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HomeMy WebLinkAboutPermit Building 1990-9-10 '1 INSPECTION LINE 726- 37 69 Job Address (,;,0 <-{ Legal Description . ~o, C Loy<-1Yl. LC:!<>.- r:- l"1o~-~?--,-/;;>" Owner' t/vI..,tt \.It-A-.;-c. Go. t-\vP""'-","-W Address &0 r (1q\l~ ,-+L(.l$ SPfJ.IA/6h6tf.) ,tJ (2. Construction Lender PA-L. C-61\."d;. Address' UlSIGN TEAI~ (name) Primary g 1C.14....D "2.t>vtC Structural Electrical Mechanical CONTRACTORS (name) Genera 1 D.4-r2-o!1l1L -S ,,>v4~ Plumbina Electrical ...1J't1\l\!'\\ L' /llechan; ca 1 CITY OF SPRINGFIELD CD/1BIIIATION APPLICATION/PERMIT EilERGY SOURCES: Heat CO"'l-'S (-later Heater . '" --- INFOR/IAnON UNt 726-3753 Sq. Ftq,I,'ain ;;i:1Y<f ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. --Fence Demo Change/Use -Other - - I ~ ~ ~ '~ 1'1 c..p 73<><> (?<tot ~ Ranqe Val u€ of Hark: ~ 5'!S"'. 8" BuilriinQ Penmit Info: Phone 7o.f-r3t9 (Family l1es;dence \~ith 974'77 I () ,?,.".oil ~ 00 oM Pi+c..l.. '/-'1 PHASE t 1 ;C5. no.) Describe Work(;~e.. Build Single Attached Garaae) S eJ!:A/t.OrL- C>4-~ Phone (address) laddrF!ss \ (1 ics. no.) ( r .:;n.\ (exoires) {nhnnf> no. (Rxoirps) (ohonf> no.) C\9-/\~()u~m J\lPf fU;blLo(o::14 Glwla ( lo~~-87z( I 25"" 25'00 ;z.5~ 1 I I I 1 I n~ I, TOTAL CHARGES that the Electrical work be done by an label has been signed by an Electrical PLUIIBING , , NO. FEE CHARGF Each Single fixture ~I tVO~q Relocated building (new fix. additional) I s. F. Res i dence (1 bath) IDuplex (1 bath) each IAdditional bath Hater servi ce Sewer 5 to rm Sewe r TOTAL CHARGES , WHERE STATE L\I~ REQUIRES shall not be val;j until the I I I I ISSUANCf OF /M~ TOTAL CHARGES ELECTRICAL Nn FFF rHARr,~ NO. MECHANICAL I j::"~~ I I I I 12- I rl-lllQr:r 16.4-0 I Residence of So' FT, INew c;rcu~ts alts. or extenslonso~.fO 1 SERV ICES b5~ I~~ I I 35~ furnace/burner to (0';> o7U> BTU' s , I Floor furnace and vent I Recessed wa 11 SOnCP hPntpr ~nrl vpnt I I Appliance vent W'/I! seoafate In. Stationary evap.' cooler Vent fan wi th sinole duct Vent system apart from heatino or A.C. 1 Mechanical exhaust hood and duct I \~ood stove/heater 3 crOI:;' I 11-.~o Temporary Construction Change in eXlsting r~,i rlpncp multifamily, comm. or Tnrlu<;t\rinl \ Of amps.1 I COMM./IND. FEEDERS Install/alter/relocate rli<;trih_ fpprlpr<; IOf amps. 6M zq-o PFR'HT / 00. 0- 7,/.50 "Electrical Contractor. the electrical portion of this per~it Supervisor and returned to the Building Division I HAVE CAREFULLY EXM1INED the completed apnlication 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 Soringfleld and the laws of the State of Oregon pertaining to the work described herein, and that NO ,QCCUPAlKY will be made of any structure without the permission of the- Building Division. I further "certify that my registration \'/ith the Builder',s Board is in full force and effect as required by QRS 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. Zone Fi re Zone Flood Plain Type/Canst. Bedrooms Stories 'I~AI"E(pIease print) rMlc..l~~tL. \~D""'le..\.>\.J SIGilATURE .~ W FO~ OFFICE USE OIIL y BUILDIIIG PERMIT Charges an': Surcharges PLU'1BING PERMIT Charges and Surcharges ELECTRI(P,L PERI~IT Charges and Surcharges 11ECHANICAL PERMIT Charges and Surcharges 3/.0;'1:) ------;.-6i-- D~TE 9 -10-'26 Sq. Ftg, 11ain :Z7~ x '1'2. ?,~__Yalue,j/~~~~>1'c; Sq. Ft!]. Access x Value . Sq. Ftg, Otherb?ttl'~""~l"1Jl.I~lUe <:./_6dc;:>r-"" t ~ /: 7/ / _ TOTAL VALUATION 1'k.?.7". /k'2~ I, -..::.. <;>~ 'syste, ms Development ~?_.....-('? ~""6 Charqe (1.5%) . I' . /02-'5.94 I Uni ts Occy load Dcey Group CommlInd Ppr Fee Res Per Fee ~l~/, ".-::--#'":.? '=\t:7;).nYj , 'i I Plan Ck. __ 73:--_[;'?.__ 65%/Bldo Plan Ck. :z~, ~~ 30%/BldQ "2 \3 5,0-0 Fence -----i;;{i.5'h D~mo 'Sidewalk A/C Paving Curb Cut {2..f / /3/1>0 Total Comb. Permit TOTAL ,b1tG, ~3, " I ' 7'-.. . COMBINATION APPLICATION/PERMIT (CAP) '~. \" , . J I. Applicant to furnish A. Job Address B. Legal Description .~ (" .\:. -,." \ 1. example- Tax Lot 100. Lane-County Map' Reference II 63 43 2. example- Lot 1. Block 3, 2nd Addition to '. ':jpringtield Estates . C. . Name, etc. of owner and cons'trlic\ion lender D. Energy Sources . 1. ex amp 1 e- h'eat/ e 1 ectri ca l"c'eili'nq/or forced air qa s 2. example- waterheater/electrlcal/or solar E. Square footage or valuation", etc; '- 1. exam~le- 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. exam~le - remodel existing garage into family room 3. examyle - 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 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 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 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. 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. I, :-,.' II. III. IV, V, FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . ;, ':..\ \ PERMIT VALIDATION , ' J . . .' ~ ':.\" \ ,'j , :,'. .; -- -1.. \ , , .$-/8401 10,2. ,QO Permit l J ' Clerk~~ P~r.m,it applicant exempt from registration with the Bu,i.lder.'s'Board'because: -:~'; .:'~:.. <" ;.. .... ".'~ ~. ... . .... '" . Additional p(qj~ct:Jn.for~ation;.., .' "-, .... ..:_, . '.:~;....... '.." .:r.:"... PLANS REVIEWED BY: name signature . 'r #.' I I ( . I . . .' " ." .". date '. " , ..J . I