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Home My WebLink AboutPermit Plumbing 1981-02-11a INSPECTION LINE __ CITY OF SPRINGFIELD 726-3769 COMBINATION APPLICATION /PERMIT � 3!S�' N__ +: Heat ENERGY SOURCES: 1 Job Address --� i Water Heater Legal Description T �--V �l_/l_J-_------- — — Range = --- i—i Value of Work: I n. % IL 01 r% 0,% 0 1 /1,?^ ) r_ I 1 4 I Address I Constructlion Leader Address —A DESIGN TEAM Primary — b. -- Phone Phone (address) INFORMATION LINE � 74(r-3753 Sq. Ftg. Ma -in t+q. Actess4& Otheir New,_ -.-Add_., Alter._ -_-Rep., Dro._-han ej Use 01her - E � #clr' Permit Info: a scribe Wok Build Single am;'y R.esadence 1I t Attached �1 iF t ( 1cs. no.) (expires) (pnone no.) 1 — ��.--r-.."•r�,,.••_�-rte. �. ��.F•• .•-.N-�� i 3f t � d � � � E S � � � --- ��! , .�..� — - -- .+..a_a �.�.. � ' - — — �,--,r .�, - - ,•—T, _ - �-- -- -- —- ..,.�� ars r j ,�■r��arr arn_rr,r �Vr �.-.�/L'�aa�aa baa � - 4+aaa�a.J-r-•r-�nC�i-moi �a:� -Thi^a-__ A a n ca Y �. n �it phone Fs :� oics. yL r��_.,.�-•__---vim �w��+� �...�.�....._ :t P U Cj lh y.�vr�a��aa��ia�-� � awl _-W/YF�t �•�_ •4 •_ r•44 _.ia—SIF■ .�..�, �1 p ti Mechanica'. _T �+ti++ •_W� r ' .y• Yom"• S�¢i��F •1/L-� • '�i�7�• �.' �7C �FL7�}� �a-r airr• F�Y'�F �I'-.} '��rti,'F ' 8ii�'•■JrL:' �.� .�� .... Y ,r �'�'T.•�-S� .i�i� �F 77�,� �i 7�=— r °" -: JQ' �� .■. Jam... 7f .. _ s L U M INS ELECTRICAL ME'N.HANICAL T „ �, .� �atdF,i T,■mac a� �� f` +rte�R�..SC _rik� rr.ti�'�1�- .a�'�__ `7ht� mss• Lr: •'.. _ 7 �.'_ r�'�►Y 3'�,ar+r�' ; - _ _ #C :�*i.?' _._ .�L L _..+H'.r� .: '�... _ • _• zjdaFa=:.z F rK JC'J"19G _Y rr--------- - - - - — ---- - - r rHARGE I N 0, FF . s rNO. to1r burner Residenice Eac Single 'H t r _Tluls a t _ T --- --- 3 1 .. Ap i ' r k building t Ne\v .mss. 1 1, SJ 1 r 1 $ i - y i; a nRelo..aed r yr '� �. 49,�}i rinirl t e- erste S.F. Residence th) i ' upi I bath) Cad,%. I Add i trona i 4 ID-k� S W Ler service ger t 'Sewer i 1 I I I i FEEDERS E � Amps. - - F � t k { E 1 Stationarye`v V t cooler Vent fan0 L 'ot singie duct Venrllt' System apart from k.--A r9 +; rl.�q ^ r A echanicae ^-, h oust hood and k i wooct stove/ . Hect PuTy_ Al r handier t 10,000 M Air handier ov 10 J900 0 C FM _ ,�� t+•+�� r-�� r .ter : .�� _ - -- --- �i E7 f . d if PS SUA AL H � � LCHARGES TOTAL GE i -_ F iiik�•i�.-'•Y�■7�� - � _may �a�.rt,r ��_�-r r•4 n�aa - _.-:iii�T �� - - ra�� _ WHER-E STATE LAW -REQUIR-ES t 'Electrical � " done, -the Electrical Contra Our, 1w electrical.pairtion, • thisperrvii'' , shall not li i _ label has been signed by an ' l rtri u - L rats t r and arta the d -to the eledricol panel a - - _- -- - --_11�k'-��-r� Twp_ aa—�. -- _ y+-+.TT-�Fl■ �.. r �peri-nit,O Cchrfi t o � all `reformation hereon ,L true* c rar ct. a I further I HAVE:CAREfULLY the o f ted ■ber T, � aOrdinances �City�Spfinqfie'd� ;� Laws a�State� Oregon certify that n and : w e �r r d hall done i * �j�I a structure hoot theperm�s i the Building. Dr iso r��r aim t tie work described •herrn, and that� fo-rce required - that i exempt the basis for er. i3tio i noted erfl that rn registration the theBtjiider'5 mar heron., and that only subcontractors and l B who are in compliance. with ORS 701.055 will be used n this rj+t PP I - - - - Basis for Suilders cjrd ex mption: el) 7 7-e f I 7(, T E + r Y t-1- 4:_ SIGNATURE D r NAME .