HomeMy WebLinkAboutPermit Miscellaneous 1983-2-11
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,.
~ IrISPECTIOII LINE.
J 726-3769
Job Address ~ifO.s- 11IA-IAJ ST,
legal Description 17' d::l' "3 ~r~ I
,
CITY OF SPRlIlGFIElD
Cm1BI:IATlON APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
Hater Heater
,
S,.Pt-=t..<7
~~~~.e
Ranqe
INFORlIATlON LlNt
726-3753
Sq. Ftq. I';ain
~q. Ptg. Access.
Sq. Ft9. Other
r~e\... Add Alter Rep.
--Fence Demo Change/Use
Other- -
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Owner
R U S 7Z>!e tZ /1tIc.
t.r4'O.r /?/,tH/I./ J r
.s~ Pt-d
ValuE' of Hark:
S~.....
Bui16ina Permit Info: Describe Work(i.e..
Familv nesidence With Attached Garaael
Address
Phone
7 ~/-o.r.r.r
Build Single
Construction lender
I/JOAJI:i'
-
tf//.{J7E. /)1//H4 Snr1r/C/IC/
~ 40:. I/"1H' ~ .cr:r
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IOf amps.1 I I
ICOMH.IIND. FEEDERS I I _I
I~~~;~~~~a~~;~~~;locate I I I
.Iof amps.111
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I I I I ISSUANCE OF PFR'1lT
TOTAL CHARGES I TOTAL CHARGES I TOTAL CHARGES
WHERE .STATE ,LAl~ REQUIRES that tile Electrical ,work ,be done -by an Electrical Contractor. the"electrical portion 'of-this pemit
shall not be valiJ until the label has been signed by an Electrical Supervisor a~d returned to the Building Division
-
Address
UI:.~lljN fEAt.'
Phone
(address)
lnamel
flics.no.)
Primary
"-
Structural
E1 ectri ca 1
Mechanical
CONTRACTORS
Genera 1
(namel
-- S &::..'7.....,e.. --
(addrpss)
(lies. no.)
Plumbino
Electrical
'.lechani ca 1
PlUI1BItIG
'ELECTRICAL
NO.
FfF
CHARt,F .Jl('
ITL J:I!ARG.E. ..lliL
I
Each single fixture
Residence of
s:-
SQ. FT.
IRelocated building
(new fix. additional)
Is.F. Residence
(1 bath)
IOupIex (1 ,bath) each
jAdditional bath'
I ~!a ter servi ce
I Sewer
IStorm Sewer
INew circuits alts.
or extensions
I SERV ICES
I
jTemporary Construction
IChange in existing
r~c;. i rtpncp
Imultifamily, comm. or
lnrl"c;.trial
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(exn;res)
(ohone no.)
~
*
(~)t"n;rps'
(chnnp nn. ,
j
.
MECHANICAL
...
rul\RliE.
,/
furnace/burner to
BTUls
I Floor furnace
.and vent
I Recessed wa 11
~n~cp hp~tpr ~nrl
vpnt
I' 'Appliance vent
sp-oa ra tp
I'Stationaryevap.
cooler
I Vent fan with
sinole lil.lct
I Vent system apart from.1
heatinq or A.c.
I Mechanical exhaust .1
.hood and 'duct.
-I-~Joodstove/heater I
I
I
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I HAVE CAREEULLY EXAIIINED .t~e..completed application for pennit.and do hereby ",ertify that all infonnation hereon is true
and correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the tity
of Spri ngfi e 1 d and the Laws of the Sta te. of Oregon perta i ni ng to the work descri bed herei n. and that NO OCCUPAIKY wi 11 be made
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 hereon, and that
only subcontractors A! JlSees w;;;e i/~~an~e with ORS mI.055 will be used on this ?ject.
