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Home My WebLink AboutPermit Mechanical 1981-03-04INSPECTION TINE 72G3769 CITY OF SPR,INGFIELD COMEINATIGT.--++iA-AIIONiPERA{II INFORMATION TINE 72G3753 4thJob ENERGY SOURCESi Sq. Ftg. Moin Heot Sq. Ftg. Access. Woler Heorer - - Sq. Frg. Other -New--Add-Alter-ReP.---Fence--Demo--Chonge / U se Other Ro Volue of Work: 4oO.oo Building Permit lnfo:Describe Work (i.e., Buil Sing le Fomil Residence With o4 5s .-c ol ,'1 I Owner Add re ss Phone Consiruclion Lender Address Phone l.oc DESIGN TEAM (nome)(oddress)(lics. no-) (expires) (phone no.) P rimo ry Strrcturo I Electricol Mechonicol CONTRACTORS (nome)(qddress)(lics. no.)(expires){ph"lre !9) Generol n'u )nl,]- Plumbinq Electricol Mechqnicol PLUMBING ELECTRICAT MECHANICAL NO.FEE CHARGE NO.I FEE CHARGE NO.FEE CHARGE Eoch rinqle fixture Residence of -sq. ft furnocefburner to -BTU'S Relocoted building (new fix. oddirionol) New circuils, olterolions or extensions Applionce vent sepq rq te S.F. Re:idence (l both)SERVICES Stolionory evop. cooler Duplex (l both) eoch Temporory Conslruction Vent fon with singie duct ,Addilionol both Amps. Vent sysrem oport from heoting or A.C. Wqler service Mechonicol exhousl hood ond duct Sewer Wood stove/heoter Siorm Sewer FE EDERS Heot Pump Ampr. Air hondler to r0,000 cFM Air hondler over 10,000 crM ISSUANCE OF PERMIT TOTAT CHARGES TOTAT CHARGES TOTAI. CHARGES WHERE STAIE LAW REAUIRES thot tho Electrical work be done by the Electrical Controcto., the alectricol portion of this permit thqll not ba volid unril slobel hos b*n signed by on Eloctricol Contractor onci ottoched to the electricol pcnel. I HAVE cAREfUtLY ExaMINED the completed opplicotion for permit, ond do hereby certify thot oll informstion hereon is true ond correct, ond I furthercertify thot ony ond oll work performed sholl be done in sccordonce with the Ordinonces of the City of Springfield ond the Lowr of the itote of Or.goipertoining to the work described herin, ond thot NO OCCUPANCY will be mode of qny structure witlout the plrmission of rhe BuilJing Division. I furtherertlfy thot my registrotion with rhe Builder's Boord is in full fore ond effect os requireJ by oRS 701.055, thot if exempt th" boJ, fo, exempiion is notedheron, ond thot only subcontroctors ond employees who qre in complionce wirh OhS 70I.055 will be usedon this proiect, Bosis for Builder's Boord exemptionr NA,lvlE (pleose n SIGNATURE DATE FOR OFFICE UsE ONLY Zone -Type/Const.-Unils -Sq. Ftg. iloin x Volue x -lqlgs x _-'{qlsg Fire Zone-Bedrooms Lood -Sq. Ftg. Access Flood Ploin Storier Occy Group-Sq. Ftg. Other- TOTAT VATUATION BUITDING PERMIT Chorges ond Surchorges Plon Ck. Commllnd 65%/Bldq Per fee Systems Development Chorqe (1.5%) Plqn Ck. Res 30%/Bldg Per Fee PTU'T{BING PERMIT Chorges ond Surcho rges Fence Demo Totoi Comb. Permit CAL PERMIT Chorge: ond S u rcho rges Sidewolk A/C Povinq MECHANICAT PERMIT Chorges ond S urcho rge s _/b o c Curb Cut TOTAI t5 bo w<0 ,{Y coMBTNATTON AppLtcATlONipERMlr (CAp) L Appliconi to furnish A. Job Address B. Legol Description -.PERMIT VATIDATION I. exomple-tox lot I00, Lone Counly Mop Reference I7 03 432. exomple-Lot l. Block 3, 2nd Addition ro Springfield Esrores C. Nome, etc. of owner ond construction lender D. Energy Sources gls rpfg- h eo t / {g!t illgljg]1rrg,.'o r f o rced o i r s o s exomple-woter heoter, electricol,ror solor2. E. Squore footoge or voluotion, etc.I. exomp!e-E!9 rq. foor house, 500 sq. foor goroge2. exomple-if new proiect, check-new-if oddition, check odd, etc. F. Building permit informotion: l. exomple-construct single fomily house with on ottoched goroge 