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Home My WebLink AboutPermit Mechanical 1982-3-3 'I INSPECTION LINE 726- 37 69 CITY Of SPRINGflELO COMBIIIATlON APPLICATION/PERMIT Job Address /J ~ '~. I" (\ EilERGY SOURCES: / -,.,,,-C) L...L)-d ItA .t:l.d." ) ~).JJ , Heat Legal De,cription / I -- ....". k 1 '":)"" '" I "'- I Hater Heater .A...A.. -, l:'\l_ _ ~P..I<'~VA ...,~ ) ~ Range /'7-'?,"{,-2'7-.7/, L JI</' OwnerflI.A"/~~~)~.._",." ~. Address/7S') 1?A:Wl.,A~ ~(1 .. . INFDRl1ATlON llNt 726-3753 Sq. Ftg. '.Iain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Pep. -Fence Demo Change/Use Other - - Phon"?P'2P'~"" ValUE o.t(W~ oi> <"o...')OD. BuildinQ Permit Info: Describe Work(i.e., Familv nesidence With Attached Garaael Build Single c{\ )-.i I~ [0\' ~, j~.ft 1.I )-~'-1J-t:lA1;..O..1' ~ Construction lender Address Ut, Hit! nAI'1 {name} Phone (address) flies. no.) (exoires) (ohane no.') Primary /)1.J}1.. 00 Structural Electrical Mechanical CONTRACTORS General OU)IA A IIJ \ Of,UYl€.Y" (name J (addrp5.s) C1 ice;._ nn.) (exo;res) (ohnnp no_ ) Plumbina Electrical flechanical All) v\ €l..v- PLUIIBING ELECTRICAL SQ. FT. MECHANICAL ':E.L .GIIARG.E. Nn <<< r'lARliE, furnace/burner to BTU's F1 oor fu rnace and vent Recessed wall ~o~rp hp~tpr ~nrl vpnt Appliance vent I ~poa ra tp Stationary evap. I cooler Vent fan with I sinole duct I Vent system apart from I heatina or A.C. I Mechanical exhaust 1 hood and duct I Hood stove/heater l~ Il"D 1 I 1 I I I I I I ISSUANCE OF PFRmT ~ FEF .QIARGF Nn Each single fixture Residence of Relocated building (new fix. additional) New circuits alts. or extensions S.F. Residence (] bath) Duplex (1 bath) each SERVICES Additional bath Temporary Construction Change in existing rp} j dJ~nrp multifamily, comm. or lnnuo;tr;al Of amps.1 ICOr*I./IND. FEEDERS I l'lnstall/alter/relocate I dio;tr;h. fppdpro; IOf amps.! I I I ~Jater service I Sewer IStorm Sewer TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be vali~ until the , TOTAL CHARGES . TOTAL CHARGES J S. (" CJ that the Electrical work be done by an .Electrical Contractor, the electricaf por"tion of label has been signed by an Electrical Supervisor and returned to the Building ~ivision thi s permit 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 performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that 110 OCCUPAIICY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builderts 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 ORS 7Q1.055 will be used on this project. Zone_. Fire Zone Flood Plain Tyoe/Const. Bedrooms Stories Units Occy load Occy Group SIG1IATURE A~~~ FOr. OFFICE USE OlllY Sq. Ftg. riain x Sq. Ftg. Access x Sq. Ftg. Other x DATE-W ~2 IWIE(please print) ~~." L ~ 'L- .... Value Value ValuE' TOTAL VALUATION BUILOING PWIlT Charges an~ Surcharges , Plan Ck. ____________ ~/Bldo Plan Ck. 30%lBldo I Fence 1 Demo hidewalk I AlC Paving _J_6.:.Q9_____11 Curb Cut I .loO Conm/! nd Pp,r Fpp Res Per Fee 'Systems Development CharQe tI.5~) , PLUI~BING PERMIT Charges and Surcharges I 1 I ELECTRICAL PERI:IT Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges ITotal Comb. Permit I .j,t, / ITOTAL I'J. \,,00 \ \. . io COMBINATION APPLICATION/PERMIT (CAP) 1. Appl icant to furnish A. Job Address B. Legal Oescription 1. example~ Tax Lot 100, Lane County Map Reference II 03 43 2. example- Lot I. Block 3, 2nd Addition to Spr,ngfield Estates C. Name. etc. of owner and construction lender D. Energy Sources ... 1. example- heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. ------ I. examole- 1250 sq. foot house, 500 sq. foot garage 2. exa~le- if new project. check:new - if addition. cheCK add, etc. F. Building permit information: 1. example... construct single family house with an a ttached garage 2. example - remodel existing garage into family room 3. example - 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. OESIGN TEM4 ANO 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 Division 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 fu 11 schedu 1 es C. BUILDING OIVISION 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 Whenever possible, the initial application will 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 permit 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. