The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1981-03-27INSPECTION tINE 72e,1769 INFONMAIION LINE 72C3753 CITY OF SPRINGTIETD COMBINAIION APPIICAIION/ PERIIAIT LL46 N3lAddre rs Legol Dercription .1L Phone Owner Addre ss Building Permit lnlo: Describe Work (i.e., I Volue of Work: Single Reriden ENERGY SOURCES: Wo ler Heoler Heot Sq. Frg. Moin 5q. Ftg. Acce:r. -New.-Add--Alter-ReP.- - -Fence--Demo-Chongel' Use 5q. Ftg. Olher -- Other ------ 1ql- il-qD Con:truction [ender oc ; (] tr.lN-> PhoneAddress DESIGN TEAA{(nome)(oddresr)(lics. no.)(expires)(phone no.) Primory Strucluro I Electricol Mechonicol CONTRACIORS (nome)(oddress)(lics. no.)(expires)(phone no.) Generol Plumbing Electricol tlechonico I PTUI^B ING ETECTR ICAt ,MECHANICAT NO i FEE CH.dRGE NO.FEE CHA,RGE NO.aaE CHARGE I Eoch sinqle fixture I Residence of --sq. ft. furnocef burner lo --BTU'SRelocoted building (new fix. ociditionol)I I New circuits, olterotions or extensions Appiionce vent sepo ro re S.F. Residence (l borh)SERVICES Stoiionory evop co o ler Duolex (l both) eoch Temporory Conslruciion Vent fon wiih single duct Additionol both Amps. Vent syslem oport from heotinq or A.C. Woler rervice Mechonicol exhoust hood ond duct Sewer Wood slove/ heoter Slorm Sewer FEEDE RS Heol Pump Amps, Air hondler to'r0,000 cFM Air honciler over r0,000 cFM ISSUANCE OF PERMIT TOIAT CHARGES TOTAT CHARGES WHERE SfAIE rAW REQUIRES rhol lhe Electritql work be done by tha Eleclricsl Conrroclor, the electricol portion of this permil sholl noi be valid unril olqbel hor been signed by on Elactricol Controclor ond qttoched to lhe electricol pgnel. TOTAT CHARGES I HAVE CAREFUttY EXA^rlNED the completed opplicqtion for permil, ond do hereby cerlify thot oll informoiion hereon is true ond correct, ond I furthercerrify thot ony ond oll work performed sholl be done in occordonce wiih the Ordinonces of rhe City of Springfield ond the Lows of the Slore of Oregon Pertoining lo the work described herin, ond lhor NO OCCUPANCY will be mode of ony sirucfure withou, the permission of the Euilding Division. I furiirercerllf), thqt my regi5trorion with the Builder's Boord ir in full fore ond effect os required by ORS 701.055, thot if exempt the bosis for exempiion is notedheron, ond ihot oniy subconlroctors ond employees who ore in complione with ORS 701.055 will be used on this proiect. DATES Bosis for Builder's Boord exemption: NAME (pleose prinr) FOR OFI!CE UsE FloodPloin-Storie3-OccyGroup-Sq.Flg.orher x Vo lue x -Volue 1-Yolue lypef Const. Bedroom:Occv Iood 5q. Ftg. Access TOTAI. VALUATION nils -Sq. Ftg. irloinZone - Fire Zone- Syslems Developmenl Chorqe (1.5%) BUIIDING PERMIT Chorges ond Surchorges Plon Ck. Comm/lnd B Per Fee 30?Ll Per Fee Plon Ck. Rer PTUMBING PERMIT Chorges ond Surchorges Fence Demo Totol Comb. Permit ETECTRICAI PERMIT SidewolkChorges ond Surchorges MECHANICAT PERMIT Chorges on- Surchorger Curb Cut TOTAT YfEZ:EJ-Aon, ),>,l-rndo 0. a/c P.,;^- COMBINATION APPLICATION;PEr^r (CAP) l. Applicoru. fo furnish A. Job Address B. Legol DescriptionI. exomple-tox lot.l 00, Lone County Mop Reference .l 7 03 432. exomple-Lor l. Block 3, 2nd Addition to Springfield EsrotesC. Nornl "t.-. of owner ond construction lender D. Energy Sources 2. exomple-heo e-xor,plE-*ot t./electricol ceilin ./or forceci oir gos er eoter.,e eci tinco or solor E. Squore footoge or voluotion, etc.I. exomple-1250 sq. foor house.5C0 sq. foot goroge2. exom';le-iT-n-Iw proiecr, .t",e.