
i conse..,!,,ve
p x..,.e. on permit 't 9ii the sc
:'�v been b+ ni aced
2. 1 f the 1tE:.,Pt81 S to b1*nstal led are not Cove
0 1
abbreviaped schedule -S you should consul
fu 11 schedules
3,'J L D ISG STAFF WIL'L FILL OUT ALL FEES
.1
CHARDS ON THE SCHE'DULES
0.
As note.,,.d on -t-he CAP,, the label must be delivere
t
{
l r ric. l contractor for signature by hisl
supervi s or. The general contractor is not au -L
to n the elec%trical label.
I Applicant
-L-.o sign and date
.
F
Whenever
possible, the initial l i cation Will be
worksheet
0
only.Where Possible,, Bui di i i l
will
SrPDare a type written return t �o
�:
dp l
i _ # �
i cant the.timethepermitis issued
yw
s i ria
ture.
Fees
and Cna
lan
- � due ani l the
r Jrl
pp l
i �i , and no plansill be processc_:,�d until
tees
are pa -%Id. All other fees Gnd chargesdue
payable
When the permit is issued.
AOR OFFICE USE ONLY
PERMIT VALIDATION
CITY CSF SP-R.INGFIELD
city Hall
Springfield, Oregon
Department of Public Works
:,,OFFICIAL RECEIPT
Date
Recd From
No.
19 C.�J
Received For.:
a
y_
Amount ReceivedPE
- 11, M,
AUTHORIZED SIGNATURE
HFETOR-TUR BLA.L PRINTERS - EUGENE. OR 97401
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
385X1-8