HomeMy WebLinkAboutPermit Building 1981-1-30
..- - CITY OF SPRINGFiElD
COMBINATION A~PlICAi~""/pERMIT
/do7
I
I
r
I TOTAL CHARGES
I WHERE STATE LAW REQUIRES that the Electrical work,be done by the Electrical Contractor, th. electrical portion of this permit shall nol b. yalid until a
label has b.~," signed by an Electrical Contrador and attached to the electrical panel.
INSPECTION LINE
726-3769
;;; C; C:'l J1'IO ~ ';
legol Description '5 ::) 00
LlDL..~O
Own" 7$' jJ '/ AJ..f.1 7&:'N/ .
Add"" & 5~9" ;t#(fJ...(P'/,/i-..Lt7
Job Addren
Construction lender
~w_
Addren
DESIGN TEAM
(nome)
11p,;ma,y ~ fydt ~ ~;Pt-
Struchl,ol
EIG.:trir:ll:
N.uch;ll~:<:oJl
CONTRACTORS (nome)
1"'.n.<o1 ~t;j{):Z 7dUAM
Plurnbinq
Electrical
all \Yl Q 1(
Mechanical
PLUMBING
NO. FEE I CHARGE NO. ,
Each sinqle fixture 1
Relocated building I
(new fi;ll;, additional)
S.F. Residence I
(1 bath)
Duplex (1 bath) each I
Additional bath I
Water service I
Sewer I
Storm Sewer I
I
-0-1
..
INFORMATION LINE
726-3753
~
ritto. Ma'n ~r~ I ~) It?
Sq. Ftg. Am,,_ 1) '67
Sq. Ftg. Other
_New_Add_Alter_Rep.
_Fence_Demo_Change/ Use
__Other.
Phon. _7L/1>~7LJt;(
ENERGY SOURCES;
H~at 'lo... J a
,
Water Heater~w
Ranqe \~_
I Value of Work: B ~
F1. ~fi.
BuiJdin~ ~r~;-i-nf;'" D~'mibe Work (i.e., Build Single
Familv Re\idence With Attached Garace)
c,1~Ft i\jtI n tI J':.u.. ^A'
etr: fYt l' -0 0 , r.A J J( 'tUi'lJ!jL
iiJ 0 U<;JJ J I
-
6
~
(j\
phone
(address)
(lies. no.)
(expire\)
(phone no.)
~C;-C;'i kl(l/~0;UlLLY
. . ~ ty
<DvJ,^OX - ~. 7ij(, ~ ;ZtflJl.
ll\~
~
(address) (lies. no.)
t:, ~c; q 7#c'/~ fLIl'L
, /
(expires)
(phcne nc.)
ow'" LV - 7"l1o-';;(<lD["
ElECTRICAL
MECHANICAL
FEE ' CHARGE NO.
I CHARGE I
I I
I
. FEE
Residence of
furnoce/burner to
Il.TU's
Appliance vent
separate
Stationaryevap.
cooler
Vent fan with
sin!:!le duct
Vent system apart from
heatin!:! or A.C.
Mechanical exhaust
hood and duct
.,: ft.
New circuits, alterations
or extensions
SERVICES 10<:> l\MPS
15,O.! I '5,O~
Temporary Construction
Amps.
Wood stove/heater
FEEDERS
Heat Pumo
Air handler to
10,000 CFM
I Air handler over
10,000 CFM
I
I
I
I
I
I
J
Amps.
ISSUANCE OF PERMIT
o
TOTAL CHARGES
/s,o!!.
TOTAL CHARGES
-0.,.
I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certHy that all information hereon is true and correct, and I further
certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon
pertaining to the work described herin, ond that NO OCCUPANCY will be made of ony structure without the permission of the Building Division. I further
certify that my n'gistrotion with 1he Builder's Boord is in full force and effect os required by ORS 701.0.55, that if exempt the basi\ for exemption is noted
heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will be used on this project.
Basis far Builder's Board exemption; .