HAI.IE(please print)~~ ttI. .rCII~C,trt.srr,;IATURF~~/~Y~DATE 1II1/IJ
r FD~ OFFICE USE <mtv- .. /j ,
Zone .:::: l:- Type/Const. Units S~. Ft~. 11aii/ x Value
Fire Zone Bedrooms Occy Load Sq. Ftn. Access x Value
Flood Plain Stories Occy Group Sq. Ft;. Other~,/>sre ~.P ValueS"~-
,,S7~T~N. JDTAL.VALUATlDN
BUILDIIIG PERfIlT
Charges and
Surcharges
<"" .... Plan Ck. Conm/lnd
____y_"-_____ 65%/81do PJ'r Fee
-<Z ~ Plan Ck. Res
. 30%/Bldq Per Fee
_____~~~__I Fence
2~ Demo
~ --- -- --- ---I:;;e::::ng
I
I
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L
PlUtlBING PERMIT
Charges and
Surcharges
ELECTRICAL PERI:IT
Cha rges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
Curb Cut
Systems Development
Charqe (1.5~)
I
Irotal Comb. Permit I
TOTAL -I
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~
tit
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax lot 100. Lane County Map Reference
II 03 43
2. exam~le- Lot 1. Block 3, 2nd Addition to
sprlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. examele- heat/electrical ceilinq/or forced air Qa
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. ------
I. exam~le- 1250 sq. foot house, SOD sq. foot garage
2. example- if new project, check-niw - if addition,
'check add. etc.
F. Building pennit information:
1. exam~le - construct single family house with an
a ttached garage
2. exalllPle - remodel existing garage into family roor
3. .example - convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Struct8ral Specialty Code
H. DESIGN TEM4 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.
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 adjacen1
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedule~
have been abbreviated
Z. If the item(s) to be installed are not covered .on
the abbreviated schedules you should consult the
full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor iscnot authorized
to sign the electrical label. ----
Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet only. Where possible, Building Division Staff
_will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for 'his
signature.
-fees and Charges
Plan -check fees are due and payable ,at .the ,time of .the
.app 1 i ca ti on, and .'no plans wi 11 be processed un ti 1 these
fees are.paid. All other fees and cha~ges are due and
payable when the permit is issued.
111.
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V. "'FOR .OFFJ CE USE 'UNL Y
1.
v.. . VI ...,. ............ I~"W'
(
CltyHan
Springfield, Oregon
Department of Public Works
OFFICIAL RECEIPT
No. 86D40.L
&;>3
57'<Y3F / He- .
,
4'L/C'.S-- MA.-".N' 5r-.
-
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Dale F~ II 19
( Rec'd From T #.i:!: l< V
Address
(
Received For.
(
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/;t,/rsT<P 7/v;y;,:z> <)r4T/?'/Y
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~50"?O /
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7.5. r-.
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p:p.
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_ '""20
s: 6<:;>
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-~-- /..1..' L/p
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c:.#€<:p{' ~ <3'93
10, ~o
Amount Received
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'Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
C6st>~l:>/H<f:r~ Il~p((j w ~.eY.s-_7/"'~ ;re.:t=>t->/J7t!:ho-~7.s
C>/Y '~./~H- ~...v '::;r-"!'9 :J,..fiT# 077 ~eJ.>wZi1/'7"C.. l'
;
/ #!;rrE"C 707<?
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name
L6?J"#E '?~E...-"'S
Signature~~ :
A
,~~
date
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fDrain'Hatch Cover
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.' F!J' Dump' 'St~'ti~'ns. Q i . .
-'4:Hex config~'-ati'on of ,I ."
:.,.t.base'. serves 'is' con. ... ' .'. .
'\ 7';~Tchor 1;:F:(~~;:.~t~~~~~~ .,
, ~41:00 ,.i:i;ain Hatc~ .Cover
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'Item
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3'
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N.me Ma'I'I.I,,,m
Base Iron 4
'Cove,. Bronze 5
P.!SI1 Bronze '
N.~
Pin
Pin'
M.t't
Cad, PI.Stl.
C.d.Pl. Stt
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-;/,~".,. ,
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..... .
r'Grade
,_ I, . Weep hole. ' ~
4" 0' J '." .';"~,\.~...~.' :": '.
.' la,'~.,..' n';:"'!:, "",. /~~~
~~:. .:" .;,. .' ~.:' ".:;~~:{~ /" ,:';.,~'~'~';,?" :"', ./j
,..:~.... "":':.<:'.-.'<\~:~.:....:.,. ",'~".'/.'
