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HomeMy WebLinkAboutPermit Building 1980-10-8 ... -\ . --.- -. i:lSPECTlO;l L11.L 726-3769 <.:! &--':t2L-~' /:0-6 r I rA '/'-J I' Hf'i .-\..( _..CL<~Y\ '~I) .;.. /1"'"- ~.....- t1'!i Llt~iuij rEfill .l".:rne\ Primary 7f;:::;:!.A~" .,!..I (address) I<::l$ 'Q" (lies. no.) (exolre'S'T 6-r. .. S-,,~ ns :?-,a , 7W:~~ '7 Stl'uctura I 6c:;,//Y~,. -----. / Electrical llechaniC.Jl CO:ITR"CTORS (",1me) (address ) (lies. no,) General Plumbino Electrical I ~~~chan;ca 1 PLUllBlIIG MECHANICAL (exo~resj - (ohane no, 1 ELECTRICAL FEF I l':HARGE ~ ~l='t:" rHARr;F Nn rl4/1Dr.F I I I-I-+- ~:w circuits, alts..mp~ ."'r ,=xt~n_c: ,nnee ~ IMDBu.e: J- ...j .:s, .., UP;:>t."" I (~'-I~;: : I ..tr ~............ / TOTAL CHARGES W' :;> ~'"'" that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit label has been siqned by an Electrical Supervisor and returned to the Building Division. :;0.1 lEaCh single fixture Relocated building (new fix. additional) NO I I furnace/burner to BTU's Floor furnace and vent S.F. P.esidence f1 bilthl Duplex (I ~ath) each Recessed wall __ . "~~~tP" ;lnri VPr'lt I I App1 iance vent seo.ar,Hp Stationarv eVdO. cooler ~ " Vent fan with sino1e duct Vent syste~ apart from heatiM or A.C. Mechanical exhaust hood .lnd rlud I I j I~!ater service I I I Sewer l'iJoo '<€~. 'I.!b.~ ~'lIStorm sewer~er""". ~ tc;~~ZplfoM"~I58~~ ~I I I I I I I I III I I Addit10nal bath WOOd stove/heater ISSUAliCE OF PERtH! TOTAL CHARGES WHERE STATE LAW REOUIRES shall not be valid until the BaS-' I TOTAL CHARGES I . Res 1 dence of F" SQ. FT. New circuits alts. or extensions I ./ I I I SERVICES jTempOrary Construction IChange in existing rp~jrlpn("p Imultifami ly, COrml. or Tnrlll<:tr1.'l1 IOf ICO:*l.fINO. FEEOERS I Install/alter/relocate di~trib" feedprs amps. I HAVE CAREF'lILL Y EXAf.lINED the camp 1 eted app 1 i ea t i on for pennit. and do hereby cert i fy that a 11 in fonna t i on 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 pert.ainin9 to the work de.;tcribe herein, and t7Ja NO OCCUPArlCY will be made of any structure without the permission of the BuildinQ Oivision. " J J I () I NAI.IE(pleaseprint) '}}=J)Io;"/5 B l;.J&,)PAISIGNATURE .... e.1'I/JU/J ..t1A1..\!4{'& /O/'?I.G-', ""1----' I,) f. / ~ FOR OFFICE USE OIlLY Zones Fz:tlr.MNP Flood Plain _ Bdrms _ Type Cnost. Deey Load" Ol.:cy GrouD Stories IJrdt.. '"3Q.)( --A-Ce U U jj T-"S'O iT,\(A~ R y Plan Ck. Comm/lnd. 65r,/Bld~ Ppr Fpp Plan Ck. Res 30Z/Bldo Per Fee Sq Ftg. Value "- "L- 'IdGld,/Q#lrV.'uC /S~, ~-- BUILOlllG PERI.IlT Charges and SurCharges ____~7L-:':._ 1'-/.8<1 "'0 s: "... ----~._----- ~'2 .20 ----~~~-'~~- IS-: ~O SOC I TOTAL I <tillS" I Other I Other Other Total PLU'.lBING PERliIT Charges and Surcharges Fence Spr"inkler System I Demo. Ale Pavi ng ELECTR I CP.L PERllIT Charges and Surcharges 11ECHAN I CP.L PERI'IIT Charges and Surcharges Curb" Cut '. 00 !(), ~.'