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Home My WebLink AboutPermit Building 1981-03-24\ INSPECTION IINE 72*3769 CITY OF SPRINGTIELD COMEINAIION APPTICAIION/ PERIIII INFOTMATION tINE 726.3753 eDe rcription r Building Permit lnfo: ched GoFomri Yolue of Work: Describe Work (i.e., Euild Single Sq. Frg. OtherWoler Heoler EN ERGY Heo t Sq. Ftg. Moin --Orhcr - -New -Add--Alter-ReP.- - -Fence -Demo-Chonge/ Use 5q. Ftg. Acces. Addrers .-*.,.In ,.U", :d k ()A -J_or c..l PhoneAddresr (nome)(oddress)(lics. no.)(e xpi re s)(phone no.)DESIGN TEAM f Primory tricql Mechonicol (nome)(oddress)(lics.qo.)(expires)(phone no.)CONTRACTORS UJlrltPlumbing I Etedricol otl)rur Merhonicol EI-ECTR ICAL MECHAN ICALPLUMBING FEE CHARGE No. I TEE CHARGENo. I I rEE CHARGE NO. furnoce/burner to I Eoch :inqle fixture I Residenca of --rq. ft. New circuits. qlterolions or exlensions Applionce vent se po ro te Relo<ored building (new {ix. ociditionol} SERVICES Stolionory evop. coole r 5.F. Residence (l bqth) Temporory Conslruclion Vent fon with single ductDuolex (l both) eoch I I Vent syrtem oporf from heotinq or A.C.Additionql both Ampr. Mechonicol exhous, hood ond dusrWoler rervice Wood slovel heoterSewer Heot PumpSlorm Sewer FEEDE RS Ampr. Air hondler to t0,000 cFM Air hondler over 'r0,000 crM ISSUANCE OF PERMIT TOTAT CHARGESTOTAL CHARGES WHERE SfAIE fAW REQUIRES rhgt tha Electri<ol work be o'one by tha Electricql Conrioclor, the :lectritol portion of this permit rhcll not bc volid unril o lqbel hos bcn signad by on Elcclricol Controclor cnd ottsched lo the electricol ponel. TOTAT CHARGES I HAVE CAREFULIY EXAMINED rhe completed opplicotion for permit. ond do hereby certify thot oll informotion hereon is lrue ond correcl, ond I further certify thot ony ond oll work performed sholl be dona in ocordonce with the Ordinonces of fhe City of Springtield ond the Lows of lhe Stote of Oregon pertoining to the work described herin, qnd thor NO OCCUPANCY will be mqde of ony siruclure withou, the permission of the Building Division. I further certlfy rhot my rcgisnotion with the Builder's Boord is in full force ond effect os required by ORS 701,055, thot if exempt the bosis for exemption it noted heron, ond fhot only 5ubcontroclors ond employees who ore in complione wirh ORS 701,055 will be used on this proiect. SIGNA DA ,<.f t; 1 Bosis for Builder's Boord exemption: NAME (pleose FOR OTFICE USE ONI.Y Zone -Typei Const. -Unils --Sq. Ftg. Moin x Yolve x Volue x -Volue Fire Zone-Bcdrooms occy lood Sq. Ftg. Access TOTAT YAI.UATION Flood Ploin ccy Group-Sq, Flg. Other- Plon Ck. Comm/lnd 6596i Blclq Per Fee Syslems Development Chorqe ( I .59'") n lrv,(. _25BUITDING PERMIT cChorges ond 5 urchorger Plon Ck. Rer 30oZ/Blds Per Fee F)?zoe Gtence Demo Totol Comb. Permit Chorger ond Surcho rges PTUIAEING PERMIT Sidewolk ETECTRICAT PERMII Chorges ond Svrchorges A/C Povinq Curb Cut MECHANICAI PERMIT Chorges ond Surchorger TOIAT 5 L -BTU': 5()0 COMBINATION APPLICATIONiPERMIT (CAP) l. Appliconr to furnish A. Job Address B. Legol DescriptionI. exomple-lox_lot .I00, Lone County Mop Reference lZ 03 432. exomple-Lot I. Block 3, 2nd Addition to springfierd EstoresC. Non*,It.. of owner ond construction lenderD. Energy Sources exo m ple-heo t,/electricoj cei I i n g z,or forceo' o ir gos6IEilEG- w o t e r IEEIEiGTecin=io t .z o.