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Home My WebLink AboutPermit Plumbing 1981-03-10INSPECIION I.INE 72G3769 Job CIIY OF SPRINGf IEI.D COMEINAIION APPI.ICAIION / PERMII ENERGY SOURCES: Heo t Wqler Heoter Ron INFORMAIION IINE 72(F37St f Volue of W, (nome)(lics. no.)(expire s)(phone no.) Electricol J+ Phone (oddress) nomel no *\_i phone Legol De:cription irmPer IBuilding nfo:Describe B.e.,(;uild s len9 Fom n w;rhce Aroched Sq. Ftg- Moin 5q. Ftg, Access. 5q. Frg. Olher Owner Address Address Mechonicol DESIGN TEAM Ele clrico I Structurq I Prim -New -Add--Alter--Rep. I Use Mechonicol PLUMBING EtECTRiCAI.MECHANICAL No. i j rEE CHARGE NO.FEE CHARGE NO.FEE CHARGE i I Eoch ringle fixture Residence of --sq. ft. furnocefburner to =--=--_BTU'SRelocoted building (new fix. odditionol) New circuits, olterotions or exiensions A,ppiionce vent seporote 5.F. Residence(l both)SERVICES Stotionory evop. cooier Duolex (l both) eoch I Temporory Construclion Vent fon with single duct Additionol both Ampr. Yent system oport from heoting or A.C. Woter rervicc Mechonicol exhousl hood qnd ductISewerlne) Wood slove/ heoter Slorm Sewer FEEDERS Heot Pvmp Amps, Air hqndler to 10,000 cFM Air hondler over 10,000 CFlt4 ISSUANCE OF PERMIT TOTAL CHARGES l[)ao TOTAI CHARGES WHERE STAIE tAW REOUIRES rhot tha Electricol work be done by the Eleclricsl Conlrcctor, the electricol poriion of rhis permir rhall not be volid unril olobel hos becn rignad by on Eloctricol Controctor ond cfached to the electricol ponel- TOT,AL CHARGES I HAvE CAREFUttY EXAMINED rhe completed opplicotion for permit, ond do hereby certify thol oil !nformoiion hereon is true ond correct, ond I furtherGertify thot ony ond oll work performed sholl be done in occordqnca w;th the Ordinonces of ihe City of Springfield ond the Lows of the itote of Oregon Pertoining lo lhe work described herin, ond lhot NO OCCUPANCY will be mode of ony siructure withou, rhe permission of the Building Division. I furiirer@rrlfy thot my registrolion with the Builder's Boord is in full fcre ond effect os required by ORS 701.055, thot if exempt the bosis for exemption is'notedheron, ond thot oniy subconiroctors ond employeer who qre in complione wiih ORS 701.055 will be used on this proiect. Bosis for Euitder'r Boord exemprio ^, ftze \ fi trZr'/ tS o r'l NA,ME (pleose print)SIGNATURE DATE 3-/o-€/ FOR OFTTCE UsE ONTY Zone -Type/ Const, -Units -Sq. Ftg. Moin FloodPloinStoriEr-occyGroup-Sq,Flg.other-x-Volue TOTAI YATUATION Fire Zone-Bedrooms occy lood 5q. Ftg. Access x Volue x -VolueSystems Developmenl Chorqe (1.5%) PIon Ck. Comm/lnd 307"1 Per Fee Per Fee Plon Ck- Rer PIUMBING PERlyllT OC Demo Chorges ond S urch o rges Totol Comb. Permit ELECTRICAT PERMIT SidewolkChorges ond Sv rcho rg e: MECHANICAT PERMIT Curb CutChorges ond S urchorg e r TOTAT .t0/o O BUITDING PERMIT Chorges ond Surchorges -lA COMBINATION APPLICATIC."TT'PERMIT (CAP) Appliconr. to furnish A. Job Address B. Legol Description l. exomple-tox lot .l00, Lone County Mop Reference I7 03 43 2. exfipie--Lot I. Block 3, 2nd Addition to Springfield Estotes Nome, etc. of owner ond construclion lender electricol ceilingT'or forced oir gos Fe"tel:,Ie-Iect'io1|.o' E. Squore footoge or voluotion, etc. l. exomple-1250 sq. foot house, 500 sq. foot goroge 2. eEmFG-iTTew