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HomeMy WebLinkAboutPermit Mechanical 1981-4-28 ,:-- ~ r 'r ~ ,... . <)i::U, ?:l..~'''... :-;', I INSPECTION LINE 726-3769 I Job Add.... :( iiJ ,as I legal Description I I Owner I Address' I I Construction lltnder I Address I DESIGN TEAM I Primary I Structural I Electrical I Mechanical I CONTRACTORS General I PlumbinQ . }h~~ CITY OF SPRINGFiElD . (OM6IN A TlON' APPLlCA liON I PERMIT , ENERGY SOURCES: . !..lIlt f e. ~:,:' H.02ruL ~.J INFORMATION LINE 726-3753 ; /Veil' 5' ,- /01 Ii' /' ij..(u 4.. , Ranqe Value of Work: / I 1 Sq. fIg_ Main Sq. Fig. Access. Sq. fIg. Other _New_Add__Alter_Rep. ___fence_Demo_Chongel Use --1.<:),her. ~ of)^ GO' 0'- Phone Building Permit Info: Describe Work (i.e., Build Single Fornil.. Residero(:1! With Attached GoroQe) }t"AJl-a.-e..Q. cof /lJJ 1ft) h.vo /J /VI J ') ), 0 r:Lto AA.- o SD (}l o rLIl~ C7~ Phone (name) (oddren) (lies. no.) (expires) (phone no.) ______ L - ~w 1Y~ jr , (nome) (address) (lies. no.) (expires) (phone no.) fleetrical M"ho";<ol (~~ ~/ ~;:'j--V/b PLUMBING ElECTRICAL ~J-p~ / MECHANICAL /.f7o Lv J-~ NO f:::1:' I CHARGE NO. I I I I I I I FEE I CHARGE NO_ FEE I CHARGE Each single fixture Relocated building (new fix. additional) S.F. ResidenJ:e (I balh) Sq: ft. New circuits, alterations or extensions furnace/burner to fl,TU's Appliance vent separate Stationary evap. cooler Vent fan with sinqie duct Vent system aport from . heatin~ or A.C. Mechanical exhaust hood and d~et Residence of SERVICES Duolu (1 both) each Temporary Construction Additional both Amps. Water lervice I I I I I I I r I TOTAL CHARGES I Sewer Wood stove/heater Stor.m Sewer FEEDERS Heat Pumo Air handler to 10.000 CFM Amps. TOTAL CHARGES Air handler over 10,000 CFM ~if J?~ v /;J14JaJ~r';- 1-1 /),. 0 ')00 ,.(.dC<4 "tAflUYIff fJ,O~ q.- ISSUANCE OF K'MIT I 0 /!)~ d:24,cG / ",C '-'. - "'00 Jd,- TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical worle be don. by the Elertrical Contractor, the electrical portion of this permit shall not b. valid unlil a label has been signed by an Electrical Conlractor ond ottach.d to th. 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 Ihat any and all work performed shall be done in accordance with the Ordi~ances of the City of Springfield and the Laws of the State of Oregon pertaining fo the worle described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I furtne, 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 bosis for exemption is noted h.ron, and that only subcontractors and employees who are in compliance with ORS 70~55 will Z. us on this project. Basis for Builder's Board exemption: NAME (pl.o.. p,;nt)~~ /l/..J/It:,vtJ.I~ SIGNAT~) ~....- ~ D~TE#!A/ FOR OFFICE USE ONLY Zone Type/Const. Units Fire Zone R<;!drooms n"y load Flood Plain e""rie- Occy Group BUilDING PERMIT Plan CIe. Comm/lnd Charges and 65%/ Blda Pcr Fee Surcharges Plan Ck. Res 30%/ Bider Per Fee PLUMBING PERMIT Charges and Fence Surcharge, Demo ElECTRICAL PERMIT Charges and Sidewalk Surcharges Alc PavinQ MECHANICAL PERMIT .,;{1, 00 Charge, and Curb Cut S"'rcharge,1~~'~ ----~-- /, 6.~ 0:::..... Ftg. Main Sq. Ftg. Access Sq. Ftg. Other x "alue Value Value x x TOTAL VALUATION Systems Development Charae {l.5%1 I Total Comb. Permit 4 '{b ;) .