HomeMy WebLinkAboutPermit Plumbing 1982-11-08INSPECTION IlNE
7263759
CITY OT SPRINGfIEID
CO'ITBINAIION APPTICATTON/ PENMII
INIORMAIION I,INE
72&.3753
ZJob Address
Legol De
ENERGY SOIJRCES:
Heot
-
Woter Heoier
Ro
Sq. Ftg. Moin
Sq. Fig. Accei3.
Sq. Ftg. Olher
-New-Add-Alter-ReP.
-Fence-Demo-Chonge/
Use
-Orher
-
DA
N
N
D
-t$
Volue of Work:
Owner
I ?j#-, ?h"^:14b-1lltAddress l23q t)Building Permit lnfo: Describe Work (i.e., Build Single
Fomily Residence With Attoched Goroge)
struclion Lender
Addre ss Phone
DESIGN TEAM (nome)(odd ress)(lics. no.)(expires)(phone no.)
Primo ry
Strucluro I
Electricol
Mechqnicol
CONTRACTORS (nome)(oddress)(lics. no.)(expires)(phone no.)
nerol oPlumbinq
Electri col
Mechonicol
PTUMBING ETECTRICAT MECHANICAL
NO.FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE
Eoch single fixture
Residence of
fr.
furnoce/burner to
Relocoled building
(new fix. odditionol)
New circuils, olterotions
or extensions
Applionce vent
sepo rote
S.F. Residence
(l both)SERVICES
Stotionory evop.
cooler
Duplex (l both) eoch Temporory Conslruclion
Vent fon with
single ducl
Additionol both Amps.
Vent syslem oport from
heoting or A.C.
Woler service
Mechonicol exhousl
hood ond duct
Sewer Wood stove/heoter
Storm Sewer FEEDERS Heot Pump
Amps.
Air hondler lo
t0,000 cFr'A
Air hondler over
10,000 cFM
ISSUANCE OI PERMIT
TOTAT CHARGES TOTAT CHARGES TOTAT CHARGES
WHERE STAIE tAw nEQUIRES thot th. Electricol work be done by the Electricot Conhoctot, rhe olectricol poilion of this parmit shqll not ba volid untit o
lobel hss been signed by qn Eleclrics! Conlractor qnd offochod to lhe cleclricol pcnel'
I HAVE CAREFULLY EXAI INED the ompleted opplicotion for permit, ond do hereby certify lhol oll infomotion hereon is lrue ond correct, ond I further
certify thot ony ond oll work perform,ei sholl be done in qcordqnce with the ordinonces of the city of springfield ond the Lows of the stole of oregon
pertoining to tie work describei herin, ond thot NO OCCUPANCY will be mode of ony structure without the permission of rhe Building Division. I furlher
certlfy thot my registrotion with the Builder,s Boord is in full fore ond effect os required by ORs 701.055, lhot if exempt lhe bosis for exemplion is noted
heron, ond *,tt Jnly subcontroctors ond employees who ore in complione with oRS 7o1.055 will be used on this proiect.
Bosis for Builder's Boord
NA.ME (pleose TURE DA
FOR OFFICE USE ONIY
Zone
-Type/Const.-Units
_.-Sq. Ftg. Moin 1--Volue
1 ---Volrex
-Volue
TOTAI. VAI.UATION
Fire Zone-Bedrooms occy lood Sq' Ftg' Access
Flood ploin
-srorier-Occy
Group-Sq. Ftg. Olher-
BUITDING PERMIT
Chorges ond
Surchorges
Plqn Ck. Comm/lnd s Development
Per Fee
Plon Ck. Res
Per Fee
PTUMBING PERMIT
Chorges ond
Surchorges
Demo Totol Comb. Permit
ETECTRICAT PERMIT
Chorges ond
Surchorges
Sidewolk
MECHANICAI. PERMIT
Chorges ond
Surchorges
Curb Cut
TOTAT M0 tr6
l-
a)o trf€
Fence
A/C Pavino
CoMBTNATTON APPLICATION/PEtu*i (CAP)
Applicont to furnish
A. Job Address
B. Legol Description
I. exomple-tox lot 100, Lone County Mop Reference l7 03 43
2. diompl6-Lot l. BIock 3,2nd Addition to Springfield Estotes
C. Nome, etc. of owner ond construction lender
D. Energy SourcesI. exomple-heot/electricol ceiling,/or forced oir gqs
2. exo m alE-wo re rIGIE r/El-ect.i co I / ", @-
E. Squore foologe or voluotion, elc.
I
2
exom le-I 250 sq. fool house, 500 sq. foot goroge
iT new proiect, check new-if oddition, checkexome-
elc
F. Building permit informolion:I. exomple-conslruct single fomily house with on oltoched
goroge
2. exomple-remodel existing goroge into fomily room
3. exompG-convert single fomily residence into
restouront (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structuro I Specio lty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or conslruclion deloys, Building Division
Stoff must be oble to conloct oppropriote persons regording
design informqtion or iob site corrections, etc.
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 Schedules
ore ovoiloble ot the Building Division
'l . 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 the full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dole
Whenever possible, the initiol opplicotion will be used os o
worksheet only. Where possible, Building Division Stoff will
prepore o lypewritten copy ond return it to the opplicont ot
the lime the octuol permit is issued for his signoture.
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
other fees ond chorges ore due ond poyoble when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Project lnformotion:
PTANS REVIEWED BY
nome signoture dote
- PERMIT VALIDATION
Permil Clerk Q J--
O/r
$