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Home My WebLink AboutPermit Mechanical 1981-4-29 . ~ .: 1 INSPECTION LINE 726-3769 . . ' aD ~,_' P J ,ENERGY SOURCE~' / tot:, / r U-I'J)/JV 44. ' H.ot ""/ /}) / 7-();;J. L _~4- 4() 71- 3 2(J:1 ~:':: H.ot.. . " I Value of Work: ~ '"* ~/Yl(11.Ao. _ .LJo'YI.LJ'1i ('-., 570. c,g Addreu (1) (Dc!t, ~/lJ~ ~~ - Phone 7;)h-9JlntJ ~~~~:~gR:,~~:~'t~n;i:th ~~:~:~eed~:r:~i;~.. Build Single .J,(J/d..:; ('Ji,o --1hdajfl/~~~~II/J1J , Con"."'Ho/".~, ./,1 d ~"" d)).;r/. W~) /r CITY OF SPRINGFIELD COMBINATION APPLlCArlON/pERMIT . INfORMATION LINE 726-3753 Job Add,!!" Sq. Ftg. Main Sq. fig. Accen. Sq. Fig. Olher _New~Add,_Alter_Rep. ___Fence_Demo_c~ Use XOlher !, \C'~A ~ CY --' o 'l'J .-0 --0 legal Description Owner Address Phone DESIGN TEAM (Mme) (address) (lies. no.) (expires) (pnone no.) Primary CONTRACTORS {nome)l G.n.,ol 0 < ^^^ , .D 0 M J I \{l/Y\Jt" o rLUnU ~OLu'l'L\ (address) /I (lies. no.) 113_")-qt5~ w- ,,, fL ~~ZJ -)? (.x.I,,,, V (phon. no,)' 7;)10- /~7t, Structural Electrical M....h"'nicol Plumbinq ~ - Electrical Mechanical PLUMBINC ElECTRICAL MECHANICAL NO. I fEE CHARGE NO. FEE CHARGE NO. FEE CHARGE I I SERVICES furnace/ burner to IlTU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent system aport from heating or A.C. Mechanicol exhoust hood clnd d~ct Residence of Each single fixture Relocared building (new fill. additional) S.F. Residen~e (1 both) Sq: ft. New circuits, alterations or e",tensions Duolu (1 bath) each Temporary Construction Additional both Amps. Water service Stor;n Sewer FEEDERS '00 0 ,"), _ ,r"SO_ I I I I I I ISSUANCE OF PERMIT /6,09 TOTAL CHARGES /6:~ Heat Pump Air handler to 10,000 CFM Sewer Woad stove/heater Amps. Air handler over 10,000 CFM TOTAL CHARGES TOTAL CHARGES WHERE STATE lAW REQUIRES that the Electrical work be done by the Ele..trical Contrattor, the electrjccd portion of this permit sholl not b. valid until a label has been signed by an Electrical Contractor and attached to the electrical panel, 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 work pIIrformed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the Slot& of Oregan pertaining to the work described herin, and that NO OCCUPANCY will be mode of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors o~ emplo;;ees wb ore in rfmpliance with ORS 701.055 will be used on Ihis project. Basis for Builder's Boord e",emption: _Jl1\ J1 ~ JJY\ ~ "GNATURE ~AJ'\-,Ol1L D~ DATE 4-;1 q-~ NAME (please print) FOR. OFFICE USE ONLY Zone Fire Zone Flood plain (-r' I Type/ Const Bedrooms Ctoria! ~nits r"'l..cy load Ocey Group c,q. Ftg. Main Sq. F'g. Access Sq. ftg. Other x Value x Value x Value TOTAL VALUATION ,""')7") 00 BUllOING PERMIT Charges and Surcharges Plan Ck, Comm/lnd 65%/ Bide Pcr Fee Plan Ck. Res 30%1 Bldg Per Fee Systems Development Chorqe (1.5%) PLUMBING PERMIT Charges and Surcharges fence Demo I Total Comb. Permit elECTRICAL PERMIT Charges and Surcharges Sidewalk TOTAL I ~5&O AI C Poy;n"! MECHANICAL PERMIT Charges and Surcharges 16,~ -----{j;V-- , {5. /' Curb Cut . , ~ , . r . . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant. to 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 '0 Springfield Estates C. Name, etc. of owner and construction lender D.. Energy Sources 1. example-heat/electrical ceiling/or forced air qas 2. exomple.water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foot house. 