HomeMy WebLinkAboutPermit Building 1986-2-11
.. RESI.NTlAL"
APPl,ICATION/PEFMIT
225 North 5th Street
Spri~~field, Oregon 97477
Building Division
726-3753
Job Loc.::.tian:
'7 try t=j
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Tc:r:Lot
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AsaeSGOl'= Nap II
Subdiv-:.sicn:
e.l~' Ev.L.. i4.\ L..L-S
Q>....'nel':
?Jg86DE~
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t= \l r...., E..l E:.
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4o'j"l-
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T rJL.-,
Pr.one: rc,e. (,,-'14 '5 \
Zip: q 14017
Add....esa:
Ci.ty:
fX1
n
n
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'lCO.1
Addi tic"
~, 'F.
Remodel.
,'fob-:. toe .:toma
1/1r.8[ t9&
Date of Applicaeion
Conz;raC1:ors
SPRINGFlEI..D
DescP";'Oe fl'or/':':
:KL.
'f2.]::::.-SI uJ:;.u c-e,
VaZue
Addres3
GO.~o
Genera! i?'l12A:: ~\:)j::,0. ~l2rr.-., . ';2../ ",Co f:- 4n :0. F.:
: Plumbing AI.E~T,\PLul'l~INb In \IAN f'>tl'I2.F...1 ~.
i ~!ectrica!Dl6ILm'N. '~/k67': r;, '(<;"' F. sq Q! Lv" ~
I Mechcr.id \Aq t:"AU(,~ Illo..-n\!c;, ('{)Pm 1283 ...I.c
I cO"se~~cti~ L~nder
.' "cceo,,' 7i'tC.)"'~~
I.
/juCll-tJL
Sigr.~d:~
Date:
, ~-//-~
Lise. FI Eroil'cS Pl1on~ ~
"2..J. /I! "30/ t? q, C,F$(.':..L~~
'2.0"")'=>~ InllO lfir.. '3~-J05'\
'Ztl.-'70t..C. "/'1n'fUo (.Bb'-/~~
4-1 P-A ?, </-1 "I Be. q c, 8' )(78 .
ji
r; is :hs l'esponaibi.1.i:y of' ehiJ permi.: holder to see :ha~ aU tnapections are .~adll at ;he ;a'opel' tim€~ t.":at .u:ch .::dt.bo~S8 i.s l'ea.::a.;:e I:
.t"rom the street~ and that the pCrm-it c~ is Z.xated at: thll front of the propert:y.
"3ui!.di~.g Di:Ji=io!': ap?rot;ed plan sr.:::.lZ remain on :;',,2 S-...::z.aiTtfl Si.ts at all t":.mes.
PROCEDUF?g ,t'OR INSPECTION REQUEST:CALL 726-3769 (recorder) state yOU!' City desigr..:1ted job nur.:ber, job adircss, type of in3DeC;:{.Crl ..
raqueStcd a~~ ~~en you ui~l be ~eady for inspection, Contractors or ~~e~s r~e cr~ pp~r.e ~cr. Reques;s l'ecei~ed c~fcr.' 7:00 ~
:.~lZ. be made the same dey, l'Bquests mczde afta' 7:00 a::J tJilZ ba r.ruie the n&:t :.)Orking day.
.r::tpmr/: '"".1 r "'i"''',!J':~r.n.q
lVl SITEI:1SPZC-:YON: To be r.rzas
~ e:cavativn, ~ut prier tc sst
forms.
o
after
up of
UNDERS[.AB P'lf.J.~fBI;VG, EL2C':'RIC,tL1
.~lECH..J"JIC:"[,: To be made befo:'<i any
work is ,::ovc'l'ed.
[E]
PCOTT?IG ~ ?OU,'IDAT:C:l: To be :xu:e
after trenches a:r8 e::cCl".;cted Gl"..d
forms are erected, but prior to
pouring ccnC:"flt.<:.
~l
UNDSRG.o/JU,'!D p:,uUI!rSG. SE:IF:.~. W.1TER,
DRAINAG2: To be ma.::.e pl"';or ::0 fi~-
7.ir.g trencr"ss.
