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HomeMy WebLinkAboutPermit Plumbing 1981-7-22 INSPECTION UNE 726-3769 t CITY Of SPRINGfiELD COMBINATION APPLICArlON/PEAMIT . INfORMATION LINE 72W753 Legal Description -1 Q .20 tr? ,,3 fV\",- ~ '" sh % <./'!-' 0 2.SQ 0 I ENERGY SOURCES: Heat I Water Heater Ronqe I Value of Work: J/ I. (.,':.:?f':> "" t> , Building Permit Info: Describe Work (i.e.. Build Single Forni/v R~~idt;nce With Attached Garone' Sq. frg. Main Sq. Ftg. Accen. Sq. Fig. Olher _New_Add_Alte,_Rep. __Fence_Demo_Change I Us. _Olher ~ \) ~ Job Addre" Addren N\ ,r- 5 .'205: ~",.\n\..., .N;(~^l.,_.'i. N L L.-:1 S.,4= ' , '~hon. ~/:.....'~ (:t~ iv. CJ,!:tJ.t)56t, le.5<"~r_,_ 00 ]V Owner Add,." Phon. ~c..U ?AHTa".",., W.,..., :r:> c:.fl4'~ .~........ "'" /M'" /' -" ~..... 'r ':;~oT/,~~_ /.../.6"',," ~4:&r"7.. J)J _,,_-._ .. ~/"':S -:/ I.:::.<!!:" ~ #//yQ. Construclion Lend.r DESIGN TEAM (name) (addreu) (li(l. no.) {expires' (phone no.) Primary. <:::pl~ Slructural Electrical Mechanical CONTRACTORS (name) (addreu) (Iics. no.) Cell:piru) (phone noJ General ~,..l -F Electrical .:u \") V\. CocK bl (. c..t or! c- ~ Plumbinct Mechanical PLUMBING ELECTRICAL MECHANICAL 1/.-4 . Each sjn~le fill:lure Relocared building (new fill:. odditionoO S.F. Residence (1 bolh) i FEE CHARGE NO. l:~<>/> ~- 8. fi. FEE CHARGE NO. I FEE CHARGE NO. ., - Residence of furnace I burner to I~TU's Appliance vent s.parote Stationory eyap. cooler Vent fan with single dud Vent system oport from . ht!otinq or A.C. M.chonical exhaust hood and duct ...:ft. New circuits. olt.rations or extensions SERVICES Duale.. (1 bath) each Temporary Construction A~dilional borh Amps. Wal.r s.rvice Sewe, Wood stove I heater Stor,m Sewer FEEDERS "f.l..n.F~ h: ",-,,e,;:>. I I I I Heat Puma Air hondl.r to 10.000 CFM Air handler 0....' 10,000 CFM Amps. I I I r- I TOTAL CHARGES I ;a- TOTAL CHARGES ISSUANCE OF PERMIT I TOTAL CHARGES WHERE STATE LAW REQUIRES that the EI.ctrical work b. dane by the Elet~rical Contractor, the .Iect,ical portion of this permit .haU not b. valid until a lobel hal be.n si9ned by an Electrical Contractor and attached 10 the .Mdrical panel. I HAVE CAREFULLy'EXAMINEO the completed application for permit, and doher.by certify that all information h.reon i. true and correct, ond I furth., certify thot o;;y C1nd all work performed sholl be done in occordonce with the Ordinances of the City of Springfield and the Laws of the Stote of Oregon pertaining to the work described herin. and that NO OCCUPANCY will b. mode of any structure without the permiuion of the Building Division. I furth.r. certIfy thot my re-gistTation with 1M Builder's Boord is in full force ond eff.ct a' required by ORS 701.0.55, thot if exempt the basis for exemption is noted N::'f:,:.u~::::~~~~::;i ld ~P,'O'~~h~ ;in ~mPli:~~N~~:R~~'~i1Q jU:6 n~ DATE 1 n- ~ \ FOR OFFICE USE ONLY Zone fire Zone Flood Plain Typo/Canst I\odrooms c.tori.- 11nih "''''y Load I1ccy Group Sq. Ftg. Main Sq. Ftg. ACetlu Sq. Ftg. Olh.r 'rolue Value Value TOTAL VALUATION x x BUilDING PERMIT Charges and Surchargu Ii:>.. 0<> Pion Ck. Comm /Ind 6.5%{81da Per fee Plan Ck. Res 30%/ BldCl Per Fee 6.5<> System, Development Charqe (1.5%) PLUMBING PERMIT Charge, (Ind Surcharges '1~ j<:!). .-. -<to fence j Total Comb. Permit I I I 'I I poJ~ oF r-qt;;" I TOTAL ;zt:>. gc::> Demo ELECTRICAL PERMIT Chorg., and Surcharges Sidewalk A/C Pavina MECHANICAL PERMIT Charges and Surchargu Curb Cut '-/B ./0 COMBINATION APPLICATION/PER" (CAP) 'I. Applicant to 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 D.. Energy Sources 1. example-heat/electrical ceiling/or forced oir qas 2. example-wafer heater/electrical/or solar E. Square footage or valuation, etc. 1. example.1250 sq. foot house. 500 sq. foot garage 2. example.jf new project, check new-if addition, chee' odd. etc. F. Building permit information: 1.. exam ole-construct single family house with on ottOI garage 2. example-remodel existing garagb into faniily room 3. exampie-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 COt>iTRACTORS To avoid design or construction delays, Building Oivisi Stoff must be able to contact appropria~e persons regl design information Oi' job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedules A. E.xcept where blank :iraces occur in the description po of the Mechanical and Electrical Schedules. the opplic r.eed fill.in only the No. Boxes adjacent to the approF item(s) to be inSlalled B. Full Plumbing, Me<h~niwl. and Electrical Schedules are cvailoble ot the Building Division . 1. To conserve space on the permit form the schedule have been abbreviated 2. If the itern(s} to be installed'are not covered on the ated schedules you should consult the full schedul, C. BUILDING DIVISION STAFF WILL Fill OUT ALL FEES A CHARGES ON THE SCHEDULES III. Applicant to sign and date Whenever possible, the initial application will be used a worksheet only. Where possible, Building Division Staff prepare a typewritten copy and return it to the applicar 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 .. and no plans will be processed until these fees are paid q! other fees and charges ore due and payable when the Ij.... is issued. V. FOR OFFICE USE ONLY ... PROJECT CONDITIONS, to BE SATISFIED BEFORE OCCUPANCY: Additional Project Infarmation: f PLANS REVIEWED BY, nome ~'fJ~ ~.s::;. ~signalUr~ . PERMIT VALIDATION ~ CITY OF SPRINGFIELD City Hall Springfield. Oregon Department of Public Works OFFICIAL RECEIPT (\ ![ ( ( 4\ . t f\{\ 9" ~O. B 56947 t1 Date ,,^\~l,. Nrl-, 19 Q lJ Rec'd ro \~Cl D d \\OOU '1 Address S<6,() YW~~t c Received "1 -( ( For: ~.~N~ 4q?-lj dro \,j r<n.co \ - ~-fl) l~\)~ (O:SO (' .'. qnr 'DoU' <'""l. Ci ,&D ' .' , In { c ( (-. Amo".!'.t Received 4-'rS . "V ( ., ,( - I _._~~. ' 5..2,uo. ( 1[\,10""1.0" .740' 5..".. ~ c ( ( Permit Clerk ,~~~.._,____J --,.-.,..,.-.-.. ----~--"'~,-=-.--_..~.._...~~ '- " , ~~ ~ot- - 7-<"::2-8, .