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Home My WebLink AboutPermit Plumbing 2031-02-20INSPECTION UNE 7?&3769 CITY OF SPRINGFIETD COI/TBINAITON APPI.ICAIION I PERMIT INTORMATION TINE 72(}37s3 lDescription IlaS q-f 0Address Phone Build Single F'n uilding Permil lnfo: Describe Work (i ENERGY SOURCES: Heot Wqter Heoler R Volue Sq. Ftg. Moin Sq. Ftg. Access. Sq. Ftg. Other - -New -Rep..9r/ Use- _Fe 1 53,, Consiruction Lender Address Phone oCI e T DESIGN TEAM (nome)(oddress)(lics. no.)(expi res)(phone no.) Primory Structurql Eleclrico I Mechonicoi CONIRACTOIS (nome)(oddress)(lics. no.)(expires)(phone no.) Pl um Electricql lv{echonicol PIUMBING ETECTRICAI,MECHANICAL NO.FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE Eoch single fixture Residence of -sq. ft. furnoce/Sirrner to ,s Reiocoted building (new fix. oddirionol) New circuits, oiterotions or exlensions Applionce vent seporo le S.F. Residence (l borh)SERVICES Slotionory evop. coo ler Duplex (l bolh) eoch Temporory Conslruciion Vent fon with sinqie ducl Addilionol both Amps. Venf syslem oport from heoting or A.C. Woter service Mechonicol exhqusl hood ond duct Sewer lo.t Y)Wood siove/heoter Slorm Sewer TEEDERS lieot Pump Ampr. Air hondler lo t0,000 cFM Air hondler over 10,000 cFM I ISSUANCE OT PERMIT TOTAL CHARGESTOTAT CHARGES WHERE STAIE tAW REOUIRES thot fhe Electrical work be done by the Electricol Conlro.lor, the electricol portion of this permif sholl not bc volid until o lobel hos been slgnod by on Elecrricol Controctor ond ottqeheri to the eleclricol ponel. TOTAT CHARGES .b I HAVE CAREfUttY EXAMINED the compleled opplicotion for permit, ond do hereby certify thot oll informotion hereon is lrue ond correct qnd I further certify thot ony ond oll work performed sholl be done in occordonce with the Ordinonces of the City of Springfield ond lhe Lows of the Stote of Oregon pertoining to the work described herin, ond thot NO OCCUPANCY will be mode of ony structure without lhe permission of the Building Division. I further ertl{y thot my registrotion with the Builder's Boord is in full force ond eFfect os required by ORS 70I.055, thol if exempt the bosis for exemption is noted heron, ond thot only subcontroclors ond employees who ore in complione wilh ORS 701.055 will be used on ihis proiecl. Bosis {or Builder's NArltE (pleose print)OATE FOR OFFICE USE ONTY ATURE Zone -Iype/ Consr. ---Units -Sq. Ftg, l|loin x Volue x Yolue a -Yolug FloodPloinstories-OccyGroup-Sq.Ftg.other- Fire Ftg. Access TOTAT YATUATION Bedrooms occy Lood Systems Development Choroe (t.5oZ) BUITDING PERMIT Plon Ck. Comm/lnd BI Per Fee B Per Fee Plon Ck, Res Chorges ond Surch c rge s fotol Comb- Permit PIUMBING PERMIT rc-OO Fence Demo Chorges ond Surcho rges Chorges ond Surchorges EtEqTRICAI. PERMIT Sidewolk C Povi TOTAT qc)( MECHANICAT PERrrtlT Curb CutChorges ond Surchorgas I (Y !t-'U Z-zcttl J L-lo coMBINATTON AppLtc,ATtON/PERMtT (CAp) l. Appliconi. to furnish A. Job Address B. Legol Description l. exomple-tox lot I00, Lone County Mop Reference'l 7 03 43 2. exomple-Lot I. Block 3, 2nd Addition ro Springfield Esrotes C. Nome, etc. of owner ond construction lender D. Energy Sources lectricol ceili or forced oir gos eoter ect iolior solor E. Squore foologe or voluotion, etc.l. exomp!s-.l.250 sq. foot house, 500 sq. foot goroge 2. exomple-if new