NAME (plea.. p"n~75: ..I!; ~L-t: J~ SIGNATURE~
, FOR OFFICE USE ONLY
" 2'-:, '" "'1""-
Units "" Sq. Ftg. Moin ~y\\' ..:::> .-,
nccy Load .=.....-.- Sq. Ftg. Access --1~_~
I1ccy Grovp 100\ : """" 2 Sq. Ftg. Other
Zone ----B..'"
Type/Const.~
Bedrooms
Fire Zone
Flood Ploin
-
Ctorie.
BUILDING PERMIT
Charges and
Surcharges
3~pE
1,.::l.B
PLUMBING PERMIT
Charges and
Surcharges
ElECTRIC-AL--fERMlf-
Charges and
Surcharges
15.0.,Q
,1.01:)
MECHANICAL PERMIT
Charges and
Surcharges
"AT,iJ -3C) -'6;
x ~. !..-:t'~ Value ;;"II't.I '.\ t ~-::;(f"
x: 9. (J..!2. Value ,I 'f\l!"'~ (l. "___.:
n Value
TOTAL VALUATION 4' f C.Z. ~ b
Plan Ck. Comm/lnd
65%/Blda Per Fee
Plan Ck. Res
30%/Bldq Per Fee
I Fence
I Systems Development I
a u,-E- Choroe (1.5%)
/0.<001--2(--'1,1 I '1fj,f:,~
'1/&/, '55tr!1 ~CF(!a.('rd<;t ~/.~
I Total Comb. Permit -47, lP..E-
L&l brd Feuz.- . dO
Demo
Sidewalk
AIC Pa";n...
Curb Cut
1=\ <i 7. fl,2
I TOTAL
COMBINATION APPLICA TlON/a'CAP)
I. Applicant IQ furnish
A. Jab Address
B. Legal Description
1. example-tax lot 100, Lane County Map Reference 17 03 43
2. example-Lot 1. Block 3, 2nd Addition to Springfield Estates
c. Nome, etc. of owner and construction lender
D. Energy Sources
1. example-heat/electrical ceiling/or forced oir gas
2. example~water heater/electrical/or solar
E. Square footage or valuation, etc.
1. example,1250 sq. foot house, 500 sq. foat garage
2. example-if new project, check new-if addition, check
add, etc.
F. Building permit information:
1. exampl~-construct single family house with an a!toched
ga..age
2.. exomple-!'emodel existing garage into family room
3. example-convert single family residence into
restaurant (change of use)
G. Value of work os defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building Division
Staff must be able to contact appropriate persons regarding
design information or job site corrections, etc.
-.,J
. ,.)
II.. Abbreviated Plumbing. Mechanical & Electrical Schedules
A. Except where blank spaces occur in the description portion
of the Mechanical and Electrical Schedules, the applicant
need fill-in 'only the No. Boxes adjacent to the appropriate
item(s) to be installed
B, Full Plumbing, Mechanical, and Electrical Schedules
ore available at the Building Division
1. To conserve spac.e 0;": thE perm:t form the schodu!es.
have been abbreviated
2. If the item(s) ta be installed are not covered on the abbrevi-
ated schedules you should consult the full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT All FEES AND
CHARGES ON THE SCHEDULES
III. Applicant to sign and date
Whenever possible. the initial application will be used os a
worksheet only. Where possible. Building Division Stoff will
prepare a typewritten copy and return it to the applicant at
the time the actual permit is issued for his signature.
IV. Fees and Charges
Plan check fees are due and payable at the time of the application,
and no plans will be processed until these fees ore paid. All
other fees and charges are due and payable when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Project Information:
PLANS REVIEWED BY,
nom'?'
"ignaturp
. ~ERMIT VALIDATION
'l
,
'"
Permit CierI-
iate
I
II
'I
INSPECTION LINE
726-3769
--
Job Add,... ;;:,:'7<:;'7 J//t!!~?
l~gal Demiption CS ::) 00
It (Y2.. 3411 0
Ow'e, -e./~ / ,/1.1'- '7:: 7d.u,.J!-l./
Add"" ~ S'~1''' )W<?)i'P,L-t";' /;!;"y'
., / /
Construction Lender
~JAJ.