[~J
UNDERPLOOR PLu:..'Sr:1G ~ NECHA.VIC:"L:
To C9 mace prier to -:'n3:aL~:;-:.on of'
fioor insulation or decking.
'POST AUD 3EAN: To::,e rode prior to
ins:cZ.z...:ticn of floor ir.st.:la:icr. 01'
dacki"G.
[ZJ
~
!fOU(],~' ?!..tr.!!!!:IC. ~!.EC7'_r)!CAL 1 VEC.9-
AHIC)!:: :;0 '.;ori-'. "':3 ::0 be cOI.:erea
ur.t~~ ;r.cse "';r~~ectior.s ~-U~ beer.
m.."'l.de 'ZT'.d -::ppr?t1~.=.
FI.'::tE?LACE: Pr.:or to plccir.g fc.cing
materiaLs ar.d. b~forf1 frxtir.g ins?sc-
tior..
FR.a..'!I;'lt;: ,\fust bs reque3ted aftal'
appl'OV~Z of rot.:gh ;L~hing, az.ect~;-
caL & mechani::::z.l.. Al.! roojir.g
bracing d chi.1m.cys, st.::. :~r..:sr; be
.comvl.e::cd. ~o ~rk is to bs con-
- eec"Zed ur.::il. this insoec:icn r.aa
. b6en r.ude end approt:ed.
o
~
Your City'Deaigr~tcd Job Nu~ber !3:
f\Il INSULATrON/VAPOF? BARRIER IHSFr::C'!'ICN:
~ To be made after all in8'..:l~tiQn a:-.d
raq-<.4ired vap02'" cCl1T";ers a:re in place
but before any lath, gypsum board or
wU coveriTlfJ is applied, ::::r..d betore
any insuZa..:-ion. i.s concealed.
D.9.~"AU, nlSP!CTICN: To be r.'.aCB
ajter aU Crt:/waZZ is in place,
bue prior to an.y taping.
O ,\fASO!lRY: Steel 'Location, bond
beam:;, groutirr.g 01' verticc:Zs in
accordance ~;eh a.E.C. Section
241~.
O ',.;r;ODSTOn.: AftliJ'l instaLlation is
ccmpl.at~d.
[K]
o
CURB & APP.r;WACH .4?r::!)1l: Atea:' forms
c::re 2reated but Pl"'':or to pC"Uring
.::on::re te.
SIDEWALK & DRTlEfv'A?: For aU CCTl-
crere paving ~irhin street right-
of-wcy, to be ma:1e a;'t.er at!. e::;cc-
vatina '::omPZe~e & fo~ ~~rk & $uO-
base ,~.::;terial in pLace.
%!o0053
DcUOLITIOt! OR ;~:QV!; 3UILDI;iCS
:J San.it::z.ry se".Jer aapped ::t p~opo:rt"':l l.ir.e
~ Septi.:: tank p~~~d a~ f~l.lad ~th ;r::z.~8!
I Final. - [-!hen 6cve ite:;:s are cc.~lated
~ and when .=~ol.ieior. is c~?Zete or s~~~~-
ture moved ar~ ?r~.,;3es ale~ed ~?
gooi l.e Ec,~es
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o
:ENCE: Wher. co:nvZ.;te -- ?rovice
gates or movable' sections through
P.U.E.
:::J Blockir~ ern Sat-~p
:::J Pl.ur.~ing connec:iQns -- s~er ar.d watsr
:::J Electrical Ccnnec:::on - BLockin;, set-up
and pZI/ll'lbinq com:ectians l7't"..st 1:01 a?prol.:ed
be;orc requese~ng ~Z6c:rical. ins?ecti.o~
~ Accss$c..,~, 3uildir.g
-, Fin::z.l - .~t"tcr ::'~rcr.es, ak.il't::ng, deck:;.
--J etc. are ~~pZe:o:d.
o
Al.Z projec~ cor.ditions, JUC~ as the ins:aZl.at~on of s:reet :r~es, :~~!a;~on of ::hc
requil'ed l.anC.sccpir.g, etc., must be saeis{:.cd bclore tr.2 3UILDI::G F!:;:"L ::cn be r:zqu~s::.sd.