proiect, check-new-if oddition, check odd, etc. F. Building permit informorion: l. exomple-construct single fomily house with on olloched goroge 2. exomple-remodel existing goroge into fomily room 3. @-convert single fomily residence into restouront (chonge of use) G. Volue of work os defined in Section 303 (q) of the Strucru rol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to contocl oopropriote p"r.on, regording design informotion or iob site corrections, elc. ll. Abbrevioted 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 Schecjules ore ovoiioble ot the Building Division I. To conserve spoce on the permit form the schedules .: hove been obbrevioted 2. lf rhe item(s) to be instolled ore not covered on the obbrevi-, oted schedules you should consult rhe full schedules C. BUILDING DIVISION STAFF WILL FILT OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign onci dote Whenever possible, the initiol opplicotion will be used qs o worksheet oniy. Where possible, Building Division Stoff will prepore o typewrilten copy ond return it to the opplicont ot fhe 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, ond no plons will be processed until these fees ore poid. All ofher 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: Additional Proiect !nformotion: nome signoture dole PLANS REVIEWED BY: INSPECTION TINE 77b3769 CIIY OF sPRIN6TIEtD COMBINAIION APPI.ICAIION / PERA{IT INTORMATION tINE 72t3753 [eg ol Description Owner New ENERGY SOURCES: Heqt Woter Heoter Ro Volue Sq. Fig. Moin Sq. ttg. Accesr. Sq. Flg. Olher -Chonge/ Use ier-Rep. Addresr ] laa cff 5 Phone 6uilding Permit lnfo: De:cribe Work (i.ef Build Single Fomily Residence With Attoched Goroge) Construction Lender .A.ddre ss Phone o0c =IJ (nome)(oddress)(lics. no.)(expires)(phone no.)DESIGN TEAM Primory trvcturol Ele ctricol CONTRACTOR.S (nome) - (oddress)(lics. no.)(expires)(phone no.) Electricq I Mechonicol PIUMEING ETECTRICAI.MECHANICAL IEENO. i CHARGE NO.FEE CHARGE NO.I fEE I CHARGE Eoch sinole fixture Residence oI fr. furnoce/b-urner lo --..--BTU'SRelocored building (new fix. oddirionol) New circuiis, olterotionr or exlensions Applionce vent sepqrqte S.F. Reridence (l both)SERVtCES Slotionory evop. cooler Duplex (1 bolh) eqch Temporory Conslruction Vent fon with sing le du:t Additionol borh Amps, Venl syslem oporl from heotinq or A.C. Woler rervice Mechonicol exhqust hood ond duct Sewer IO,I Wood stove/ heoier Slorm Sewcr FEEDERS Heot Pump Ampr. Air hondler to 10,000 cFM Air hondler over r0,000 cFi{ t ISSUANCE OF PERMIT TOTAI, CHARGES TOTAT CHARGES WHERE STATE tAW REOUIRES thot the Elactricol work bc donc by the Elcctricol Conlroctor, thc clectricol porrioa of this permit shsll not ba volid until o lobel hqr b*n rigned by on Elecricol Controctor ond ottoched to thc electricol ponel. .bTOTAT CHARGES I HAVE CAREfUt[Y EXAMINED the completed opplicotion for permil, ond do hereby cerlify thot oll informotion hereon is true ond correct, ond I further certify thot ony ond oll work performed sholl be done in occordonce with lhe Ordinonces of rhe City of Springfield ond the Lows of the Stote of Oregon pertoining to lhe work described herin, ond thot NO OCCUPANCY will be mc<ie of ony structure without the permission of the Building Division. I further ertify thol my registrotion with the Builder's Boord is in full force qnd effecl os required by ORS 701.055, fhot if exempt ihe bosis for exemption is noted heron, ond thot only rubontroctors ond employees who ore in complione with ORS 701,055 will be ued on this proiect. Bo:ir for Builder's 2oNA,!lE (pleose print)DATE FOR OTFICE USE ONLY SIGNATURE Zone -Type/Consr.