Address
DESIGN TEAM
(nome)
\Primary
'-/? JY~~ ;E 7.~.-;Pt
.l)lruCrvrol
EIe':fl"ir.o:
Ml~C;':l.:;t;.:J1
CONTRJ GORS (nome)
'Gen..ol e../yjf)
Z l'k",Jv,
PlumuinCl
Electrical
Oln vl Q.J(
Mec!--anicol
PLUMBING
I
I CHARGE I
I
I
NO.
FEE
Each SinClle fixture
Relocated building
(new fix. additional)
S.F. Residence
(l balh)
Duplex (1 both) each
Additianol bath
Water service
Sewer
Storm Sewer
TOTAL CHARGES
-0-
WHERE STATE LAW REQUIRES tho. the Electrical work,be done by the Electrical Contractor, the electrical portion of this permit shall nat be valid until a
label has been signed by on Electrical Contractor and attached to the electrical panel.
CITY OF SPRINGFielD
COMBINAIION lpplICATMN/PERMIT
.-
..
INFORMATION LINE
726..3753
I'~,f\g. Main 04,,:\ '-!..J In
So: flg. Am". J 1 ) ~ 7
Sq. Ftg. Other
_New_Add_Alter_Rep.
__Fence_Demo_Change/ Use
__Other.
B~iIJ~~ ~r-;'it"lnf~: Desc;ibe Work {i.e., Build Sing!1t
Family Residenclt With Attached CaraCle)
.C,"\-flvnf')}', 1\111 () t1I, ~
r.:11/.p,() If') - <t'ltYi l' J\ O'J Cl f1n/ )n 01)
iiJ no l)<;;.p J
r-l)
---,.
6
~
(j\
FEE
CHARGE I
/ I
I
I
I
I
I
I
l.iu7
ENERGY SOURCES:
'r-. /~....
(expires)
(phone no.)
0.,.
I HAVE CAREFUtl Y EXAMINED the completed application for permit, and do hltrltby certify that 011 information hereon is true and correct, and I further
certify thot any and all worlt performed sholl be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon
pertaining 10 the worle. deuribed herin, and that NO OCCUPANCY will be made of any structure without thlt permission of the Building Division. I fUrther
certify that my registration with the Bvilder's Soard is in full force and effect os required by QRS 701.055, that if exempt the basis for exemption is noted
heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will be used on this project.
Basis for Builder's Soard exemption:
NAME (please prin1\
Rr>
Type/Const. \f ~
Bedroom'
'=torief
Zonlt
Fire Zone
Flood Plain
BUILDING PERMIT
Charges and
Surcharges
~ ^' ......0
0c\.'---
~o
If~
PLUMBING PERMIT
Charges and
Surcharges
ELECTRICAL PERMIT
Charges and
Surcharges
15.0~
! f.c..;;
MECHANICAL PERMIT
Charges and
Surcharges
"-- --
Hec'.
Water Heater
'^
Ranqe
,/I, I ,..-,
Yalue af Wark: B::,
~,~ri.
Phone 7t/t,..7LJ{.{
phone
(address)
(Iks. no.)
or '"'.:;.\..1...)\'\ t'f
74{' - ;U/ot
I Systems Development
4 ~ Charae (1.5%\
~; ~~~j -~~ FecL.,~" :~'::
-47. &~
,(, '>S 'i k/ (/'~'-J;V /ilLL'" .
,;;' tI
(address) (lies. no.)
~ <os 'i :Ufl/~ kLtl'L
" /
elECTRICAL
NO.
CHARGE
FEE
Residence of
\q: ft.
New circuits, Cllterations
ar e.xtensions
SERVICES
Ibl.C>rP\';-S
,:::::-J"
1--.-
/-=- "J:
. ...., -
Temporary Consfructian
Amps.
FEEDERS
Amps.