- I TOTAL ~ 4 _~<O t,. '-:t=- \ ~... r COMBINA nON APPLICATION/PER. (CAP) 'I. Applica~ to furnish A. Job Address B. legal Description 1. example-tax lot 100, lane County Map Reference 17 03 43 2. example-Lot 1. Block 3, 2nd Additian to Springfield Estates C. Name, etc. of owner and construction lender D.. Energy Sources 1. exomple.heot/electrical ceiling/or forced air gas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq, faot house, 500 sq. foot go rage 2. example-if new project, check new-if addition, check odd, etc. F. Building permit information: 1. example-construct single family house with an attached garage 2. example-remodel existing gorag~ into family room. 3. example-convert single family residence into restaurant (change of use) G. Value af work as defined in Section 303 (0) 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. Abbrevioted Plumbing, Mechanical & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the app.licant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechonical. 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. oted 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 ond payable at the time of the opplication, ,ond na 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: name ~ ~. 2~- .~_. '(2:mJ.- ) ~,ignatur'" , &ERMIT VALIDATION '" Permit CierI. ~ate .' , \',\ ~ COMBINA nON APPLICATION/PER. (CAP) 'I. Applica~ to furnish . A. Job Address B. legal Description C- 1. example-tax 101' 100, lane County Map Referenco 2. example-lot 1. Block 3, 2nd Addition 10 Springfiel 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. e 1. example-1250 sq_ foat house, 500 sq. foot garage 2. example-if new project. check new-if addition, chi add. etc. ( F. Building permit information: 1. examole-construct single family house with an aU. garage ( 2. example-remodel existing garagE:. into faniily roor 3. example-convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the ( Structurol Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Divis ( Stoff must be able fa contact appropriate persons reg design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedules C A. Except where blenk spaces occur in the description po of the Mechanical and Electrical Schedules, the applic. need fill.in only the No. Boxes adjacent to the opprop ( item(s) to be installed B. Full Plumbing, Mechonical, and Electricol Schedules ore avoilable at the Building Division 1. To conserve space on the permit form the sched'ule! / have been abbreviated l " 2. If the item(s) to be installed are not covered on the aled schedules you should consult the full schedule, l C. BUilDING DIVISION STAFF Will Fill OUT All FEES A" CHARGES ON THE SCHEDULES III. Applicant to sign and dote ( Whenever possible, the inWal application will be used os worksheet only. Where possible, Building Division Staff w prepare a typewritten copy and return it to the applicant t ( the time the actual permit is issued for his signaturE. IV. Fees and Charges -I-: . .. Plan check fees are due and payable at the time of the application, and no pions 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, name e-::! f?~- ...,- '/t:::J ~ ) _signaturl" .. ---,---- ( - , ;1 ;. ,~~ . PERMIT VALIDATION 1 I CITY OF SPRINGFIELD ( City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT ( No. B 56391- Date 4,':) f) 19 <5 / . , ., . Rec'd From ~ ~~~ ~<1f)[~ Address ~/O /J),;::l _. ~r'~O_ Received For: CClYlol.JfVUJ\....C:Ao-t ~4, o!!. " " '-'VY[ J r .At, J c -40!r:o to.'-1.\<> (0 (I , \, '( Amount Received ~-'t ' vy- Ll-ul-aL /Po, _a..O;-n/'li::, e,l ~J JuM.