(Please prV USqilf1-I= J OF. &33� . FOR OF-FICE USE ONLY Ver � e X.n Coast. ni t� Fire r � . Ft . Acte � ver I U Zone Flood Plain StoriesOce Ft.ther �—Va I U TOTAL VALUATION ir BU iPlon Commlind System Deval rpt �L ill ��_ charas and /Blda PFee - -- - Chorge,- ■ ( 1cs. no.) (expires) (pnone no.) 1 — ��.--r-.."•r�,,.••_�-rte. �. ��.F•• .•-.N-�� i 3f t � d � � � E S � � � --- ��! , .�..� — - -- .+..a_a �.�.. � ' - — — �,--,r .�, - - ,•—T, _ - �-- -- -- —- ..,.�� ars r j ,�■r��arr arn_rr,r �Vr �.-.�/L'�aa�aa baa � - 4+aaa�a.J-r-•r-�nC�i-moi �a:� -Thi^a-__ A a n ca Y �. n �it phone Fs :� oics. yL r��_.,.�-•__---vim �w��+� �...�.�....._ :t P U Cj lh y.�vr�a��aa��ia�-� � awl _-W/YF�t �•�_ •4 •_ r•44 _.ia—SIF■ .�..�, �1 p ti Mechanica'. _T �+ti++ •_W� r ' .y• Yom"• S�¢i��F •1/L-� • '�i�7�• �.' �7C �FL7�}� �a-r airr• F�Y'�F �I'-.} '��rti,'F ' 8ii�'•■JrL:' �.� .�� .... Y ,r �'�'T.•�-S� .i�i� �F 77�,� �i 7�=— r °" -: JQ' �� .■. Jam... 7f .. _ s L U M INS ELECTRICAL ME'N.HANICAL T „ �, .� �atdF,i T,■mac a� �� f` +rte�R�..SC _rik� rr.ti�'�1�- .a�'�__ `7ht� mss• Lr: •'.. _ 7 �.'_ r�'�►Y 3'�,ar+r�' ; - _ _ #C :�*i.?' _._ .�L L _..+H'.r� .: '�... _ • _• zjdaFa=:.z F rK JC'J"19G _Y rr--------- - - - - — ---- - - r rHARGE I N 0, FF . s rNO. to1r burner Residenice Eac Single 'H t r _Tluls a t _ T --- --- 3 1 .. Ap i ' r k building t Ne\v .mss. 1 1, SJ 1 r 1 $ i - y i; a nRelo..aed r yr '� �. 49,�}i rinirl t e- erste S.F. Residence th) i ' upi I bath) Cad,%. I Add i trona i 4 ID-k� S W Ler service ger t 'Sewer i 1 I I I i FEEDERS E � Amps. - - F � t k { E 1 Stationarye`v V t cooler Vent fan0 L 'ot singie duct Venrllt' System apart from k.--A r9 +; rl.�q ^ r A echanicae ^-, h oust hood and k i wooct stove/ . Hect PuTy_ Al r handier t 10,000 M Air handier ov 10 J900 0 C FM _ ,�� t+•+�� r-�� r .ter : .�� _ - -- --- �i E7 f . d if PS SUA AL H � � LCHARGES TOTAL GE i -_ F iiik�•i�.-'•Y�■7�� - � _may �a�.rt,r ��_�-r r•4 n�aa - _.-:iii�T �� - - ra�� _ WHER-E STATE LAW -REQUIR-ES t 'Electrical � " done, -the Electrical Contra Our, 1w electrical.pairtion, • thisperrvii'' , shall not li i _ label has been signed by an ' l rtri u - L rats t r and arta the d -to the eledricol panel a - - _- -- - --_11�k'-��-r� Twp_ aa—�. -- _ y+-+.TT-�Fl■ �.. r �peri-nit,O Cchrfi t o � all `reformation hereon ,L true* c rar ct. a I further I HAVE:CAREfULLY the o f ted ■ber T, � aOrdinances �City�Spfinqfie'd� ;� Laws a�State� Oregon certify that n and : w e �r r d hall done i * �j�I a structure hoot theperm�s i the Building. Dr iso r��r aim t tie work described •herrn, and that� fo-rce required - that i exempt the basis for er. i3tio i noted erfl that rn registration the theBtjiider'5 mar heron., and that only subcontractors and l B who are in compliance. with ORS 701.055 will be used n this rj+t PP I - - - - Basis for Suilders cjrd ex mption: el) 7 7-e f I 7(, T E + r Y t-1- 4:_ SIGNATURE D r NAME .