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HomeMy WebLinkAboutPermit Fence 1981-04-27Job ENERGY SOURCES: INFORIAAIION TINE 72&3f 53 INSP€CTION IINE 72U3769 CITY OF SPRINGFIETD COMBTNAIION APPTICAIION I PERMII Heot - Woter Heoter -- Sq. ttg. Main Sq. Ftg. Acccrs' Sq. Frg. Other Addrers Ra\ N. \Bqft St,Phone Fomilv Reridence With Aroched Goroqe) Euilding Permit lnfo: Dercribe Work (i.e., Build Single 1*b-Lo1rg*\r-[tr't $tq- I.o.lilX)."r",-,-{ Q'b or:\ )o' l- RP\ I IAddrer:Phonc OESIGN TEAM (nome)(lics, no.) (expirar)(phone no.) Primory Alcchoni<ol Electricol Mechonicol ETECTRICATPTUMBING MECHANICAL FEENo.FEE CHARGE NO CHARGE NO.FEE I CHARGE Eoch cinqle fixture Residence of --tq. ft. furnoce/'burner lo -BTU'T Relocoled building (new fix. odditionol) New circuifs, qlteroiions or extensions Applionce vent Sepq ro te S.F. Reridence (l both)SERVICES Stoiionory evop. cooler Temporory Conrlruclion Vent fon with sinqle ductDuolex (l both) eoch Additionol both Ampr. Vent syslem oporf from heofing or A,C. Wotar retvice Mechonicol exhqust hood ond ducr Scwer Wood:love/heoier Slorm Sawer FEEDERS Heot Pump Ampr, Air hondler to t0,000 cFA{ Air hondler over I0,000 cFA{ ISSUANCE Of PERMIT TOTAI CHARGES IOTAL CHARGES WHERE STAIE tAW REQUIRES rhol lhe Electricol work be done by the Eleclricol Contrsctor, the alectricol porlion of lhir pcrmit rholl not be volid unril o lobel hos bccn :igncd by on Electrical Controctor ond ottochsd to the electricol ponel. TOTAI. CHARGES I HAVE CAREFULIY EXAMINED lhe completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is rue ond correct, ond I furrher certify thot ony ond oll work performed sholl be done in occordonce with the OrCinqnces of the City of Springfield ond the Lowr of the Stote of Oregon pertoining lo lhe work dcrcribed herin, snd thor NO OCCUPANCY will be mode of ony siructure without the permission of rhe Building Division, t further certlfy thor my .egittroiion with rhe Builder's Eoord is in full fare ond effect os required by ORS 701.055, thot if exempt tha bosis for cxemption is'noted heron. ond lhot only subconlrociors ond employees who ore in complione wiih ORS 701.055 will be used on this proiect. SIGNATURE DATE Boris for Builda/c Boord cxcmption: NArftE (pleose print) FOR OFTICE UsE ONLY Zonc -Type/Const, -Units --Sq. x Yolue x --Voluex -Yolue IOTAI. VATUATION Fire Zone-Bedrooms ccy Lood Sq. flg. Accesr Flood Ploin torior-Occy Group-Sq. Flg, Other- Ftg. Main Syslemr Devalopmenl Chorqe ( I .5?'o) BUITDING PERMIT Chorges ond Surchcrger Plon Ck. Comm/lnd Per Fee Plqn Ck. Ra: Per Fee /o. oo Tolol Comb, Permit PLUrrlBlNG PERMIT Chorges ond Surchorges fence Demo ETECTRICAI. PERMII Chorger ond Surchorger c Sidewolk MECHANICAT pER,\ tT Chorger onl S urchorg e r Curb Cut TOTAT I - New --Add--Alter-ReP. ffip"mo-chonge/ Use EO Volue of Work: (oddrer:) (lics. no.)(ohano na I{oddress)(exoires)aoNTRACTORS (nome) +v)E) C,od . COMBINATION APPLICATION,'Pr{ IT (CAP) l. Appliconf. to furnish'A. Job Address B. Legol DescriptionI. exomple-rox-lot,lOp,-Lo1e County Mop Reference I7 0- - 3. @-Lot I. Block 3, Z"a aJJit,{on to Sprinsfietd EsrcC. Nome, etc. of owner ond construction lenderD. Energy Sources l. exomple-heot,'electricol ceili col 'or forced oir oos/:+.'or solor2exomote-woter eoter eci PERI\,IIT VATIDATION _ctTY OF SPRTNGFTELD Ciry Holt Springfield, Oregon Deportment of public WorksOFFICIAT RECEIPT No. B 50376 r I ) I,E. Squore fooroge or. "olrotioilr-l]-I =+ef-.l2lg rq. foor house, 500 sq. foot sorosel. exomole-rt new proiecl, check new-if ocjdition, check;A-f. F. Building permit informotion:l. exomple-construct single fomily house with on ottochegoroge 2. exomple-remodel existing goroge into fomily room3. exom;l-e-converr single fir;ily residence into relTEGEnt (chonge of use) G. Volue of work os defined in Secrion 303 (o) of theStructurol Soecio lry Code H. DESIGN TEATA AND CONTRACTORS To ovoid design or construciion Celoys, Building DivisionStoff must be oble to contoct oppropriote p...Jn, regor.didesign informction or iob site corrections, etc. ll. ,A,bbrevioted Plumbing, Mechonicol & Electricol Schedules A, Except where bionk spoces occur in the description portioof the Mechonicol ond Electricol Schedules, the oppiicont need fill-in oniy the No. Boxes odiocent to the oppropriot item(s) to be insrolle<j B. Fuil Plumbing, Mechonicoi, ond Elecrricol Scheciules ore ovoiloble or the Building Division I. To conserve socce on the permit form the schedules hove been obbrevioted 2. lf the irem(s) to be instolled ore not covered on the ob. oted scheduies you should consult the fuil schedules C. SUILDING DIVISION STAFF WILL FILI OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible. the initiol opplicorion will be used os o worksheet oniy. Where possible, Builciing Division Stoff will prepqre o iypewritten copy oncj return it to the opplicont ot the rime fhe octuol permit is issued for his signotuie. lV- Fees cnd Chorges Plon check fees ore due ond poyoble ot the time of the oppl,, ond no plons will be processed until lhese fees ore poia. ,lttL other fees ond chorges ore due ond poyoble when ihe permit is issued- V. FOR OFFICE USE ONLY Address 6A \K\tr { ( ( ( ( ( ( l|vr' Dote Rec' I9 \\ For ( Amount R eceived ( (.EY AUTHORIZEO SIGNATURE SHELTON.IURI'U!L PRINTERS - EUGENE OR 97'O! Permit Clerk 3a5tt.a ( PROJECT CONDTTIONS TO SE SATTSFIED BEFORE OCCUPANCY: Additionol Pro[eo lnformorion: nome signoture ote PLANS REVIEWED BY: ( (