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(1) :$103.95 ..
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.:. Plastic 'Liners
:'
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.....
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Plasti~ liners .are conve~ient fo~ lining
trash can.
. .
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or 'for filli~g where there is no .'
.
trash containers,
....
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'50.0016.00
50.0015.00
50.0017-00
50-0228.00
50-0227.00
Plastic Liners. 15 x 9 x 24 x 1 mil. ~ 10.15 Gallon. 500/Case ,$30.45
Plastic Liners. 30 x 37 x 1.4 mil.' 30 Gallon. 250/Case . '~' :$30.45
Plastic Liners. 33 x 40 x 1.4 mil.' 33 Gallon. 250/Case '$36.9!j'
Heavy Duty Liners. 22 x 14 x 60 x 1.45 mil. .55 C..llon .100/Case $39.99
He~VY DutyLin.r~ .23:X17 x 48 x 3.0 mil. " ~ GaIlO~ - 250/~se $52./
,,' .Sanitary .. j";;'!/':--x;, ~
'. . ;,;' ~if4!~
Dump Station ;",:;;;:':, ,
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, INSTALLATION PLAN ' ' . ..':.~, .
';,' . ,'., :7 (!~ 1/ rn"N'.r-. <,' \
. I f!Jre)jn"k~'~C;:
_'. DISPOSAl:'SIAI!QN.!'
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m. TO Sf: OV(Rt PAD WHIlE.
DRAINING; PlACf DRAIN Hon
, SlCURUY'IN-DRAIN;DPlNING'
WHlll HOLDING COV(R'OP(N:
WITH FOOT. (fHCTIVUY.flUSH'
PAD AFnRrUCH USE.'
, '~i#:\F
. . L Shut off valve ' . .
~r NOzz~e~' ~. SIGN B
M'/', 1'. 6" 1-1/4':'1'e.
""" . , & Plug
Mm. 1 1/4" 'po
.~. Ipe
I ~ T S.~ee~e
\fl. . '".,. ,."'.'
.... "~ ,;;iJ . '.
J. Service box
_ _ . _frost Line :--
.--" .
. L:S/3-Way Cock,with
,_", ~';. Extension Handle
',., . ~'. '. . - I
":'(.<~:..:
I
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SIGNA
; -~...
.Sanitary stations provic;le for proper
.. ~ disposal of liquid wastes from sew~
age holding tanks of recreational ve.
; hicles~ Each sanitary station has a
.~. wate; tower to permit periodic wash.
. ...' '-down of the drain inlet area and to
identify its location. A separate wap
.' - tering station has another water
, tower to fill RV water storage tanks.
Ground Level
, [DRAIN HATCH~"
(50-0011-00)
..
,
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10
. III
,B
;; -;
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II A-Vacuum breaker. .
~ :___,,-C"":_3/8" 10 flexible hose;'9' long,
,,': ' with approximately 15' reach.
. - '7~;- C-Extra heavy spring, 5" diameter,
_".''-.;..'.'~..';:'':'. ." ..'. returns the arm to its normal ver.
tical position.
";io : . -0 0-2" red painted steel pipe.
';, .':l; ---E') . "E-3/B" shut-off valve. '.
f =.....' f...:.open water nn:rz1e..b.w1-. . .
.',. T'"l. . '.G-~ater connection bushing, 1/2"
'. .' pIpe. , .' ..
. . .'.' . H-9.3/4" round steel casting base
..!!!l . G 'with foundation holes for 1/2"
... H bolt...
! / ..
.51.0064-00 Water Tower for Dump St~tion . ~ J
~.().B. Oakfield, Wisconsin - Allow 4 weeks for delivey
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to... - >=
4'; C:I:-O~ VitrmedPipe:~
. Control Valve
o, .!l,Access Door I-- 2'.0" --t
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foo'. . Co 0-]
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~1'.8"-....'...'.,! .............
I / I ! Sewer Drain . ...............
. . .: -:-5'- 0;', Minimu... : ; I
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.564
PRICES SUBJECT TO CHANGE WITHOUT NOTICE
~ CALL FO.R PRICI~
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