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Home My WebLink AboutPermit Building 1985-3-18 (2) "I IrISPECTlON LItlE 726-3769 . . Job Address ....:) ,,~ CITY UF SPRINGFIELD COMB IllATION APPLICATION/PERMIT E!IERGY.--50UI!l;~-,- . _ "",. Heat t::LC::C\ Hater Heater ----- Ranqe .- INFORtIATION liNe 726-3753 Sq. Ftq. Hain /'--. I ~) ~q. rtg. Access. ---- Sq,-,tg. Other ----- ~ew Add Alter Rep. --fence Demo Change/Use V~,;'r??r_ _ Other- - BUllt;no Permit Info: Describe Work(i.e.. Build Single Fa~ily nesidence With Attached Garaqe) 'V~ d-L A Legal Description -Sa-, 5-<- :J;-' Lf.::r '<;,~ ::.,(::; IV, /? - '"( /A/ u/ ~ Lo'l 2. ern Owner s:;~ \-,i I., . ,..; P IH' "f tr I? P. Address 15'0-0 JU (,,) f:. ....... OA ~ Phone ZZlf - (? IM+#. ~jJ ^ v0 q 7::L.o 1 B-1'? 1 .. / Construction lender A/~ ~fI!{!;; (name) 17, I Dhone <:::J \J-.. r--.... ~ bo Address 8lS 1 GN fEAt,' Phone (address) ;- F: IJ" If} () s: G- /', , . (J ..(' (2. / c.. r:;- (lies. no.1LJ<2xo;~ e. fI~ , no. \ Primary l~/::?jtJt, Structural 4LL6/1/ / J? c,,, .0::::. iilL::t.i lU rLM1.uJoJ~IJ.F .-fir'1- '1~... /_ Electrical f1echanical CONTRACTORS (name) (address) (1 ;~c:.. no. (PlCn'irpc;) (ohnn", !'In.,.) General D f.J/ 1}1" T 1/"lf"./''''''" P'umbino Electrical PA'/~_ _C C-Lcr7/1f!t:r IS, n /",-r;-{ "',""1I<"'SS-ZS-'<;"1I') <1-:1<./...10''''' Jf'~ rt.?{) Puvi!:GRdUC- 5S51) td~-.v, (;f'7 -'2P4 ! ~1echanical PLUllBI NG "'1,, ~ FEE CHARGE ELECTRICAL MECHANICAL \J ~ NO.1 Each single fixture NO I Residence of I H"C- I r~AIU::1=" NO I I ~n: I r~ll.lu::~ SQ, FT, furnace/burner to BTU's Relocated building (new fix. additional) S.F. Residence (I bath) Duplex (1 bath) each New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wall So~rp he~tpr nnd vpnt Storm Sewer Of amps. Apoliance vent $poar~te Stationary evap. cooler Vent fan with sinole duct Vent system apart from I heatinq or A.C. MeChanical exhaust hond rind rluct Wood stove/heater Additional bath ~Ia ter servi ce Temporary Construction Change in existing rl;'s_i drJ1ce multifamily, comm. or lnrlustriill Sewer COI~1,/IND, FEEDERS Install/alter/relocate dic;.trih. fpeders \ \ ofi (:::::',:, \. nD amps. Ii)- \0' .:..t.. ,\. \ I SSUANCF OF PFRillT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L'\H REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division 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 1m OCCUPArKY 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 ORS 7nl.05 wil be u on this project. V01f1J p Yf1.4W...Ot.t.V6 ~~_ llAf.IE(please print) DI'1-AI fJ1<7U!v/?; SIr.IIATU F 7...~- f Fo~ OFFICE USE Q;ILY Units \ So, Ftg, 11ain 'ie) "; Occy load Sq. Ft~. Access occy Grou~-? Sq, Ftg, Other ... iJ.tif \3 "31~ Z. -::2.., - ' Plan Ck, Conmflnd '.Jl _...d1t:L___ ___ 65%/Bldnp.prFpp NJ/3.(J{) \ Y II Plan Ck, Res ,"\ 3D%/Bldo Per Fee s~rlPre'\ oATE/O- .5U-~c, " (' --- Zone. \-....- Fire Zone - TYDe/Const:0 \.. ) x ':J,() .. .\- LLL Flood Plain _ Bedrooms Stories x Value t.'""'I Value Value \ x TOTAL VALUATION BUILDING PERfIIT Charges and Surcharges IO~'l..O"-r;.<{ Systems Development I ,f'& Charoe (1.5~) . C\O,0.3 PLUI~BING PERMIT Charges and Surcha rges 'N\~ ------------ Fence ~\\:I\,\:,\r::',-,';:..\~\\} .", ')-=<. '-\0 \~ CO 1--'..., '-:), ; to,L-\O ELECTRICAL PERt~1T Charges and Su.r~harges \.t . \ '.-) , -----~~\O-- \J , '?\ _______::.6____ "--... - OfJRlO Sidewalk Ale Pavi n9 Total Comb. rermit TOTAL 1---- ~" \::j, '711 '\ l' ...."'1 .'- l:- IlFCHANICAL PERMIT Cha rges and Surcharges Curb Cut . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION HI 0~3 9~ IJ --;,?!J/IfJ/ I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II 63 43 2. examEle- Lot 1. Block 3. 2nd Addition to Sprlngfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examEle- heat/electrical ceiling/or forced air Qas 2. examole- waterheater/electrlcal}or solar E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house. 500 sq. foot garage 2. example- Tflnew project. check-new - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached 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 Speciafty Code H. OESIGN TEM1 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 ~ivision 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 schedules C. BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO 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 Permit Clerk 0:7/ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: (::~\S\\ \...) c.--.. "~:\(;:-\..)LRJ '\")E ( \-\'C1"?-,\ 0? \ \\"",,\,,,\ \c\ \::>:t- ~FY\O\. ,\pC) , '?--H~l Q P r--c~' "'::;'? ~\. \C-" () ~ DC=-\.....,_) \.. \ \\ (\ Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name\.J~':..J\0-"'=" \;:::'"T' signatureeJrh_,\ V~_V-- date \ \ -2 \..\- \~q .