-' Sidewalk6&'O Storm Sewer Connec. Comb. Permit I ;:'cc .::...I'....n"Y~_~ A7'T-k:.H-<5 P j;;::. ~H" ,f/93"7.7'7 I - CO~BINATIOi~ APPLlCATlON/PERfIlT (CAP) 1. , II. Applicant to furnish A. Job hddress B. legal DescriPtion 1. examole- Tax lot 100. Lane County Map II OJ 43 2. examnle- lot 1. Block 3. 2nd Addition Sprlngfield Estates C. Name. etc. of owner and construction lendel O. Energy Sources ( 1. exa:r.Dle- heat/electrical ceilinQ/or fOt -. 2. exa~Jle- waterheater/electrical/or s~ E. Square footage or valuation, etc. - 1. examD I e- 1250 sq. foot house. 500 sq. f '''9 2. exa~Dle- if new project. check-new - if ~~~ c::JeClo:. add. etc. f. Building permit information: 1. example - construct single family house ~n dtt::!ched gar~ge 2. exa~ole - remodel existing garage into 3. example - convert single famlly residen_ restaurant (change of use) G. Value of work as defined in Section 303 (a) Structural Specialty Code H. OESIG:I TEA:-i ArlO COIITRACTORS To avoid design or construction delays. Bull tY Division Staff must be able to contact apprc ~t persons regarding design information or job corrections. etc. Abbreviatea Plumbing. r'lechanical. & Electrical S ,du A. Except \':here blank spaces occur in the descr \i(l' porcion of the Mechanical and Electrical 5ch the aoplicant need fill-in only the No. Boxe to the appropriate item(s) to be installed I B. Full Plumbing, l.lechanical. and Electrical Sci ~lf are available at the Building Division 1. To conserve space on the permit form the have been abbreviated . 2. If the item(s) to be installed are not c( {ec1 the abbreviated schedules you should con~ full schedules C. BUILDI:IG OIVISrDN STAFF WILL FILL OUT ALL FEE CHARGES 011 THE SCHEDULES D. As noted on the CAP. the label must electrical contractor for Signature SUDerv i sor. .The genera 1 contractor to sign the electrical label. Applicant to sign and date Whenever possible. the initial application will bl a worksneet only. Where possible. Building Divis' will ~reDare a type written copy and return it to ~~ applicant at the time the actual permit is issued signature. f.-. _ 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 I'lhen the permit is issued. ( ( be delive by his 01 is not au II!. IV. V. FOR OFFICE USE O;~LY r. I CITY OF \ ---..-- --- SPRINGFIELD ( City Hall Springfield, Oregon Deportment of Public Works OFFICIAL RECEIPT ( S4842( ( .. -. r ~ jeJP 40)" /- No. B Dole 10 - S 19nO Reed From O-k'nnl:5 U)8.l:e.o AddressqSn :-t-a i h ))1 ill} Qv Received For: ,,- -'-- ~Ji2.rcrrii ~(j!W( IYH:9 pp 'AnG.OO - 37 :1.-0 3j l.OD I L\-.1-A . - ,3q().oO I ':') .(n n 1?H ' L'6 70. C't) L\Ob crY i\OIO pC y: CC'i'\V{l ~L, / ,CJ1) I ( ( ( ( , ( '" (. Amounl Received t q ~l1 ,1_L1 ('.If', _-= ( ~'--- \ (~ r "{:?c""D "ON""", s..nTO...TU.....Ull ....'..a..S - EuGE"E. 0" ~~.O' 5&511'. (. .' \ J 1 Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: J- 5"ZA:::::. L.#A;t1.::=.€5 Ar.?<!': I ~n.>P ?~.M/T A- IZ--#C ~<,v~A--1;/~- (<5 (., ~'fRiFT.!!2:>. I , I I I J /~ ??e ~7'A/~2> /lU.6W'CD Additional Project Information: PLANS REVIEWED BY: na~e Lc:RNIfE /2e:-..::::;-: signature , .. A/~ M~ ( .!-4";::>,?s'/LE" . ~G UTR-. 5~,z:> k?~,ra:;y_ V' date /e>-,b-;?9