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Home My WebLink AboutPermit Building 1981-4-16 INSPECTION LINE 726-:)7., 1 . CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT . INFORMATION LINE 716-3753 Con,truclion Lender -"':"... ..- ~-- ," ENERGY SQURCESl Sq. Ftg. Main Heo~/errlJ..'RfI ~YI<T/1IIi; Sq. Ftg. Access. fC' Woter Heater;Z:'"xIfiT~/ A- ,...... Sq. FIg. 0Ihor--,/2 Ronqe -fi.A.. ~ _New_Add.~Alter_Rep. Volu. of w~ g 120 ~ I =~',:::_D.mo_Cheng./U" Building Permi Info: Describe Work (i.e., Build Single Famil~~i_~el'lce With Attached Garaoe) ~k>i:xr,,7'r- L~_~.F :5~-<c: ~ A.CJ.. c.....P,?/....7 , Sfi~_ )<) --,' 2J .~ l Jeb Add.... I O~, &/lrE'LtJIfYl.?c(';, S f'Ii'l/l~AtlJ) legol Description l..JDO ~_ ~ b () 4't' <"lJ ~ f1 Own,,/; <'<M'/.IrE"'t;'ZJ~F6-D-rJ ).,D6~S. Add.... LtJ...!Jr7 ("qIFWMIIlO I? Phon..719.~-?// C;?P",1I6..Flr2tJ {!)tPC- . ,. Addren DESIGN TEAM Phone (name) (address) (lies. na.) (expires) (phone no.) Primory Struch.;;",d Electrical Mechonicol Plumbinq (address) (Iics. na.) (expires)..:zA._ (j<<oPf:!:.:~L ,.,!. ' At2i..L.t:..N.LM:?I a.c7l1P/(J;t ('ONTlrIWIIJ!. /-l?}'/~ua.UU)~ "'J.(6~/X'{)1 !Jw;;I,'lfl C 6gi'-2?S-~ &III-tv /rAt/} S'ElTf>N ;Jl.?//7S- flttTL~ P/)J:{JfY (/99 -Ft:7J /If/?.GF IV14v EZ l.FZ..71hc /-;-"/4-'/'7 e! ff'/'INd-FlfiUJ _LlL -'l9P? ." , . A/o.NE" - (LP' AN? / rNclJUJ 1Jl2.. !I.4PI/e-r- ..=.?RLCe CONTRACTORS (nome) General elt~ctrical Mechonicol PLUMBING ElECTRICAL MECHANICAL I NO. I 1/ FEE ! CHARGE NO. FEE CHARGE I NO. FEE I CHARGE Temporary Conslru,tion z. furnoce/burner fa J:lTU's AppJionce vent seporote Slotionory evap. cooler Vent fan with single duct Vent system apart from heating or A.C. Mechanical exhau" hood and duct 3..... 6.""'1 I I i I I Duoln (l bol;') each L5: Cb I I I I Residence of I 1:5:- Each ,in!=lle fill:ture RelOCaTed building (new fill, addilionol) S.F, Residl!n~. (1 bolh) ./ .q: ft. New circuits, alterations or l!lItensior:s 2~~. SERVICES Additional bolh Amps. Woter service Sewer Wood slave/healer Stor.m Sewer FEEDERS Heat Pump Air handler to 10,000 CFM Air handler over 10,000 CFM ,/ A<.~7'r V<.>q-s; . h ... Amp,. TOTAL CHARGES I 5, .... TOTAL CHARGES ISSUANCE OF PERMIT /<:", -" I c.J . TOTAL CHARGES ~ ~~ I""', -=< <- - WHERE STATE LAW REQUIRES ,hat the Electrical work be done by the Elll.-tricol Contractor, the electrical portion of this permit sholl not b. valid until a lab. I has been signed by an Electricol Controctor and attached to the electrical pone!. I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify thot any and all work performed sholl be done in accordance with the Ordinonces of the City of Springfield C1nd the laws of the State of Oregon pertoining to the work de"rihed herin, and that NO OCCUPANCY will be- made of cny structure without Ihe permission of the Building Division. I further certify thot my registrotion with the 8uilder's Board is in fuJl fOrce and effect as required by ORS 701.055, that if exempt the bosis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be uled on this project. Basis for Builder's Board e.