- PERMIT VALIDATION 2. E. Squore footoge o. "olrorioilI. - l. exomp!e-.I 250 sq. foot house.500 sq. foot gorogez. ex.qmpte-rr new proiect, check new-if oddition, checkodd, erc. F. Building permit informotion:I. exomple-construcr single fomily house with on oltochedgoroge 2. exomple-remodel existing goioge into fomily room3. @-convert single fomily r-esidence into resfouront (chonge of use) G. Volue of work os defined in Section 303 (o) of theStructurol Speciolry Code H. DESIGN IEAM AND CONTRACTORS To ovoid design or construct:on deloys, Building DivisionStoff must be oble to contoct oppropriote p...Jn, regor.dingdesign informction or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol SchedulesA, Except where blonk spoces occur in the description portionof the Mechonicol ond Electricol Schedules, the oppiicont need fill-in oniy the No. Boxes odiocent to the oppropriote item(s) to be instolled 8. Fuil Plumbing, Mechonicoi, ond Electricol Scheciules ore ovoiloble or rhe 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 scheduies you should consult 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 oppiicorion will be used os oworksheet oniy. Where possible, Builciing Division Stoff willprepore o typewritten copy oncj return it to the opplicont ol the rime the ocruol permir is issued for his signotuie. lV. Fees cnd Chorges Plon check fees ore due ond poyobre or the time of the opplicotion,ond no plons will be processed until these fees ore poid. Allother fees ond chorges ore due ond poyoble when ihe permit is issued. V. FOR OFFICE USE ONLY Permit Clerk PR.OJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: nqme signoture dote PLANS REVIEWED BY: \\, CITY OF SPRINGTIELD COMEINAIION APPTICAIIONIPERIiIT INFORAAAIION IINE 7247753 Legol De:cription !! e-l Addresr EN ER,GY inq Permit lnfb: Sq. Frg. Olher Volue of Work: Heor Woter Heoter R tto ched 5q. Ftg. Acce;r. --Other .-_..-_--.==---. -New.-Add -Alter-ReP'- - -Fence --Demo-Chonge/ Usc Describe Work (i.e., Build Singie Sq. Frg. i\{oin :d t"U".kx DA _i'o! 0J Addrcrs Phone (nomc)(oddrers)(lics. no.)r Je^pirrrl (phone no.)DESIGN TEAM Primory tricq I Mechonicol (nome)(oddress)-(ics. no.)(expires)(phone no.)CONTRACTORS WItItPlumbinq I Erearicor CtL)Y\AF Mecho ni col ETECTRICAI.PLUMBING MECHANIC,AL No. i I rEE CHARGE NO. I I rEE CHARGE NO. i FE! I CHARGE I Eoch rinqle fixture i Residence oi --sq. ft. furnocei'burner lo ---BTU'S New circuits, ollerotions or exlensioni Appiionce vent Seporqte Relocoted building (new {ix, ocjditionoi) SERVICES Stolionory evoo. cooler 5.F. Reridence (l both) Temporory Conrlruction Vent fon with sinqle ductDuolex (l both) eoch I i I Additionol both .Ampr. Yent ryslem oport from heoting or A.C. Mechonicqi exhoust hood ond ductWoter rervice Wood rlove/heorerSewer l Slorm Sewer FEEDERS Heot Pump Amps. .Air hondler to 10,000 cFM Air honciler over r0,000 crM ISSUANCE OF PERTAIT TOTAT CHARGES TOTAT CHARGES WHERE 5TAIE fAW REQUIR€S thot the Elec?ricol work be tione by the Electricol Conrroctor, the electricol portion of rhis permit :holl not bc volid unrit o lqbcl hos brn rigned by on Electricol Controstor ond oltoched lo lhe electricol pcnel. TOTAI" CHARGES IHAVE CAREFULLY EXAMINED the completed opplico?ion for permit, ond do hereby certify thot oll informoiion hereon is lrue ond correct. ond I furrher cerrify thot ony ond oll work performed shoil be done in ocordonce wirh rhe Ordinonces of rhe City of Springfield ond the Lows of the Stote oi Oregon pertoining to the work described herin, ond