[ n.*-ii ocidirion, cieck odd, etc. F. Building permit informotion: l. exomple-conslruct single fomily house with on ottoched goroge 2. exomple-remodel existing goroge into fomily room3. ;;;;-Ta-convert single fomily residence into restouronl (chonge of use) G. Volue of work os definecj in Section 303 (cr) of the Structurol Speciolry Code H. DESIGN TEAIA AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to contoct oppropriote p...on, regoriing design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicql & Electriccl Scheduies A,. Except where blonk spcces occur in the description oortion of the Mechonicol ond Electricol Schedules, rhe oppiicont need fill-in oniy the No. Boxes odiocent to the oppropriote item(s) to be instollecj B. Fuil Plurnbing, Mechonicol, ond Eleciricol Scheciules ore ovoiloble or the Building Division I. To conserve spoce on the permil form the schedules l hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on the obbrevi-. oted schedules you should consult rhe fuil schedules C. SUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont fo sign ond dote Whenever possible, the initiol opplicotion will be used qs q worksheet oniy. Where possible, Builciing Division Sroff will prepore o iypewritten copy ond return it to the oopliconl oi the time 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 PERMIT VATIDATION Permit Clerk c PROJECT CONDITIONS TO BE SATISIIED BEFORE OCCUPANCY: Additional Proiect lnformotion: nome signqture dote PLANS REVIEWED BY: : clTY oF sPRtNcf tEtD coMBtNATtoN aPpttcArtoH/prnntl INFORMAIION tINE 72C3753INSPEC'ION TIN€ 72G3769 Addrcsr LL+5 N3l I Ro ENERGY SOURCES: Heot - Woler Heqler --- Sq. Ftg. Moin 5q. ttg. Acce:r. -New -Add--Alter-RaP. - -Fence--Demo -Chong"f U sa _ rL-. Sq. Ftg. Other Volue of Work: De:cribe Work (i.e., Build Single boFomi Bui ng Permil I Re:ide nceeddrert ?-Phone O N, D PhoneAddrer DESIGN TEAM no.)no.)(no me) nicol Plumbinq Elecrricol Mechonicol MECHANICALETECTRICAT)Ptul^9rNG FE5 CHARGEFEECHARGENO. iCHARGENO. INo. I i FEE furnocei/burner lo TU'T Residence oI ---rq. ft,Eoch ringle fixture I Appiionce vent 5eporo re New circuits, olterotions or extensions Relocoted buiiding (new fix- ociditionol) Stoiionory evop coo lerSERVICES S.F. Residence (l both) Vent fon with sinqle ductTemporory ConslructionDuolex (l both) eo<h Yent sy5lem oporf from heoting or A.C.Ampr.Additionol both Mechonicol exhsust hood ond ductWoler rervice Wood stove/ heolerSewer Heol PumpFEEDERSSlorm Sewer Air hondler lo I0,000 cFMAmpr. Air honciler over '10,000 cFM ISSUANCE OF PERA,\IT TOTAT CH^RGES TOTAL CHARGES WHERE STAIE tAW REOUIRES lhot iha Electricol work be dona by lhe Electricol Contrqctot, the ;lettricql portion of fhis permit sholl not bo volid unril o lqbel hor bcen rigned by on Elocrricol Controdot ond oltochad to the electricol pcnel. TCTAL CHARGES I HAVE CAREFUTIY EXAA^INED the completed opplicqtion for permit, ond do hereby certify thot oll informoiion hereon is lrue ond correct, ond I furrher <errify thor ony ond oll work performed sholl be done in occordonce with the OrCinonces of the City of Springfield ond lhe Lows of the Slote oi Oregon pe*qiniog to the work described herin, ond thot NO OCCUPANCY will be mode of sny siruclure without lhe permission of the Building Division. I further