}temption- NAME (pl.e.. p,;nt).IMJLU/O....U~.J 6E;AlEli'HI.. 6>,.Jr- SIGNATURE r~.- ,,,,0 FOR OFFICE USE ONLY xl #t~.? DATE '(~~/,?) / Zone C-" Fire Zone Flood Plain Type/Canst. ~-I#;z;?_ Bedrooms C:torie- I Units f'lccy load Occy Group~R-::2. c;q. Ftg. Main Sq. Ftg. Access Sq. Ftg. Olher //2a Volue x Value x Volue "":)~~-o. TOTAL VALUATION ~~ ....~ BUILDING PERMIT Charge, and Surcharges -=< 'I ~ c>c> .9(,{, s-. ...e>- Pion Ck. Commllnd 65%1 Blda Per Fee Plan Ck. Res 30%/Sldq Per Fee ;S", ~O Systems Dev~lopment Cheroe (1.5%) 1Y-4. PLUMBING PERMIT Charge, and Surchorges Fence ~p Demo Total Comb. Permit ~g.~'f ELECTRICAL PERMIT Charges and Surcharges If). ... .. Sidewalk MECHANICAL PERMIT Charges and Surchorges 60 :2 :< . ...- AI C Povina Curb Cut ..3~ , TOTAL f1~.< 1 . COMBINATION APPLICATION/PERMIT (CAP) . I. Applica~ to furnish A. Jab Address B. legal Description 1. example-tax lot 100, lane Counly Map Reference 17 03 43 2. exampie-lot 1. Block 3, 2nd Addition 10 Springfield Estates C. Name, etc. of owner and construction lender D.. Energy Sources 1. exomple.heot/electrical ceiling/or forced oir gas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. exomple-1250 sq. fool house, 500 sq. fool gorage 2. example-if new project, check r:;ew.if addition, check add. etc. F. Building pe-'mit information: 1. example-construct single family house with an attached garage 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 ~ivision Stoff must .be able to contact appropriate persons regarding design information or job site corrections. etc. . II. Abbrevioted Plumbing, Mechanical'& Eleclricol Sched~les A. Except where blank spaces occur in the description portion of Ihe Mechanical and Eleclrical Schedules, the applicanl need fill.in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules . ore 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 abbrevi. ated schedules you should consull Ihe full schedules C: BUilDING DIVISION STAFF Will Fill OUT All FEES AND CHARGES ON THE SCHEDULES 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 typewritten cOPy'ond return it to the applicant at the time the actual permit is issued for his signatur&. IV. Fees and Charges Plan check fees ore due and payable at the time of the application, and no plans will be processed until Ihese 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: ~ , Additional Project Information: PLANS REVIEWED B'y' "amp cignaturp. . Permil Cler~ PERMIT VALIDATION r J / ~otD I J I lo:tpire,; . ..:;:t,._ ~ol2~'.:.?L:.'AJ <;.;;., .~'- i _ ., /}j,{(.~1. 3'Lc 6g?-~f!;:<,.l_ . (jCj9 -F/ /:;;- . ~ 71/~ :22.&':d INSPECTlON~ LINE 726.-3769 .. . INFORMAJlON LINE 126-.;1753 . CITY OF SPRINGFiElD COMBINAl'ICN APPLlCAflON/PERMIT Job Add,..'-/.-,;;</,; I,.'tW:!/1lJY t..,O r , , ENERGY SOURCES: l Sq. ftg. Main S (,li'ltV~Fia.n H.o,c,eL.#. P'f'! '::!,,<r/J"~ Sq. ftg. A".... ""-- .zoo,., 1/2<0 Waler Heaterr- .Jt'fS7 c..-../ ~"7"'~ Sq. ftg. Other Ronq8 ~, ~ _Ne.....