proiect, checkiEi-if oddition, check odd, etc. F. Building permit informotion: l. exomple-construct single fomily house with on ottoched goroge 2. exomple-remodel existing goroge inlo {omily room 3. Zt-FG-convert single fomily residence into restcwont (chonge of use) G. Volue of work os defined in Section 303 (o) oi the Structurol Speciolry Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construciion deloys, Building Division Stoff must be oble to contoct oppropriote persons regorCing design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing. Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description porlion 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 Eleciricol Scheciules ore ovoiloble ot the Building Division I. To conserve spoce on the permit form the schedules l hove been obbrevioted 2. lf the item(s) to be instolleo' ore not covered on the obbrevi- . oled schedules you should consull the fuil 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, Builciing Division Stoff will prepore o iypewritten copy ond return it to the opplicont ot the rime 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. Ail other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY c. D.Energy Sources I . exomple-heot,r, 2. exompG-woler PROJECT CONDITIONS TO BE SATTSFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: nome signo ture dote { PLANS REVIEWED BY: PERMIT VATIDATION Permit Clerk INSPECTION UHg 72G3769 CIIY OF SPRINGfIELD COMSINAIION APPI.ICAIION/PERMIT TNFORMATION LINE 72U3753 (nome)(oddre s s)(expires)(phone no.) l! De rcriprion j+ Singla R Phone no.) *n Phone Sq. Frg- Moin 5q. Ftg. Accesr. ENERGY SOURCES: Heq t Woter Heoler Ron Volue of therOwner ,Addre:s Suil Fo With Aroched Addrerr DESIGN TEAM Prim .g./ Ure Sq. Ftg. Other -New -Add--Alter-Rep. Permil lnfo: Describe Work (i.e., ,\techonicol nome)(phone no.)no s) Gencrol Plvmbing Electricol Mechonicoi PLUA1BING ETECTR iCAt MECHANICAL i FEE I CHARGEFlo. i No.l FEE CHARGE NO. i FE5 CHARGE I I i tg.h ringle fixturc Residence of it. furnocef burner lo .----BTU'T Relccoted buiiding {new {ix. ociditionol) New circuits, olterolions or exlensions Applionce vent sePdrqte S.F. Reridence (l both) I I SERVICES Slolionory evoo. cooler Duolex (l both) eorh I i I Temporory Conrlruclion Vent fon with single duct Additionol both ,Ampr. Vent system oport from heoting or A.C. Woler rqrYicc Mechonicol exhousl hood ond duct Vna/ I ,.*..) Wood slove/ heoier Storm Sewcr FEEDERS Heot Pump Ampr, Air hondler over r0,000 crM ISSUANCE OF PERMII TOIAT CHARGES IDOO TOTAL CHARGES WHERE 5rAIE tAw REQUIRES thol the Electricol work be done by the Electricql Conrioclor, the electricol portion of thi: permir ehall not ba volid unril olqbel hor ben rigncd by on Elcctricol conrracfor ond ottached to tho etectricol ponel. ICTAI. CHARGES to the work dercribcd heria. ond thot NO OCCUPANCY will be made of ony siructure my t.gitnation with the Euilcier'r Boord is in full {ore ond effect os required by ORS 7O1.O55, rn, ond thqt oniy lubcontrsstors ond employeer who ore in complione wiih oRs 701,055 will r ror Buitder'r Boord exemptio ^, ffze\ fr fZr/ AS a z't NAME (pleosc print) SIGNATURE -/o-€/OATE City of without pplico perioining hero Bo:i I HAVE CAREFUtIY EXAMINED rhe completed o lion for permit, ond do