[!J. .t'IUAl. PLU:HJI:iG
~. FINAl. NE~P.A."IC~1L
Cll FI.'lAL ELEC':'RIC:':'
10
<E>
~INAL BUI~DING: The Fi.nal BuiZd~r.g !ns~ection ,~se bq requested af:er ;r.e :i~~Z PZ~T.bing
5L.zcericaZ, ani Hecr,a.":iccZ Ir.speceion:J 'have .;een :nade ar.c. c.pprovJ:i.
o
"AL~ NANHCLES AND C~EANOUT5 ,'ruST BE AC::r:SSIELZ, .4IJJUS'i','S,',"T TO 3E :.ti:DS :~T NO :~S': T? CI':Y I :;........1 of ~
?~g(] 2
: JOB NO: xlo(){)5~ SOLAR.ESS REQ- (D. #'
'/i :Po -::1 ".,.
i ::cr:a: II<.. /__ CCC"J.=:anc:J Crou:;: I ,--.,',/ T~'?e/Cor.st:
ILot Sq. Feg, 6....'?tft:) LOT I':?E I Lot faces - ~rd
. r' . r .. ~~ -X I' I Setbach
I'.:; ..:J" ....:roel'cq.. ~ I':terWl" I" I;J., I C
~ . oJ. ,.0...88 arc:ce Access.
!.~ of StoT"'~es:2. Corner ]1I01'th q"if' I
I. . 1 " ' . ..,- . p-~-';'e IE' h ""tf." I
! .0..<:.. ..e1.ql'l:: L"'" ....,........,......" as..
, .r_ Sou'h I -:z.1 '
I Iopogra;hy ~T /"., 0_!-de-sac Iwes; "1"',(;'"1
I "~'I
1 ,'I:in
l~x2
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! C.:zr=cr::
I
I .~cO'cs3'r'J
I SQ. fIG
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I
TOTA& ,'AU'S
Is.D.c.
( UCI.U,C;
1.5 =
?t,,;ildir.g Pe1'1r.";-::
State Surcn:;:::oge
~o=a ~ Cr.a......ge:J
11':::;'1
I ~:_,-.. S"~RM'
I Residential (l b;t:hJ
I Sanit.:z'!"j SetJ61'
I ;';a~e!'
Il'PP/7'. &;7'#<;
I;'i~~'
I'
/ ~,J~'
I <'S'61
I Z. iI~"'"
Pl:.unbing Perr.:i. t
State. SU1'cr..moge
T::tal Chc=roces
11;:'[N I.VO. I :;>:;'1:'
'8es. Sa. fta. /557'1' II I
I N.a1J/Ertend Circui ts I
I Tempcra:ry Service II
I I
Electrical Pe~t
St:::.te Sla'O'narae
Total C'tlarces
1;le.1 FEE
II
I t
13 I?"""
I I
145 ;qr7~. I I
f'i'z''1
F':.a-r.ace ETU' S
E::haus t: Hood
I Vent: Fan
I .
I ;toodsto;;e
Perrm.t ISsu.a:nc2
Me:;;..anic::l Perr:':i.t
Stat~ Surc~e
,!,(J~t'!.r.~"1I'trJ
I -- 2:1CRCACSX:::!':' --
Is . n '
I e~~.tu ~2~3~=
I Stor~qB
I !-!a~nter.cr.c~
I Permit:
Total C"flar7CS
I CUr';C"..lt
! Sid6'Ja!'<
I :c~e
I EZ.ac ::l'ica Z
,
] Mobi Ze Hame
If!, ,
~~'
labe Z
I TOTA!. ANOU.'lT DUE:"
x
I Value I
60:\~.""
I" I
I I
.
~7fI 3edrooms: 3
... - 11 Ertsrcru Sou.l'~es . IiJ'C(/
I 1 Heat <;i #i~ H .r-' .
I I Wat"" 0_"0'" ~ .
I i Range
I 1 XI ""eoiace
:: I WaOGcto,e
'L-COG~
Fees --
Building Value
&
Permit
Thi.s permit iD granted on the e:press ~ondition that the sdid. constI"..lc:ion
shaZl, in. all respects. aonfor.m to the Ordinance adopted by the Cit~ of
SpT'ir.gf'ieZd. incZw:iing ;ae Zoning Crdinance. l'eg-.A.Lt;ti'~g the ccn.st~jcticn
ar.d ~3e of buildings, and m::y ce ~uopended or revokec at cr.y ti~e ~;cr. ~ic-
lation oj' zny pr:)vi3ior:s of said Ordir.ances.
