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Home My WebLink AboutPermit Electrical 1981-03-09INSPECIION LINE CIIY OF SPRINGFIETD COA{B;NAT;ON AppuCA - CN I pl.,f,IT INFORTAAIION TINE 77L37537263769 Yl--ENERGY SOURCES:Sq. frg. Moin.----- Sq. trg. Accats. Sq. ftg. Other -New-Add--Alter--ReP., -Fence-Demo-Chonge/ Use Address Heo t Wqter Heoler Legol Z --OtherI Add ress L (+.i\-t Building Permit lnfo: Describe Work (i.e., Build Single Residence With Da c S { Construciion h\Y\ Address Phone \ DESIGN TEAM (nome)(oddress)(lics. no.)(phone no.) Strucfurol Electrico I Mechqnicol I Plumbi E lectri co I ,/!lechonicol PTUMEING ETECTRICAT AAECHANICAL NO.FEE CHARGE NO FEE CHARGE NO.FEE CHARGE Eoch ringle fixture Residence of furnoce/burner to -=--BTU'SRelocoted building (new fix. odditionol) New circuits, olterotions or exlensions Applionce vent sepqro re S.F. Residence (l both)SERVICES Duplex (l both) eoch Temporory Conslruction Vent fon with single duct Additionol both Amps. Venl syslem oport from heoting or A.C. Woter rervice Mechonicol exhoust hood ond duct Sewer Wood stove/ heoler Slorm Sewer F EEDERS Heot Pump 4-Pt. Air hondler to r0,000 cFM Air hqndler over r0,000 cFM ISSUANCE OF PERMIT TOTAT CHARGES TOTAT CHARGES IOTAI. CHARGES WHERE sTArE rAw REoUIRES thot thc Elcclricol work ba dona by thc Electricol contrnctor. rha clcctricot portion of this permit shsll not be votid until olobel hos been signed by on Electricol conlroclor ond ottoched ro the elactricol ponel. I HAVE CAREFUILY EXAMINED the ompleted opplicotion for parmit, ond do hereby certify fhot oll informotion hereon is true ond correei. ond I furthercertify thot ony ond oll work performed sholl be done in ociordonce with the oidinon.". of rhe city oi spr;ngfield ond the Lows of the stote of oregonpertoining to the work described herin, ond tho, No occUPANcY will be mode of ony strucrure witirout ihe ftrmission or th" aritling Division, I furthercertify thot my tegistrotion wilh lhe Builder's Boord is in full force ond e,ffect os requirej by oRS 7ol.os5; ihot if .r.-pt rhe bosis for exemption is noiedheron, ond thot only subcontrqctors ond employcer who ore in omplionce with oi?s 70l.05s will be used on fhis proiect. Bosis for Builder's Boord exempiion: NA.lviE (pleose print)SIGNATURE DATE FOR OFFICE USE ONTY Zone -...-.._-fyp"/Conrr.Units -.-_-Sq. Ftg. lr{oin x Volue x Yolue x -[qlgg Fire Zone-Bedroom:Octw Lood Sq. Ftg. Access Flood Ploin Srorier Occy Group_Sq. Ftg. Other TOTAT YATUATION BUIIDING PERMIT Chorges ond S u rcho rge: PIon Ck. Comm/lnd 6596/Bldg per Fee Systems Chorqe Development Q.s%\ Plon Ck. Res 30%/8ldg per fee PTUMBING PERMIT Chorges ond Surchorges Fence Demo Totol Comb. Permit ( ELECTRICA.-ERMIT -Chorges ond Surchorges ----JC u)-,40 Sidewolk 'fitf_o A/C Povinq MECHANICAT PERMIT Chorger ond Surchorges Curb Cur TOTAT d/o bo Volue of Work: Stolionory evop. cooler \ ,)(A COMBINATION APPLICATION/PER l. Applicont to furnish A. Job Address B. Legol Description (cAP) l. exomple-tox lot .l00, Lone County Mop Reference I7 03 43 2. exomple-Lot I. Block 3, 2nd Addition to Springfield Estotes C. Nome, elc. of owner ond construction lender D. Energy Sources exom ple-heotz'electricol cei I ing1, e-Io m pl e - w o t e r 1iercG;TEGEiko I or forced qir gos or solor E. Squore footoge or voluotion, etc. I. exomple-l 250 sq. foot house, 500 sq. foot goroge 2. exomple-if new proiect, check new-if oddition, check odd, etc. F. Building permit informotion: l. exomple-construct single fomily house with on ottoched goroge 2. exomple-remodel existing goroge into fomily room 3. ex;mpT-e-convert single fomily residence into r,6ftourdnt (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construclion deloys, Building Division Stoff must be oble to contoct oppropriote persons regording design information or iob site correclions, etc. ll. .A,bbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only the No. Boxes odiocent to the oppropriote item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ol the Building Division l. To conserve spoce on the permit form the schedules : hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on the obbrevi- oted scheduies you shouid consull the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Sroff will prepore o typewritten copy ond return it to the oPPlicont ot the time the octuol permit is issued for his signolure. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the opplicotion, qnd no plons will be processed until lhese fees ore poid. All other fees ond chorges ore due ond poyoble when the permif is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect Informolion: PLANS REVIEWED BY: nome signoture dote - PERMIT VATIDATION Permit Clerk I INSPECIION TINE 72C3/69 CTIY OT SPRINGFIETD COA{E|NAilON AppilcA-oN /p; tMtr INTORA{AItON tINE 726-3/ 53 '{cQC- lU sfl---Job Addresr Legol De:cription Addrer:t ENERGY SOURCES: Heot - Woter Hootar -- Sq. Frg. Olher .