thot NO QCCUPANCY will be mqde of ony siruclure wirhou, the permission of fhe Building Divi:ion. I further ertlfy thot my regirtrotion with the Builder': Boord i: in full fore ond effect os required by ORS 7O1.O55, thol if exempt the bosis for exemption is'noted hcron, ond thot only :ubcontroctorr ond employees who qre in compliona with ORS 701.055 will be ured on thir proiect. SIGNATU DA',<#q') Bosir for Euilder'r Boord exempfion: NA,\lE (pleore FOR OTFICE UsE ONTY Zone-Type1,Con:t.Unils-Sq.ftg.lr{oinxVolue Fire Zone-Bedroom: occy Lood Sg. Ftg. Acce:s FloodPloin-5te'ie'-OccyGroup-Sq.Ftg.other x -Volua TOTAT VATUAIION Syslemr Development Choroe ( I .5?'1,) n hrc,(?-oe BUII.DING PERMIT Z5 651',"1 Per fee BI Per Fee Plon Ck. Comm/lnd Plon Ck. Rer Chorger ond Surchorger trpa-1rY(4=- Tolol Comb. Permit PTUMEING PERMIT Demo Chorges ond Surchorges ETECTRICAI Chorger ond 5vrchorg es Sidewolk II -L MECHANICAL PERAAIT Curb CutChorger onl S urchorger IOTAI alo INSP€CTION tINE 7263769 \2 E-Fence 4 o a/C Pcvina COMBINATION APPLICATION,'PERMIT (CAP) l. Applicoru. to furnish A. Job Address B. legol Descriptionl. exomple-tox -lor .l 0!, -to1e .County Mop Referer: ^ 2. exE-ilE-Lot l. Block 3, 2nd Addit'ion ro SpringfiC. Nome, etc. of owner ond construclion lenderD. Energy Sources I ceili col or forced oir oo / or solo r PERMIT VALIDATION ,. CITY OF SPRINGFIELD City Holl Springfield, Oregon Deporlment of Public Works OFFICI/\T RECEIPT 2 e E. Squore footoge or roluotioill]-l. exomple-l.jlg .q. foor house, 500 sq. foor gorol2. exAffilE-iFi.w i.";".t, ir.,..l ""*-li oddirioi,lodd, erc. F. Building permit informorion:I. exompie-construct single fomily house wilh on ogoroge 2. exomple-remodel existing goi.oge info fomily ro.3. d;mpG-convert single fi,iily residence intorEliEiEnt (chonge of use) G. Volue of work os defined in Section 303 (o) of theStructurol Speciolry Code H. DESIGN IEAIA AND CONTRACTORS To ovoid design or construciion deloys, Building DirSroff mus, bc oble to contoct oppropriote p"rrJn, .,design informction or iob site corrections, etc. ll- Abbreviored Plumbing, Mechonicor & Erecrricor schedurA. Except where blonk spoces occur in the description rof the Mechoniccl ond Elecrricol Schedules, th; ";p;need fill-in oniy the No. Boxes odiocent to the opprritem(s) to be instolled B. Fuil Plumbing, Alechonicoi, ond Electricol Schedulesore ovoiloble or rhe Building Divisionl. To conserve spoce on the permit form the schedu hove been cbbrevioted 2. lf ,he item(s) to be instolled ore not covered on tl. o,ed scheduies you should consult rhe full schedr. C. SUILDING DIVISION STAFF WILL FILI OUT ALL FEES, CHARGES ON THE SCHEDULES lll. Applicont ro sign onci dot'6 Whenever possible, the initiol ooplicorion will be used rworksheet oniy. Where possible, builciing Division Stoffprepore o typewritten copy onci return it to the opplicothe rime the octuol permit is issued for his signoture. ( ( J{0. B I 56147 { t9 ,d Recei Amount Received Permit Clerk UTHORIZED SIGNATURE PR|IIEAs EU6ERE Oi 97aot !atI.a rn ({n ( (' ( ( /l( i ( lV. Fees ond Chorges l- Plon check fees ore due oird p"yoblB& thj time of rhe oppricotion,ond no plons will be processed unril these fees 6re p"ia. ih - other fees ond chorges ore due ond poyoble lrh.n tli" p.riitis issued. V. FOR OFFICE USE ONLY PROJECT CONDTTIONS TO BE SATISFIED EEFORE OCCUPANCY: Additionol Proiec lnformorion: nome signoture dote PLANS REVIEWED BY: I BY I (,