I
19~7.:>c I.
-? 1/ ~ I' P""ifIYCtE OF PG/.AI
Q/f:;>. ~EwE"" ~C' p",/p
1;(',~9'1 2.~'8~~#9~.~8...
~.28.6yl.
CHARG~ I
~~."'b
':? 7. s<>
'"26. eo.,. I
1'5. ~..
'3"0. -I>
1'37. S"t>
<[).501
I 17'3: 60 I .
CHARGE
?7,f)l?
,ro 0(;>
/;./~
"5'"2. 5''''> I
I :2 . It> 1
I 57". 6C> I.
CHARGE I
(;, ~I>
i./. S'p I
~.p"'l
I
-;;;:.<:>~ I
I
2/.6'<!!) I
.&6 1
'2<:.J'6 I.
,
12.70
I ;5". /"
#11$7. ?t>
Plumbing
No person chell. construct, instaZ.Z... aLter or change any I".eW Cl" e::isting
plumbing or drainage systen in ~hole or in part, unless such Ferson is trA
legal p08se3sor of a valid plumber's licensB, e=cept tr~t a pe~son ,~~ do
plumbing ~ork to properPd which is owned, Zaased or operated by the appli-
cant.
.'
Electrical Perm it
Where State Lc:1.J requires tr.at the electrical work be done by em Elactrical
Contractor, the electrical portion of this permit shall. root be valid untiL
the ZabeL has been signed by the Electrical ~ontra:ator.
Mechanical Permit
/:7 -=r-...
or ~~;rI("- W-E~-..<7
<: -/o-&:;;
va::.a
I.
I
I
I
I
I
I
I
I HAVE CAREFULLY SXA-"fINED t,t.,g complatad =?plication ,for permit. c:n.d do
hereby certify that alZ injormation hereon is true ar~ co~cctJ ar~ I
f.aother certijy that any ar.d all work peri'or.ned shaU be do:1e in ac=or-
dance :.lith <;he Ordinances of the City of Spl"";rtgficLd. and ;n: Uz.;8 of tho
State of Oreg:Jn p~rt.:lining to the uor.1.:: desc:'"';bcd herein, cr.d the: NO OCCU-
PJ.NCl wilL ba made of any structw'a without permis3ion of the Euildir.g rr;-
vision. I .J:"urther ~eT'tif:.J t;'.::t only ~cr.tra.:tol'S and e::rpl.;;yees who arg in
c~pZian.ce with ORS 701.0S5 will be used en this projsat
s~ (<~~~
II ~8G;,
Date
t .
.. RESIDENTIAL'.
APPL:iCATION/PERMIT
225 North 5th Street
Springfi.eld, Oregon 97477
Building Division
726-3753
,/
',/
7tryt=j
AS:::SBoor= ,\fa:p.f \., i ~ "3
SUbdi",osic",e. l~' E. v.L.. \-1,. \ L..l.-'5.
SPRINGFlEI..D
MlllJ T ,} I S\J
'.:::; <1- 1''7
<;:"")'1 ~\)I 11 I <;'ltlI-1
Tez we
,,-<,I A Y
#/3ql)lJ
S, o~l.
I.
Job !.oc.::ti071:
~'>ter: ?Jge 6DE~
?:-,r,,(o F
City: t='\ 1 r....,E.lE:.
~ 1<0' r,'S"
4o'~
/')c<..
TrJC-.
Pr.one: rc,5 (,,-ll4 '5 \
<114017
Add....es3:
fX1
n
n
n
lltr.'
Addi ticn
'2"
'F.
Remodal
.'f"b'i.!.a :lQrfft!
1/1r.8 ( t9&
Da'tB of Applic::.ticn
Zi?:
DBscPibe f.'ork:
,~.....
:V/
"'~'.. ...~.
'f2. }::: S I \.) J:; .J..) vt:. .