cortlfy thot my regiitrorion wirh the Builder's Boord ir in full force ond effect os required by ORS 70I.055, thot if exempt the bosis for exemplion is noted heron, on<i thot only subcontroctor5 ond employees who ore in complione wiih ORS 701,055 will be used on thir proiect. NAME (pleose prinr) SIGNAIURE DATE Bosis fo: Euilder's Boord exemption: FOR OTFICE UsE ONLY Zonc-Type/Const'-Unils-5q.Frg.lr{oinxVolug rooms ------_-.Occy Lood Sq. Ftg. Access FloodPloin-Storiel-OccyGroup-sq.F'g.olher- Fire TOTAT VATUAIION x -Volue x -Volve Systems Developmenl Chorqe (1.5?'i) BUItDING PERrrllT Chorge: ond Surchorges Plon Ck. Comm/lnd Plon Ck. Res Per Fee Per Fee fotol Comb. Permit PTUMBING PERMIT Chorges ond S urchorger Demo ETECTRICAT PERMII Chorger ond Surchorger A c Sidewolk MECHANICAT PERIAIT Chorger onl Surchorger Curb Cut TOTAI. (odCress)(lics. no.)(expires)(phone no.).6NTPACTORS (nome) COMBIN.ATION AppLICATtON :, pE l. Applicoru. ro furnish A. Job Address B. Legol Description . l. exomple-lox -lot .l 0!, -Lole.County Mop Referen' ^ 2. exomoie-Lot l. Block 3, 2nd Addition ro Soringfi rEsC. Nome, etc. of owner ond construclion lender - i D. Energy Sources I. exomple-heot.'electricol ceilinou'2. e-iEEEi6-*,o re r IEJGfTEGEi?tso I Sguore footoge o. rrolrotioill[]- ,T (CAP) or forceo' oir qo: or solor PERMIT VATIDATION CITY OF SPRINGFIELD Cify Holl Springfield, Oregon Deportment of Public Works OFFICIAT RECEIPT ( ( E. I 2 . exom e- I 250 sq. foot house, . exom new proiecl, check , elc 5C0 sq. foot ooroc nEi"-ii ocidition, c'i ( (ne Ilo. B 561813-l9F. Building permit informorion:l. exomple-construct single fomily house with on ogoroge 2. excmple-remodel exisring goi,oge inlo fomily ro<3. exd;;E-ccnvert single fo,;ily r-esidence intorEiEiT6nt (chonge of use) G. Volue of work os definecj in Section 303 (o) of theStructurol Soeciolry Code H. DESIGN TEAM AND CONTRACTORS To ovoid Cesign or consiruciion deloys, Building DivStoff mus, be oble to contoct opproprioie purrJr. .udesiEn informction or iob site correclions, etc. ll. Abbrevioted Plumbing, Mechonicol & Erectricor scheduirA. Except where blonk spcces occur in the description rof the Mechonicol ond Electricol Schedules, the oooiineed fill-in oniy the No. Boxes odiocent to the opprcitem(s) ro be insrolled 8. Full Plurnbinq, Alechonicoi, ond Eleciricol Scheciulesore ovoiioble or the Building DivisionI. To conserve spoce on the permit form the schedul hoye been cbbrevioted 2. lf the item(s) to be instolled ore not covered on th. o,eci schedules you should consult the fuil schedulC. SUILDING DIVISION STAFF WILL FILL OUT.ALL FEES A CHARGES ON THE SCHEDULES lll. Agplicont to sign ond dote Whenever possible. the initiol ooplicotion will be used oworkshee, oniy. Where possible, builciing Division Stoff , prepore o iypewrilren copy ond rerurn it to the opplicon the time the octuol permit is issued for his signotule. lV. Fees ond Chorget ,{Plon check fees ore due ond poyoble ot the time of the c --:.ond no plons will be processed until these fees ore poid. yrt) other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY d ( Received For: O Amounl Received ( ( (; ( 6r ( (' ( ( ( ( BY ,n I | . -sxrrror.ruareurr larrrens EUGENE oR er.or !a!r!.a \ C ( ( (. 1 Permit Clerk PROJECT CONDTTIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: nome signoture dote PLANS REVIEWED BY; -- tO.4e e lr'-