HomeMy WebLinkAboutPermit Building 1985-10-16 (2)
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IIIISPECTIOtI LItlE CITY OF SPRltlGFIELD INFORJIATION Lltlo
726-3769 COf1BIIIATION APPLICATION/PERMIT 726-3753
. -. ErIERGY SOURCES: Sq. Ftg. '.lain
Job Address ""j L" 7 -71~ ., ",.., -.o~.--_ < rt A
L... J [.,/UFY -:::., rJC:C::-" Heat _q. , g. ccess.
Legal Description 17-"""-27.'" "/" ....C ~ Hater Heater Sq. Ftg. Other
,.,,. iO ~. ~ ~ )(lIew Add Alter Pep.
Range -Fence Demo Change/Use
ValuE of Hork: KOther~~""".QV_
~a::t::'. tf>-o ~~-
BUllriinQ Permit Info: Describe Work(;~e.t Build Single
Familv nesidence With Attash~d Garaae)
F'4UA(p..rr_..... ~.N(;..... .F~iP
r~A<'7';P ,.0. ~~/~E";<;
. ,
WARE'/JI7?~~
. (lies. no.)
! . MECHANICAL
I r':lARll.E ..JlQ.....1
I furnace/burner to
BTU's
I Floor furnace
and vent
1 Recessed wall
~n~rp hp~tpr ~nrl vpnt
ITemporary Construction
I'Change in existing I
l"P'S- j qpnrp
Imultifamily. COIllTl. or I
Tnnuc;,tri,,1
10f amps.j I
ICOMl-I.IlNO. FEEOERS I
IInstall/alter/relocate I I
di~trih. fppder~
10f amps.1 I
I I
I I
I I I ISSUANCE OF PFRfm
~ TOTAL CHARGES I TOTAL CHARGES
that the Electrical work be done by an"Electrical Contractor~ the electrical portion 'of this pemit
label has been signed by an Electrical Supervisor and returned to the Building Division
Owner
Jt/~N ~~"-_;C-h'p~c.::~
'1/$ ~~~ ~~<:
~~~.
Address
Phone
~~-99Y'"
Construction Lender
Address
UESIGN TEAl.!
(name)
Phone
"(a-ddress \
Primary
C~jN'N~
Structural
Electrical
Mechanical
CONTRACTORS
(namel
(address)
(lice;.. no.)
General
/:)WA/~_
Plumbino
Electrical
t-techanical
PLUllBIIlG
--1!Q.,,1 FEF rHARr,E
,/ Each single fixture ~_ ~I>"
fQ ,,~..~.;.'\ fit.41!J it I.' ..,."
Relocated building
(new fix. additional)
ELECTRICAL
"n
~ H~
Residence of
SQ. FT.
I'New circu~ts alts.
or extenSlons .
I SERVICES
I
IS.F. Residence
(1 bath]
IDuplex (1 bath)
IAdditional bath
I~Jater service
I Sewer
each
Storm Sewer
TOTAL CHARGES
WHERE STATE L~H REQUIRES
shall not be valiJ until the
~
()
~
~
€../ F<:"Z2-
S"_~ Y
(exoires)
(ohone no.
(pxoi rpc;. \
(ohnnp nn. l
I ~~~
Irl-lllRG..E...
.'
I Appl iance vent
se>oarate
I Stationary evap.
cooler
I Vent fan with
~inole duct
I Vent system apart from I
he>atina or A.C.
I Mechanical exhaust
hond and clurt
11',ood stove/heater
I HAVE CAREFULLY EXAMINED the completed aprlication 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 IlO OCCUPAllCY 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 701.055 will be used on this project.
!lANE (p I ease pri nt) ~r.."".x- G:u c k'CnJ bt;7i?-'1 t:Z
SI-GfIATURE~~
Far. OfFICE USE miL Y
Sq. Ftg.
Sq. Ftg.
Sq. Ftg.
20ne /f(f./'4'7
Fire Zone
Flood Plain
Tyoe/Const, ,'\"-)(/
Bed rooms
Stories '2
Units
Occy Load
Occy Group .if -:2
t1ain x Value
Access x Value
Other mJ..vn.",_-/ a(; ~alue
TOTAL VALUATION
41~. '-0
.)-.:....-
DATE IP-/? d'J-
BUILDING PERIIIT ___:;?~_o_~_ ~~;!R~~~ ConmlI nd Shstems Development ~E r>>,p
Charges and Ppr J:'pp C arQe tl.5~) .
Surcharges /./<. Plan Ck. Res . ~. ~.-:-.
-,7
30%/BldQ Per Fee _.#., ... _."JIT
I Fence I ' .
PLUl1BING PERMIT 2. ct:J -
Charges and ---- -_.:._---
Surcharges 1.2t:? I Ocmo I
ELECTRICAL PERI:IT I Sidewalk I
Cha rges and ------------ I A/C Pavin9
Surcharges ITota' Comb, Permi t 6(). ;?Z j
MECHANICAL PERMIT I Curb Cut I roo.
Charges and ------------ 3.1
Surcharges I I TOTAL
....sr~ $/-'-'/ a+l?p
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