Varus
co 0 .sOD
~o"crcc:or8 Aaar€S3
Genera! i?'l Ofi;: ~\:)i=j~ 1"-,l2rh . -;; 1"(0 f:- 4n :0. F.:
, P!umbing AI.6i2.T PLl,lI'-l'~\Nb In \IAN Y...,tl.I2.F...!.. P
I ~!ectrica! ni c ;i it~ '~ Ul'.T-: r;, '1 <;"' r_ 1<'1 I~ l.v" ~
I ,'Iechcr.id W:~ (;,AU(,~ Illo..-n\!c;, ('()Pm 12f13 ...1.[.
I. COrtstl'"".Jctian t:.~l1der
r:. is :ka r8sponaibili:y of ehs permit 1u:Jldu tc 8a8 that aLZ incpections are :-::00. at :h. pI'op.ar :i.~.. t.t-oat .::.::en .:::idre88 is rea.=ab:.
from ehs street, an:i. that the pc:t'7:T'it c.:uv.i is Z..xa:ed at the f1'CJ1t of the ;;roper'ty.
.9ui!dir.g Lnui::ior: approved Fl.cn sr.:::.lZ. remain on tha S-",iZding $it~ at alZ. :imss.
P.'?OCSDW~S Fon INSP=(;TIOu R!'alJEST:CALL 726-3769 (recorder) stata yOUJ" City desigr-::ted job nur.:bel', job adircss, typo of ir.3pec=icn
raques'Ccd a.....d lJ.':en you lJil.l bo ;osady lor in3pccdon.. Contractors or C'I.;nB:"S r.cm.e .:r.d fr.ane nw:Wcr. Requ&s'C8 rl1ceit:ad celer. 7:00 .=::
~'iZl be ITGde eh" sams dcy.. rflqueses mcds afta' 7:00 ct'l"I 1Jil.Z ba r.r::de the m::t :x:trking day.
Reauiyopa rnSl:'P!!t"iC7!s
~ C!r"OC" ..,SP-r-'....", T' . ....
....l.:_.:.. .:...._..1..: 0 os r.rzc.s al.,~r
e.:~avation.. ,;ut; pricr t:: ss: up of
forms.
o
UND!RSLA3 ?!A'::.fBI,'IC. ~l.e=-:'.~IC,lL {
NECi:'.':',"IIC';'[.: To os rr.ad.:t bs:-ortJ any
wori( is ::ovcrtld.
[pJ
flOOTING ~ FOU,'/DAT:C.'l: To be r.xu!a
af:itT :rencnes are exca-~ated GrA
farms are erected.. ,:;ut pricr to
pourir4 c=nC:"Bt~.
~J
UNDrRG.~'J:l!) ?~tJH3n;G. sr".IC:.~. W.1TER.
DRA.illAGF: :'0 be ma::.e p,...~ar :0 fi l.-
l.i.r.g 'Crer.cr.s.3.
~.
UN!)ERPr.OOP. P!.U.".'9I:lG ~ ,'1::CH.4.VrC,"-!,:
To be maCa prier to in3t:al.i..;l~-::on of
j7.c0r insula;:;:ion or decking.
'P'JST A~ID 3EAU: To bs rr.ad~ pl"'ior to
ins'CaLl...:ticn of f7,oor insr.:laticn or
dscki"S,
lKl
~
[lJ
'f(),}(;.q ?~tr."l!!I"1C. ~:..E~PICA.[,. 1 .'.(FCH-
AN!':A!.: .~'o '.Jor;.: -::.3 :0 oe cOl.'area
untiL ;r.c8e ~r~cec:ior.s h--v~ ~e?r.
nra.=e ~d ~pr~u6~. .
F!.~::?['ACZ: Pr:.or to plccir.g fc.C"';ng
mc:;el'iaz,s ar.d b~fors lrar.tir.g inspec-
tior.:.
FF1.4."~!.'Ir;: .\f1I.3t ~e: reque3ted af:ar
approv.::L of rough ?L~.i;irtg.. Jlecm-
caL J mecr.ani.:al. ril! rooj~r.g
bracing ~ c:hi.1tn.l:Ys~ at.:. t.'I"'.lS'C be
. corrrole:cd. .'10 ~ric is to b4 can-
. cs,iLfld w::i l this ir.sDec:icn r.as
. bs~ rrr:zd~ anC appro1.'ed.