__Add~Alter_Rep. I Value of Work: _.._Fence__Demo_ChongeJU,e &! ~ _Other 12D Building Permi Info: Describe Work (i,e., Build Single Fomil... Re,id.,nce With Attnr:hed Go;I,oo.!1 ~""'DLC=7'= c..t:"<rl-_~~ _~<"'" A.C)_ L. Pr",.7 5;';'=7>. legal Olluriotion OW"" /1t,5NIIJrc-P t.7K!F64JN /"O(rYl-FP<' Add"" / /l "';"7 l'yJrEi,'I1Y'ilJD p Pho"..7~ -//-? / / C;'P('IAl6..1'" 1/-70 C iY,-. / ~"'2--1'~;;-'7r' Construction lender Add,... Phone DESICN TEAM (odd..,,) (lies. no.) . (expire1) (nome) Primary Structural F1C'!ctrical Mechanical CONTRACTORS (name) (addreu) {lies. na.l G.""ol M/L..""LI-t:?./ ~mk"Hl t'DNlifllIfTlIl l.:f? j';~t/a .i:AAlL~ 4.1. #/9tJ / . ,. . P1umbl", Sgll.-EY /rJI/P s&l{ TfJ N .7- j-,y 7:> 8 i/TL~ P~. J: DIY /}/RGE 1Jt11.,'" el...GZnJK /{;",/ d -1-'7 ~ 517'IN<,'Flfd.LJ N't';V'F" - (/ P/}'lij-> c:-- 11;I~cfrical I / TN",,,..11 <JR#/f./?l/"'-;-- ~ .P.fl~_-. I MECHANICAL , -,-- -"--~---- ..- ----'--.--,-... Mechanical PLUMBING ELECTRICAL -:;<1 -' LJ '\ .+ /C.>P (phone no.) ------l-FE'E""" CHARGE NO':'"T----.'.,.- -=_...-,..,- --.f~ElCH1RGE~ NO. f:a: I CHARGE NO. I 1/ I I I I I I l l).<= furnoce/burner to IOTU', ApplianCE:! ven; separate Stationary evap. cooler Vent fan with single duct Vent sy'tem apart from heating or A.C. Mechanical exhau1t hood and duct Relidence of Sq: ft. /'" New circuits. aherotions or eXTensio~1 '2 ~R~. Each lin!:!le fillture Relocated building {new fill: oddiMonQIl S.F. Reliden~e (1 bQthl 1:5:<"" SERVICES DUDln (1 bath) each Temporary Conltruction z. Additionol both Ampl. Woter service Sewer Wood Ilo....~dheater Stor,m Sewer FEEDERS Heat Pum;) Air handler to 10.000 CFM I Air handler aver 10.000 CFM ./ I A<.77:=7Y 7l'<:7~ . I I Amps. -.... I ISSUANCE OF PERMIT TOT At CHARGES 5. uh IS". _I> TOTAL CHARGES TOTAL CHARGES )" I 3.~16.""1 I I I .1 I I I I .1 I ? b~ _ ~t> I"', ~ <-- --- . WHERE STATE LAW REQUIRES that the Elactrical work be done by the Elertrical Contractor, the electrical portion of this permit shall not b. valid until ~ lobel has been siSned by on Electrical Contractor and attach.d to the el.drical panel. I HAVE CAREFUllY EXAMINED the completed application for permit. and do hereby certify that 011 information hereon is true and correct, and I further certify that any and 011 work performed shaJl be done in accordance with the Ordinance1 of the City of Springfield :::Ind the Law1 of the Stote of Oregon pertaining 10 the work described herin, and that NO OCCUPANCY will b. made of any structure without the perm inion of the Building Di....ision. I further cartify thot my regiltration" with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for e.emption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. Balis far Builder'~ Board exemption: NAME '(ple,u P""t}jJd.J.J,.I.iJO~LF.J. 6EAlEli'I1L ~,Jr: SIGNATURe f ~'""" ,,?D fOR OFFICE USE ONLY d~d~ ~ ,-r Zone C. -<I . . "ol\,le Val~ J( Value "'?~~. .-',,~~ TOTAL VALUATION -::2~.:'It:.>. -..~ Type/Const. ";?-Ifr-k=' 't......