The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 1985-4-22 . \name} Phone (address) INFORlIATION liNe Ii 726-3753 Sq. Ftq. ~ain ~ ~q. Hg. Access. ~ Sq, Ftg, Other ~ ~ew Add Alter ~ep. q -Fence Demo Change/Use f\.~ ;~~~ Other- - ~'.~ I Builtiino Pennit Info: Oescnbe Work.{l.e.. BU11d S1ngle I \.1 Familv nesidence I-lith l'.ttached l1araoe) UJ /fVDT/e:::>W.f"c*.z:::w-Akr..&uAz:. I N I !7 ff~~=,.:s~ 6.-l=' ~~..:;:J ;;;.~,./~~. -I nics. no.'~ {p;mires) . " Job Address _ ?t?,'f" ~~r# ;;:t' 577 legal De5cription CITY OF SPRHlGflcLD COMBHlATION APPLICATION/PERMIT EilERGY SOURCES: Heat Hater Heater '" I IrlSPcCTlOII L1I1E 726-3769 Owner ~T~,N ~:.C/;z:-/c::::-- t"~ B-- AddressL.,S ..4~' ~......-.-.;, :2.~ C::;~ ~. .,~~? Construction lender Address m.':ilI.iU IEAfo\ {ohane no.} Primary Structural Electrical Mechanical CONTRACTORS \ (name) (address) (1 in.. nn.) (pxnirpc;,) (ohnnp nn ) General L~LtP'<. ~v/...,""" -, Va,,~. ~')~~S5 ~ ~;R- 92.Y$?'. -~~/ ,. ~... ,.., Plumbina Electrical " ., ~'echanical PLUII6 I NG ELECTRICAL MECHANICAL NO'I Each single fixture FFE 'CHARGF: Nn F~..cHAR!iE. NO. Residence of furnace/burner to SQ, FT. BTU's F F F r IJAR!.iL Relocated building (new fix. additional) New circuits a1ts. or extensions Floor furnace and vent S.F. Residence (1 bath' Duplex (1 bath) each Additional bath SERVICES Recessed wall ~n~rp hp~tpr ~nrl vpnt Storm Sewer Of ilmps, Appliance vent s.eoaratp Stationary evap. cooler Vent fan wi th sinole duct Vent syste~ apart from heatina or A.l.. Mechanical exhaust hood and dur.t Sewer Temporary Construction Change in existing re~iqf!nce multifamily, corrrn. or Industrial Water service CO~1,/IND, FEEDERS IInstall/alter/relocate dio;trih. fppders IOf Wood stove/heater amps. TOTAL CHARGES WHERE STATE l~W REQUIRES shall not be vali~ until the ISSUANCf OF PFRllIT I TOTAL CHARGES I TOTAL CHARGES that tile Electrical work be done by an Electrical Contractor, the electrical portion of this pemit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXN1INED the completed apr1ication 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 !)ertaining to the work described herein, and that !~O OCClJPI\tKY 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 OP.S 7Dl.055 will be used on this project. SIGI~/J!~~ ,/ riain ./ Value Access_ ;r x Value Other~~ . x value""'3~ - TOTAL VALUATION 1IA11E(p1ease print)(70(tN PfYlAI1l..-()t.uc, DATE ~ z...:z--f' Zone..Jt: c::. Fire Zone TYOe/Const,/JiY/~ _Units Bedrooms Occy load Stories Occy Group F(H'I nnICE uS(" ow v ., - V::... Sq, Ftg, Sq, Ftg, Sq, Ftg, Flood Plain BUILDING PERHIT Charges and Surcharges I Plan Ck. 65%1Bldn Plan Ck. 30%/B1do Fence COlTlTl/ I nd P.rr 1=,01:> Res - Per Fee lSystems Development I Charoe (J.5T,) PlU1lBING PERMIT Charges and Surcharges Demo ElECTRIC~,L PERlm Cha rges and Surcharges Sidewalk AIC Paving ::< 2!>. co.... Irotal Comb. rermit flECHANICAL PERMIT Charges and Surcharges Curb Cut I I TOTAL ~:?g:'-~ , . .. COMBINATION APPLICATION/PERMIT (CAP) t. Applicant to furnish A. Job Address B. Legal Description (' 1. eXdm9,le- Tax lot 100. lane County Map Reference II U3 43 2. example- Lot 1. Block 3, 2nd Addition to "..: sp.rl~gtield Es~ates. ...... :', . C. Name. etc. of owner and construction lender !;~. 0." Energy .Sources . . 1. examp 1 e- hea tIe 1 ectri ca 1 ceil i na/or forced air ' 2. examole- waterheater/electr;cal/or solar E. Square footage or valuation, etc. - 1. example- 1250 sq. foot house. 