~
lour City. Desigr.atcd Job //umbiW" !D:
I V I J.iJSULAT~QNIVAPOR EARRI::::? I.'JS?=:C-:-IC,'I:
lCJ To bs mads after all in$".lL.:;:;i.:;m a:-.d
. rCC".lired v@or tarriers are in. Dlace
. Cut before ~y lath.. gyp8WTt bcai-d or
wl.l covering is cpplied, =r.d ce;'o'l"fI
any in3ula~ion is concealed.
fXl D.~~.iAL~ !NSP::CT!ON,: Tc be lrJUis
~ after all. Grdwll 1,S in pLace,
bu'C prior :;0 a:n.y :aping.
O "'IASO.llRY: SteeL locatiol1~ bond
oeamD, grou:in.g or uer:iccls in
accordancs ~th u.a.c. Section
2415.
O ;"'OODS?O'/E: Aft.I" instaLlation is
ac'':'Ip l.. :€d.
l.l1 CURB & AJ'PRC~CH .4P.~N: Alte-:o .fo~s
/" are ere::::;ed out p1'"'!.or to pC"oU"1..ng
.::on..::rete.
ril SIO=rJALt<. & [JRTlE(';A"!: FOr qLZ ccn-
~ eret'e paving wi'Chin street right-
of-way.. to be made att~r aLL e=:::=.-
vating ::c:mptete & fomr !.:Crk & 3140-
bass :rc.t:enal in plaae.
o
o
:"ENCE: When compl.ite -- ?roui.de
ga;;s or :novab Le 3ecticns through
P.IJ.E.
. .,cceo," '
t5~.s7o/q
~~
1 /jucIJ-tJ/~
Sicn:ed: A~
Gat:e: '~<-K-~ .
["iac. ;!
~ircs
?1:0n.~
t,F$(.,:..Ll1..:li
~4~-J"<;\
(:~8/f}{
'l.:J. , 1/3 L'I n en
.2o..'"),.....,.~ IniH> 'I('J(,>
'2n .-7Qt..t"~ ''''3d) Il C,
4-1 F4 ?, ~I "I fI{.~
ff'h0053
I ~2,'.!Or.ITIO:.' OR ,~:DV!'; 3i.JILDI;:CS
=:J Sani ::r'd se:Jer ~a;:?ed =:t ~~p.r:--:1' lir.a
.=J Septi::: tank P:"9cX: ~ f~llad :Jith ;ra-;a!
:J PinaL - rthen a.Xl,.'S ite~s a:!'B cc..::~t.dt'~d
ar~ when i~L~:ior.: i$ c~i~~e or s:~.l~-
~e ~aved ar~ ?r~..;3as ~le=r~d ~p.
1.~!~i:Ji l~ P.c."::es
:=J alockir~ ar.d Sa:-~p
:=J PLumbing cannec:icns -- s~er ar~ UC:ar
I Elect,...;caL Ccr.nec-::ion - Blocking~ 8St-!lp
--.J and p~wnbing conr.ec1:ions r.r..st ~e CZ?pral.'~
before request~ng ~Zec:ri~aL inspsc:io~
:J .4.,::::es:;o,':,' 3uil.i-::r.g
:J Fin.:r.L - 11ft;;"/" ;:;1'c;.;as, akirting.. dec;.....3~
et~. ers ca::ple:~d.
o
W. FIUA!. P!.U;~!BI:"G
ALL projee'C cor.di:ions.. ~uc~ as er~ {ns=aZla=ian of s:reet :r.es. :~~!a:~~n of :~
l"squiroed l..anC.sccpir.g.. etc... muse :'0 satisfied b.tOl'B tr.a 3UI:'DI.~'~ Fr::/,L :-ah ~e raqu3s:.:zd.
GrJ, FINAL, !/E:oi!A:IICAL
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PINAL BUILDI.'IG: The Final Building !ns?8ctian .':':USt be l"eque3:ed :::.f:er ei:iI :~r.al ?l:J.::;:'i~
Sl.~ccri:::aL.. and Nechar.iccL Ir:speatio1'U1 i1avc .;een made ar.d approved.
