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HomeMy WebLinkAboutPermit Building 1984-10-8 . (rn~~~~INE _ COMBIII~mNU~p~mmm~ERMlT - -:2 ~ Ib E!IERGY SOURCES: 'J1l't'Adoress -;;;>0 -;::jO E::::'Jo~,,uOLl U'), Heat Legal Oescription \'1 () ~ ?? ?f'\ I ()~ I/ater Heater Range lNfORlIATlON L1NL , 726-3753 Sq. Ftg, I-lain ~q. Ftg. Access. Sq. Ftg, Other Ilew Add A 1ter Pep. -Fence Demo Change/Use , ;; n //// /J.- ~ - V./1~' lJ Val~ of Hork: ~ Other-- Owner~ \J.AA~"4JVu.PAf:'fY U'Lf:Au."r 1'v.,Ji. ~ 7. t?r;70. _ -r;-- h Bui1C11nQ Permit Info: Descnbe \~ork.(i.e.. Build Single Address ~O -30 I'{AI7. tJ/iA) Phone 7</1- Familv Residence IHth Attached Gara.a~) SI~/&>dl/tG--O 'a~Os atf~ /Sb-?,dJ (~~;z.f, 97Y'o~ Mechanical CONTRACTORS (p.ame) (addrp.ss) (lies. no.) Genera I '--J-'J4 ,jjk_;-?}f~ A< a../.." 1;).(rO ~y. e2ft?...JI Plumbino ~ Electrical~1xf11t _ ?t/: ~ 1::7A1!~ ~'echanical;1. AHQh.J1'""tllJ.LA, 3/SS'-<.l~ Cv.o/~L <' ~ Constructi~n render Address UL:lIGN TEAl,' ~, ~ 1 /t Primary Structural Electrical NO. . \.- ,. I )- c\J ~ (J ~ ()o (name) Phone (address) "ba..lfL- . f " ~~Q'~ VI [IV (lies. no.) (exn; res) (ohone no. (~xoirps' ------TOhoneno l ( bJ(q-~'?9.r- !OW- 4'7...1& -::SYS" -027, /C/ PLUlIBING ELECTRICAL MECHANICAL FEE rHARGF FFF IJ:H.Il.RG.E. NO I f'lrn~eLil!Jrner to ~\.~r> BTll's NO FFLJ:H.Il.RG.E. S~ :0- Residence of Each single fixture \ {g <0-: Co~ SQ, FT. Relocated building (new fix. additional) Floor furnace and vent S.F. Residence (] bath) Ouplex (1 bath) each Additional bath TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be val;~ until the Hater service Sewer Storm Sewer New circuits a1t5. or extensions SERVICES Recessed wall Sll~rp hpiltpl" :mti lIont Temporary Construction Change in existing rps- i rlJ'nrp' multifamily, camm. or TndlJ<;.tr;al Appl iance vent seoa ra tf> Stationary evap. cooler Vent fan wit~....., _ sinole duct Gll,'~ ~ Vent system apart from I heatina or A.C. Mechanical exhaust I hond and durt I I (....CD I I '2.. I I I I I I I ~,o::> TOTAL CHARGES /.s09- TOTAL CHARGES that the Electrical work be done by an Electrical Contractor, the electrical portion of label has been signed by an Electrical Supervisor and returned to the Building Division Of amps. COI*l./IND, FEEDERS I Install/alter/relocate dic;trih. fppdprc; IOf I I I Wood stove/heater amps. ISSUANCF OF PFRllIT V2.~ thi s permit I HAVE CAREFULLY EXAMINED the completed aprlication 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 Ore[lon pertaining 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 ons 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 7nl.055 will be used on this project. D. A4.E,vc;ES SIGII^TURE d#~",-f' /..J C#fP>-<o,_ FO~ OFFICE USE 0111. l"- V / Sq. Ftg. f1ain x Value Sq. Ftg. Access x Value Sq. Ftg. Other x Value TOTAL VALUATION r;') '1. rT Y'", IW,'E(please print) ~/&#MI!. Zone C ( Fi re Zone '""- Flood Plain ___ BUILDING PERIIIT Charges and Surcharges PLU!1BING PERMIT Charges and Surcharges ELECTRICAL PERI~IT Charges and Surcharges 11ECHANICAL PERMIT Charges and Surcharges DATE /0-8-,%;..- Tyoe/Const. \.)-\. '\ Bedrooms Stories Units Occy Load Occy Grou~ r'2. ? _ _L~\.co..~ 5.C\'2, ___20-#~__ Fence \ 'GoO )s- cro I Sidewalk ----- -.-~b--I A/C Paving \f(,. c::c> I Curb Cut ------~u.~---I ~ c,~(pO ~ 1);.1 0/ a 0 n,,,1. ,,/ Slsteos Development /". rra 7/0/-1/, ~rQe tI. 5~) 555.- Plan Ck, 65%/Blda Plan Ck. 30%/Bldn Co","/! nd Per Fee Res Per Fee Demo I I 8'ffiffi Total Comb. Permit a\'C)\\\."('",\ I I TOTAL ~~ 7~~, - ~ . \ rx L( () 0 '2 <-/ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B, legal Description 1. example- Tax Lot 100, lane County Map Reference 11 U3 43 2. example- lot 1, Block 3, 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. exam~le- heat/electrical ceilinqlor forced air Qas 2. examyle- waterheater/electrical/or solar E. Square footage or valuation, etc. ------ 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project. check-new - if addition, check add, etc, F. Building pennit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exa~Je - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (aJ 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. 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 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. --- Ill, 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 signa ture. 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 -- . , ' PERMIT VALIDATION fJ# (Pl~6g f,j IC!v'~y M " , \ '. '\ Permi t Cl erk 4J>I. lo/~v ,I PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ~L \;).E.a\ 'l\~,~ \~~r\.\C')\ \~ \l"\~, Cl""I ""Y<.1~\.1:;'C'\ ~\. '\l"I ~-V~N~ \7-.F~~F. C"\tt.\ ~",\C',-( Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name..\. )~~ rl ~')\ SignatuQu...l\.~_' ~ date\()-~~~lt . . .~ . . F ~te>~ ~ '-. OCCUPANCYNAMEj::'C,rrI'hrU;c:-Ir,'1<'<; (1, U, AOORESS ,::SO~O r;~A+' Loo.-o , FIRE DEPARTMENT INSPECTION CLASS BUILDING OWNER PHONE BUS, PHONE OCCUP. NAME HOME PH. ADDRESS I CODE SECTION VIOLATIONS .c'r7~f l)("r~o.d;5~ / 'A; 5-Pec I, ~-,J , &LLJp~cl I , H, k- ok. r-:v ,./.,'",,% 1-/, ',,,j,,,,. - ..e.Y I 5 * 'a."I / - ./ V YOU ARE HEREBY NOTIFIED TO CORRECT THE ABOVE VIOLATIONS WITHIN S]GNED: ]NSPECTOR ,....,b1u Ul 's- S k~ DAYS, VIOLAT]ONS: Noted - co, OATE ,;{ -:U-fr5-- ABATED NUMBER