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Home My WebLink AboutPermit Building 1981-04-07IN5PECTION UNE 7263769 CIIY OF SPRINGFIEtD COMEINAIION APPTICAIION/PERMII INFORMATION IINE 726.37s3 Job Addrers ? Owner Address Fo Ro Build Single Woter Heqter Volue of Work: Sq. Ftg. Moin Sq. Flg. Acces3. 5q. Frg. Othet Alter-Rep. ngrf Use Residence With Ailoched -New --Fen__o Permit lnfo: Describe Work Constr \ Ic n Addre ss Phone DESIGN TEAM (nome)(oddress)(lics- no.)(expires)(phone no.) Primory Struclurql Electricol ,l,iechonicol CONTRACICRS (nome)(odCress)(lics. no.)(expire s)(phone no.) l.o Plv Electricol Mechonicol ELECTRICATPLUMBING MECHANICAL No.FEE CHARGE NO.I FEE CHARGE NO FEE CHARGE Eoch ringle fixture Residence of --rq. ft. furnoce/burner to =*-_--BTU': Relocoted building (new fix. odditionol) New circuits, olterclions or exlensions Applionce vent seporq te 5.F. Residence (l both)SERYICES Slolionory evoo. cooler Duolex (l both) eoch I I Temporory Conrlruclion Vent fon with single duct Additionol both Amps. Yent syslem oport from heoting or A.C. Woler rervice ,\{echqnicol exhoust hood ond duct Sewer Wood stove/ heoler Storm Sewer FEE DER S Heot Pump Ampr. Air hondler to 10,000 cFM Air honriler over I0,000 cFM ISSUANCE OF PERMIT TOTAL CHARGES TOTAL CHARGES WHERE STAIE LAW REQUIRES lhqt the Electricol work be rione by the Ele.tricsl Conrroctor, the electricol portion of this permir rholl not ba volid unril q lobel hos becn rigned by on Electricol Controctor and otached to the electricol ponel. TOTAI. CHARGES I HAVE CAREFUTLY EXAMINED lhe completed opplicotion for permit, ond do hereby certify lhot oil informoiion hereon i, <ertify thot ony ond oll work performed sholl be done in qcordonce with rhe Ordinonces of the City of Springfield ond Pertoining to the work de:cribed herin, ond lhat NO OCCUPANCY will be mode of ony siructure withou, the permission ertlfy thot my regirtrotion wirh lhe Euilder's Boord is in full force onci effecl os required by ORS 701.055, rhot if heron, ond thot only subcontroqtors ond employees who qre in compliane wirh ORS 701.055 will be used on this I +rs(Bosis for Builder's NA.r\{E (pleqse print) s lrue ond correct, ond I further the Lows of the Stote of Oregon of the Building Division. I furrher the bosis for exemption is noted FOR OFFICE UsE ONI.Y FloodPloin-slorier-OccyGroup-5q.Flg.olher- x Volue x -Volue x -Volue TOTAI. VATUATION, Type/ Const.Zone Sq. Ftg. AccsssLoodFire Zone-Bedroomr nits -Sq, Ftg. Moin Systems Development Choroe (1.5%) BUII.DING PERMIT Chorges ond Surchorge r 8Le"_ l-----' 651',"1 Per Fee 301/"1 Per Fee Plqn Ck. Cqmm/lnd Plon Ck. Rer Pl,Ur,tBlNG PERrrllT oo Fence Demo Chorges ond Surchorges Totol Comb. Permit ETECTRICAI'PERMII cc)SidewolkTChorge: ond 5 urchorger MECHANICAT PERMIT Chorges onl Surchorger Curb Cut TOTAI.OO5\ ,t"O A/ C Po"i". COMBINATION APPLICATION,/PERMIT (CAP) l. Applicoru. ro furnish A. Job Address B. Legol Descriptionl. exomp"le-rox _lot .l 00, Lone County Moo Reference I7 03 432. exomple-rot I' Block 3,2nd Addition ro springfierd EsroresC. Nome. etc. of owner ond construction lender D. Energy Sources I. exompie-hsot,i, 2. e-iE?iElE-woter E. Squore footoge or electricol ceilin ,/or forced oir os PERMIT VATIDATION iol,ioi SO "oirotioiE-l. exomole-l2jg tq.foor house,5C0 sq. foof goroge2. e?omEle-ianew proiecr, checkl-ew-ii oddition, Jheck odd, etc. F. Building permit informorion:I. exsmple-construct single