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Home My WebLink AboutPermit Building 1981-04-05INSPECTION tINE 72(..3769 CIIY OF SPRINGFIELD COMEINATION APPTICATION / PERMII INFORMATION I,INE 72&3753 4l O *h ,^","726^%!g Legol Dercripiion Lr1tu t/-nT, Owner Job //, f L Addre:s Lla Ll 5,Fomi I Ron ing Permit lnfo: -Rep. Describe Work (i.e., Build Single Attoched 5q. Ftg. Access. Sq. Ftg. Moin Vqlue of Work: - -Fence--Demo-Chonge/ Usc - -Other .-- Sq. Flg. - New Woler Heoler Conrtruction lender A,) 0lll?-RAorvr nlru s fir*! 6p oq B, 13 I Addresr Phone FxsTan/T'oru, I $o s (/ (nome)(oddress)(lics. no.)(phone no.)OESIGN TEAM Primory ol Mechonicol n Generol Plumbinq El e ctrico I Mechonicol PTUMBING ETECTRICAI MECHANICAL No. I EE NOCHARGE FEE CHARGE NO FEE CHARGE i I Eoch single fixture Residence of --_sq. ft. furnoce/burner to__,-_BTU'r Relocoted building (new fix. odditionol)2t New circuits, olteroiions or exlensions /5q t EOb Applionce vent seporqle S.F. Re:idence (l bqth)SERVICES Stolionory evop. cooler Duolex (l both) eoch Temporory Conslrvclion Yent fon with single duct Additionol both .Amps. Yent sysrem oport from heoting or A.C. Woter rervice liechonicol exhousl hood ond duct Sewer I i Wood siove/heoler Slorm Sewer rE EDE RS Heol Pump Amps. Air hondler to r0,000 cFA4 Air hondler over 10,000 cFM ISSUANCE OF PERMII .-O -TOTAL CHARGES tR60TOTAI" CHARGES WHERE SfAIE tAw REQUIRES thot lhc Elactricol work bs riona by the Elactricol Conlroclor. thc cledricol portion of this permir :hqll not ba volid unril o lqbel hos bon rigncd by on Electricol Controctor ond ottoched lo lha electricol ponel. TOTAL CHARGES -.o- I HAVE CAREFUIIY EXAMINED the completed opplicotion for permil, ond do hereby certify lhot oll informotion hereon is true ond correcl, ond I furrherceriify thot ony ond oll work parformed sholl be dona in scordqnce with ,he Ordinoncer of the Ciiy of Springfield ond the Lowr of ,he Stqta of Oregonpertoining to the work dercribed herin, ond tho? NO OCCUPANCY will be mode of ony struclure withou, the permission of rhe Building Division. I further certlfy thot my regi:trotion with lhc Builder's Boord is in full fore ond effect os required by ORS 7O1.O55, thot if exempt the bosis for exemption i:'noted heron. ond lhot oniy subcontroclorr ond employees who ore in complione with ORS 701,055 will be used on this proiect. 7-,t- rrDATESIGNATURE Bo:is for Euildar's Boord exemption: NAME (pleose print) FOR OFfICE UsE ONLY Zone -Typc/Con:t.-Units -Sq. Ftg. Moin Ll7 fire Zone-Bedrooms occy Lood Sq. Ftg. Acce:s tlood Ploin Slorir. Occy Group-Sq. Ftg. Orhcr-x -Volua TOTAT VAIUATION , lL,E vo1u" x -Voluea.o3 Syslems Development Chqroe (1.59'.) BUILDING PERMIT Chorger ond Surchorger Plon Ck. Comm/lnd7c.o9 ^go BI Per Fee Per Fee650,',. Plon Ck. Res fS" re ,r*;1 tir fO,3O due,9vc TldvlChL&6.33. Totoi Comb. Permit '703L PTUMBING PERMIT ----O-:- Demo Chorges ond 5 u rcho rg e: Labd Fec 20oPERM IT Sidewolk o,b9 ,.cooChorge: ond Surchorger q 3L,q3 MECHANIC.AI. PERMIT Chorger onri Surchorger Curb Cut-o- IOTAT ENERGY Heot l')Nd.(7 (expires) Electricol A/C Pavino PERMIT VATIDATIONcoMBtNATtON AppLtcATtO, .,ERMIT (CAp) l. Appliconr ro furnish A. Job Address B. Legol DescriptionI. exomple-tox lot .l00, Lone County Mop Reference l7 03.432. exEmile-Lor I. Block 3, 2nd Addition ro Springfield Esrores C. Nome, etc. of owner ond construclion lender D. Energy Sources exomple -heot,'electricol ceilin z"or forced oir qos ')-woler eoter r e col r'oi solET- E. Squore footoge or voluotion, etc.l. exomple- l250 sq. foot house, 500 sq. foor goroge2. exoEEIE-iT n-ew proiecr, che.