HomeMy WebLinkAboutPermit Mechanical 1981-6-2
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CITY OF SPRINGFIELD
COMB1NAJlON APPLICATION/PERMIT
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INfORMATION LINE
726-.3753
I INSPECTION LINE
726-3769
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I ENERGY SOURCES:
/758 R/I/NJ3I)W Del/J~ H.at -W/-<;
n I Water Heater
L'9aIOm.;p.;an Lot 5 f3~/ URE1VSDliLE ,<;uP,- Ranq.
/7- D;1, - ,:;0- ifti. 3/ TL 114~uoof wo~~
Own.. (?/-I/lRI.€5 12. _<;0"5<:" ~p '!<D6. -
Add,,,, /758 e/HNJ3Dw Dl2l\J!: . Phon. 747- 4:2tJI
Sq. fIg. Main
Sq. Ftg. Acean.
Sq. FIg. O,ner
_New _Ad d._Alter _Rep.
___fence _Demo_Change I U 50
JLb'her
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Job Addren
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Con1truction lend.r
Ii15T1l(1. R?1::/JJ.tJI( WOOD 57lJvt::
UL ItppJE'{)VaJ#:51~81/ -..3f!.OA.B~
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Building Permit Info: -D~scribe Work (i.e., Build Single
Family Residence With Attached Goraoel
Addren
Phone
DESIGN TEAM
(nome;
. (address) -.
(lies. no.)
(expires)
(phone no.)
Primary
()\AJ '" Ef2
StruC'turol
Electrical
Mechanical
CONTRACTORS
(namel
(address)
(lies. no.)
(ex.,ires)
(phone no.)
c,
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0~r"tral
I"\U)~FR
PlumbinCl
t:Jl'Ictrical
....-:
Mechanicol
PLUMBING
ELECTRICAL
MECHANICAL
NO.
FEE
I CHARGE I NO.
FEE
I CHARGE
NO.
FEE
CHARGE ~
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Each sin~le fixture
Rdlacated building
(ne..... fix. additianol)
S.F. Re.iden!=e
(1 both)
s~: ft.
New circuill. alterations
or extensions
furnace/ burner to
"TUfs
Ap?liance vent
separate
Stationary evap.
cooler
Yent fon .....ith
single dud
Vent system aport from
heating or A.e.
M.manical exhaust
hood and d~ct
,/
Residence of
SERVICES
Duoltt'll: (1 bath) l'Iach
Temporary Construction
Additional balh
Amps.
Water se,.,.ice
Sewer
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Wood sto....1 heoter
5.0~
Stor,m Sltwer
fEEDERS
Hltat Puma
Air handler to
10.000 CfM
Air handler ov.r
10.000 CfM
50.1"
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Amps.
r
I TOTAL CHARGES
I WHERE SlAtE LAW REQUIRES thai th. Electrit;:al work b. done by the Elertrical Contracta1, the electrical portion of Ihis permit shall not b. walid until a
label has b_n signed by an Electrical Contractor and attached 10 the electrical panel.
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ISSUANCE -Of ..PeRMIT
10. ~~
150~
TOTAL CHARGES
-G-
TOTAL CHARGES
I HAVE CAREFUllY 'EXAMINED the completed applicotion for permit, and do hereby certify that all information hereon is true and corred, Gnd I further
certify that any and' all work performed sholl be done in accordance with rhe Ordinanc.. of Ihe City of Springfield and Ihe laws of th. State of Oregan
pertaining to the work d~scrio.d herin. and thai NO OCCUPANCY will be made of any structure withoUI Ihe perm inion of the Building Di...i.ian. I further
certify thai my re-gisrra1ion with the Builder's Board is in full farce and effect a s required by ORS 701.055. Ihat if ex.~mpt Ih. ba.is far exemption is noted
::.~~::~~=~"'~"~:~~;"',~:::.:{~@~ ~..~h/
FOR OFFICE USE ONLY
Zone 'R \
Fir. Zone
Flood Plain
Type/ Canst.
~drooms
"Iari-'
Units
t"hcy load
f'lccy Group
Sq. Fig. Main
Sq. Fig. Accen
Sq. Ftg. Olher
x
Value
x. Valu.
x Yolue
TOTAL VALUATlON..-0D,Oj!
BUILDING PERMIT
Charges and
Surcharge.
-6-
Plan CIl:. Camm/lnd
65%/ Blda Per Fee
Plan CX. Res
30%1 Bid" Per Fee
Systems Deyelopment
Charae (1.5%'
-e-
-*9
PLUMBING PERMIT
Charges and
Surcharges
-G-
~
fence
Demo
Total Comb. Permit
/5. tD!}
ELECTRICAL PERMIT
Charg"l and
Surcharge.
-e
Sidewalk
MECHANICAL PERMIT
Charges and
Surcharges
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/5.00 I
:-- O~~ ---I
AI C Pavino
I TOTAL
~5.t<>9
Curb Cut
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