fomily house with on oltoched gorctge 2. exomple-remodel existing goroge into fomily room3. @-convert single fomilv i.esidence into resrouronl (chonge of use) G. Volue of work os defineci in Section 303 (cr) of the Structurol Specio lry Code H. DESIGN TEAI,A AND CONTRACTORS To ovoid design or construciion deloys, Building Division Stoff must be oble to contoct opprooriote pu.ron, regor.ding design informction or fob site correclions, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Eiectricol Schedules, the oppiicont need fill-in oniy rhe No. Boxes odiocent to ihe oppropriote item(s) to be instolled B. Fuil Plumbing, Mechonicoi, ond Electricol Schecjules ore ovoiloble or the Building Division '| . To conserve spoce on the permit form the schedules : hove been obbrevioted 2. lf the item(s) to be installeo'ore nol covered on the obbrevi-. oted scheduies you should consult rhe fuil schedules C. SUILDING DIVISION STAFF WILL FILL OUT.ALL FEES ,AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol ooplicotion will be used os q worksheet only. Where possible, Builcling Division Stoff will prepore o iypewritten copy oncj return it to the opplicont oi the rime the oouol permit is issued for his signotuie. lV. Fees cnd Chorges Plon check fees ore due ond poyoble ot the time of the onplicotion, ond no plons will be processed until these fees ore poid. ,lll other fees ond chorges ore due ond poyoble when the permii is issued. V. FOR OFFICE USE ONLY eoteil e Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect Informoiion: nome signolure dote PTANS REVIEWED BY lN5?ECflON UNE 72U3769 CIIY OF--iPTINGFiETD COMSINATION APPIICAIION / PERI'iIT- INFORMATION tINE 726.3753 tegol Dercription ;;;Tene- \\i\\ :iil@ -NewVolue of Work: Sq. Ftg. /*oin 5q. Frg. Acce33. 5q. Frg. Olhcr --Rep. nge/ Use Wo ler Heo ter Addrers bzq Scrrd:innF,lu ilFur ,, Build Singleinq Permit lnfo: Re Describe Work (i h Attoched zrIlEne-.q-14()2 J [e nder ec n NPhoneaddrerr (nome)(ocldrers)(lics. no,)( ex pire r)(phone no.)DESIGN TEAM Primory Mechonicol (nome)(odd ress)(lics. no.)(expires)(phone no.)CONTRACIORS to Electricol Mechonicol ETECIRICAT ,ITECHANICATPTUA{8ING CHARGE NO.FEE CHARGE No. I rE5 CHARGENo. I FEE furnoce/burner to -BTIJ'r I Eoch sinqle fixture I Residence oi l. Applionce vent seporqte Relocoted building (new {ix. odditionol) New circuits, olterclions or extensions Stolionory evop. cooler 5.f (r R e sidence both)SERVICES Temporory Conslruclion Yent fon with single ductDuolex (l both) eoch I Amp:. Vent syslem oporf from heotinq or A.C.Additionol both AAechonicol exhoust hood ond ductWoler rervice Wood slove/ heolerScwer Heot PumpSlorm Sewer FEEDERS Air hondler to r0.000 cFMAmpr. Air honriler over 10,000 crM ISSUANCE OF PERMII TOTAT CHARGES TOTAT CHARGES WHERE 5fAIE fAW REQUIRES that the Electricol work be tiorc by ihe Electricol Conltoclor, the clectricol portion of thi: permit rholl not bc volid unril o lobel hor brn :igned by on Electricol Controctor ond ottachad lo lhe electricol ponel. TOTAT CHARGES I HAVE CAREFULTY EXAMINED the completed opplicotion for permit, ond do hereby certify thqt qll informorion hereon is true ond correct, ond I further(ertify thot ony ond oll work pcrformed sholl be done in occordonca wirh the OrCinonces of the City of Springfield ond the lows of the Stote of Oregon pertoining to the work described herin, ond that NO OCCUPANCY will be mode of ony errlfy thor my regiinotion with lhe Builde/r Boord is in full fcre ond effecl os required heron, oad lhot only subcont.octor5 ond employces who qre in complione with ORS 701.055 will be used on lhis Boris for Euilde/s NAIIE (pleore print) t ,TE {t+ of rhe Building Divirion. I further the bosis for e:emption is'noted siructure withoui the permi:rion by ORS 701.055, thot if FON OFFICE USE ONIY Flood Ploin Storie:-Occy Group-Sq. Ftg. Other x ---Volue x ---Yolue x -Yolue 2.," f.