500 sq, foot garage 2. example-if new project, check new-if addition, check add, etc. F. Building permit information: 1. example-construct single family house with an ottached garage 2. example-remodel existing garagE. into family room 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 Cade H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Stoff must be able to contact ap'propriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Elec'rical Sched~les 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 are available at the Building Division ,. To conserve space on the permit form the sched'ules have been abbreviated 2. If the item(s) to be installed are not covered on the abbrevi~ ated schedules you should consult ,he 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 as a workshee' only. Where passible, Building Divisian Staff 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 PIon check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and poyable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ~.. , Additional Project Information: PLANS REVIEWED BY, name .,ignatur.... ... ~...t~ · PERMIT VALIDATION Permit Cler~ '"'are ~ " ~ - '. ( . INSPECTION LINE 726-3769 . . INFORMATION LINE 726-3753 CITY OF SPRINGFiElD COMBINATION APPlICAJlON/pERMIT (;'~90 ~).M.J J1. logal o.""p';on L.7-()~ 31- 4() T7 . f> ~ 1f1\-1 J.j ..;,. vdl'V?1FJA 0- 'o'YLI:J:1i h Add,... 10 ({)4~ -iYJ111~, v.J- Phon. 7;;;t,-9.:JU) I - 70.111 Job Add,."" I ENERGY SOURCES: H.at L' y./J) 3 ?Qj;:';: Heat., I'Value of Work: .:575. c!7 Sq. fig. Main Sq. flg_ Ace.n. Sq. fIg. Other _New _Add _Alter_Rep. ___Fenc~_oemo_c~uut XOlher ! - \(,11/1 W Owner . ., tj --' Cl )'J .-0 'l"O I I I can",",f[jf.~ Building Permit Info: Describe Work (1.." Build Single Familv R",idencf! With Mt~~"'ed Gorcee) J/YJdaifl, ~? =-r-t1t1A?~J!/A1J , ./-1 j t'.b,rffd>J.ui LU~ J - /r Address DESIGN TEAM Phone . (address) (lies. no.) (expires) (nome) Primary Structural Electrical Mechanical CONTRACTORS (nome) a < 'l^^ ' f) 0 1\11 >> I IIlmJ-. 0(" U..\nU tOuJ-Y1 ,) ;:... (address) (J'\ h (lies. no.) If ~.'"i 1) 15 -, ,1--1- / U (expire,) G~neral PlumbinQ ~ Electrical Mechanical PLUM81NG ELECTRICAL MECHANICAL NO. I fEE CHARGE NO. CHARGE NO. FEE Residence of furnace I burner to :l.1U', Appliance 'tent separate Stationary eyop. cooler Vent fan with singl. duct Vent sy$fem aport from heotinq 0'" A.C. Muhonical exhaust hood and d~ct Eoch ,ingle filllur. R"locol.d building (new fix. additionol} S.F. Reside"~. (1 both) Sq: ft. New circuits, alterations or .xtensions SERVICES Ouolell. (1 bolhl each Temporary Construction Additional bc:Jth Amps. Waler s.,vice Sewer Wood sloy./heate, ShJt.m Sewe, FEEDERS Heot Pump Air handler to 10,000 CFM Air handler over 10,000 CfM Amps. I r I TOT At CHARGES I TOTAL CHARGES ISSUANCE Of PERMIT I TOT At CHARGES (phone no.) (phone no.) 7c2lo- 11S7e.:, FEE j CHARGE I I I I I I I , , '00 0 .5. - .'S.O_ I I I I I I I / (y,,9 /6o:! WHERE STATE LAW REOUIRES Ihal Ihe Electrical work b. don. by Ih. Elertrical ConlraCfor, Ihe electrical porlion of Ihis permit shall nOI b. valid unlil a label has b..n s;gned by on Electrical Contractor and attached 10 Ih. electricol panel. I HAVE CAREFULLY EXAMINED the completed applicalion f"or permit, and do hereby certify thai aU information hereon is Irue and carred, and I further certify Ihat any and all work performed sholl be done in accordance with the Ordinanus of Ihe City of Springfield and the Laws of the State of Oregon pertaining to the worl.: described herin, and thai NO OCCUPANCY will b. made of any Itructure withoul the permission of the Building Division. I further cerllfy Ihat my registration wilh the Builder's Board is in full force and effect 0 s required by ORS 701.055, thai if exempt the bosis for exemption is noted heron, ond that only subcontractOrs anp> emplo".., wR. or. in (ffmplianc. with ORS 701.055 will b. used on Ihis project. Basis for Builder', Boord exemplion: !:J.A..f\. >>l1 ~ JJlrYl.It:K.A- ."