.AU, NANHCr.ES AND CL'EANOUTS .'tUS1' BE: .~C::E:S:S:3r.t. .~DJt'Sr:~:..'!' TO 3S g.~rs :~T NO -::S-: :'J CT:Y I ~""'.a of:
SOLA_CCESS
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E1.e.:tr-ical Pe~t
State Surd/croll
T~tal C'~ce8
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I E::hau.st Hood
l Vent F~
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lfIor," ~ -:r
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IWesT;
l.OT TYPE
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-- Fees
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~', DA'-"'/fC~ OF F'C;/N
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Corner
Panhandle
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CHARCE
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~OTA!: ANOU.'/T DUe:"
.<)'711
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I I Watl3"!' r.Jt'(J~:n' ~ ~
I I .,ange
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301d.....?OTr:S: '3
7./ '
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Building Value
&
Pe r m it
This p6rnr::t is granted on :he e::press -:ondi:ion that the said. aonstl"'.lc::ion
shall, in ~Zl respects. confcrm ~o the Jrdinar.ce adopted by the =it~ ~f
Sprir.af:.eZd. :.nc~w:i:.ng the Zonina Ord~r.ancs, l'ea-.ll.t.:tiJ:a tits ccr.3er:lc:.;Cr:
ar~ ~;~ of buildings, and ~~y ce~ Ju~?ended or revoked ~t cr.: :~me ~;cr. vie-
lation of ~y pr,vi.si.or.s of said Ordi~~ces.
Plumbing
Permit
No person chall c~~truct, ~ns~l!, aZter or change any ~~~ cr e=isting
plumbing or drainage systen in ~hole 01' in part, unless such Ferson is tr~
, legaL posse3sor of 3 valid plumber's license, e::cept tr.at a pe:oso'fl ma:! do
pZumbing :.;ork to property ~hich is CLJr'~d, Laased or opera1:1Ui by the appLi-
cant.
Electrical Permi t
Where State !CJJ l'equires tJo.at the elecerical ~ork oe done by an Ete::tl'icaL
Cont"ractOI', the electrical portion of this permit shalL r.ot ba valid untit
the Label has b~en signed by the Electrical ~O'fltractor.
Mechanical Permit
0,...,.,---".....
.rt{;f~:-rer
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urE ~.-J.:>
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<: -/o-&;:
L/ar;2
I HAve" CAREFULLY EXA.'fINF:D ths aompl2ted =?pLica1:ion jor permit. end do
hereby certify t;hat; aU ir:fo:-mation hereon is true a~.d cor:occt, ar.d I
f'..aother certify that any ar.d al1. :':Ol'k perlor:ned 3haLl oe do:-:e i:-: .;:c::or-
dance :.rith the Ordinances of the City of SpringfieLd, and th~ i:.C'..;s of th,3
.. State of OreG.:m pzrt.:zining to the I.JOrk, cesc:-;bcd herein, cr.a the;..:: :.'0 OCC!'J-
PIoNCY will be m:.z.:!e of (ZTIy atruc1:ura ~itho"'t ?~l'f7r'~s3ion of the 3uildir.g tr;-
vision_ I further -:ertif"d th:.::.t o:tly ::!ontract~rs ar.d e::rpl.:yees w;.,o .:1'9 in
~pZ.iance with CRS 701.05E will be used en thia projsat
5~ (<~~"~
II ~..J,8 G;,
Date
CITY OF SPRINGFIEI '
,
City HIli
Sprlngftlld, Oregon
Department of Public Works
OFFICIAL RECEIPT
-,
J No. B 65917
DBtec:l-1 199(0
, Rec'd From h1// tV~ ift~J1,
, Address ~/; II e. 40lif 7 A/YJlfl !J)~
~ Received For Z' I dl() 53-1 tft.~
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ttb~~ jfJJtvv
C IV I IJ ;1j lP 'I
(~ IIJ, j,Jj;L/
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'-'
Amount Received
~
Cj6,3-(/
0/
AUTHORIZED SIGNATURE
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r . -, _ DUSINESSfORMS,INC, 1!;03IJ.l12-81.e 63$3
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