(Please prV USqilf1-I= J OF. &33� . FOR OF-FICE USE ONLY Ver � e X.n Coast. ni t� Fire r � . Ft . Acte � ver I U Zone Flood Plain StoriesOce Ft.ther �—Va I U TOTAL VALUATION ir BU iPlon Commlind System Deval rpt �L ill ��_ charas and /Blda PFee - -- - Chorge,- COMBINATION APPLICATION// PERMIT �. Appli'canl V furnish A. .fob Address B. Legal Description 1. exam ie -tax lot 100, LCounty Map Reference 17 03 43 2, examp#e-Lot 1. Block 3., end Add*iivn to Springfiel� Pri"`=r C. Name,,, etc. of owner and construction lender CITY D. Energy Sources (CAP) 1. example-heat/electrical ceiling i'or forced air gas 2. example. -water heater.0,"electrical 0 P'.0 or solar E. Square footage or valuation, etc. 1. example -1250 sq. foot douse, 54n sq. foot garage 2. exam „pie -if new proiect, check new --if addifian, chi add, etc, F. Building permit information: I. example -construct single family house with an att garag� 2 example -remodel existing garage into family rovi 3. example -convert single famiiy residence into restaurant (change Of use) G. Value of work as defined in Section 303 (a) vT the Structuripal Specialty bode H. DESIGN TEAM AND CONTRACTORS TQ avoid design or construct - :on delays, Bu�idinq D*v'&. Staff must be able to contact appropriate persons pec design informction or �ob site correcT]ons, etC. , 11. Abbreviated Plumbing, Mechanical & Electrical ScheduIe A. Except where -blank spaces occur in the description p of the Mechanical and Electrical Schedules, the appli need fill-in only the No. Sixes adjacent to the appro �iern(s) to be installed �. Full Plumbing, Mechanical, and Electrical Schedules 0 are available at the Building Division 1, To cons-erve spr,-ice on the permit form the schedul have been abbreviated 2. If the item(s) to be installed are not covered ars th ated schedules you should consult the full schedui C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEE'S A CHARGES ON THE SCHEDULES Ill. Applicant to sign and date Whenever possible, the initial application will be used c worksheet only. Where possible, Building Drivision Staff prepare ❑ typewritten copy and return it to the applicor the time the actual permit is issued for his 5ignatur--c,;b. IV. Fees and Charges Pian check fess are due and payable at the dime vgr the { 5 and no plans will be processed -until these fees are DOid nthPr fppr-. nncl CkCIrAP_S nrP due and navanle when the t4 (4, Date OF SPRINGF1 City Hall Springfield, OrGgon Department of Public Works OFFICIAL RECEIPT Recd From Addres r IL It t9Q 0 E L D B 0 5 7 %100 J a r �f Received For: 4F C C Amount Received I L� L .+ -% r i i r ;0 P %W 7 7 Jul J W 4-L� SHELTOM-TURN BU LL PRINTERS - EUGENE. OR 97401 58 511 -fl m4 t