-"ATURE ~n,OJ1. D~ NAME (please print" FOR OFFICE USE ONLY Zone Fire Zone Flood Plain l-r-' I x Type/ Canst 6edrooml Ctorillr !nib t"'l'..cy Load "".cy Group Sq. Ftg. Main Sq. Ftg. Access Sq. Ftg. Other DATE 4--;:l q.3L . I I "alue x Value Value TOTAL VALUATION ...''')7~~;> x BUILDING PERMIT Charges and Surcharges Pion CI.:. Comm/lnd 65%/ Blda Per Felt PIon Ck. Res JIWol BldCl Per Fee Systems Developmlllnt Chorae (1..5%1 PLUMBING PERMIT Charges and Surcharge. Fence I Total Comb. Permit Demo ELECTRICAL PERMIT. ChQrges and Surchargu Sidewall.: I I I I TOTAL 'FJ5 I I --I Curb Cut AIr: Povin~ MECHANICAL PERMIT Charges and Suu;halges /6, c:5' ---C!>. (p~ .. ~ .. {pO ~. ., . ,. , .. , - l ) . .PERMIT VALIDATION . " , COMBINATION APPLICATION/PERMIT (CAP) I. ApplicanJ. to furnish C. D., OF SPR\NGF\ElO City Hall springfield, orega~. rk' 01 Public .. a DepartrneCn: A l R E C E' p" Offl 101 B 1,0. h~' Dole -4.'}. ~ j ~;l~a ~oI1r)~' C" ~." "0. ~':f::;:;'~ Aftt/~ ( ~r~55 (j,-~ _ _.- -' f2)(j r. =- -'-- ))~ I; Jdr-l. ~/" - ~eceived for: .J - I/.J~' _ I' _ - ( ( \ , A. Job Address B. legal Description 1. example'lax 101 100, lone County Mop Ref---- 2. example-lot 1. Block 3, 2nd Addition 10 Spr (h Nome, etc. of owner and construction lender . Energy Sources 1. example.heot/electricol ceiling/or forced air L! 2. example.water heater/electrical/or solar { E. Square footage or valuation, etc. - 1. exomple-1250 sq. foot house. 500 sq. foot go 2. example-if new project, check n;w.if additior odd. etc. F. Building permit information: 1. example.construct single family house with an garage 2. example-remodel existing garagt. into family r 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 ovoid design or construction delays, Building Oi\! Staff must be able to contact appropriate persons re design information or job site corrections, etc. II. Abbreviated Plumbing. Mechanical & Electrical Sched~le A. Except where blank spaces occur in the description p( of the Mechanical and Electrical Schedules, the applic need fill.in only the No. Boxes adiacen' to the approp item(s) to be installed B. Full Plumbing, Me<:hanical. and Electrical Schedules . are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the c oted schedules you should consult the full schedules C. BUllOING DIVISION STAFF Will Fill OUT All FEES ANC CHARGES ON THE SCHEDULES --c\lY , ( 56405( \ \ - c ft1 0 r J.. ) ~ 1-4% I ..:. Io:lI oC> J ~-S,- o.~- ( ( ~ ( ( ~ - (I - c_ ~(J ~e' ( -...-------:.-1'--:-~ 00 _A .1____ ---rr J I ,- ~=- t Received , -'.- -- - Amoy" -' ;..-----" - _....-.~ ~..-= IV. III. Applicant to sign and dole Whenever possible. the initial application will be used as a worksheet only. Where possible, Building Division Staff will .{ prepare a typewritten copy and re'urn it to the applicant at ' the time the actual permit is issued for his signatur~. Fees and Charges { Plan check fees are due and payable at the time of the appliclolllP5> and no plans will be processed until these fees are paid. All "",//' other fees and charges are due and payable when the permit is issued. ( ...- ( "UTt~Ofl;'1.EO 5IGI'4"TU:: ,..,,0' ...,..u:". .I;UGIIMI, ....\.TO..."U.....UI.\. ..."., ( ) . ..-" .---- ----- - --- ---- --. V. fOR OFFICE USE ONLY Permit Cler~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: , Additional Project Information: PLANS REVIEWED BY: name signature ,..IatD .,'-' .--~ .. t-' . '. ,-........ -. . -~. ~ ..... .--. ,'. . . i'ie, -... '-,. '.,~ .' 1 ";::" '>;,,~;~~,,-_.ii~It,' "_~'l,~1 . . . . . " . . . r: I . .\ ~J';', ' ," --"- it _,,1U..O ~'J"- _~",,'.' ,~::---;v_,'.'1!&' ......."-:._.../!1.~(C::;. "" ". ....- "i"1" ".. " "'. . '- ",",,~r .,...... ~.. 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