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Home My WebLink AboutPermit Mechanical 1981-11-26 I INSPECTION LINE 726-3769 . CITY Of SPRINGFIELD COMBHIATION APPLICATION/PERIIIT '" E!IERGY SOURCES: Heata ;.1. Hate! Heater Ranqe ValuE, of l'lork: . INFORltATlON LINt 726-3753 'Sq, Ftg, I.lain ~q. Ftg. Access. Sq, Ftg, Other New Add Alter Pep, Fence _Demo_Change/Use _Other I ~ - Q )0 G .( Legal De,cription I I \ Job Address,'?f7..t:;'./J)JA~1v S 1ev,1.... !7-DZ-cz,/-tJ-1 OJ_<;tHJ Owner .8fJt.T ~L j,.;.... E/I:'"'I-A>~.' Address ~ lr 7~' . ~ 0.. ,..;/ ,r.L ?~nl::.1 J) .I . ('.6?~7,(" 1fti' 6L 1 Constructi~Le~der ..... Address O[~ I GN T[AI~ (name) Phone (address I I BullriinQ Permit Info: Describe Work(i.e., Build Single Familv nesidence With Attached Gara~e) J-f~~O~^~ ~f\' Mechanical CONTRACTORS ' (name) (address) (lies. no. \ lexoiresl (ohane no. ,~ I . , ~ _._-,-~ " ,,-- j i . . I - (11CS_ no.l (exnirp~\=__. "':"dnhnnp nn.....r-- i Primary- Structural Electrical Genera 1 . P!umbinn ,7":; <.LV".,..I./ .,/J/- h"'J" Electrical . <JC ? i " ~7r1,:, .#u~~~, '; r -llJ, . I - -, . i , ' _ 'J~~chanical --~"'-=....~~ =-"-'-"'---_."..=-'-=--=~-~---=,,---...,... - PLUllB I NG ELECTRICAL MECHANICAL ""'NO. -'-"--"- ~.. - '-~'...., ...~-'~.....,-. ,--....:..:.....""'-'--"'~..- FEF "EiiARGr .1'n, ... '.. ..,-, , -, FFF ___ ~~_=--""""7W. rHARt,F NO. FFL CHARI~F " 1 I , Each single fixture Residence of SQ, FT. furnace/burner to BTU's Relocated building (new fix, additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (I bath] Duplex (1 bath) each Additional bath SERVICES ,~ Recessed wall S~np~tpr ~nrl vpnt /, l'lo.: lP- b/.!- i , Storm Sewer Of amps. Appliance vent ~eoarittp Stationary evap. coolpr . Vent - fan wi th ~inal~ duct Vent system apart from heatina or A.C. Mechanical exhaust hood and duct Sewer Temporary Construction Change in existing rp~ j tirJu"p multifamily, camm. or Tndu~tr;al \oolater service ISSUANCE OF PFR!1IT I I I I 1"o.OC \. I / /).W i COW1./IND, FEEDERS Install/alter/relocate di~trih. feeders amps. t., Wood stove/heater Of .OllUl. TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the I TOTAL CHARGES that the Electrica1 work be done by an label has been signed by an Electrical I TOTAL CHARGES &LI.a:J 'Electrical Contractor, the electrical portion of this penmit Supervisor and ~eturned to the Building Division 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 oerformed 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 herein. and that NO OCCUPAI~CY 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 force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon. and that only subcontractors and employees who are in compliance with OP.S 7nl.055 will be use on this project. NAt.IE(please print) h~~7. ~. -cR~~~~I('IIATURE FO~ OFFICE USE miL\"" Zone Type/Canst, Units Sq, Ftg, riain Fire Zone Bedrooms Occy Load Sq. Ftg, Access F1 Dad Pl a i n Stories Occy Group Sq, Ftg, Other L DATE j/';'"..I.-G; \ x Value Value Value x x TOTAL VALUATION BUILDING PERfIIT ' Plan Ck, C0111ll1I nd Charges anc ------------ 65%/Bldo ppr ~pp Surcharges Plan Ck. Res 30%/Bldo Per Fee PLU'~BING PERMIT Fence Charges and ------------ Surcharges Demo ELECTRICAL PERlm Sidewalk Charges and ------------ Surcharges A/C Paving MECHANICAL PERMIT -~!J~W--- Curb Cut Charges and Surcharges , . (1 'Systems Development Charoe (1.'5~) I Total Comb. Permit TOTAL !\~u vq~ " :} , i , ; '~" r-. ~ I , ''-.'' / . ,F . ;-:' . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION 1. Applicant to furnish A, Job Address B, Legal Oescription 1. example- Tax Lot lOa, Lane County Map Refere~ce 17 03 43 2. example- Lot 1, Block 3. 