-- (I AUTHORIZED SIG"....TUIU: ".su.,. (, S".UO...Tu'''..uu ....ton.".. .UG..... O. ,,7_0' ( I '. Permit Cler~ I I' J J I I I ..Jate / ..... \ . .,....,-,.:00[.- ~',f.'--...-. i-' ': '. INSPECTION LINE 726.-3769 Job Add",,?_ q.t7S . Jh~~ -/ Ulltf CITY OF SPRINGFIELD COMBINATION APPLlCAflON/PERMIT I ENERGY SOURCES: H.ot qrL4- I Water HecKr Ranqe Value of Work: . INFORMATION LINE 7'26-31 S3 (!; '..!d'J) Sq. Fig. Main Sq. Fig. ACCDss. Sq. Ftg. Other _Ne....._Add_Alter _Rep. _._Fence_Demo_Change/ Use -kOlher /Q1 of J.. 00 O~: hgol Description , Addre\! phone -ifuilding Permit Info: Describe Work (i.e.. Build Single F~""ily Re.i~,:"~,: Wj~.!"'~t':'.~~'!~_0aro...c:utl Jt,,, MrJ.ll.. =f ~!JJ;.) . ! J '/1M k j, 1n1oALL hvD 0'"'-""_ CI ))) ,9J I~ I I Owner ~r5r /r9R/'fJ'/Ud__= Construction lender Address Phone DESIGN TEAM (name) (addreu) (lies. no.) (expires) (phone no.) Primary Structural Electrical Mechanical I NO. j I I I I I I I I FEE CHARGE I NO. FEE 1 I I j I I CHARGE I I I I I I ,I ,/ CONTRACTuRS Cnamel (oddreu) (lics.no.l (upires) (phone no,) General Plumbina Electrical M",on',ol /~.... ~/ '~.f"VV/b ;> PlUMBlNG-' I p:t: I CHARGE i NO. / J70 U/ J- &- elECTRICAL ~~-~ I MECHANICAl Residence of furnace/ burner to IlTU's Appliance vent separate Stationary evop. cooler Vent fan with single dud Vent system aport from . heatinq or A.C. Mechanical exhaust hood and d~ct Each ,;nqle fixture Relocou!ld building (new fill;. additional) S.F. Re,iden~e (I balh) sC!:h. New circuits. alterations or ell;tensions SERVICES OUDlu (1 bath) each Temporary ConstrucTion AddiTional both Amp.. WaTer service Sewer Wood sta...e/heoter Storm Sewer FEEDERS Heat Puma Air handler 10 10.000 CFM I I I (".."f? J..'),~I I ,fJ.O'j ,::{ ,0:;: I lOP:!. 1 d4,0.91 Amps. r I TOT At CHARGES I Air handler o.-er 10.000 CFM /P4if ,4vJ..v I /:J1",ClJ~"<- 1.dC<.<1 .;:];UnCi. ISSUANCE OF ~MIT TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be don. by the Elert,ical Contraaor, the .Jedr;ca portion of Ihi.. permit ..hall nol be valid until CI label has b_n signed by an Electrical Contractor and attached to the el.aricol panel. I HAVE CAREFUllY EXAMINED the completed application fa, permit, and do hereby certify that 011 information hereon is true and correct, and I further certify thot any and 0/1 work. ~rformed ,haH b. done in occordance .....ith the Ordi!"anc... of the City of Springfield and the law. of the State of Oregon pertaining to the work de.cribed herin, and that NO OCCUPANCY will b. mad. of any structure without the permission of the Building Di...ision. I further certify that my registration .....ith the Builder's Board is in full force and effect os required by ORS 701.055, that if exempt the basi. for exemption i. notwd heron, and that only Sl,lbcontractars and employees who ore in complianctl' with ORS 70~Sj will ze u on this project. Bosis fo, Build.,'s Boord exemption: NAME (pl.... p"nt)~-5 ~lJ/l~L/i/.Ic..:. SIGNAT~). >:/~~ OATE1l!;J.j.dJ fOR OFfiCE USE ONLY Zone Type/ Canst. Units Sq. FIg. Main Fir. Zone 'l.edroams ro,cy load Sq. Ftg. Acceu Flood Plain <:Tori.r n.cy Group Sq. Ftg. Other BUilDING PERMIT plan Ck. Comm/lnd Charges and 65~:'/ Blda Per Fee Surcharges Plan Ck. Res 30%1 Blda Per Fee PLUMBING PERMIT Charges and Fence Surcharges Demo ElEGRICAl PERMIT Charges and Sidewalk Sutchorges ..Ie Po...it":, MECHANICAL PERMIT ~4, 00 Charge. and Curb Cut Surcharge. '---~-- ! " 6,~ . x Value x Value x Value TOTAL VALUATION Systems De....eloprnent Charne {, .5~,,\ I Total Comb. Permit ;)4,'1.b I TOTAL ~+ct<O ;" %1..