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Home My WebLink AboutPermit Mechanical 1981-08-31INSPECTION tINE 726376r) clrY COMBINATION TtON/PERI'III INFOBIIAAIlON TINE 7263753 Job Address Legol Description ENERGY SOURCES; l.leC+ Woter Heoter -...._=---- ae Ro Sq. Ftg. Moin Volue of Sq. Ftg. Access. Sq. Ftg. Orher -New-Add-Alter-ReP.nge/ Use Owner Describe Work (i.e.,SingleBuilding Permit lnfor ResidencePhoneAddress-1---=-81 d Constr 5 IB IU Address Phone (lics. no.)DESIGN TEAM no.)(odd ress)(nome) Primo Mechonicol Electricql Mechonicol MECHANICAL CHARGEFEE ETECTRICATPTUMBING NO.FEE CHARGECHARGENO.FEENO.furnoce/burner toResidence of frEoch single fixture Applionce vent seporole New circuils, olterqtions or extensions Relocoted building (new fix. odditionol) Slolionory evop. coo lerSERVTCES S.F (l Residence bqth) Vent fon with single duttTemporory ConslructionDuplex (l both) eoch Yent system oport from heqtinq or A.C,Amps.Additionol both Mechonicql exhoust hood ond ductWoler service <( t ). (} Wood stove/ heoterSewer Heqt PumpTEEDERSSlorm Sewer Air hondler to r0.000 cFMAmps. Air hondler over r0,000 crM rssuANcE oF PERMTT lc.u) TOTAT CHARGESTOTAT CHARGESTOTAT CHARGES WHERE STAIE tAW REeUIRES rhor rhe Etecrricol work be done by the Electricol Confroclor, tha eleclricol porlion of this permit rhqll not lre volid until o lobel hss been signad by on Electricot Conlrqclor ond ottqched to the electricol ponel. I HAVE CAREFULTY EXAMINED the completed opplicotion for permit, ond do hereby certify lhot oll informotion hereon is lrue ond correct. ond I further certify thot ony ond qll work pe.rformed sholl be done in occordqnce with the Ordinonces of the City of Springfield ond the Lows of the Stote of Oregon pertoining to t'he work described herin, ond rhot NO OCCUPANCY will be mode of ony structure withoul the permission of the Building Division. I further ertlfy thot my registrotion with, the Builder's Boord is in full force ond effect os required by ORS 701.055, lhot if exempt lhe bosis for exemption is noled heron, ond thot only subcontroctors ond employees who qre in complionce wirh ORS 7OI.055 will be used on this proiect. SIGNATURE DATE Bosis for Builder's Boord NAME (pleose print) FOR OTIICE USE ONTY Flood Ploin Stories-Occy Group-Sq. Ftg. Other- x Volue x Volue x -!6lsg TOTAL YATUATION, Sq. Ftg. Access Zone Const,-Units -Sq Fire Zone-Bedrooms Occy lood PIon Ck. Comm/lnd 6596/Blds Per Fee s Development 0.5%\ Sysfemr Chorqe BUITDING PERAAIT Chorges ond Surchorges Plqn Ck, Res 30"/of Blds Pet Fee Fence PTUMBING PERMIT Chorges ond Surchorges Demo fotol Comb. permit Sidewolk lcAt II Chorges ond Surchorges A/C Pqving Curb Cut MECHANICAI. PERMIT Chorges ond Surchorges IOTAT Mlsb F tC\ H \\1q \"(\ U Ftg. t\{oin COMBINATION APPLICATTON/PERMt] rcAp) Applicont to furnish A. Job Address B. Legol DescriptionI. exomple-lox lot 100, Lone County Mop Reference I7 03 432. exomple-Lot l. Block 3,2nd Addirion to Springfield Estqtes C. Nome, etc. of owner ond construction lender D. Energy SourcesI. exomple-heot/electricol ceiling /or torced oir gos 2. exo mFIE-w o te r Teo G iTel-ect ri co l / "l@_-E. Squore foologe or voluotion, etc. exomple-l 250 sq. foot house, 500 sq. foot goroge exomFiE-iT-newproiect,checi-new-iioddiri'on,c'heck odd, etc. F. Building permit informotion:l. exomple-construct single fomily house with qn ofioched goroge 2. exomple-remodel existing goroge into fomily room 3. exompfe-convert single fomily residence inlo restouront (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to conlocl oppropriote persons regording design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricql Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only rhe No. Boxes odiocent to the oppropriote item(s) to be instolled B. Full PIumbing, Mechonicol, ond Electricol Schedules 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 instolled ore not covered on the obbrevi- oted schedules you should consult rhe full 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, Building Division Stoff will prepore o typewritten copy ond return it to the opplicont ot fie time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble qt 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 TERMIT VAI.IDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAN€Y: Additionol Proiect lnformolion: PTANS REVIEWED BY: signoture dote nome CITY OF SPTINGTIETD COMBIN;iION APPTICAIION / PERI^II INFORISAITON IINE 726.3753 INSPECITON I.INE 7?.63769 DESIGN TEAM Electricql Mechonicol U (oddress)(lie.no.)