2. exomple--remodel existing goroge into fomily room 3. @-convert single fomily residence into restouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be obie to contoct oppropriole persons regording designinformolionor[obsitecorreclions,etc. ll. .A,bbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the oppiicont 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 fhe schedules j hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on ihe obbrevi-. oted schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDUTES lll. Appliconl to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Sroff will prepore o typewritten copy ond return it to the opplicont ol the time the octuol permit is issued for his signoture. lY. 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 ofher fees ond chorges ore due ond poyoble when lhe permif is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SAIISFIED BEFORE OCCUPANCY: Permit Clerk Additional Proiect lnformotion: PLANS REVIEWED BY: nome signoture ".AntrRE$$- G 18 S 34'IH ST I]E${:R : FRNNT lEE If,ECI 3'.381 *OhINER- ltATt-lY T0[,NSENn 747*3S57 6T8 SOUTH 34TH STREET $PH INfiT IELN " OH q7 477 * INr0* t'lEtl EI.JS ITIENT IAL 99?9 */U ILIr ING n IU IS I0N J0fJ* S 10I -/ -LEfiAL-tfiT ttLECt( 1 70?3 1 3403?00 r INAI.. -UAtUE* 400 810304 / *11:22 .5TAT$* BLNff ZONE E 1 STOR IH$ TLOEI'PLA IN T{ EETIRH 0f,f, IJRP }'I L'N IT$ Ijft TEHT fl IONST TYPE I"I -EHERGY-. HEAT 1 - tJ?li-. RANfiE* -CONTHACTOES* GENI"-O CONTRACTOR PHI]NH" pLl,lIl * r:I,EIT* l'lEIH*0tJNHR IrESrSN - tl tl r] I {juatr Ar{}:A $nff*EEnU IEEIr PERi,IIT$--- -f EE-SUHf HAHf:E-trATE-HECE IPT-REPT f,AT----*-UALUE--** 001-0?6-Hu0tlsTfiuE 15.00 0.60 s10304 55963 $ 400 SEA-H IN II.IUM INSFECT IOI'IS + REAU I&E}{ENTs ---.EXF NATE.--ACT T'ATE* 001*03?-t,00tt ST0UE s Etl*- I H$P ECT I0N$-. * - - *- - C0l.tFtHHT$-- * .--IIAT E- - - -.ft ESULT* - INSP- *. s1 ltx? NAPP 03$0 I *03x*t^,00tr $T0ul.j INSPECITON t.INE 72&3769 crrY o "\Gf lEl.D COMBINATIOR AI" ., ;AIION/PERMII INFORMATION I.INE 72f>3753 4rn ENERGY SOURCESi Heot - Woter Heorer - Sq. Ftg. Accest. Sq. Ftg. Olher -New-Add-Alter -Rep.--Fence -Demo-Chonge/ Use -Other 5q. Ftg. Moin Volue of Work: 4oA.ca Addre:s Phone Building Permit lnfo: Describe Work (i.e., Build Single Fomily Residence With Attoched Goroqe) PhoneAddress fruclion Iloc 04 5 (phone no.)DESIGN TEAM (expires)(nome)(oddress)(lics. Str,rcturo i no.)dd rTtt)l/tl rGenerol Plum bing Electrico I Mechqnicol PTUMBING ETECTRICAT MECHANICAL No. I FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE Eoch rinqie fixture Residence of .--sq. ft. furnoce/burner to Relocored building (new fix. odditionol) New circuits, olterotions or exlensions Applionce vent seporqle S.F, Residence (l both)SERVICES Stoiionory evop. cooler Duplex (l both) eoch Temporory Consiruciion Vent fon with singie duct Additionol both Amps. Venl syslem oporl from heoting or A.C. Wolar:ervice Mechonicol exhoust hood ond duct Sewer Wood stove/heoter 5torm Sewer FEEDERS Heot Pumo Ampr. Air hondler to I0,000 cFM Air hondler over r0,000 cFAl ISSUANCE OT PERMIT TOTAT CHARGESTOTAT CHARGESTOTAT CHARGES work be done by ths Eleciricsl Conlroc?or, the clectricol porlion of thir permit :holl not bc volid until s anti ottached to lhe eleclricol ponel. I HAVE CAREFULIy EXAMINED the completed opplicotion for permit. ond do hereby certify thol. oll informotion hereon is lrue ond correct, ond I further certify thot ony ond oll *orf p.rfor-"j sholl be done in o".ordonc. with the Ordinonces of the City of Springfield ond the Lowr of the Stqte of Oregon p"rtoining to tie work described herin. ond thot No occupANcY wlll be mode