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Home My WebLink AboutPermit Electrical 1981-03-13INSPECIION TINE 7263769 Job CITY OT SPRINGFIETD COMSINAIION APPTICAIION I PERMIT INFORMATION IINE 72C3753 Legol Dercripiion Addre:r ENERGY SOURCES: Heot - Woler Heoler Sq. Ftg. Olher -New.-Add --Alter-Rep' -- -Fence--Demo-Chonge/ U re _ _Qrhlr Building Permit lnfo: Describe Work (i.e., Volue of Work: Single Re 5q. Flg. Acces3. Sq. Ftg. Moin -- [e nder Dc J S Addre sr Phone DE5IGN TEAM (nome)(oddrers)(lics. no.)(expi res)(phone no.) Primory Mechonicol CONTRACTORS (nome)(oddress)(lics. no.)(expires)(phone no.) Generol Plumbing Eleclricol Mechonicol ETECTR ICAIPLUMBING MECHANICAL No. i i FEE CHARGE NO. I FEE CHARGE NO.FEE i CHARGE i I Eoch sinqle fixture Residencc of --sq. ft. furnocel'burner lo__-.--8rU',r I Relocoted building (new fix. odditionol) New circuits, olterolions or exlen5ionr Applionce vent se po ro te S.F. Residence (l borh)SERVICES Stolionory evop. coo ler Duolex (l both) eoch I Temporory Conrlruclion Vent fon with single duct Additionol both I I I Ampr. Yent syslem oport from heoting or A.C. Woler rervice Mechonicol exhoust hood ond duct Sewer Wood slove / heoier Storm Sewer FE EDERS Heot Pump Ampr Air hondler to t0,000 cFM Air hqndler over 10,000 cFM ISSUANCE OT PERMIT TOTAL CHARGES TOIAT CHARGES WHERE SIAIE tAW REQUIRES thqt lhr Electricql work be done by the Elerlricol Conlrqclor, tha clectricol portion of rhis permit :holl nof ba volid until o lobel hos beon :igncd by on Electricol Controctor ond ortached ?o lhe electricol panel. TOTAL CHARGES I HAVE CAREFULIY EXAlv1INED lhe completed opplicotion for permit, ond do hereby certify lhot oll informotion hereon is true ond correct, ond I furrher certify thot ony ond oll work pe#ormed sholl be done in oc@rdonce with the OrCinqnces of the City of Springfield ond the lows of the Stoie of Oregon pertoining lo the work dercribcd herin, ond lhot NO OCCUPANCY will be mode of ony siruslure withoui the permission of the Building Division. I further ertlfy lhot my regirtrciion wirh the Builder's Eoord ir in full force ond effecl os required by ORS 701.055, thoi if exempt the bosis for exempiion is noted heron. ond thot only subconlroctorr ond employees who ore in complione wiih ORS 70l.055 will be used on this proiect. oorra:-/.x--91SIGNATURE Bosis for Builder'r Boord NA}{E (pleore print) FOR OfFICE UsE ONTY Fire Zone-Eedrooms occy Lood Sq. Flg, Access x ---Volue x -fqlsg x -Volue FloodPloinslorier-occyGroup-Sq.Ftg,other- Ftg. Moin TOTAL VATUATION Zone 'pr/ Conrt. -Units -Sq. Pton Ck. Comm/lnd 6596/8ldq Per fee Systems Developmcnl Chorqe ( I .5?'o) BUITDING PERMIT Chorge: ond Surchorge s Plon Ck. Rer 309'"/Bldq Per Fee Fence fotol Comb. Permit Chorge: ond Surcho rges PTUMBING PERMIT Demo SidewolkChorge: ond Surcho rge: ELECTRICAT A/C Pcvinq Curb Cut MECHANICAL PERMIT Chorger one Surchorger IOIAT t0 {o lU//t'//N \ Conr COMBINATION APPLICATION,, PERMTT (CAP) Appliconf. ro furnish A. Job Address B. Legol DescriptionI. exomple-tox lot.l 00, Lone County Mop Reference lZ 03 432. exomple-Lot I. Block 3, 2nd Addition ro Springfield EsroresC. Nome, etc. of owner ond construclion lender D.. Energy Sources a exomple, exomDle. -heot,/electricol ceili /or forcad oir gos-woter oter eci co l./'o-;G;-- E. Squore fooroge or, ,oluotioi].