(nome) Lr\ ENERGY SOURCES: Heot Woter Heoler legol Sq. Ftg. Moin Sq. Etg. Accesr' Sq. Frg. Other -New -Add-Alter-ReP.UseVolue of ()o Owner Describe Work (i.e., Build SingleBuilding Permit lnfo: PhoneAddre:s PhoncAddresr EI.ECTRICATPTUMBING FEE CHARGE NO.FEE CHARINO.FEE CHARGE NO. Eoch sinqle fixture Reridence o{ -sq. ft. furnoce/burner lo -BTU'S Relocoted building (new fix. odditionol) New circuits, olterotions or extensions Applionce vent seporqte S.F. Residence (I both)SERYICES Sfotionory evop. cooler Duplex (l both) eoch Temporory Conslruction Yent fon with single ducf Additionol both Amps. Vent syslem oport from heofing or A.C. Wqler reryice Mechonicol exhoust hood ond ducr Sewer s.r Slorm Sewer FEEDERS Amps.I Air hondler to A.ir hondler over cFn TOTAI. CHARGES TOTAT CHANGES ISSUANCE OF PERMIT tD. ATTOTWHERE CHARGESSTATE,wTA REQUIRES rhe Elcctricol work be donehqslobel rhebecnby Elactricolsignedqnby rhcConrroctor,Electricql Contioctot ele$ric€tond porrionqttochcd rhistothc pcrmitclectricol rholl not bcPonol.vqlid until o SIGNAIURE DAIE NAME (pleose print) roR OFFICE USE ONTY Flood Ploin A{oinFtg. Zone Fire ryP"/ co.rt. Eedrooms Group ---Sq. Flg. Other IOTAI VAIUAIION ________Occy lood Ftg. Access x Voluex yolue x Vqlue Plon Cl<.Comm/lnd BUIIDING PERMIIcharge, qnd Surchorger Plon Cl,Res DamoChorges ondSurchorges fotol PERMIT Curb Cut IOTAI MECHANICAI Wood stova/heotr thot of COMBINAIION APPLICATION/PERMIT (CAP) l. Applicont to f urnish A. Job Address B. legol Descriptionl. exomole-tox lot 100, Lone County Mop Reference l7 03 43 ^ ?: ffi-Lor l. Bto;k'3);;jiiion ro sprinsfietd EstoresC. Nome, etc. of owner ond construcrion lenderD. Energy Sources (l. exomple-heot/eleoricol ceiling/or forced oir oos2. exEmEE-woterIEEIEi,GlEI colior r6ffi E. Squore footoge or voluotion-*t.. L' exorpiel,*O rO. +"ot f,orr", SOO sg. foof goroge l'. 2. exomple-if new proiecr, check new-ii odditi*on, ."huc odd, etc. F. Building permit informotion: ( PERMIT VALIDATION CITY OF SPRI NGFI EID Ciry Holl Springfield, Oregon Deporlmenf of Public Works OFFICIAI RECETPT ilo. B 571S7 I9l. exomple-construct single fomily house with on otto goroge 2. exomple-remodel existing goroge into fomily room3. @-convert single fomily residence into reitouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of rhe Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Divisir Stoff must be oble lo contocl oppropriote persons regc design informotion or iob site corrections, etc. ll. ,Abbrevioted Plumbing, Mechonicol & Elecrricol Schedules A, Except where blonk spoces occur in the description por of the Mechonicol ond Electricol Schedules, the opplico need fill-in only the No. Boxes odiocent to the oppropr item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ol the Building Division 'I . To conserve spoce on lhe permil form the schedules hove been obbrevioted 2. lf the item(s) to be instolled ore nol covered on the oted schedules you should consull the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os' worksheel only. Where possible, Building Division Stoff w prepore o typewritten coPy ond relurn it to the opplicont ' ihe 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-op i* oid no plons will be processed until these fees ore poid' I ''' other fees qnd chorges qre due ond poyoble when lhe pei-- is issued. V. FOR OTFICE USE ONLY Dote I 1 I :l \ Add t-- -----qReceivedFor: ( ( tne 1 ( ( ,I il () ('l ( EY ( Received AUTXORIZEO SIGNATURE Permit Clerk PROJECI CONDIIIONS TO BE SAIISFIED BEFORE OCCUPANCY: Additionol Proiect ln{ormotion: PLANS REVIEWED BY: signoture dote nome ")nl