--Unih 8edroams r"'Iccy Load <:'torief i "'ccy Group _~R-::Z Sq. Fig. Main Sq. Ftg. Accen Sq. Ftg. Olher Fir. Zone Flood Plain //2<::> BUILDING PERMIT Charge 1 ond' Surcharges Plan Ck. Comm/lnd 65%/ Blda Per Fee Pion Ck. Res 36~o/Bldq Per Fee IS, C,C SYltems Development Chorae f1.5~;,1 ~'1..".,. ,. . .?~ ~ ...~ ii). PLUM81NG PERMIT Chargu and Surcharge 1 Fence "::\C> Demo Total Comb. Permit elECTRICAL PERMIT Charges and Surcharges If). ...", Sidewalk {,-c Ii./("P....v;,.'" MECHANICAL PERMIT Chor~es and Surchorgel :.::z :< ~ <>~ Curb Cut , ..&~ I TOTAL " DATE 0~ /l!.., '1 I I. /Y..4, 08.'-'1 ~~. :< y . . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant.lo furnish A, Job Address B. Legal Descriplion 1. example-tax 101 100. Lane County Map Reference 17 2. example-Lot 1, Black 3. 2nd Addition 10 Springfield E, C. Name, etc. of owner and construction lender D.. Energy Sources 1. example-heat/electrical ceilinq/or forced oir qas 2. examoleawater heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foal house. 500 sq. fool garage 2. example-if new project, check ne'Waif addition, check add. etc. F. Building pe'rmit information: 1. examole-construct single family house with an attachE garage 1 2. example-remodel existing garQg~ into family room 3. example-convert single family residence into restourant (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 Stoff must be able to contact appropriate persons regardi design information or job site corrections, etc. II. Abbrevialed Plumbing. Mechonical'& Electrical Schedules A. Except where blank spaces occur in the description portior of the Mechanical and Electrical Schedules. the applicanl Ijeed fil1~in only" the No. Boxes adjacent to the appro"pr.iah I1em(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 nol covered an Ihe 'abl: cited schedules you should consult the full schedules C: BUILDING DIVISION STAFF WILL fiLL OUT ALL fEES AND CHARGES ON THE SCHEDULES III. Applicanl 10 sign and date Whenever possible, the initial application will be used os a worksheet only, Where possible. Building ~ivision SIaff will prepare a typewritten 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. lV, V, FOR OfFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY: nam"" ~ignoturt" , 1-. . PERMIT V ALIDA TlOr< . , ( CITY OF 'SPRINGFI ELD City Hall Springfield. Oregon Department of Public Work. OFFICIAL RECEIPT I \ . r No.' B 5 6 311 ( . /\ I (' ,( \ Dote "-l-- \. \ -' 11~"\, . . Rec'd from \\\~~\'\\t\~C (\ C.f:5\D\ Address \ '?j?) ':~~\'\.."( \ (\}n ( (" ( Received For: '. . (' (\, " \:'1\..\, i A4/' \ .\.:U\\\.'~\ 'i;:/i l C. C' C' (~'r +/, . ~ -.........;. ;,. . \ '\ \\~ C X-\ ~/~-, ~ \) "f'\ iCL'i n,': 7"" 1.,'<_.' ( (" ( Amount Received ( ~.," , '-:nIJY(j Aun40RlzeD SiGNATURe ."IUO.."TUII".ULL ..",..Till.' IUG.I..I 0" .'.0' ( ",- Permit Cler~ ,-fatQl .. .-' Vi "(: (Y,l... C/(C (- '''.CJ .-j C., .2(-"" ~ C'~ L....() (. \ . , . .. :l;{i , l -) "'~- ',-\ -;A.' <_-...1..' ('xl . (':>' l. "-' . ~ 1':-; (cU () r / - ' ..."'. ( '.