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HomeMy WebLinkAboutPermit Building 1990-6-20 y f: ,'1 EriERGY SOURCES; Heat \~a ter Hea ter Range -r Ir!rOKI1AT!O~ Ul1t 726-3753 ' 'Sq"; F tq .i'!a in ~q. Ftg.Access.__~ Sq. ,Fts, Other' N'!\~ Add Alter Eep. -F~nce, Demo Change/Use "-O~her- - , IS) ::J o ~ I INSPECTION LINE 726-3769 Job Address 0037 ref1l-~fl J1 reef Wc~r Legal Description "' J ()?. ~ (,.:;LJ3.. ~- 1 ~ IfX') CITY OF SPRINGETELD COMBINATION APPLiCATION/PERMIT -I '\="~~ r~p~~ P. {}.. B r'N.. I ~ ') <;l Phone "F,I,~L V ~:>jZOl r A OJ S <...6 ) Construction Lender Address ValuE of Hork: I_S,OOO Bui1ciinq Permit Info: 'Descrioe Work(i:e., Build Sjngle Family ne~idence With Attached Garaoe) ('~)WvU ~. le~ ~ Ci. .. 11\ (UA) . - Owner' Address DESIGN TEAr4 (name) Phone (address) (lies. no.) (exoires) , (ohone no. I Primary Structural i;ly <S~oo Electrical Mechanical CONTRACTORS _ (name) (address) (lies. no.) (exoires) ,..",1 ~CWl1 m Co Q,.,.., t 1(' u Bek . I?SSlJ{) ~.lklP~ Rc.p ~ ~ Plumbinq ~ p\- VYv. ' ~=3SCS;V V:;; Electrical ~d.A , h:lO-IS~6 ")/~D - ~1echanical f)..eyC'f'~O\,r, S11\.LP;/ Vv\;i-Cti 'L-(Cj(~/q '~/q() PLUr,1B I NG (Dhone no.) q 1 LlOC;;- C:J7 -;;))# / ELECTRICAL MECHANICAL NO. ' , FEE 'CHARGE NO, , FEE 'CHARGF1 NO. ' 'FFF 'CHARGF ? Each single fixture Residence of z ~ :?:?-9 SQ. FT. / furnace/burner to </~ ...........-:>BTU's Floor furnace and vent 6,'1> Relocated building - (new fix. additional) ~'New circuits alts. or extensions -? ,--r-? M~G SERVICES ~'2.~ . S.F. Residence (1 bath) Duplex (1 bath) each Additional bath Recessed wall Soace heater and vent Storm Sewer Of amps. Appliance vent , seoarate Stationarv evao. cooler - , I Vent fan with sinole duct Vent system apart from I heating or A.C. Mechanical exhaust hood and duct ?-~ ~Iater service Temporary Construction Change in existing residence multifamily, comm. or Industrial Sewer COMM./IND. FEEDERS Install/alter/relocate distrih. feeders Wood stove/heater I I I I I I amps. ISSUANCE OF PF.Rr1IT TOTAL CHARGES ',.( --<_SiP TOTAL CHARGES -3 ~ 5et:> TOTAL CHARGES ~A7. /:5"': ~' , WHERE STATE L"\~ REQUIRES that the Electrical work be done by an,Electrical Contractor, the electrical rortionof 'this permit shall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXA/1INED 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 oertaining to the work described herein, and that NO OCCUPAHCY 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 sUbcontract~~., nd emPlo~~liance with ORS 701.0~~~~~~~~~ect. ~__~~~ NAr'1E(please )/ ljl!ta./~ 7. tUC--;{';:;L-' SIr;~lATURE 2/././ .d!t~c!.<,,~R-#?- y. DATE.0-72//9(') FOR OFFICE USE ONLY Sq. Ftg. t1a i n x Va 1 ue Sq. Ftg. Access x Value Sq. Ftg. Other ~~ ~sP~ 7/SFF' Va 1 ue /5; c:3~, ~ , CD &>/.lt1 0 19a TOTAL VALUATION ., I . <;(3 cc - Type!COnst.~ 5~ni ts Bedrooms Occy Load Stories O~cy GrouP-1:~-~ Zone Fire Zone Flood Plain BUILDING PER~1IT Charges and Surcharges ___I/d._~~__ S--~ ;:5 ~c FT n~b9 Plan Ck. Comm/Ind 65%/Bldo Per Fee Plan Ck. Res 30%/Bldq Per Fee Systems Development Charge (1.5%) , / (lJ!A- PLUt1BING PERMIT Charges and rh Surcharges ___~~2"':::__ Fence j./3 D!;mo _ _ _ _ '37.../:; t:? Sidewalk / -&b A/C Paving _ _ _ _!~~::_ _ Curb Cut .75 Total Comb, Permit ELECTRICAL PERMIT Cha rges and Surcha rges 0'1 TOTAL 1J?7'. 7~ I MECHANICAL PERMIT Charges and Surcharges J\.f ) '" COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lar.e County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceiling/or forced air gas 2. example- waterheater/electrical/or solar 'E. Square footage or valuation, etc, 1. 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 ~,~onstruct single family house with an attached ga'rage 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. 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 bee_n 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 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. --- Applicant to sign and date , Whenever possible, the initial application will be used as a worksheet only. Where poss~ble, 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 permit is issued. II. III. IV. V. FOR OFFICE USE ONLY ~ " , PERMIT VALIDATION t:JJL /6 , ! [UCejf* P:Y l740D , (0 --Z,1 - 90 . Permit Cl erk (iAJlAI\..L- .. : ',~ .~. - -, "'; !'l' . , PROJECT CONDITIONS TO BE SATISFIED BE~ORE OCCUPANCY~ Permit applicant e~empt from registration with the Builder's Board because: 'Additional Project Information: PLANS REVIEWED BY: name signature " date