hereby cartify ,hot oll informoiion hereon is true qnd correcl, ond I furthercerlify thqt ony ond oil work pcrformed:holi be do ne in occordqnce with the OrCinonces of the Springfield ond the Lows of the Stote of Ore gonthe permisrion of rhe B uilding Division, I furthercsrtlfy thot thot if exempt the bosi: for exemption ir' noted be used on this proiect. FOR OffrCE UsE Ot{tY x Volue x Yolue x -Yolue TOTAT YALUATION, Ftg. Moin Flg. Access Flood Plqin toriel Occy Group Zone -Iype/ Consr, Sq. F19. Olher- Units -Sq. Syslems Developmenl Choroe (1.591) BUIIDING PERMIT Chorge: ond Surchorge: Plqn Ck, Comm/lnd Plqn Ck. Res Per PTUMBING PERMIT Chorger ond Surchorges OC Fence Demo Tolol Comb. Permit ETECTRICAI PERMII Chorges ond Svrchorge: c Sidewolk i I A,\ECHANICAT PERMIT Chorge: ond S urchorge r Curb Cut TOTAI /o ft) Air hondler to 10,000 crM Fire Zone-Bedroomr occy lood 5q, -+/) COMBINAIION APPLICATIb--,/PERMIT (CAP) l. Applicoru. to furnish -- A. Job Address B. Legol DescriptionI. exomple-tox lot'l 00, Lone County Mop Reference I7 03 432. exomple-Lor l. Block 3, 2nd Addition to Springfield EstoresC. Nome, etc. of owner ond construction lender D. Energy Sources PERMIT VALIDATIOT.I CITY OF SPRINGFIELD 2. exomple-heo el6li-EG-*ot t,/electricol ceilin ,/or forced oi! gos er eoter ectricol,,'or soloJ CifY Holl Springfield. Oregon o"oJ-"it of Public workr- brFtclAt REcEIPT No. B E. Squore footoge or voluqtion, etc. (l. exomple-l 250 sq. foot house, 500 sq. foor goroge2. "r;@tr-iFiIw proieo, .h;;[ ,"*-ii oddition, Jhe.;a;, erc. F. Building permit informotion: l I. exomple-construct single fomily house with on oilo<goroge 2. exomple-remodel existing goroge into fomily room r. rGfiEfiEnt (chonge of use) G. Volue of work os definecj in Seciion 303 (o) of the Structurol Speciolry Code H. DESIGN TEAIA AND CONTRACTORS To ovoid design or construciion deloys, Building DivisiorStoff must be oble to contoct oppropriote persons regor( !design informction or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules .A,. Except where blonk spoces occur in the description oorlicof the Mechonicol ond Electrico! Schedules, the oppiicont need fill-in only the No. Boxes odiocent to the oppropriot item(s) ro be insrolled 8. Full Plumbing, Me<honicol, ond Electricol Scheciules ore ovoiloble ot the Building Divisionl. To conserve spoce on the permit form the schedules hove been obbrevioted 2. lf the item(s) to be instolleo'ore not covered on the obb. oted scheduies you should consult the fuil schedules C. BUILDING DIVISION STAFF WILI FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Agplicont to sign ond dote Whenever possible, the initiol ooplicotion will be used os q worksheet oniy. Where possible, Builciing Division Stoff willprepore o iypewritten copy ond return it to the oppliconl ot the rime the octuol permit is issued for his signotuie. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the cpplicotond no plons will be processed until these fees ore poici. ailother fees ond chorges ore due ond poyoble when ihe permit is issued. V. FOR OFFICE USE ONLY s6013 te F Receiv ed For: ( ( Amou nt Rece ived -(D SIGNATUi EUGEHE Oi .,.O! 5Xf LroN luFreu!L PtlilEiS ( |- Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: signo tu re dotenomet PLANS REVIEWED BY: ( I ( (.