--Unitr -Sq. Ftg. Aloin x Vo lue x Volw I -Volue Fire Zone-Bedroom: occy Lood Sq. Ftg. Access FloodPloinstorier-occyGroup-Sq.Ft9.olher- TOTAT VATUATION Syslems Development Chorqe ( I .59'.) BUI[DING PERMIT Chorger ond Surchorges Plon Ck. Comm/lnd Per fee Plon Ck. Res Per Fee fotol Comb- Permit PTUMBING PERMIT Chorges ond Su r cho rges oc) Fence Demo ETECTRICAI. PERMIT Chorger ond S ur chorg e r Sidewolk C Pqvi MECHANICAT PERMIT Chorget ond Surchorgcr Curb Cut TOTAT qc)( -lnBt C -l :]J53^ A1e cho n ico I 0 a coMBINATION AppLtcATtoNipERM|T (CAp) l. Applicoru to furnish A. Job- Address B. Legol Descriptionl. exomole-rox-lot.I 00, Lone County Mop Reference IZ 03 43- 3: ffi;ttr.Lor r. Bro;k'3;;;:;;;?Iio., ro springrierd EsroresC. Nome, etc. of owner ond construction lenderD. _EnergySources., , CI. exomple-h.orl._l=.t.i.ol5gililg /or lorcedoir qos ( _ 2. eTfrEIE-wqrer heorer,, elecrricolrofj#a€E. Squore fooroge o. rolrotioi]lf,]_l. exomple-1250 sg. foo, house,500 sq. foot goroge (2. exl,mEE-iI;6^/ proiect, .fr..[;i"r_ir oddirion, cheodd, etc. PERMIT VATIDATION ITY OF SPRINGFIELD Cify Holl Springfield. Oregon Deporlment of Public Works OFFICIAT RECEIPT No. B 55873 (i .lF lg. H Building permit informo,ion:l. exomple-construct single fomily house with on oficgoroge 2. 3.3;gel.e-remodel exisring gorqge inro fomily roomgxgnlqe-convert single fomily residence intorestouront (chonge of use) Volue of work os defined in Secrion 303 (o) of theStructurol Speciolty Code OESlGN TEAM AND CONTR,ACTORS Iff "il j,ft'J n;; lJ,T:,,,u o i o n d e I o ys, B u i I d i n s D i v i s i, d u, i g n #o7; ; ;;"' ;.,'i:TTlT.?::ff i o t e p e rso n s re g c ( d Received For il rl(ns ll. Abbrevioted prumbing, Mechonicor & Erecrricor scheduresA. Except where blonk spoces occur in the descriplion porof rhe Mechonicot ond Elecrricol Siil;;;I.#I';;;f:;need fill-in only the No. Boxes odiicent r.ih.-"p!"r"piitem(s) ro be instolled ' B' Full Plumbing, Mechonicol, ond Electricor schecjuresore ovoiloble or the Building DivisionI. To conserve spoce on thJpermit form the scheduleshove been obbrevioted2. lf the item(s) to be instqlled ore no, covered on the (' ored schedures you shourd consurr rr," rrir ..r,1arilC. BUILDING DIVISION STAFF WILL Fttt OUT ALL FEES ANICHARGES ON THE SCHEDUTES lll. Applicont ro sign ond dote Whenever possible, rhe iniiio.l .opplicolion will be used os oworkshee, only. Where p"rriLl.IEriilins oivirion Sroff wilprepore o rypewrirten copy ond return iito the ;p;i;;";;the time the ocruol permit i. irrr"i'io, his signolure. lV. Fees ond Chorges Plon check fees ore due ond poyob.le ot lhe time of the oppond no plons will be processed until these fees ore poid. Alother fees ond chorges oru .iuu "it p.y"Uf";h;;;^:;;is issued- -"- r't l_ V. FOR OFFICE USE ONIY 1 (l ,l ( (u^zlo -oK-,rAmounl Received BY( AUIHOR'ZED SIGNATURE 9XftTOr'iutiluLt ptrxrfis Euoanf oR 9raot Permit Clerk IN\IA PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional prolect lnformotion: PTANS REVIEWED BYI signoture dote nome ( ( (. I I I