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Home My WebLink AboutPermit Mechanical 1982-2-12 INSPECTION LINE 72~769 -. CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT . INFORMATION LINE 726-3753 c Job Add,... (./4',1 0;;.:>,'-1/7 )/2-,~\. legal Description J 7 - n .....J - 2.. 'J - ~ I -r./- - . - . *.:\-,' "- .' '4- '->.....'-1 ':I Owner _ t ---, Add,... ./~;:: (\ ). '"'"> ~ Phon. (" '> n.Cl..- ENERGY SOURCES, Hea" Water Heater Range Value of Work: Sq. Ftg. Main Sq. Ftg. Acc:eu. Sq. Ftg. Other _New_Add_Alter_Rep. _Fence_Demo_Change/Use _Other "~ '}" \) () \) ~ ^ ;': Construction lender +.. Building Permit Info: Describe Work (i.e., Build Single Family Residence With Attached Garaae) j.)'JflJJ(b .~/. .2. _ C' a -. .,..t.././ -"',..4-<--,,-",,-'./:1 Address DESIGN TEAM Phone (name) (address) (Iics. no.) (expires) (phone no.) Primary Structural " Flnrtrirnl Mechanical CONTRACTORS (name) (address) (lies. no.) (expires) (phone no.' G..nerol Plumbina Electrical M.ohon;",1 --1/Y1 /J.A~' .I jlJ:; PLUMBING ELECTRICAL MECHANICAL NO. FEE I CHARGE NO. FEE CHARGE NO. FEE CHARGE Residence of ,:) furnace/burner to 111 J .1,,\, \IlTU's Appliance vent separate Stationary eyap. cooler Vent fan with single duct Vent system apart from heatinp or A.C. Mechanical exhaust hood and duct U,lJv /.1'>: Each sinRle fixture Relocated building (new fjx. additional) S.F. Residence (1 bath) s9' ft. New circuits, alterations or extensions SERVICES Duplex (I bath) each Temporary Construction .1 I I: I I I '1 Additional bath Amps. Water service Sewer Wood stove/heater Storm Sewer FEEDERS Heat Puma Air handler to 10.000 CFM Air handler over 10.000 CFM Amps. ISSUANCE OF PERMIT I I tJ,()b ;.{..),) .,J' TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES ,vl WHERE STATE LAW REQUIRES that the Electrical work be done by the Eledrical Contractor, ,he electrical portion of this p.rmit shall not b. yalid until 0 . label has been signed by an Electrical Contractor and attached to the .lectrical panel. I HAVE CAREFULLY EXAMINED the completed application for permit, and da hereby certify that all information hereon is true and correct, and I fUrther. certify that any and all work, performed sholl 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. and that NO OCCUPANCY will 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 fOt'co and effect a s required by ORS 701.055, that if exempt the basis for exemption is noted ~rS~:'fO:n:Ui:::~so::r:u:::::i:~s and employees who are in compliance with ORS 71201.055 will be used ~n}hiS ~roied. o' '7l i~..,./ / I/? } NAME (please print" c;lGNATURE ,:!, ,l1 / ;5....;-:-,":IU./ / E{. L > /i!. DATE fOR OFFICE usE' ONLY Zone Fire Zone Flood Plain Type/Const. Bedrooms Ctorie..__. Units nccy Load ":'ccy Group Sq. Ftg. Main c:". Ftg. Acces' Sq. Ftg. Other x Value Value Value x TOTAL VALUATION BUILDING PERMIT Charges and Surcharges Plan Ck. Comm/lnd 65%/ Blda Per fee Plan Ck. Res 30%/ Bldt:l Per Fee Systems Development Chor,Qe (1.5%\ PLUMBING PERMIT Charges and Surcharges Fence Demo Total Comb. Permit ELECTRICAL PERMIT Charges and Surcharges Sidewalk MECHANI~AL PERMIT Cho,m;.~- ~\- '~___-",,"lJ,7, S~rges ~ -, 1/1 - Curb Cut ( , ~,~ \, TOTAL A f C Pavin,Q - ~' /.2'., 'I . . . LV"';, nf. .. - - - . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant ta furnish A. Jab Address B. Legal Descriptian 1. example-tax lot 100, Lane County Map Reference 17 03 43 2. example-Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender O. 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 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 attached 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 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. 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 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 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 as a worksheet only. Where possible, Building Division 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 Plan 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 payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY, .ignature-d , nom"" . . PERMIT VALIDATION ~:If ~ ~gv 35" J)jt r Permit Clerlr dated_,",/,:2 -YL , .. COMBINATION , ,._' l.