TOTAL CHARGES
/~"o
-" -
c:,IGNATURE~
fOR OFFICE USE ONLY
:J
"-" r-. ,_._--
Sq. Ftg. Main --=-~~::;, J>
(.,. Ftg.Access---1~_:::'
Sq, Ftg. Other
IJnih
nccy Load
Occy Group H I ~ ~ :.
-'----
Pion Ck. Comm/lnd
65%1 BldQ Per Fee
Pion Ck. Res
30%/ Bldo Per Fee
Fence
Demo
Sidewalk
AI C Pavina
Curb Cut
I TOTAL
(expires)
(phcne no.)
7.q1-:,'.;;'."r) L~
..)"'-'.~'r\ rJ_\r
MECHANICAL
NO.
furnace/burner 10
R.TU's
Appliance Venf
seporate
Stationary evap.
cooler
Yent fan with
sinqle duct
Yent system apart from
heating or A.C.
Mecnonical exhaust
hood and duct
Wood stove/heater
Heat Pumt>
Air handler to
10.000 CFM
Air handler over
10,000 CFM
ISSUANCE OF PERMIT <:>
TOTAL CHARGES
DATEt
-"''-'
- - Volue
',V
, - Yolue
.-'1,
. q
.2..f....l~.
l-::...a(..)
x Volue A{ / 7 ::;, b
TOTAL VALUATION --I Ilfl_. -
Total Comb. Permit
L-"":\ b.z/ Fr!rL
,';'0
fl<:r 6.2
I I,
I
:;l.;
~~
I
I
I
I
I
I
I
I
I. Applicant 19 furnish
A. Job Addres.
B. Legal Description
1. example.tax lot 100, Lane County Map Reference 17 03 43
2. exomple.Lot 1. Block 3, 2nd Addition to Springfi.
C. Name, etc. of owner and construction lender
D. Energy Sources
1. example-heat/electrical ceiling/or forced air gas
2. example-water heater/electrical/or solar
E. Square footage or valuation, etc. -
1. example,1250 'q. foot house, 500 'q. foot garag
2. exomple.if new project, check new-if addition, c~
add. etc. C
F. Building permit information:
1. exompl~.construct single family house with an a~
ga,'oge C
2.. example.remodel existing garage into family roc
3. example-convert single family residence info
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction delays, Building Divi 'n
Staff must be able to contact appropriate persons reo
design information or job site corrections, etc.
COMBINATION
APPlICATION/~CAP)
!
II.. Abbreviated Plumbing. Mechanical & Electrical Schedul.
A. Except where blank spaces occur in the description p
of the Mechanical and Electrical Schedules, the appli
need fill-in only the No. Boxes adjacent to the appro
item(,) 10 be installed
B. Full Plumbing, Mechanical, and Electrical Schedule,
are available at the Building Division
1. To ,on~rve spoc~ 0:-: thE perm:t forM the schede!
have been abbreviated
2. If the item(s) to be installed qre not covered on th
oted schedules you should consult the full schedul
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A
CHARGES ON THE SCHEDULES
III. Applicant to sign and date
Whenever possible, the initial application will be used a
worksheet only. Where possible, Building Division Stoff .
prepare 0 typewritten copy and return it to the applican
the time the octual permit is issued for his signature.
IV.
Fees and Charges ,
Plan check fee, are due and payable at the time of the c ~.ic
,and no plans will be processed until these fees ore paid, b
other fees and charges ore due ond payable when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Project Information:
PLANS REVIEWED BY,
namp'
",ignaturo
,~ ..'---
~
. .~"
.
. PERMIT V ALIDA nON
(
CITY OF
SPRINGFIELD
(
City Hall
Springfield, Oregan
Department of Public Warks
OFFICIAL RECEIPT
(
(
557141
(
No. B
I Q/"
Date' - '?>() 19 ^. .
Rec'd From ()t(O(J,Llli1l~.A ) (
Address/r)~~~' t.l r f(.(J nzl-t !HtJ )l~
r)(
Received For:
( --)p
37 00
. I.?_ S<
~
(
(
(
(
I,.
(
4010
(
Cfr'
~i.