500 sq. foot gara~ 2. example- if new project. check new - if additior thee k add. ete. F. Building pennit information: 1. example - construct single family house with an attached ganlge 2. examele - remodel existing garage into family rc (.' 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 n, H, DESIGN TEM1 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 adjacer ( 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 schedule (_ have been abbreviated )_ 2. If the item{s) to be installed are not covered on the abbreviated schedules you should consult the full schedules f 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. --- 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: o ..alTY OF SPRINGFIELD . City HIli ( Springfield, Or~on Department 01 Public Works OFFICIAL RECEIPT No. B Ome Jar.fa.. 2'1J 19612!!r . Rec'd From L..,tG A.vre> ~ ~ r75' .-#:> :>" C' Address2!7-S- ~- /., .~~.,...... - ( 64551 ( R';"eived For "'~, ~;>e>~;? '2 ( ~ ?~,w/r ~;o!S.- ( ( ~~5"28 Amount ReCejVed:J!:~ &... ~ ~' *eZED~~( ~ '~ r , UUSINESSFORMS.INC. t5031~2,1I" " Permit Clerk J Permit applicant exempt from registration with the Builder's Board because: " "Additional Project Information: PLANS REVIEWED BY: . , . ~- /'> name~/Y.- H~~ Signatur~~~~--. . date y...~..;..tI~ , I 1 1=====- ---- , ---=F= =1=-+- =======--- ~=== 'I ~--- -- --~~ ---------'===__1==== ---------- _1__- --_:'j ~ I ==,- __ J '.. ~------ -~.--'; -,---- , ====1 ----- _____ 1 -------- I +------'--- =====___==1==1+--= ,=-~===----== ------- ---- I- 1-- - -.-. .,_.... -.= - - -'-, ;~;:: =. ,-- -'-, I __ _ _ ,I ::lJ '[11- {<,c ~~J(! :::,{ ;.....~:':~. ~cr-_ ~O. Nc ~ a _ __ ___ j _, Z !..!~, __ O~Ufl',,\ ~r;;'( Gm upJ I . - --, =r.= ~ cq . """""- ~ -l- - -- ---" ~~ ~~"';'"~".'"~'.,.'':':.!': ===-- _ _ _ _..-.:= 9R' '9_~ ..ocr" '. ..1,.J.!~ . ~~ .~~ - L :;; --;~ ,cmr"'r, ,. _.,I=:::t:: = =- _ __ _ ,..!:, ~o,' :,~~ :$'=:iZ'=-~ = = -- _~"'N' '.I..:ilS _-A:~?!!?-- ~~~ e5- -- l:.-.------e- . -------, ----I, --- tHe-; l;.'~~ .!.u, ~.\'l !i-?"~: ':.. Ir.F: ...'r ",,-, .~ ~ ~!:N ~ !~.... '-J-:-W~lj-- _ _ _ _ ~~Ni'; 'Nt:: ,r:...",'i~:) ;~ etLt.:':: ':D :-::X',:L. c,;/ ~~;.:;:: ; _ ~" ":...~',,,._.._ __~-",,~~_~"AI' R ~i't; ",;.\ f;~ 0'_' ,.JI;: ~ \..l\\..I:N.... OF 'lei,. -- I _--I' r ~ _ -1 ~ T, ~ :F~S,Fl"i ,;G ~!;:Bf ; ;R'. ~3'~ i~,'l_. :.~_, r,' :""" - = = = = = = = = - - - - - - - - - - - - ,- -----i ,,'p,~''', ""'/.. ,,-,..r.. ",,'C;;. l... ~...~ ------.---- ______ ' '--:-rc --,~c:-' .~_=___ ------------ ----------" 1--1 ,- ------------ --------,.. .T~. ': -~l I -, - ___h -- ----'-1-1- =-____1'_ -- -- - 1 '[ _ -- --[-' - I - ,-- '- --- '-' -- I' I , M';/)?l.-~I ::l?,:,~~<:r ~hJ'h2::;; ~~_I . ~ I I ------'r:;'6m""~ibIWG /",,,,"J"1-~II' I.. '" II - I -------1---- : .' 1 / I ',+ .... ~I 1 . : -====1-1 _=1. C:=. t;;, 1--:-1--r-- -_I~/Y- ')~I''''( 1 1-- ~------- ------------ --------~~~~ - ---- " i-01r.~(L.t,..."tS \ ~ /ri//l1" ~' 'J. -- -- __ _IY.P,^'_pll~ 1101,: I I 11 r1, /1 ". 1------ 1+' I~: -===1=1---=1--'= I I ~:::tL~-I-'\," . . .. · I-f.;--= C==T-= I 1== =1--==_ : == s=: '- 1=====-1__===+ _========-==__J=+ __I_~= I ~~ '; 4)(~7'/^'c. 'O,lve ,') --r- I \ 1 ,do~" II I 1 1 1 II i I I I I I I I 1 . ~ I-===-~ .~~r-+=---l-==- '-. . .1+1 "I" -- ======: . I-------~'I . I' I ---I -,--'----- --.--1- '-1-- '~I I 1 I III I I I 1,04 J.I ~ S r 1 I 1 I 1 I r--l .1=+-1- -1==4~r~S:~ I}Vi,"O -:S~/er 1--1 I 1__ I --+H+3.a.,.CI.s)vr.<,~1 R oS r _I I I I - -I . -\ I l I I .' I, , J,. ill I I I I I 1 I I I 1 I I I S l__,~.:I~.,_, --~, -=l,-~,.-,,- .,-L-.J-,-~,.-tll+~:,--I-~-' I. ,I. .- I" ...,L -:.J-ll- .,_ _,' -- ,-,,__ ,,_,_, u I ., I I -~------ I~~____- l,t /. "- ) -~--