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . " " PERMIT VALIDATION B6~ I tf. 7 lu-o-() cf! 5-f~ 4~ I~.O(J J.o 0 - $1/ <). fo 0 j ~. Permit Cl erk ;:!~o--w Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name~. "8.... J.... ~ L< .. <.~'t Signature~~~~J , {r' date "rA h>2 / / ,. ,'. . COMBINATION APPLlCA T10NiPERM9(CAP) . I. Applica~ to furnish A. Jab Address B. legal Description 1. examole-tax lot 100, lane County Map Reference 2. examole-Lot 1. Block 3, 2nd Addition to Springfiel C. Name, etc. of owner and construction lender' D. Energy Sources 1. exomole.heat/electrical ceilinq/or forced oir gas 2. examole-water heater, electrical/or solar E. Square footage or valuation, etc. 1. examole-1250 sq. fool house, 500 sq. foot garage 2. example.if new project, check ilEW,.if addition, chI add. etc. F. Building permit information: , 1. exam ole-construct single family ho~.~~ ~ith an ott garage 2. exomo/e-remadel existing garag& into family roor J. example-convert single family residence into restourant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays. Building Divis Staff must be able to contact appropriate persons reg design informction or job site corrections, etc. II. Abbreviated Plumbing. Mechanical & Electrical Sched~le~ A. Except where blank spaces occur in the description pc of the Mechanical ond Electrical Schedules, the applic need fill.in only the No. Boxes adjacent to the approF item(s) to be installed B. Full Plumoing, Mechanical, and Electrical Schedules . ore available at the Building Division , 1. To conserve space on the permit form the schedule hove been abbreviated 2. If the itemis) ta be installed are not covered on the oted schedules you should consult the full schedule 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 as worksheet only. Where possible. Building Division Staff '^' prepare a typewrirten copy and return it to the applicant the time the actual permit is issued for his signatur€.. Fees and Charges ( Plan check fees are due and payable at the time of the OF . and no plans will be processed until these fees are paid. k: other fees and charges ore due and payable when the permit is issued.' IV. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: C! a.U.. . PERMIT VALIDATION . . . .. 17 03 43 CITY OF SPRINGFIELD ( ( ( Date ( Rec'd City Hall Springfield. Oregan Department of Public Works OFFICIAL RECEIPT ( 56645. . No. B {D-hl 195j From t:H.JqPI.1=. e SOPS<=' ::.')I? Address / 7::S;~ JfJJ./AifJrlltJ Dp-5'P;::/J ( ( ( Received For: /8.-:; '- tV/< ( ( t{PCku'1 Jr".o / /.......-. 0.2 ,~ '()/ -4 /,,\ r5. (pO ( ( " (" ( Amount Received /0. fD9 CAs# ( ., c----.,~.::>~ ~I ( I AUTHOJUZIID S'C"'ATU'U: ...11'. C., SHIlLYO".YU"H.ULL""'HYIl".' IlU'U"1l o".uo, (", '. Permit CierI- r . ~oa-d ~" dv:;U . ..Ih1~/'~/~ 6~ I . Additional Project Information, I I I I I PLANS REVIEWED BY, naml'" .-,ignatur'"" .~. ~ .J-t,co, .- _. ., . . . . CITY Of SPRINGFIElD COMBINATION APPlICA TlON I PERMIT . INFORMAJlON LINE 726-.3753 I INSPECTION UNE 726-3769 I Job Add,eu Il'9010,"',PII,o LoC ~ BIt. / ---1...7, O~..:...2..7-,a 3/ 7L Owo" (7./-IP/?I.€5 R.<"/JFSc:., :0;-.", Add",. /7~p., l?AIN.P.()LU D~l\!": . . ~ I I /758 R/I/N&JW D/:/i.J1S O,eewSDPIESUA- //4 -, ENERGY SOURCES: . H.ol .~/< Wgter Heater Ronqe - Value of Work: -If~OO,6!! i Sq. FIg. Main I Sq. fIg. AcCllu. Sq. FIg. Other . _New _Add_Alter _Rep. ___Fence_Demo_Change I U 'II .uOlher Building Permit Info: Describe Work (i.c., Build Sing I. Forna.. Residel'lce With Alfoch"d Coroce) 747.4' ::<fJI Phone CQn'truct;on lender IXs-mll. R?;:::I1IL1 U UL ,qPPI9DVcn "v'OC,D S'7Z>V,", 1 "'"5t,8/} -.3f!..O:ABLI!- Addreu Phone DESIGN TEAM (nClmlti . (address) (lies. no.) (."'pires) Primary O\N I-J Ef2 Structural Electrical Mechanical CONTRACTORS (nome) (address) (1ies. no.) (e)Cpires) G~"~ral r,l1i......IFf< Plumbinq ., Electrical Mechanic;ol PLUMBING ELECTRICAL MECHANICAL NO. I f~C: I CHARGE. I NO. I CHARGE NO. fEE Residence of furnace/burner to Il,TU's Ap?liance ...ent separate Stationary eYap. cooler Vent fan with single duct Vent system apart from heating or A.C. Mechanical ~)Chaust hood and duct Each ,inqle fi.