of ony slructure withou, the permission of lhe Building Division. I further certlfy thot my rcgistrolion with the Brilder', Boord is in full force ond e+fecl os required by oRS 701.055, thot if exempt the bosis for exemplion is noted heron, ond thot only subcontroctors ond employees who ore in complione with ORS 701'055 will be used on this proiect' DATE Torol Demo lr 6s%l Per WHERE $ATE tAW REOUIRES ihor lhe Electricol lobet hor b*n:igned by on Electticol Controctor Bosis for Builder's Boord exemplion: stems DeYeloPment NAlr{E (pleose PIon Ck. Comm/lnd Plon Ck. Res Per Fee FOR OfFICE UsE ONIY ,TURE BUILDING PERMIT Chorger ond Surchorges a ------Voluex -Volue x -Volue TOTAT YATUATION Zone TYPe/Const'nits Sq' flg' Moin Lood Sq. Ftg. Access Group Sq. Ftg' Other ---Fire Zone Bedrooms occY Flood Ploin Storist OccY PtU}TBING PTR}l\\I Chorger ond Surchorges lOIAL Curb Cul ondChorger Surchorger ?tRl{\1 o$dChorget Surchorges tbbo Primory Electricol -BTLI'S Additionol Proiect lnformotion: nome signoture dole PLANS REVIEWED BY: COMBINATION APPLICATIONi-PERMIT (C.AP) l. Appliconl to furnish A. Job Address B. Legol Description 1. 2. C. Nome, etc. of owner ond construction lender D. Energy Sources l. exomple-heot/electricol ceiling/or forced oi 2. ;io m aE-woterTEElETElEEiiio I /or@-- E. Squore footoge or voluotion, etc. l. exomple-l 250 sq. foot house, 500 sq. foot g, 2. e x o m plE- iT-iEw p ro i e ct, c h e c L -n ew - i i o d d i t ic odd, etc. F. Building permit informotion: l. exomple-construct single fomily house with o goroge 2. exomple-remodel existing goroge into fomily 3. ilompG-convert single fomily residence into i6lJouT6nt (chonge of use) G. Volue of work os defined in Section 303 (o) of th Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construciion deloys, Buiiding E sic Stoff must be oble to contocl oppropriote persons design informotion or iob site correcfions, etc. ll. Abbrevioted Plumbing, Mechonicoi & Electricol Sched' A. Except where blonk spoces occur in fhe descriplion of the Mechonicol ond Electricol Schedules, the opp need fill-in only the No. Boxes odiocent to the oppr 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 schecju hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on tl . oted schedules you should consult the full schedu C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES I CHARGES ON THE SCHEDUI-ES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used or worksheet only. Where possible, Building Division Stoff \ prepore o typewritten copy ond return it to the opplicont - the time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time cf the o1 ,io ond no plons will be processed until rhese fees qre poid, l, ofher fees ond chorges ore due ond poyoble when the peit;,,, is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SAIISFIED BEFORE OCCUPANCY: exomple-tox lot I00, lone Counly Mop Reference exomple-Lot 1. Block 3, 2nd Addition to Spri--r:-' 'OF SPRINGFIELD 17 c3,43.CITY PERMTT VATIDATION CirY Holl . Oregon Public Works RECEIPT ( Soringfield DePortment of OFFICIAL B 55962 -q ( q {1L1 \Am ount Recei ved (!tcretu"e €uGEle oi 97AO1rl ( Permit Clerk C\ (l ( ( t._ { ir DR. WILLIAM A. DUNN, M.S. 5892 MAIN ST., SPRINGFIELO. OREGON97477 726-6€22 7V'h, PaJ-n-j, -}n /48/ L^/L rybaaLrud * A^d /.rd*ru/ Oa'L b-Z (//L haa lte c-e*-<"/ Pt/,'L N uAf,-Eflor\u>lln-. a-- .t-rW7ofur Ca-rn-p, g-zL a-r.o/ *t2/ h+7 /'t//a^ba-'d -fhb+ t^e /u/zb"/ ,b A'ld a- g,b,J U,z a/dd ah/- 2J/'}+ Pr,{/t -trr,afalcr*ton u-z?A h/Q a^r- t1u7.o ; -tL. f Mfr fu,, fiar,e4- ond uro*ld "bh ^ thil V M hetdD*F U^f*i'\, fl*- l6antt*/-t.' bry s. sq+ ^ Jsagrc€ud, g<, \_J