- --::...I 1'" . .. ~.' .~ "...,'" ~' .. APPlICATION/P~'P (CAP) i I. Applicant to furnish A. Job Address B. legal Description 1. exomple.tox lot 100, Lone County Mop Reference 17 03 43 2. exomple-Lot 1. Block 3. 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender O. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example-water heater/electrical/or solar E. Square fo<?tage 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 attached 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 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. II. Abbreviated Plumbing, Mechanical & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechonical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanicol, 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 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 as a worksheet only. Where possible, Building Division 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 Plan 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 payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: t PLANS REVIEWED BY: nam"" "',ignatur... 1."., .' ,....f- 1 .. ,. . 1 .,.,.f .,>.:,:...' ..- , '. ~ERMIT V ALlDA TIOf',l I' # ~'';''':'';'--"I' \ Permit CierI- r .Jat.. ~ .\ INSPECTION LINE 7264769 . CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT .. INFORMATION LINE 726-3753 Job Add,e.. I./'Iri.S c:.yy;~ Water Heeter legol O",dp'lon I I~12:J~.3>:).~~/--.-5L ._~300_ Ron.e I Volue of Wo,k, ENERGY SOURCES: Sq. Fig. Main Sq. Ftg. Access. Sq. Fig. Other _New_Add_Alter_Rep. _Fence_Domo_Change' Use _Other ~ B ~ ~ Heat Owner Addreu phone Building Permit Info: Oescribe Work (i.e., Build Single Famih Residence With Attached GaroQe) Construction lender ~. .2.-t:e.A<~. ~~ Addreu phone DESIGN TEAM (nome) (address) (lies. no.) (expires) (phone no.) Primar\" StruduroJ Electrical Mechanical CONTRACTORS (name) (address) (lies. no.) (expires) (ohone no.:' General plumbina Electrical Mechanical ~~ PLUMBING ELECTRICAL MECHANICAL NO_ I fEE , CHARGE I NO. FEE I CHARGE NO. FEE ~CHARGE Residence of J furnace/burner to .I0"OQO.BTU', (,~O /2."1I Eocn sin!=lle fixture Relocated building (new fix. additional) S.F. Residence (1 batn) s9. ft. New circuits, alterations or extensions I I I r--- Water service I I I I I I I I I TOTAL CHARGES I WHERE STATE LAW REQUIRES thai the Electrical work b. done by the EI.ctrical Contractor, the electrical portion of Ihis permit shall not be valid until a label has bHn liuned by an Electrical Contractor and attached to the electrical panel. SERVICES Appliance vent separate Stationary evap. cooler Vent fan with sin!=lle duct Vent system apart from heatine or A.C. Mechanical exhoust hood and dud Duolex 1I bathl each Temporary Construction Additional both Am!)s. Sewer Wood stove/heater Storm Sewer FEEDERS Heat PumD Air handler to 10.000 CfM Amps. Air handler over 10,000 CfM ISSUANCE OF PERMIT . I/),{)l $~~.t::7/. TOTAL CHARGES TOTAL CHARGES I HA VE 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 performed sholl 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, and that NO OCCUPANCY will b. mode of any structure without the permission of the Building .Division. 1 further eertffy that my re-gistration with the Builder's Board is in full force and effecl os required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used this project. r:../J Units Occy Load nccy Group C;:IGNATURE FOR Of'CE USE CNl Y Sq. ftg. Moin Sq. Fig. Access Sq. ftg. Other DATE Basis for Builder's Board exemption: NAME (please print) Zone Fire Zone Flood Plain Type/Canst. Bedroom' C;:tori~'. Value Value Value TOTAL VALUATION x x BUILDING PERMIT Charges ond Surcharges Plan Ck. Comm/lnd 65%/ Bid!=! Per fee Plan Ck. Res 30%/ Bid!=! Per fee Systems Development Char';le 11.5%l PLUMBING PERMIT Charges and Surcharges Fence Demo Totol Comb. Permit ELECTRICAL PERMIT Charges and Surchorges Sidewalk AfC Pavina MECHANICAL PERMIT Charges and Surcharges _____d2.(Jn Cu,b Cut ,'If. iOTAL ~ 0&{, 08'