[i-e*-ii "Jairi"n, .L.t odd, etc. F. Building permit informorion: l. exomple-construct single fomily house with on ottoched goroge 2. exomple-remcdel existing goroge into fomily room3. exompG-ccnvert single fomily residence into restouront (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structurol Speciolty Code H. DESIGN IEAIVI AND CONTRACTORS To ovoid design or construciion deloys, Building Division Sloff mus, be oble to contoct oppropriote persons regoriing design informction or iob site corrections, etc. ll. Abbrevioted Plumbing. Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description oortionof the Mechonicol ond Electricol Schedules, the oppiicont need fill-in only the No. Boxes odiocent to the oppropriole item(s) to be instolled B. Fuil Plumbing, Mechonicoi, ond Electricol Schecjules ore ovoiloble or the Building Division l. To conserve spoce on the permit form the schedules .: hove been cbbrevioted 2. lf the item(s) to be instolled ore no, covered on the obbrevi- oted schedules you should consult the fuil schedules C. BUILDING DIVISION STAFF WILL FiLL OUT ALL FEES AND CHARGES ON THE SCHEDUTES lll. Applicont to sign ond dote Whenever possible, the initiol onplicotion will be used os o worksheet oniy. Where possible, Builcjing Division Stoff will prepore o iypewritten copy ond return it to the opplicont ot the time the ocruol permit is issued for his signotuie. lV. Fees cnd Chorges Plon check fees qre due ond poyoble ot the time of the opplicotion, ond no plons will be processed until these fees ore poid. All other fees ond chorges ore due ond poyoble when ihe permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDTTIONS TO BE SATISFIED EEFORE OCCUPANCY: Additionol Proiecr lnformotion: srgno e dote 4-tt..^-tq6rnomenBor,t%*r..Sha PLANS REVIEWED BY: I Permit Clerk #CIIY OF 5PRINGf IEtD COMBINAIION APPTICAIION I PERI'III -=#INFORMAIION tINE 7?63153 Lcaol De:cripiio^AssilsqB'tfi'lAl LO, /) aj ?/ t!,, L/ Ll r tlDl Ronge Woter Heoter ENERGY SOURCES: w"t i rtrfanTH&Nh7 Ow --Fence--Demo-Chongs/ U sa -Othcr Sq. Ft9.Other - New -ReP, Sq. Ftg. Acce:r. 5q. ttg. Moin Volue of Work: rrTi^*h.f Vdo ,a Addrerr qa Ll 5, t)b *h ,^"^.726-%!f Iiuilding Permit lnfor Dercribe Work (i.e., Build Singlc Fomilv Reridence With Alroched Go.gg!L- I A)contrrucrion Lend.r N OnA c NIr L^ Ex sTenlT'oru o I PhoneAddrerr (nomc)(oddre:r)no.)ne no.)OESIGN TEAM ?rimoty Mechonicol 5 (nome) I Plvmbinq Ele<tricol Mechonicol ETECIRICATPTUMEING CHARGE MECHANICAL NO.FEE CHARGENO.I FEENo. I i iEE I CHARGE furnoce/ burner fo --_BIU'r Residence of --rq. ftI I I I Eoch rinqlc fixtura t E;U !et t EOA Appiionce vent sePorote New circuils, olterotions or extensions Relorotcd buiiding (new fix. odcjitionol) SERVICES Stotionory evop. cooler S.t. Reridenca (l bothl Vent fon with single ductDuolex ( I bo th) eocir I I I I Temporory Conrlruction Vent syrlem oport from heotino or A,C.Amp:.Additionol both Alechonicol exhoust hood ond ductWoler:ervicc Wood :love/ heoicrSewcr Heot PumpFEEDERSStorm Sewer Ampr. Air hondler to I0,000 crM Air honciler over 10,000 crM ISSUANCE OF PER,ITIT TOTAT CHARGES tf db--O-TOIAL CHARGES WHERE sIAIE tAW REQUIRES rhsr rhc Etectricol work be donc by lhr Elsctrirsl Conlroclor, tha clccricol portion of this pcrmil sholl not bc volid unril o lobcl hor bcon riEncd by on Elcctricol Contractor ond ottcchod to fha eleorical poncl. TOTAI CHARGES --(3 - I HAVE CAREFULLY EXAMINED rhe completad opplicotion for permil, ond do hereby certify thot oll informofion hereon is lrue ond correct, o1d I further (e*ify thqr ony ond oll work parformed sholl be dona in ocordoncc with the OrCinoncer of the City