~
(
qulo
\5.00
f(j()
.zn
c
y j..J loh1(b
_ _135j~~ f"v"r
DVt:-I- F'~ .\-"-' - I. 'Z.()
Amoun~ Received t\j CJ.-. Cb. J t.--
(
I
, ~..I
() €,,'" "GN"U",
'HIUO"'T\I~".U~~ ..~,..TIE:.5 . [u.."..E. 0" ,"uo'
,..11'. (~
('"
Permit Cler~
..I.,te
,
.. __~ -........t_-=:....
-~....
r/
INSPECTION LINE
72~3769
Job Add.." ,,:;,: c; c; c; )-1'/ tJ d!L1d.p
legal Description 'S ::) 00
Li D2.. 34~O
Owne' ~/jJ.P, ~ 7d,unl-l/
Add,e" & c;" -;" ;t//"J(P~/'/~7
Construction Lender
AA---"lA.4.
Address
DESIGN TEAM (namel
Ilpdmo,y -r.? -o/-eb 7: 7/-; j~ ~
Stroci",al
Eh.:rrir.u:
N.l!ch;l.~:r:.;]i
CONTR/.CTORS (name)
l'Gene,ol ~tyjo
'Z Jiu/J--t
Plumbinq
Electrical
01J\YlQJr
Med"l<lnical
PLUMBING
NO.
fEE I CHARGE NO.
I
I
Each single fixture
RelocoTed building
(new fill:. additionoll
S.F. Residence
(1 both)
Duptu (1 beth) eoch
Additional both
Water service
Sewer
Storm Sewer
0-
.~
.~
INFORMA lION LINE
726--3753
CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
I ENERGY SOURC~S, ~tt.o Mo'n 1q:Z'I/~~~
Heat ..... f 'j, Sq: FIg. Access. l> I
I Wore, Heoter . '^ I .",....-- Sq. FIg. Other
Ronqe \.^ /" "". New_Add_Aher_Rep.
I YOIUSI Wi7i. B~ 1__~I~::_DemO_ChOnge/U'.
~, Info~ O~-s~ri'be Work (i.e.. Build Single
7Y'7~ '~~~~:~11; ~,)hr n rrJ
. i-tJ Dl)~ I - --
;'!u7
Phone
Phone
~
---,.
~
~
(]I
(address) (lie1. no.) (~,l{pjres)
.(, ''is 'i k/ ('J~";;if /(l,C>y' ,r "D <.0 VI Iv
0' y"
(phone no.)
7i/f, ~ .ziftJt
(address) (ljes. no.)
~ L:;C; 9 Jtlr!/~ i:l1..1l'L
" /
Units
:!
Residence of
(expires)
(ohene no.)
74fo"';::1)(r.
O\.U'f\(L',
ElECTRICAL
MECHANICAL
FEE I CHARGE NO.
FEE ! CHARGE'
I
I /
so: ft.
furnace/burner to
R.TU's
Appliance vent
seporote
Stationary evcp.
cooler
Vent fan with
sin!:lle duct
Vent system apart from
heotin~ or A.C.
Mechanical exhaust
hood and duct
New circuits, alterations
or extensions
15:'': 15:';;;
SERVICES I Ob (~MD,::>
Amps.
Temporary Construction
FEEDERS
Amps.
TOTAL CHARGES
Wood stove/heater
Heot Pume.
Air handler to
10,000 CFM
Air handler over
10,000 CFM
ISSUANCE OF PERMIT
o
I
I
I
I
I
I
I
r
I TOT At CHARGES
" WHERE S1'ATE LAW REQUIRES that the Electrical work:be done by tha Electrical Contractor, the aledrica portion of this permit sholl na.t b. valid until a
label has bHn signed by an Elactrical Cantractor and attached to the electrical panel.
/5,,j!!.
