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Home My WebLink AboutPermit Building 1988-8-15 T . Ranqe - INFORllATION UNt 726-3753 Sq. Ftg. 1.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. Fence_Demo~hange/Use _Other ~ ~ ~ t\ ValUE of Hark: ~Z 5"96. Y'.-.:> Buiidino Permit Info: Describe Work(Le.. Family nesidence With Attached Garaqe) Owner ~/;>To/ C'P ~~.1""'7~ Address ~~.N'~ J?!' 57: - - ~Ln .o.i'i'. '97<777 Construction Lender Address UI:.~I(jN TEAf1 Primary Structural Electrical J?E~""~~ I,IBo.::>F~ 7??Al>7~ <)"~A,:...b> SI"..2a::>~ ~- ~~.EAf;- q~~~ (1 ics. no.) Phone ~-~.,,&"-- .t_ ZJ.,,~#< (name) Phone (address) Mechanical CONTRACTORS (name) General .#~HG;.A.d""""'/~ ~FC::;;. Plumbina NO. I FFF ~ Each single fixture L #:P ~?i'~/?;t>rEZ . Relocated building (new fix. additional) I each I I I I I I I I I I I TOTAL CHARGES /?P--,-t'. 6: -- TOTAL CHARGES -:;;;;':;?~50 ,TOTAL CHARGES ~H. /&:;". - WHERE STATE L\\~ REQUIRES that tile Electrical work be done by an .Electrical Contractor, the electrical rortion of this rermit shall not be valij until the label has been signed by an Electrical Supervisor and returned to the Building Division Electrical ~1echanica1 S.F. Residence (J bath) Duplex (I bath) Additional bath ~Iater servi ce Sewer Storm Sewer (address) (l ics. no.) Build Single ."":";?- (exoi res) (ohooe no. 1 PLUIIBING ELECTRICAL (pxoires) (phone no. .K........~~ ~_ .v~/~ MECHANICAL ... n-lAJ:?r.~ r.HARr;F ... r~AJ:?r.1=' NO. furnace/burner to BTUts Floor furnace and vent Recessed wall So~rp hp~tpr ~nrl vpnt ~ ~T~2?~~A'"1 #(p;liance vent . seoarate Stationary evap. cooler Vent fan with sina1e duct Vent system apart from heatinq or A.C. Mechanical exhaust hood and dur:t / Nn Residence of SQ. FT. ~ New circu~ts alts. or extenslons '2A.R ~e b~o I I I I I I I Wood stove/heater ISSUANCE OF PFRPlIT I HAVE CAREFULLY EXMlINED the completed application 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 pertaining to the work described herein, and that rm OCCUPAlKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Bui1derts 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 7nl.055 will be used on this pro~~ ~ HAIIE(rlease print) CITY bP SFR/t)G-rr6lJ) SIGNATUREbe(! d~ tj( ~DATE FOr. OFFICE USE Orll'i I f\ Zone pi , Fi re Zone Flood Plain BUILDING PERfIlT Charges and Surcharges PLU'~BING PERMIT Charges and Surcharges ELECTRICAL PERmT Charges and Surcharges MECHANICAL rERM1J Charges and Surcharges SERVICES ITempOrary Construction IChange in existing rP'S i deJlcP Imultifami1y, comm. or Inoustrial Of amps.1 I I COMM./INO. FEEDERS I Install/alter/relocate distrih. fppdprs 10f amp~1 I I I I I I TYOe/Const,~ ~ ynits Bedrooms Occy Load Stories Occy Group Sq. Sq. Sq. Ftg. Ftg. Ftg. riain x Value Access x Value Other/1'~~ x Valuef2~. TOTAL VALUATION ff"-2 -9'~ , Plan Ck. Corrrn/l nd 'S~stems Development //# __~ -~ __ 65%/Bldn ~Pl" I='""e /,,~ ......... C arqe (1.5~) Plan Ck. Res /2-~8 3D%/Bldo Per Fee _n_t~~___ Fence .7S- Demo ____'3'3:2__ Sidewalk /./"3 A/C Paving Total Comb. rermit IS:. - I Curb Cut ~,.,OW"~ .60 Fee ---- ~-?S=I I TOTA~~#Ij . ~--- - . ~ T .. COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION ',' . I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Ref~rence II U3 43 2. example- Lot 1. Block 3. 2nd Addition to . Spnngfield Estates C: Name, etc. of owner and construction lender D. Energy Sources. . . . L example- heat/electrical" ceilin'q/or forced air qas 2. examDle- waterneater/electrlcal/or solar E. Square footage or valuation, etc. ----- 1. examDle- 1250 sq. foot house, 500 sq. foot garage 2. exa~le- if new project, check new - if addition, check add, etc. F. Building penna information: 1. exa~ple - construct single family house with an attached gan~ge 2. example - remodel existing garage into family room 3. exa~le - convert single family residence into restaurant (change of use) G. Valu~ qf work as defined in Section 303 (a) of the ~tructural 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. 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 full schedu 1 es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D, .As noted on the CAP, the label must electrical contractor for signature supervisor. The general contractor to sign the electrical label. 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. 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 p,ermit is issued. ..... '" II. be delivered to the by his electrical is ,not authorized III. IV. V. FOR OFFICE USE ONLY Permit Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Aqditional Project Information: PLANS REVIEWED BY: name ~:3~ W";Z~~Signature~.--< /k~ ~ . ,. ., J>-/ -of' . ~-- , date f57"S-&'8 .