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air oas 2. exam~le- waterheater/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. exam~le - 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- desiyn 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 whe~e 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 abbreviated schedules you should consult the full schedules C, BUILDING'DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES 0, As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical label. --- 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 type written 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 Permit Clerk . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: ] name signature date CITY Of SPRINGFIELD COIIBl!IATION APPLICATION/PERMIT I EilERGY SOURCES: Heata ;~ I ~'lat";Heater Ranqe 1 INSPECTION LIrlE 726-3769 . Job Address....'?P7,!:;.4JJA~:u S /-eu-L, legal Description INFORllATION LINE 726-3753 Sq, Ftq, 1.lain ~q. Ftg. Access. Sq. Ftg, Other New Add Alter Rep, Fence_Demo _Change/Use _Other . u Valu, of 1,/ork: Owner .,eQt.7,/?L L.), fL E/c.-.-,4,,,.' Address.;slr?&-. . ~~,...,.;/ .r.;/ ?JIli'nel:.I~/ 0.t:)A'.J7-" L.. /;/ 1.(' , ConstructirD( Lender - ~ Builc:lna Permit Info: Describe Work( Le., Build Single Famil v neSt dence \'Jith Attached Garaa.e) 0'" rM ~ 0 _' r1\~,- ~). f\) I -4 mf\,-~ ) I cj Address UE,IGN TENI (name) Phone (address) Primarv- , Structural Electrical Mechanical CONTRACTORS (name) (addrp",,) General plumbinn ..... 7A ,;.1 >>/..L"" /.( Electrical . kit.. .... '~i ,,' ~I'r, -"""'- -+'-.---..1 " ! -.:..i -"ohonfll r.n...J o. i , (l ics. no.) i (exn;res) (ohane no.) ~/_ h....e. / '?C7, . ~~ ~1li~;7f/jj-~J~f ' l. . i ' _ '~~h~~ical ''''-=-~~~__~~-~~'=...c.=_..=. PLUllBING ELECTRICAL NO. ..,.._~____.'"'~. "'-==-~.:_'=--"---=-C __..~~...,~-,,-.=~. fHARr,E Nn FEE Each single fixture Residence of SQ. FT. IRelocated building (new fix. additional) I S.F. Residence (] bath) -----Iouplex (1 bath) each IAdditional bath I Water servi ce 1 Sewer IStorm Sewer INew circuits alts. or extensions _____I SERVICES Cons'truction existing Temporary IChange in rp".i d_pnr:p Imultifamily, comm. or Tndu<;tri<ll IOf ICOMM,/INO. FEEDERS IInstall/alter/relocate I n;~trih fppnpr~ IOf amps.1 I I I , 'l..EtL..l LIiARl.iL ' I I , I "pnt Ib_ ~ I : I I I I I I I I I Ice ~. I I ISSUANCE OF PFRllIT, /1),tV, , (lies. no. (~l(l)irpc:' ...-:-:.=-'--=:- i l TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES c9U. a.J WHERE STATE L'I~ REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this pen:1it shall not be valij until the label has been signed by an Electrical Supervisor and ~eturned to the Building Division 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 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 herein, and that NO OCCUPAHCY 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 force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 7nl.055 will be use on this project. ...../. vi? .....~J;IG:rATURE FO~ O(FICE USE OIIL'r Sn, .Flg. Ilain Sq. Ftg, Access Sq, FIg. Other HAl-IE(please print) e €"A7. Zone Fire Zone Flood Plain Tvpe/Const. Bedrooms Stories Units Occy Load Occy Group BUILDING PER/lIT Charges an~ Surcharges Plan Ck. Comm/Ind 65%/~ldo Ppr ~~p ------------ Plan Ck. Res 30%/Bldo Per Foe I Fence ------------, Dem~-- I Sidewalk ------------ I AIC Paving _~.!.LR!-_-' Curb Cut , . ..-,( () I PLU'iB ING PERMI T Charges and Surcharges ELECTRICAL PERI~lT Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges MECHANICAL a.mps.[ II I I I I I I I I Floor furnace and vent Nn, furnace/burner to BTU's "I Recessed wall ~ ~n<lrp hp~tpr ~nn I I App 1 i ance vent s~narat~ I Stationary evap; cooler . I Vent fan with sinole duct I Vent system apart from I heatina or A.C. I [Mechanical exhaust hnnn i'inddurt !l~ I Wood stove/heater ~ I. Outq , I I \ J -- .x Value Value Value x .x TOTAL VALUATION Systems Development Charoe (1.5%) Total Comb. rermit 1- ---l'OTAL O~,TE .) /.;.. '-~ -S>; i ~LLq)Le : . ! . , -.' .. ~ COMBINATION APPLICATION/PERMIT (CAP) , 1. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Referenc! II '03 43 , ' 2, examole- Lot I, Block 3, 2nd AdditIon to Sp~ingfield Estates C. Name. etc. of owner and construction lender D. Energy :Sources 1. examole- heat/electrical ceilinq/or forced air 2. examole- waterheater/electrical/or solar Eo Square .footage or valuation, etc. - 1. examole- 1250 sq, foot house, 500 sq, foot gara' ( 2. examole- if new project, check-new - if additiOI check add, etc. F. Building permit information: (' 1. example - construct Single family house withlan attached garage 2. example - remodel existing garage into family rc 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, ~ivision Staff must be able to contact appropriate' persons, regarding design information or job site corrections, etc. II, Abbreviated' Plumbing, Mechanical, & Electrical Schedules ( A. Except whe~e blank spaces'occur in the description portion. of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacer to the appropriate item(s) to be installed ( B, Full Plumbing, Mechanical, and Electr;cal Schedules are avallable at the Building Division 1. To conserve space on the permit form the schedulE have been abbreviated ( 2. 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 t electrical contractor for signature by his electrical supervisor. The general contractor is.not authorized (~ to sign:the electrical label, --- Applicant to Sign and date Whenever possible, the initial application will be used a~ a worksheet ;on1y. Where possible, Building Division Staf1 (. will prepare a type written 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 pai.d. All other fees' and charges are due and payable when th~ permit is issued. '~. III. V. FOR OFFICE USE ONLY / , PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPANCY: . /' " I CITY OF SPRINGFIELD I City Hall Springfield, Oregan Department of Public Works OFFICIAL RECEIPT . N~ B 57671 Dofe \\\,\), ~~ 19~ \ ' Rec'd From ~"-\I ~ J'Y\ ~ ~ Address ~cp, \ S mt:\{ 1\ Received For: /' \ '\\ 0 r J-l cO.-.\. ~ _ . - \ 'L!~ ;Y/.-.. _ = ( !'mounl .!:~ceived r;)Lj 4-~ cr - Hv (VC_ / AUT~OR12.EO SIGNATURE SHnTOH'TU"NlIULL ....'HTIt..S. EUGENI.. 0" 117.GI "..n.. ;\ r ~'" \, Pennit Cl erk J Permit applicant exempt from registration with the Builder's Board because: Additional Rroject Infonnation: PLANS REVIEW~D BY: name signature . date , , ..., I IrISPECTlOII LIIIE 726-3769 Job Address...'?'i~,>./J?IAJw S Legal Description . . CITY UF SPRUIGFIELO CmlBIilATlON APPLICATION/PERMIT E!lERGY SOURCES: 'Heate;1 ;oS. . !lat....... Heater Ranqe INFORllATlON LINE 726-3753 Sq, Ftg, 1.lain ~q. Ftg. Access. Sq, Ftg. Other lie" Add A 1ter Rep, Fence_Demo _Change/Use _Other 1 I: I -----~ . '~ ~ohnnp Yln..l.J .i , 1- ._;J'-7' ~7' r/.... .k'U~:7<1~-~J1 ' L" , , , , : 1 I Temporary Construction IChange in existing re<;jdenl":p Imultifamily, camm. or tnrluc;trial IOf amps,l ICOW1./INO, FEEDERS I IInstall/alter/relocate I rlic:.tr;h. f",pr!F'rc:. jOf amps.1 1 I I I TOTAL CHARGES I TOTAL CHARGES TOTAL CHARGES &U. tXJ WHERE STATE L,\1/ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pemit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division , Owner -8Qtz.t?L L~ ll. Ek~~...' Address ~ lI"?.s-. -"?7?"i',:;;.r.L ?~nl::'/ ~ ,/ , , , (\k/A'....... ~.. /;/ ~L Construct;~lender ~ ~ ValUE. of l'lork: BUlhllna Permit Info: Descl"lbe Workli-,e.. Famil v ~es ; dence Iii th At tached GaraQ.e) ~.!\ Ntr\ ~ Q ~\ d\~, ~>. -4- at\l\~') I (j Address DESIGN TEAr.1 Phone (address) (name) llies. no.) (exniresl Primary- Structural , ~t:;r ~ (~lC~i'r~.5.) -. . Electrical Mechanical CONTRACTORS (name) (address) (lies_ nn~\ Genera 1 Plumbino -.....::r-;, 1...1 )./ lJ~ ;., ! Electrical '_ ~'echanj c~.-z"_. .,JJ/- h.....I!..... / -, ~-"'-" "'-__-..:..=~.___=,--""-'__....".