-:ture R.locored building (new fill;. addirional) S.F. Residen~. (1 bath) Sq: ft. New circuits. alterations or extensions SERVICES Dualu (I both) each Temporary Construction Additional balh Amps. Worer ser"ice Sewer / Wood sto...el heatar Stor.m Sewer FEEDERS Heat Pump Air handler to 10.000 CFM Air handler a....r 10,000 CFM Amos. I I I t. I TOTAL CHARGES I I TOTAL CHARGES -G- ISSUANCE -OF"PEJl:MIT I TOTAL CHARGES -G- (phone no.) ,.,ha"e no.) FEE I CHARGE I 1 ' I; I I I I I 509 JS.oq I I I I I I /0. f>.!! /50;> WHERE STAlE lAW REOUIRES that the Electrical work b. done by the E!ertrical Cont,acloP, the electrical -portion of this permit sholl not b. yalid until a lobel has been sig"edby an Electrical Contractlllr and attached ta the electrical panel. I HAve CAREfULLY EXAMINED the completed application for permit, and do hereby certify that 011 information her.on is true and correct, and I further certify that any and 011 work performed ,hoJl be done in accordance with Ihe Ordinances of the City of Springfield and the laws of Ih. State- of Ore90n pertainin9 to the work' described herin. and that NO OCCUPANCY will b. mode of CIny struetule without the permission of the Building Division. I furlher atrlify that my regisfTOlion with the Builder's Soald is in full force and effect as required by ORS 701.055, that if u.~mpt the basis for uemption i. na~d h.ron, and thot only subcontractors ond employ..s who ore in compliance witk ORS 701.0'5 will b. used on Ihis praj. . Bo.i. fa< Build". Boood .,,"'ptioo, /l~ ~ NAME (p'.o.. p"o" p~~ l:? S::=:<'&-SIGNATURE.( f!(AIff:r/W p,~ FOR OfFICE USE ONLY ~ Zoo, 'R \ OATE t/eh/ I'nih rlcey Load n~cy Group c:..... Ftg.Mtrin Sq. Ftg. Access Sq. Ftg. Other x Yalue x Va"... Yol" . TOTAL VALUATlON,....;:bD,O~ Typel Canst '..drooms c;torie~ Fire ZllIne Flood Ploin BUilDING PERMIT Chor!)es and Surcharge, Plan CIt. CllImm/lnd 65%1 Bider Per Fen Plan CIt. Res 30%/ BldCl Per Fee ~ --A- Systems Development Choro. (1.5%' PLUMBING PERMIT Chorges and Surcharges -e- Fence I Total Comb. Permit Demo elECTRICAL PERMIT Charges and Surcharge, -e Sidewalk Ale; Povinn -&- /5, ti>5! MECHANICAL PERMIT1 Chorges and Surcharges TOTAL .JJ'K'liJO /......;, - I 5c,o / .- --- O~~-- ClJrb Cui ~~ . , , COMBINA nON APPlICA TION/PERM.CAP) . I. Applicanl, to furnish A. Jab Address B. legal Description 1. example'lax lot 100, Lane Caunty Map Reference 17 03 43 2. example-Lot 1. Black 3, 2nd Addition ta Springfield Estates C. Name, etc. of owner and construction lender D.. Energy Sources 1. exornole-heot/electrical ceiling/or forced oir gos 2. examDle.water heater,. electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. faat house, 500 sq. foot garage 2. exompie.if new project. check ii'eW.if addition, check odd. etc. F. Building permit information: 1. examole-construct single family house with an attached garage 2. example-remodel existing garagE: into family room 3. exompie-convert single family residence into restaurant (change of use) G. Value of work os defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM 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 Sched~les 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 Division . 1. To conserve space on the permit form the schedules hove been abbreviated 2. If the item(s} to be installed are not covered on the abbrevi~ ated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES III. Applicanlto sign and dale Whenever possible. the initial application will be used os a worksheet only. Where possible, Building Division Stoff will prepare 0 typewritten copy and return it to the applicant at the time the actual permit is issued for his signaturE. IV. Fees and Charges Plan check fees ore 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 ore due and payable when the permit is issued.' V. FOR OFFICE USE ONLY '. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: C? a..U 6c-L L-Uo04 ~"D":;U . Additional Project Information: PLANS REVIEWED BY: namf" ",ignaturl"" ~>..... . . PERMIT V ALIDA liON ',' , ,,~. ~ '. Permit Cler~ r hYJ~~/~ ~ote ..-... ......'