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Home My WebLink AboutPermit Building 1989-2-2 , . ,~ ..oJ' ~....). ,.---, I, . I INSPECTION LINE 726-3769 , " Job Address 223 North A, Suite E . CITY Uf SPRINGfIELD CDMBIIIATION APPLICATION/PERMIT EIIERGY SOURCES: Heat-.Rl..e..c..t-ri (' Hater Heater"'1 ':>f't-r; f' ~ 1~ ~ 'l\ INFDRrtATIDN liNt 726-3753 Sq, Ftq, I".in !:q. Ftg. Access. Sq, Ftg, Other ~ew Add Alter Rep. --Fence Demo Change/Use Other- - -, f , I Legal Description 17-03-35-3-2-03000-801 Owner Range Va 1 U€ of I.jark: $12,500 Phone-146 841:; Bui1dlnQ P~rm;t Info: -, - ....1 Famllv Resldence Hlth I Describe Work(i.e.. Attached Garaoe) Address 250 North A Springfield Utility Board Build Single Remodel Suite E to increase office space Springfield, Oregon Construction lender Self for tenant. Address Same as above DESIGN frArI (namel Primary Structural Electrical Mechanical CDNTRACTDRS Phone (address) (1 ics. no.) (exn; res J (phone no. In_l (address) (l ics_ no.) (pxn;res) (ohonp nn.) General Unknown- - bidding Plumbina Richard's Plumbing 33410 Nieb10ck Ln, Creswell, OR Electrical C & SElectric 2140 Centennial Bl. Eugene. OR 20-14C 895-4883 344-2236 IO-I-89 ~lechanical TJnknown - hirlrline NO, ' l'UIIlIIIllIG ELECTRICAL MECHANICAL . FFF '(HAR(;E /1m , n.~ 'r1-lARr.:~ NO '~~~ 'n-lllRr.:~ Res i dence of furnace/burner to -::! 72:w APBTU's 6,- Each single fixture ~ IHI:f I Relocated building (new fix. .dd;tianal) IS,F, Res;c!eIl1:e (] bath\ IDuPlex (1 bath) eacb IAdditional bath ~Jater senrice I Sewer I 7.5e? SQ, FT, ~INew circu~ts alts. or extenslons '2 <,p ~d-'?~ I SERVICES I ITempOrary Construction Change in existing rpc;.inen("e multifamily, COrJIII. or TnnlJc;.triill App 1 i ance vent seoaratp Stationary evap. cooler Vent fan with sinole duct Vent system apart from heatinq or A.r.. Mechanical exhaust hood and duct ::?:52 Floor furnace and vent Recessed wall SOilrp np;;,tpr ;lo"r1 \/pnt Of amps. Storm Sewer '-I ;:;.>'TV~';. '?~,._.Y~?1? ~.~ CDMM,/IND, FEEDERS Install/alter/relocate nic;.trih. feenerc; Wood stove/heater IOf I I I "37..5(:::J TOTAL CHARGES that the Electrical work be done by an label has been signed by an Electrical amps.1 I I I -:?;2-~ ISSUANCF OF PFR'HT TOTAL CHARGES ~#, /:..5":- TOTAL CHARGES WHERE STATE lXW REQU1RES shall not be vaH1 until the I HAVE CAREf'ULL1 iEXA11INED the completed application for permit, and do hereby certify that all information hereon is true and correct. and I f~rth€r certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfiel(J and the Laws of the State of Oregon pertaining to the work described herein, and that rw OCCUPA!~CY will be made of any strycture ~thout the permission of the Building Division. I further certify that my registration with the Builder's Board is in fu1] 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 701.055 will be used on this project. ~ LQ DATE 7-1-?Cf NAME(please print I Zone Fire Zone Flood Plain BUILDING PERMIT Charges and Surcharges PLU/~BING PERMIT Charges and Surcha rges ELECTRICAL PERI~IT Cha rges and Surcharges /IECHAN I CAL PERMIT Charges and Surcha rges Electrical Contractor. the electrical portion of this permit Supervisor and returned to the Building Division Steve Read SIGNATURE FOr. OFFICE USE DilLY Sq. Ftg. Sq, Fta, 8--2 Sq, Ftg, t1ain x Value Access x Value Other~_~ Value /:?~.-'" TDTAL VALUATION Tvpe/Const, "'?-/#.-R. Units Bedrooms Stories Occy Load Occy Group Q Plan Ck. ___/k_~9___ 65%/Rldo Plan Ck, ~. 93' 3D%/Blda ___..3'Z:2~_ Fence I _~g D~mo _ __2-::l- S-o Sidewalk /./9 IS; ~ Curb Cut _uu ~.-7?-1 CommlInd Ppr Fpp Res Per Fee R="d'v.3/76 [,? 41,,,p ~ , ?-/-89' I / Systems Development Charoe (L5~) A/C Paving Total Comb. rermit I I TOTAL /&>::?./~ . . ,"'.. \~ '. ~ , " COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 1/ oj 43 2. example- Lot 1. Block 3, 2nd Addition to sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air qas 2. exa~le- waterheaterjelectrlcal/or solar E. Square footage or valuation, etc. I, example- 1250 sq, foot house, 500 sq, foot garage 2. example- if new project, check new - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. examp.le - remodel existing garage into family room 3. examole - 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, 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 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 onl 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, BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOULES 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. ?-/(J- V, FOR OFFICE USE ONLY Permit Cl erk tV . PROJECT CONDITIONS TO BE SATISFIED 8EFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additi ona 1 Project, Information: I PLANS REVIEWED BY: name !.LP8#~ ~ o::;-~ Signatu~ // _,~ - - .~, date 'Z'-2 /' 6T .