\$,S rype/consr. Fire Zone-Bedrooms lood Ftg. Atoin Sa Flg. Access IOTAI. YATUATION Syslems Development Choroe ll -59'l) BUII.DING PERMIT Chorger ond Surchorger 6LE\---- Pton Ck. Comm/lnd Plon Ck. Rer Fence Demo Totol Comb. Permit ELECTRICAT'PERMIT Chorger ond Surchorger cc) c Sidewolk MECHANICAT PERMIT Chorger onl Surchorger Curb Cut TOTAI.5\.oo k-fg).fl \ Strurluro I Electricol \a.ooPtUr,{BING PERAiIT Chorges ond Surcho rges ,bo . COMBINATION APPLICATION/,'PERMtT (CAP) l. Applicoru. ro furnish A. Job Address B. Legol Descriptionl. exomple-tox lot 100, Lone County Mop Reference2. exfi;le--lot l. Block 3,2nd Addition to Springfield C. Nome, etc. of owner ond construction lender D.. Energy SourcesI. exomple-heot./electricol ceilinqz'or forced oir oasz. exomDte-worer heoler eleciricol,,'or solor E. Squore footoge or voluotion, efc. foot goroge oddition, chr PERMIT VALIDATION 17 03 13 Estotes { ctTY oF SPRINGFIELD Clty Holl Springfleld, Oregon( Deportmcnt of Publlc Works OFFICIAT RECE!PTI. exomole-l250 sq. foor house,500 sq.2. eEJiEE-i;-new proiecr, check i?-w-if odd, erc. F. Building permit informotion:l. exomple-construct single fomily house wirh on ott goroge 2. exomple-remodel existing goroge into fomily roor ( 3. @-convert single fomily r-esidence into rGliE!?6nt (chonge of use) G- Volue of work os defineci in Section 303 (cr) of the Structurol Speciolry Code H. DESIGN TEA}A AND CONTRACTORS To ovoid design or constiuciion deloys, Building Divi: ,Sloff must be oble to contoct oppropriote pu.ro-n, ..g 8i, design informction or iob site correitions, etc. ll. ,Abbrevioted Plumbing, Mechonicol & Electricol Schedule A. Except where blonk spoces occur in the description p< of the Mechonicol ond Elecrricol Schedules, rhe oppiir need fill-in only the No. Boxes odiocent to the opprol item(s) to be instolled 8. Fuil Plumbing, Mechonicoi, ond Electricol Schedules ore ovoiloble or the BuilcJing Division l. To conserve spoce on the permit form the schedule hoye been obbrevioted 2. If the item(s) ro be instolleo' ore not covered on fht. oted scheduies you should consult the fuil schedulr C. SUILDING DIVISION STATF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULES lll. Applicont io sign ond dote Whenever possible, the initiol opplicorion will be used o: worksheet oniy. Where possible, Builciing Division Stoff r prepore o iypewritten copy oncj return it to the oppliconl lhe time the octuol permit is issued for his signotuie. lV. Fees cnd Chorges Plon check fees ore due ond poyoble ot the time of the o ond no plons will be processed until these fees ore poid. other fees ond chorges ore due ond poyoble when the p,p is issued. V. FOR OFFICE USE ONLY I{0. B 56239 r9 R ( Address Received For: ' Amounr Received f1\ OC)Q,r- \16\341lI\ ( ( ( (( BY ( (: ( ( lt AUTXORIZED SIGNATURE SXEIIO(.TUiN€ULL PRINIER3 . EUGENE OR '7'Ot (- Permit Clerk PROJECT CONDTTIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: nome signoture dote PTANS REVIEWED BY: ( I