TOTAL CHARGES
0-
I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further
certify that any and all ......ork performed shall be done in actQrdance with the Ordinances of the City of Springfield and the Laws of the State of Oregon
pertaining to ,h. ......ork described herin, clI'ld thot NO OCCUPANCY will be made of any structure without the permission of the Building Division, I further
certify that my registTation wi'h the Builder's Boord is in full force and effect as required by ORS 701.05.5, that if exempt the basis for exemption is noted
heron, ond that only subcontractors and employees who ore in compliance with ORS 701.0.55 will be used on this project.
Basis for Builder's Board exemption-
NAME (pleose prin1\.
Zane_R Ii_
Fire Zon-
Flood Plain
Type! Const. " ~
Bedrooms
<:'ories_1
BUilDING PERMIT
Charges ond
Surchorges
m __10.. '" ^ :>00
.,:)"', -
/,;1.3
PLUMBING PERMIT
Charges and
Surchorges
I
1
15.02 I
,lee I
I
---------1
ElECTRICAL PERMIT
Chorges ond
Surcharges
MECHANICAL PERMIT
Chorges and
Surcharges
<:,IGNATURF~
fOR OffiCE USE ONLY
Occy Load
Occy Group K I -+ r::: ::.
Plan Ck. Comm!lnd
65%! BldCl Per Fee
Plan Ck. Res
30%1 B[d... p..r Fe'!'
Fence
Demo
Sidewolk
Ale Pnvin..
Curb Cut
DATEi.
I
J
I
i
.1
-'-------
. :':"'U C'I ., -, .:;~.
Sq. Ftg. Mom ~~ ~=
Sq. Ftg. Access -..i .::.\.---
Sq. Ftg. Other
x Value -
TOTAL YALUATlON~b'Z, ~
x '1. .::..:-~~ Value
J( C~. '.:-\j "'alue
;,J....I.-.{ ,
,....::....<:1;"./
I I Systems Development
a Co~ Charoft (1.5%1
i~~;~~~l4'>: ~Cc(v'
- I Totol Comb. Permit
.qfj,'8G
"
hI""; ~/~~
-47. (;,2
L::1 b'l! F~r,!-
,.;20
I TOTAL
11d 7 6,2
j' I
COMBINA TlON
APPlICATlON/~ (CAP)
I. Applicant IQ furnish
A. Jab Address
B. legal Description
1. example-tax lot 100, lane County Map Reference
2. example-lot 1. Block 3, 2nd Addition to SpringfiE'
C. Nome, etc. of owner and construction lender
O. Energy Sources
1. example-heat! electrical ceiling./ or forced air gas
2. example-water heater/electrical/or soiar
E. Square footage or valuation, etc. -
1. exomple-1250 sq. foot house. 500 sq. foot garag
2. exompie-if new project, check ~-if addition, d-
add. etc.
F. Building permit information:
1. exampl~.construct single family house with an c!
go,'nge
2.. example.remodel existing garage into family roc
3. example-convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
.Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building Oivi
Stoff must be able to contact appropriate persons re.
design information or job site corrections, etc.
II.' Abbreviated Plumbing,.Mechanical & Electrical Schedul,
A. Except where blank spaces occur in the description p
of the Mechanical and Electrical Schedules, the appli
need fill-in only the No. Boxes adjacent to the appro
item(s) to be installed
B. Full Plumbing, Mechanical, and Electric,,1 Schedules
ore a....ailable at the Building Division .
1. r (.; con5erve spec,:; O~ tlit: psr:;;:t for!Tl the schedc!
hove been abbreviated
2. If the item(s) to be installed are not covered on th
ated schedules you should consult the full schedul
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A
CHARGES ON THE SCHEDULES
III. Applicant to sign and date
Whenever possible, the initiol application will be used a
worksheet only. Where possible, Building Division Stoff .
prepare a typewritten copy and return it to the appliean
the time the actual permit is issued for his signature.
IV.
Fees and Charges
Plan check fees ore due and payable at the time of the c Jic.
.and no plans will be processed until these fees are poid.~
other fees and charges are due and payable when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Project Information:
PLANS REVIEWED BY,
naml?
c,ignatur-:-
~.~.
~ PERMIT VALIDATION
17 03 43
CITY OF SPRINGFIELD
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