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Home My WebLink AboutPermit Plumbing 1983-1-19 Job Address /.39 (. 1?1/l;Nsl ('{r.id: Legal De<<ription 7-;; Shr-e.. ._ \1 '" ~'?-,{r3~ oo~ I Dwner~~,..,vilZ/ C1rrjJ, - , Address ');; a".....?; 61 j ,,/ b~?'A./~. c::zrr~. Constructiont{ender ~~^~ .~,,-r.!~ Address f6 R~)( )'(;J.,O{, a...ut!... ~e, Ut~IG~ ItAM (name) '1I1ISPECTIOII LIIIE, 1726-3769 , Primary Structural Electrical - CITY Uf SPRINGfIELD COt1BI ,IATI ON APPLI CATION/PERMIT . ErlERGY SOURCES: Heat Hater Heater ~. y J P .:J ~ ()r. INfORllATION liNE 726-3753 Sq. Ftg. 1,lain ~q. Ftg. Access. Sq, Ftg. Other Ilew Add A Her Rep, --Fence Demo Change/Use Other - - Phone,,87-!i'Jl! Ranqe ValuE of l'lor':l' 19s:~ Builciinq Permit Info: Describe Worl<(Le.. Build Single Familv nesidence With Attached Garaae) !2. ;"'/}tlP r:M./P /".J~~.-,(yi",-;,t!i':I- {lI'/lt:? S;'..l)"..- Orl/.'"j_ I l1.MJk""" e:." ~ Phone 977-'1/.)A (address f (exniresl (ohane no.') flies. no.) A ~ AT ~ 'Ill Hechanical CONTRACTORS {name} (arlrlrpss) General .-I. [), JII-i//cr h..//".-t>r:s...::; (;? &x r Plumbino ~.,,/t""< PI"",,~,w<; f,?, (?,nX 13<) J v V IOf !cOI1l'!. /IND, . FEEDERS IInstall/alter/relocate I rii~trih_ f""rlpr~ I Of amp~1 I I, 1\ ~ 0 II r,-h()')L.., I V /)tU I I- I I' I /( ), CU I TOTAL CHARGES / jj};ft!? TOTAL CHARGES WHERE STATE L,\I1 REQUIRES that tile Electrical work be done by an,'Electrical Contractor, the electrical portion 'of this shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division Electrical ~lechanical ''',i PLUIIBIIIG :' ," NO, FEf -', fHARr.f d Each Single fixture Relocated building (new fix. additional) ! .-' .S.F.. Residence (1 bath\, ", Duplex (1 bath) each I I I I I Storm Sewer / / if)lllf\\ rnrl I I I I , Additional bath ~Jater service Sewer ll)'W I I I I TOTAL CHARGES (1 ics. no.) (,."ltl)ires) (I)hnl"lp nn, ) J3 S- r:LPN~'" Flol'i!'-Vt!F ,.r. ,<}1677 It).'/<,-'F(,<, ;tJ6)',t.. PR QC;7- 7500 797- [:ISO / ELECTRICAL' MECHANICAL, NO rHARG.E. NO <<> <<> r"AJlliE.. / Residence of furnace/burner to BTU's SQ, FT. INew circuits alts. or extensions I SERVICES -I Floor furnace and vent Recessed wall ~nrirp hpritpr rlnn vpnt ITemporary Construction IChange in existing rP5-; rlJ'.nl'"p Imultifgiilnj, COrtii.. or Induc:.tr;;11 Appliance vent seoaratp Stationary evap. cooler I Vei",t fan wi th sinole duct I Vent system apart from I heating or A,C. I Mechanica 1, exhaust hnnri and dud I \iood stove/heater 1 I I amps.j ISSUANCE OF PfRllIT .0 penait I HAVE CAREFUllY EXAt1INED the completed ap[Jlication 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 Ore~on pertaining to the work described herein, and that 1W'OCCUPAHCY \'lil1 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 701.055 will be used on this project. HAI,IE(please print) ---;k;;;;',--, iJ lk?/i.c~ ,,>__ SIG;IATURE~ dJ~DATE /-/9-r3 Zone Tvoe/cons: r Units FOr. OFFICE ~~~ ~01P \./ ~ Value Fire Zone Bedrooms Occy load Sq. Ft~. Access x Value Flood Plain Stories Occy Group Sq. Ftg. Other x Value TOTAL VALUATlQrI --5..QQ---- (~~~~R~~~ II r, Plan Ck, rJ-t ~ 30t/Bldo --1D-,~ I Fence .40 1 Demo __lD)?~ ___I Sidewalk ,4D I A/C Paving I Curb Cut I BUILDING PER/-l1T Charges and Surcharges PLU'1BING PERMIT Cha rges and Surcharges ELECTRICAL PERI:IT Charges and Surcharges 11ECHMIlCAL PERMIT Charges and Surcharges " Conmllnd Ppr Fpp Res Per Fee Systems Development Charoe (l.Sr,) , I ITotal Comb. rermit I dLo~ -----<.: I-OT" II Jl.L ;~ " k ~-: e , COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. legal Description I. ~xamFle- Tax lot 100. lane County Map Reference 11 U3 43 2. example- lot I, Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources. 1. examole- heat/electrical ceilinq/or forced air Qas 2. examyle. waterheater/electrical/or solar E. Square footage or valuation, etc. I. example- 1250 sq, foot house. SOD sq, foot garage 2. examjple- 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. examl:le - remoaei existing.garage-lnto famlly" room 3. examole. 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 TEN4 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 ~ivision 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 D. 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 l~henever possible, the 'initial app1'ic..t'ic;; \;;11 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 penmit 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. f ./ looi6~ V. fOR OffiCE USE ONLY Clerk~ Permi t PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: - PLANS REVIEWED BY: (.",,~;/IJDffiA . ''', 1-/tf-R3 , -;j$---'" - "_:,,~- -.-- ~' _'_'h___ m' -- --.'--- -',---- -- '. ~7/hr --- --- -,.-.---....- -- .,... -- i<J,e.- -'L^-., ~ name __-::. :: ":='7."'::':':=_~-.::~~-~":::'::':..~'::::-~.:::. ':'::~.:::'-;:;;':::':