of Springfield ond the Lowr of ihe Store of Oregon perroining to thc work dercribed herin, ond thor NO OCCUPANCY will be mode of ony structure without lhe permission of the Building Division. I further ertlfy lhot my rcgirnotion with thc Buildcr's Soord is in full force ond sffcct os required. by ORS 70I.055, thot if exempr rhe bosir for exemplion is'notcd horon, ond thot only rubcoorroqror! ond employces who ore in complione wiih ORS 701.055 will be u$d on this proiect, 7-,t- rrTUREDATE Bo:ir for Euildcr': Boord Gxemptionr N&\{E (pleorc prinr) FOR OFTICE USE ONTY Flood Ploin Sroricr-Occy Group-Sq. Ftg. Othcr- x Voluc x -Yolue TOTAI. VATUATION tl1 x ,-Occv Lood Sa Ftg. Acces:Firc Zonc-Bcdroomr Ftg. MoinZona -fype/ Con:t. -.Unitr /-.a3 Systemr Development Chorqe ( I .5?'o)ffr zO tfs6z4 -)" - A-q.-t BUITDING PERMIT Plqn Ck. Comm/ lnd goo 1/\oo Per Fee Plon Ck. Rer Per Fee Chorger ond Surchorger 6,€.fo,3o duc O,tc FlauqChetE 2t '7o -)irrt - Totol Comb. Permit Pt.UMBING PERMIT Demo __s_-___Chorges ond Surchorger 6 20Labc( Fec € 2/ qc'*'14, - o,b9 PERMIT , <OO Sidewolk C Pcvi Chorger ond Surchorgo: A{ECHANICAT PERMIT -o-Curb CulChorgcr onci Surchorgcr TOTAI INSPEC'ION tINE 72t3t69 e^ l. exomole-tox lot I00, Lone County Mop Reference l72. eEEtG-[ot I. Block 3,2nd Addiiion ro Sprinsfietd E:C. Nome, etc. of owner ond construction lender D.. Energy Sources l. exomple-heot,ielectricol ceilinqz,'or forced oir oosz. exomole-woter heoteil eleciricol.r'or solor f. Sqro7EJoge or voluorio;;;. I. e:omole-1250 sq. foot house,500 sg. foor goroge2. elGrnElE-iGew proiec, checkE-ew-ii oddirion, cieckodd. etc- F. Building permit informolion:I. exomple-construct single fomily house with on ofiochtgoroge 2. exomple.remodel existing goroge inlo fomily room3. exomoG-ccnvert single fomily residence infoffiEnt (chonge of use) G. Volue of work os defineci in Section 303 (o) of the Structurol Soeciolry Code H. DESIGN TEAIi{ AND CONTRACTORS To o-void design or consiruciion Celoys, Building DivisionStoff must be oble to contoct oppropriote purrJn. regoi.ddesign informction or iob site corrections, etc. ll. Abbrevioted Plumbin-o, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portio of the Mechonicol ond Electricol Schedules, rhe cppiicont need. fill-in oniy rhe No. Boxes odiocent to the oppropriot item(s) to be instolled B. Fuil Plurnbing, Mechonicoi, ond Eleciricol Scheciules ore ovoiloble ot the Buiidinq DivisionI. To conserve spoce on thJpermit form the schedules hove been cbbrevioted 2. lf rhe item(s) to be instolled ore not covered on the obl. oted schedules you should consult rhe fuil schedules C. BUITDING DIVISION STA.FF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, rhe initiol onplicotion will be used os oworksheet oniy. Where possible, Buiiciing Division Stoff willprepore o typewritren copy oncj return it to the opplicont otthe time the octuol permit is issued for his signotuie. lV. Fees cnd Chorges Plon check fees ore due ond poyoble qt the time of the opplicotion,ond no plons will be processed until these fees ore poid. Ail other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY COMBINATION APPLICAI l. Applicont ro furnish A. Job Address B. Legol Description r#- ren,vrrr (cap) For: ( k PERMIT VATIDATION CITY OF SPRINGFIETD Ciry Holl Springfield, Oregon Deportment of Public Workr OFFICIAI RECETPT No. B 56306 I9 Rec', Address { (OC ( ( ( I Amount Received ( (l 3X€LiOX.TUXffaUlL pitxtErs . EU6ENE OR gtaot !aa[.! Permit Clerk |- I)1\ I PROJECT CONOTTIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: nctme T^6ha-trn PTANS REVIEWED BY: I ( ,in.,orr* a"r" 't-lb- ttg L