~t-~. PLUIIBIrIG ELECTRICAL MECHANICAL NO.1 ~-__""'--~~&.... ...:.s=......---".c_-=--""--~,. __.....=-..-:"'" ~--".=-:.___ CHAIUiF: .Jill. ~f:~ ----_.:... ----. r"~_ NO FEE Each single fixture Residence of furnace/burner to BTU's SQ, FT. Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence _ (1 bath] IDuPlex (1 bath) IAdditional bath _I SERVICES Recessed wall ~n~~p hp~tp~ ~nrl each ~ I ~Ia ter servi ce I App 1 i ance vent seoarate . I Stationary evap;. cooler I Vent fan with sinole duet I Vent system apart from I hea t i no or A _ C. I 1 Mechanical exhaust hood ~nd dud. IJ ~ I Wood stove/heater ~ I. 0 dI.Q , I I Sewer Storm Sewer ISSUANCE OF PFRIlIT ~ Bui ld Single - C> Do o ..c. f'\) (ohone I no. \ I , , -1.llCl'r.HARG'F I L I vP~_ _t:J" I I I I I I I I I 1...0. c;t: I ~ I lAW: 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 oerformed 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 herein, and that NO OCCUPAr~CY 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 force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 7nl.055 will be use on this project. rWIE(please print) ~ FA 7. '\./ . ~.R ....Q~Ir.:IATURE FOr. OYFICE usE" DlILt" So. ,Ftg, rlain Sq. Ft9. Access Sq. Ftg, Other \ ~ Zone Fire Zone Flood Plain Tvoe/Const, Bedrooms Stories Units O<cy Load Occy Group , , Value Value Value x TOTAL VALUATION BUILDING PERflIT Charges an:::: Surcharges Plan Ck. Comm/Ind . 65%/B1 do ppr ~pp ------------ Plan Ck. R-es 10t~!j~ Per F~e I Fence ------------1 Demo' ___________J Sidewalk I A/C Paving _~'y~~__-' Curb Cut . <.-,( () I l:rotal Comb. rermit J TOTAL Systems Development Charoe rl,5~) , PLW1BING PERMIT Charges and . Surcharges ELECTRICft,L PERI~IT Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges DATE_.1 /.;. ..~-s:; J ~Uyq)~ , . 0, COMBINATION APPLICATION/PERMIT (CAP) .' . I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax lot 100. Lane County Map ReferenCE (,' 1103 4j 2. example- Lot I, Block 3, 2nd Addition to sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources '1. examQle- heat/electrical ceilinq/or forced air 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. ------ I. examo 1 e- 1250 sq, foot house. 500 sq. foot gara' ( 2. example- if new project. checknew - if addi,tiol check. add, etc. F, Building permit information: (' 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family r( 3. exam~le - 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 TEM1 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 whe~e blank spaces' occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No, Boxes adjace, 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 ( 2, If the item(s) to be installed are not covered on the abbreviated schedules you should consult the fu}l 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 t ~~~~;~~~~~.co~~~a~;~~r:~rc~~~~:~~~~ ~;.~~~ :~~~~~~~:~ ('~ to sign the electrical label. - Applicant to sign and date Whenever possible, the'initial application will be used a, a worksheet only. Where possible, Building Division Staf1 (~ will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his ~ signa ture. 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. '....-'" III. V. FOR OFFICE USE ONLY I,~ ~.' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . " I, I CITY OF 5 P R I N G FI E l 0 . " City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT . No. B 5 7 6 71 Date \\,\,,\), 6)~ 19~ \. ".. - Rec'd Fron\ . ~"'\I ~ f'^.. Yr? vO oed - Address 3'BlS m~ f) ! Received For: r' \-." (' \\\0 r~ c-.~~_ - - \ '1 '0.. ;"Yt-.. L..1 ,~ - ( Amouot~cei~q7CJ (~~,Q.~", ~ S"~lTO"'TU"".Ull ..",,,T';"S' ~ua,;..~_ 0" .T.O' i ...".. \ r (1JL... ( . ~;; ! ~ Pennit Clerk . Pennit applicant exempt from registration with the Builder's Board because: Additional Project Infonnation: " . I PLANS REVIEWED BY: name signature !. . ~ !, date