Loading...
HomeMy WebLinkAboutPermit Building 1988-1-29 Owner M ~ leA Y /)J;} 67 ~'1 (ffJ/ Address 1~'~6& 01:1:. /I.M.'J! Ivll Y El1r; nJF f;>. CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT EflERGY SOURCES: Heat \~ater Heater Range ValuE of Hork: A5;.?>~ ~e. CST. nt. ' Buifc;inq Permit Info: Describe Work(Le., Build Single Phone'fIf~47A Famil v Res i dence With Il.ttached Garaqe) , ~4~PC~.4 7C7i'/t:S~ c:=>r V/API!:/"/J~/~/ '5T&R~;:(GXP~/9"-D /#1"'0 r<:::'.~j.;G7? ::?~(~ / I"Q~ ?7C:::>..Re ~~~ . 11 i cs. no.) (exoi res) (ohone no. ) . INFORllATION UNt 726-3753 Sq. Ftc). "la in ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. '--Fence Demo Change/Use --Other -- -- '% NY ~ 6\ IN Af2d\ A ozJ 1- INSPECTION LINE 726-3769 .~ Job Address /0 5"0 Ctf1~/I!AJN/A ( r<.U'O. Description I/',:?], <~."j; y c:?,-::S9~ Legal Construction Lender N. ,t:) - Address DESIGN TEAI~ (name) Phone (address) Primary Structural Electrical Mechanical CONTRACTORS (name) (address) General C);U:>~<c... L6~7.. 'Z~(}(/AK~/Vr~'" , / Plumbinq /-JtHi!:Cc> ? Li3c.. . l1ics. no.) (exoires) (ohone nn.) EV.,t;;Z:-H~ ~~?/~/ ij'~ i/7// I" -=<C>"<~FB 6-30 -&'J ~.s-- 7/;1/7". , Electrical ~lechani ca 1 PLUl1BI NG ELECTRICAL MECHANICAL NO. FEE CHARGE NO. FFF r~ARr,F NO. SQ. FT. furnace/burner to BTU's FFF r:~AI\r,F /& Each single fixture "2:;0 13~E)b< Residence of Relocated building (new fix. additional) New circuits alts. ~-or extensions J- '< 4~. /'77p,r.1 C' SERVICES ::;>:z ~!:2 ,. Floor furnace and vent IS.F. Residence (1 bath) I Duplex (l bath) Additional bath each I I I 1 1 Recessed wall Soace heatpr and vpnt Sewer Temporary Construction Change in existing residence Imultifamily, comm. or Industrial 10f amps.1 ICOMM./IND. FEEDERS I Install/alter/relocate I distrib. feeders Of amp~1 I I I. I ISSUANCE OF PFR~lIT -:::? 2- S-e>j TOTAL CHARGES 2<( -- Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division -:z ~P/i"~..s- 4"~ S Appliance vent seoarate Stationary evao. cooler . . Vent fan with sinale duct I Vent system apart from I heating or A.C. Mechanical exhaust hood and duct 16-f /2. I I I ~Iater servi ce Storm Sewer I I I I I /3:5. _6 TOTAL CHARGES . WHERE STATE L}l.l~ REQUIRES that the Electrical work be done by an shall not be val i,j until the label has been signed by an Electrical Wood stove/heater I I ~.~ p- ~ I I 1"2 I IgY~?OH/75 . I r TOTAL CHARGES I HAVE CAREFULLY EXNlINED 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 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 NO OCCUPArKY will be made of any structure without the permission of the Building Division. I further p r ify that my re~'stration with the Builder's Board is in full force and effect a s required bY.ORS 701.055, th.at if exempt/the basis for exemY;.Jt. 'on \is noted hereon. and .tha. t only subcontractors and employees who are in compliance with ORS 701.055 wi~l be u on this p~oj c . """(pJ"" pdo') 16 Ll iC-H BR I R l). "'''ATURE /. ~\ . OAT'/-'?'f.AJO FOR OFFICE USE or)L Y Zone}/.c::.' Type/Const.,.3'-# S)?~ Units Sq. iltg.llain x Value Fire Zone Bedrooms Occy Load Sq. Ftg. Access x Value Flood Plain Stories / Occy Group 13'....2 Sq. Ftg. Other5~.d.ocL:~4'?Value ::::;?S/~~""- TOTAL VALUATION PLur~B ING PERMIT Charges and Surcha rges / ~ .c-; Pl an Ck. Comm/I nd ____~~._"::!~_ 65%/Blda Per Fee ~~ Plan Ck. Res ~. ~ ~ 30%/Bldq Per Fee 1-35. ...-- I Fence ------'6.-75--' D~mo ';r:<-sc> I Sidewalk - --- -- /-.-;~-IA/C Paving -::2 y- c::oe. .1 Curb Cut ------/~2o-1 //61.~"3 Sys terns Development I Charqe ("1.5%) IV~. BUILDING PER~1IT Charges and Surcharges ELECTRICAL PERMIT Charges and Surcharges MECHANICAL PERMIT Charges and I Surcharges I I I ITotal Comb. Permit I TOTAl 369.6/ fgo. ~j4 I " tit COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION III. I. Applicant to. furnish A. Jab Address B. Legal Descriptian 1. example- Tax Lat 100, Lane Caunty Map ~eference 17 03 43 2. example- Lat 1. Black 3, 2nd Additian to. Springfield Estates 'C. Name, etc. af awner and canstructian 'lender D. Energy Saurces 1. 'example- heat/electrical ceilinq/ar farced air qas 2. example- waterheater/electrical/ar salar E. Squ'are faatage ar valuation, etc. " 1. example- 1250 sq. faat hause, 500 sq. faat garage 2. example- if new praject, check-new - if additian, check add, etc. F. Building permit informatian: 1. example - canstruct single family hause with an attached garage 2. example - remadel existing garage into. family raam 3. example - canvert single family residence into. restaurant (change af use) G. Value af wark as defined in Sectian 303 (a) af the " Structural Specialty Cade H. DESIGN TEAM AND CONTRACTORS " , ,,' To. avaid design ar canstructian delays, Building Divisian Staff must be able to. cantact apprapriate ' persans regarding design infarmatian ar jab site carrectians, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces accur in the descriptian partian af the Mechanical and Electrical Schedules, the applicant need fill-in anly the No.. Baxes adjacent to. the apprapriate item(s) ta,be installed' , B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Divisian I.' To. canserve space an the permit farm the schedules have been abbreviated 2. If the item(s) to. be installed are nat cavered an the abbreviated schedules yau shauld cansult the fu 11 schedu 1 es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As nated an the CAP, the label must be delivered to. the 'electrical cantractar far signature by his electrical supervisar. The general cantractar is ,nat autharized to. sign the electrical label. - Applicant to. sign and date , Whenever passible, the initial applicatian will be used as a warksheet anly. Where passible, Building Divisian Staff will prepare a type written capy and return it to. the applicant at the time the actual permit is issued far his signature. Fees and Charges Plan check fees are due and payable'at the time af the applicatian, and no. plans will be processed until these fees are paid. All ather fees and charges are due and payable when the permit,is issued. , .. - ' ( (j (/0 ~ ( ~;)1-H " ", - ~ IV. V. FOR OFFICE USE ONLY Permit Clerk Cf-/' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: , ,~ ", Additional Project Information: PLANS REVIEWED BY: name LeP~A/~ ?:: C:Z;~ signature ~-~~~ /' ~' .;/" da te /- -:;?& . 88 ...