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Home My WebLink AboutPermit Mechanical 1981-01-26IN 72U3759 TINE CITY OT SPRINGFIETD COMBINAIION APPTICAIION I PERMII INFORMATION tINE 72U3753 Structvro I Electricol Eu2 TtcZ- t ? 74A z i 1^., o Phone b*22ofAddress \ 107-36 t ,!V<, " f 5. D,+ uzbc, Addresc Owner Legol Description / Other uilding Permit lnfo; Describe Work (i.e., Build Single Mo in AD lue of Work: Sq. Ftg. Accesr. Sq. Ft9. Other ENERGY SOURCES: --New---Add-Alter-ReP.ng"/ Ur" Woter Heo! k/ -2.-q:ICB()fiAddressPhone q ?u UJ T' DESIGN TEAM (nome)(oddress)(lics. no.)(expires)(phone no.) Primory no Electricol Mechonical a)o4Sor.u kr-l I PLUMBING I NO FEE CHARGE 0 t-t NO.FEE CHARGE ra ETECTRICAT NO. v4{ MECHANICAL V FEE CHARGE i Eoch sinqle fixture I Residence of --sq. ft. furnoce/burner to Relocoled building (new fix. odditionol) New circuiis, olterofions or extensigns Applionce vent sepqrqte S.F. Residence (l both)SERVICES Duplex (l bqth) eoch Temporory Conslruction Vent fon with single duet Additionol both Amps. Vent system oport from heotinq or A.C. Wqler service Mechqnicol exhoust hood ond duct Sewer Wood stove/heoier 5!) Slorm Sewer FEEDERS Heot Pump Ampr Air hondler to t0,000 cFM Air hondler over 10,000 cFM lO.OOISSUANCE OF PERMIT TOTAT CHARGES tsooTOTAT CHARGES WHERE STATE tAW REOUIRES thor thc Electricot work be done by rhs Electricol Controclor. the elcctricol portion of this permir rhqll not ba volid unril olobcl hos beon signed by on Elactrirol Controctor ond ottoched to thc electricol ponel. TOTAT CHARGES I HAVE CAREtUttY EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is ,rue ond correct, ond I further certify lhot ony ond oll work performed sholl be done in occordonce wifh the Ordinonces of the City of Springfield ond the Lows of the Stote of Oregon pertoining to the work described herin, ond lhot NO OCCUPANCY will be mode of ony slruclure without ihe permission of the Building.Division. t furtirer certify thot my registroiion with lhe Builder's Boord is in full force ond effect os reguired by ORS 701.055, lhot if exempt lhe bosis for exemption is noled heron. ond thot only subcontroclors ond employees who ore in complionce with ORS 701.055 will be OATE t-zL-(SIGNATUREM,, L Otn t \. ",n-, Bosi: for Builder's Boord exemptionr NArl{E (pleose print) .this proiect. FOR OFTICE USE ONTY Zone -Type/Consl. -Unils -_Sq. Ftg. flain x Volue x --Volue 1 -Vslue TOTAT VATUATION FloodPloin-slorier-OccyGroup--Sq.Fi9.other- Flg. AccessFire Zone-Bedrooms Occy Lood Systems Development Chorce (1.5olo) BUItDING PERrr{lT Pion Ck. Commf lnd Per Fee Plqn Ck. Res Per Fee Chorges ond Surchorges Totol Comb. Permit PTUMBING PERMIT Chorges ond Surchorges Demo ICAT PERMIT c SidewolkChorges ond Surchorger TOTAT lSco MECHANICAT PERMIT Chorges ond Surchorger Lurb LulLb Mechonicol CONTRACTORS (nome)(oddress)(lics. no.)(expires) Generol Plumbinq f r - BTIJ'S Stotionorv evop. cooler coMBtNATroN AppLrcATroN/pER.