-il- l. exomple-1250 sq. foot house.500 sq. foot goroge2. eEmple-iT;& proiecr, check-new-ii oddiri-on, cieckodd, etc. F. Building permit informotion:l. exomple-construct single fomily house wilh on ottochedgoroge 2. exomple-remodel existing goroge inlo fomily room3. @-converr single fomily residence inro restouront (chonge of use) G. Volue of work os deiined in Secrion 303 (o) of the Strucrurol Speciolty Code H. DESIGN TEAIV1 AND CONTRACTORS To ovoid design or construction deloys, Building DivisionStoff mus, be oble to conloct oppropriole pu.ro-.r, regor.dingdesign informction or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in fhe description oorlionof the Mechonicol ond Electricsl Schedules, rhe oppiiconr need fill-in only the No. Boxes odiocent to the oppropriote item(s) to be insrolled 8. Full Plumbing, Mechonicol, ond Elecrricol Schedules ore ovoiloble or the Building Division 'l . To conserve spoce on the per.mil form the schedules : hove been cbbrevioted 2. lf the item(s) to be instolled ore not 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 SCHEDULES !ll. ,Applicont to sign ond dore Whenever possible, the iniriol opplicotion will be used os o worksheet oniy. Where possible, Builciing Division Stoff will prepqre o typewriilen copy ond return it to the opplicont ot the time the octuol permit is issued for his signotuie. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the oppricorion, ond no plons will be processed unril these fees ore poid. Xil other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VATIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect Informotion: nome signoture dote PLANS REVIEWED BY: INSPECTION I.INE 12u3769 CITY OF SPRINGTIETD COMBINAIION APPT.ICAIIONI PENMII INFORMAIION IINE 77U37s3 Job I Dercriprion Owner Addre:r Attoched Building Permit lnfo: Fomi Rqn Dercribe Work (i.e., Build Single ENERGY SOURCES: Heot --Othcr Woter Heote? Volue of Work: 5q. Ftg. Accesr. Sq. f tg. Other Sq. ftg. Moin -New,-Add --Alter__ReP. - - -Fence--Demo-Chongef Usc Addre tr Phone OESIGN TEAM (lics. no.)(phone no.)(ex pi re r)(oddrers)(nomc) Slrudv.ol Electricol Mechonicol CONTRACTORS (nome)(oddress)(lics. no.)(expire s)(phone no.) Generol Plumbing Elecrricol Mecho nicol EI.ECTR ICAtPLUI^ BING MECHANICAL No. i i 'EE I CHARGE No.l I FEE CHARGE I I I I Eoch :inqle fixture Residence oi ----rq. ft. furnocef burner lo ---.BTU'SRelo(oted building (new {ix. odditionol) New circuits, olterolion! or exlensions Applionce vent 5e po ro te S.F. Reridcnce (t both)SERVICES Slolionory evop. coo ler Duolex (l both) eoch I I Temporory Conslruclion Vent fqn with sinqle duct Additionol both ,Ampr. Venl system oport from heoting or A.C. Woler rervi<e Mechonicol exhqust hood qnd duct I Sewer Wood stove/heoter I I ISlorm Sewcr FEE DE RS Heot Pump Ampr. Air hondler to 10,000 cFM Air honciler over 't 0,000 crM ISSUANCE OI PERA{II TOTAI CHARGES TOTAT CHARGES WHERE SfAIE tAW REOUIRES thqt thc Elecrricol wo.k be dona by thc Elaclricol Conttoctot, tho ;lectricol portion of this permit rholl not bc volid until o lobel hor bcra rignod by on Elcctricol Conrrosfo. ond sttoched to lhe electricol ponel. TOTAI, CHARGES I HAVE CAREFUttY EXAA^INED the completed opplicotion for permit, ond do hereby certify thot oll informorion hereon is true ond correct, ond I further certify lhot ony ond oll work performed sholl be done in ocordonce with lhe Ordinqnces of rhe City of Springfield ond the Lowr of the Stot" of Oregon