-New -Add--Alter--ReP.- -Fence-Demo-Chonge/ Usa Building Permit lnfo: Dercribe Work (i.e., Euild Single Volue of Work: -Other Fomil Re:idence With Sq. Ftg. Acces' sq. ftg. Moin Conslruction Lender II(,(>r1\t\-\ c !.-. (ltC.n'V-. \ Da c G \) Addre sc Phone DESICN TEAM (nome)(oddress)(lics. no.)(expi res)(phone no.) ?(inot,/ .t"'lechqnicol CONIRACTORS Eleclri co I Mechonicol PTUMSING ETECTRICAI MECHANICAL FEE CHARGE NO I FEE CHARGE NO FEE CHARGE Eoch single fixture Rasidence of --sq. fi furnoce/burner to -----BTU'T Relocored building (new {ix. odditionol) New circuits, olterotions or extenrions Applionce vent seporote S.F. Residence (l both)SERVTCES Stotionory evop. cooler Duplex (l both) eoch Temporory Construction Vent fon with single duct Additionol both Ampr. Vent system oporl from heoting or A.C. Woler rervica Mechoniccl exhoust hood ond duct Sewer Wood srove/heoler Slorm Sewer F EEDE RS Heol Pumo Ampt. Air hondler to I0,000 cFM Air hondlsr over r0,000 cfM ISSUANCE OF PERMIT WHERE TTAIE lAw REoUIRES thol thc Etectricol work be dono by lhc Eledricol Controctor. the clcrtricol porrion of this parmit sholl not be votid unril olobel hor been signcd by on Elcctricol conrrodor ond a[oched to rha clectricol ponel. I HAVE CAREFUTLY EXAMINED the completed opplicotion for permit, ond do hereby. certify ihot oll informorion hereon is frue ond correcl, ond I furiherGe"ify thot ony ond oll work pcrformed :holl be done in occordonce with the Oidinonces of the City of Springfield ond the lows of the ltote of O;";;;Pertoining io the work described herin, ond lhot NO occUPANcY will be mode of ony rtructure wirirou, the plrmisrion of the Builling Division. I furthercerilfy ihot my registrotion with lhe Builder's Boord is in full force ond e{fect os requirei by oRS 7ol ,oss, thot if exempf tto iorir'fo, exemption is notedheron, ond lhot only tubconlroctorr ond employees who ore in complionce wirh oRs 7Ol.O55 will be us€d on this proiect. Fire Zonc-Bcdrooms occy Lood Sq. Flg. Accesr TOTAT CHARGES TOTAT CHARGES OATE j Ftg. lloin TOTAT CHARGES Bcris for Euilder's Boord eremplion: NA.lv{E (pleo:e print) Flood Ploin Srorie TOIAT VATUATION FOR OFFICE USE ONTY SIGNATURE Zone Typc/Conrt. -Units Group-Sq. Frg. Other....- x Volue x Volue I -Volse Plon Ck- Comm/lnd 6lhlgldg pet fee Syrlems Development Chorge (1.59lo) BUITDING PERMIT Chorger ond Surchorges Plon Ck. Res 307"/Bldg per Fee fen ce PTUMBING PERMIT Chorges ond Surchorges Demo Totol Comb. Permit Sidewolk (c "(i. t Fff,-t _LChorger ond Surchorges PERMII JC A/C Povinq Curb Cut MECHANICAT PERMIT Chorger onf S urchorge:IOTAT sio bc ( t X-z NO So Occv COMBINATION AppLICATION/pEi._.. (CAp) l. Appliconl ro furnish A. Job Address B. Legol Descriptionl. exomple-tox lot I00, Lone County Mop Reference l7 03 432. exomple-Lot I. Block 3,2nd Addition to Springfield Eqrores C. Nome. etc. of owner ond construction lender D. Energy Sources l. exomple-heot/'electricol ceilinq,ror forced oir oos Z. gXOmple-wOtef heoter / elcclricdl / nr <alar E. Squore footoge or voluotion, etc.I. exomple-1250 sg. foot house, 500 sg. foot gorog, 2. exomFE-iFilw proiecr, checki&-ii oddition, c-h odd, etc. F. Building permit informotion: I I. exomple-construct single fomily house with on ot gclroge 2. exompie-remodel existing gcroge into fomily roo i 3. 9r".r,l"E-convert single fomily residence into reslouront (chonge of use) G. Volue of work os defined in Section 303 (q) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deioys, Building Divi Stoff must be oble to contoct oppropriote persons re( design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedule A. Except where blonk spoces occur in the description p of the Mechonicol ond ElectricoI Schedules, the oppii, need fill-in only the No. Boxes cdiocent to the opprol item(s) to be instolled B. Full Plumbing, Mechonicol. ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve spoce on the permit form the schedult hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on thr. oted schedules you should consult the full schedul, C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULES lll. Applicont to sign ond dole Whenever possible, the initiol opplicotion will be used or worksheet only. Where possible, Building Division Stoff \ prepore o typewritten copy ond return it to the oppliconl the time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the o ond no plons will be processed until these fees ore poid. other fees ond chorges ore due ond poyoble when the p4- is issued- V. FOR OFFICE USE ONLY PERMIT VATIDATION OF SPRINGFIELD Ciry Holl Springfield, Oregon Deportmenl of Public Works OFFICIAL RECEIPT I{0. B 56008 '/ /\ CITY ( ( ( ( ( ( ( \ ) BY ( ( ( (, ( C ( ( ( ( Dole Received For ( (q)ao Amount Received AUYHORIZEO SIGNAIURE SXEL'Oi.TUNXBULL PRINT€RS ' €UC€iE Oi 97'OI ( ( ( .t'\t, Permit CIerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: PLANS REVIEWED BY: dotesignoturenome