^ (cap) l. Applicont tp furnish A. Job Address B. Legol DescriptionI. exomple-tox lot 100, Lone County Mop Reference I7 03 43 2. exomple-Lot I. Block 3,2nd Addition ro Springfield Esrores C. Nome, etc. of owner ond €onstruction lender D. Energy Sources I exomple-heol/electricol ceiling /or lorced oir gos e-Io-frElE-w o t". T-6EIE;G@q | / o @-2. ilt E. Squore footoge or voluotion, etc. l. exomple-l 250 sq. foot house, 500 sq. foot goroge 2. exomFlE-iT-new proiect, check new'if oddition, check odd, etc. F. Building permit informotion: I. exomple-construct single fomily house with on oltqched goroge 2. exomple-remodei existing goroEe into fomily room 3. exompE-convert single fomily residence into ElTdu76nt (chonge of use) G. Volue of work os defined in Section 303 (cr) of the Structurol Specio lty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or conslruction deloys, Building Division Stoff must be oble lo contocl oppropriole persons regording design informction or iob site corrections, etc. 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 I. 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 schedules'you should consult lhe full schedules C. BUILDING DIVISION STAFF WILI. FILI OUT ALL FEES.AND CHARGES ON THE SCHEDULES Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Stoff will prepore o typewritten copy ond return it to the oPPlicont ot the time the octuol permit is issued for his signoture. 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. FOR OFFICE USE ONLY IV PERMIT VATIDATION Permit Clerk PROJECT CONDITIONS TO BE SAIISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: PLANS REVIEWED BY: nome signolure dote Legol Dercription VA fl-., AD Owner ,v Volue of Work: Sq. Ftg. Access. Sq. Flg. Orher ENERGY SOURCES: -N e w -Ad d-Alter-Re P' -Demo-Chonge/ Ut" Woler Heoi IhSPECTIO'N tINE 72(}.3769 INFORMATION IINE 7283753CIIY OF SPRINGTIETD COMBINATION APPI.ICATION/ PERAIIT Address l-? f S. D,+ uzbc, phone t *LSZAI F*,omily Residence With Attoched uilding Permit Inio: Describe Work (i.e.,Build Single 74A z lL,'L-nslruclion (/ q 2u u) T' Addresr Phone (expires)(phone no.)(lics. no.)DESIGN TEAM (oddress)(nome) Primory E Iectrico I Mechonicol Structuro I (exoire r)(phone no.)(lics. no.)(oddress)CONTRACTORS (nome) Generol Plumbing f\Electricol / cA s.o l.u l. il IMechonicole) PIU.UBING I 0 tt-t ,\lECHANICAL vc ETECTRICAL FEE CHARGE NO.CNC.FEE CHA.RGENO. i furnocel burner lo -BTU'S Residence of -.q. ftEoch sinEie fixture Applionce vent seporqte New circuits, olhrqtions or exlensions Relocoted building (new fix. odditionol) Stolionory evop. coo le rSERVICES S.F. Residence (l both) Yent fon with sinqle duclTemporory ConslruciionDuplex (l both) eoch Venl.syslem oport from heotino or A,.C.Amps.Addilionol bolh Mechonicol exhoust hood ond ductWqter terYice Wood slove/ heoier 5d ) Sewer Heot PumoFEEDERSStorm Sewer AtPt' Air hondler to't0,0c0 cFM Air hondler over r0,000 cFM /O,OOISSUA.T]CE OF PER}AIT t5coTOTAT CHARGESTOTAL CHARGES WHERE STATE tAV/ REOUIRES thqr rha Electricol work be done by lhe Eleclricql Contrcctor, lhe electritql portion of this permit rholl not ba volid until o lobel hor been signad by on Eleclriccl Conlrqctor ond ottoched lo lhe electritol pcnel. IOTAT CHARGES Ieted opplicotion for permit, ond do hereby certify lhol qll informotion hereon is irue onJ correcl. ond I further sholl be done in occordonce with the Ordinonces of the City of Springfield ond lhe Lows of the Stote of Oregon thqt NO OCCUpINCy will be mode of ony slructure without the permission of lhe Building Division. I further Boord is in full force ond effect cs