pertoining to the work de:cribcd herin, ond thot NO OCCUPANCY will be mode of on), siructute wiihour the permisrion of the Building Division. I further ceitlfy thot.my regirtrotion with lhe Builder's Boord ir in full force dnd effect os required by ORS 7O1,A55, lhol if exempt the bosir for exempiion is'noted heron, ond lhot only rubcontroclorr ond employeer who ore in complione wirh ORS 701,055 will be used on ihis proiect. '/5'SIGNATURE OATE Boris for Euildc/r Boord cxcmption: NAfiE (pleore print) FOR OTFICE U5E ONI.Y Zone -Typc/ Conrt. Units -Sq. Ftg. Moin Firc Zonc-Bcdroomr occy Lood Sq. Flg. Accssr TOTAI YATUATION x Vo lue x Volue BUILDING PERMIT Sysiems Development 6s9Ll Per Fee Plon Ck. Comm/tnd Plon Ck. Rer Per Fee Chorge: ond Surchorger PTUMBING PERMIT Demo Chorger ond Surchorges Tolol Comb. Permit Chorgar ond Svrchorge: PERMII c Sidewolk ,IAECHANICAL PERMIT Chorge: onl S urchorgrr Curb Cut TOIAT t0 {c FEE CHARGENC. Ch^.ao ir 5ci1 Fence COMBINAIION APPLICATION, PERMIT (CAP) l. Applicoru. ro furnish A. Job Address B. Legol Descriprion l. exomple-heot,/, 2. 6f6itElE-woter electricol ceili t'or forced oir gos oter. e ci nco l,"or-loG?-: E. Sguore footoge 6r voluotion, etc. CITY OF SPRI NGFI EtD Ciry Holl _ Springfield, OregonDeportmenr of publii-works OFFICIAT RECEI;; PERMIT VATIDATION -- IYo. B c. D. l. exomple-tox lot .l00, Lone County Mop Reference.l Z 03 432. e-EmiG-Lot l. Btock 3,2nd Addilion tJsp.i"sli"ia Nome, etc. of owner ond construction lender { Energy Sources l. exomole-l 250 sg. foot house. 500 sq. foot goroge2. eFFEE-iT;ew projecr, checkilew-ii oddiri'on, c"heodd, etc. F. Building permit informorion: l. exomple-construct single fomily house with on ott goroge 2. exomple-remodel existing goroge into fomily roor3. exom;G-convert single fomily residence into GlroliEnt (chonge of use) G. Volue of work os defined in Secrion 303 (o) oi the Struourol Soeciolty Code H. DESIGN iEAlvl AND CONTRACTORS To o,void design or construciion deloys, Building Divr Stoff must be oble to contocl opprooriote persons re design informction or iob site corrections. etc. F ( ( { ( s6014 ( ( ( l9 -+\-1l Rece ived For ( ( ll. Abbrevioted Plumbing, Mechonicol & Elecrricol Schedul A. Except where blonk spoces occur in the description , of the Mechonicol ond Electricol Schedules, the opp need fill-in oniy the No. Boxes odiocent to ihe oppr item(s) to be instolled 8. Full Plumbing, Mechonicoi, ond Electricol Scheciuler ore ovoiloble or the Building Division l. To cons.erve spoce on the permit form the sched hove been cbbrevioted 2. lf the item(s) to be instolled ore not covered on. oted schedules you should consult the fuil schec C. BUITDING DIVISION STAFF WILL FILL OUT ALL FEES CHARGES ON THE SCHEDULES lll. .A,gplicont to sign onci dote Whenever possible, rhe initiol ooplicotion will be use, worksheet oniy. Where possible, Building Division Stc prepore o typewriilen copy onci return it to the oppli, the rime the octuol permit is issued for his signotuie. IV V ( ( ( (.r € (" ( ( ( o ( ( Amoun Recei ved 6.BY t Fees ond Chorges Plon check fees ore due ond poyoble ot the time of I (' a. aat"" rrrr".i:::;:::at:SIGNA TURE EU6E ond no plons will be processed until lhese fees ore pl- other fees ond chorges ore due ond poyoble when lhe permit is issued. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Proiect Informotion: nome signoture dote PTANS REVIEWED BY: (