required by ORS 70I.055, thol if exempt the bosis for exemplion is noted orP TURE DATE t-t_L { ihi s proiect, I HAVE CAREFULLY EXAMINED the comp cerrify thot ony ond oll work performed pertoining to ihe work described herin, ond ertify thot my regisfrotion with the Builder's who ore in complionce wirh ORS 701.055 will beheron, ond thot only subcontroctors ond employees Bq:ir for Builder's Boord exemptionr NArl{E (pleose print) FOR OFFICE USE ONtY Fire Zone-Bedrooms---------Occy lood 5q. Ftg' Accers x Vo lue x -Volue x -Volue TOTAI- YATUATION. FloodPloinStorie;-occyGroup-Sq.Ftg.other- Ftg, ,Y{oinZone -Type/ Consr. -Units Syslems Development Choroe (1.5%) Plon Ck. Comm/lndBUILDING PERMIT Per Fee Plon Ck. Res Per Fee Chorges ond Surchorges Totol Comb. Permit PTUMBING PERMIT Chorge: ond Surchorges Demo ELECTRICAL PERMIT c SidewolkChorger ond Surcho rg e r MECHANICAT PERMIT Curb CutL*Chorges ond Surchorges TOTAI.ls@ Moin -- I ( nC) COMBINATION APPLICATION/PER. l. Applicont ts furnish A. Job Address B. Legol Descriptionl. exomple-rox lot 100, Lone Cou2. exomple-Lot I. Block 3, 2nd Ad, (cAP) nty Mop Reference i7 03 43 dit ion to Springfield Estotes PERMIT VALIDATION CITY OF SPRINGFIELD (C. Nome, etc. of owner ond constructio n ienderD. Energy Sources I lectricol ceiii ,1or forced oir o52.eoter e ect co lio or CirY Holl Springfield, Oregon Deporiment of Public Works OFFICIAL RECEIPT E. Squore footoge o. rolrotioiE-l. exomple-.1_250 sg. foot house, 500 sg. foot gorog,z. exomple-if new project, check new-if oddition, ch;aa=r. F. Building permit informotion: l. exompie-construct single fomily house with on of1 ooroge : 2. exomple-remodel existing goroge into fomily roor3. @-convert single fomily rlsidence inro rGstEl?dnt (chonge of use) G. Volue of work os defined in Section 303 (cr) of the Structurol Specio lty Cocie H. DESIGN TEAM AND CONTRACTORS To ovoid design or ccnstruction deloys, Building Divis Stoff must be oble to contocl oppropriote pe.ron, r.eg, {in,design informction or [ob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A, Except where blonk spoces occur in the cjescripiion poi of the Mechonicol ond Elecrricol Schedules, the oppiicc need fill-in only the No. Boxes odiocent to the oppropr item(s) to be instolled B. Full Ptumbing, iAechonicol, ond Electricol Schedules ore ovoiloble or rhe Building DivisionI. 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 <' oted scheduies you should consult the full schedules C. BUITDING DIVISION STAFF WILL FILL OUT ALL FEES,ANt CHARGES ON THE SCHEDULES lll. Applicont to sign ond dore Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Stcff wil. prepore o lypewritten copy ond return it to the opplicont o.i the time the octuol permit is issued for his signotuie. lV. Fees ond Chorges l{0. B 55663 ,,B\Dote R F s %,513 ( (t \n (l 'l ,.f (oo ( Amoun t Received BY I AUTHORIZEO RE SHELTON'IUR!BULL PRIXIERS ' EUGENE Oi 9"OI 56tll 6 Permit Clerk ( (.PIon check fees qre due ond poyoble ot the time of the oppold no plons will be processed until these. fees ore poid. ,lll (other fees ond chorges ore due ond poyoble when ihe perrr. is issued. +- V. TOR OFFICE USE ONLY Additional Proiect lnformorion: PLANS REVIEWED BY: PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: _dnomesignolure qte ( I I