The URL can be used to link to this page

Home My WebLink AboutPermit Building 1980-9-29 1 INSPECTION LIIIE 726-3769 Job Address 'b 33 J\JU.J.D Legal De5cription II ~C>6 J I 1633C,Z'2-- Owner' Hr-ur LUo f!:JV-0-1fld....;L ~ CITY Of SPRINGfIELD COMBINATION APPLICATION/PERMrT E!IERGY SOURCES: Heat l'later Heater Range 0,ft. p() .{)(); h . IN~,ORlIATION UNt 726-3753 Sq. Ftg. 1.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Demo ChangelUse -Other - - I-J -S:J ~ (jl ~ II~ ~ Address .s~ Phone va50~r"OO Builnina Pernl;t Info: Deser be Work(i.e., Build Single Family Residence With Attached Garaael .3-rt.YI UJOYE (LA.;, pxv OJOU/\ S (' PYYnYYL.QY\.jD '147 -5422. Construction lender Address Ut~ I uN T tArl (name) Phone {address 1 Mechanical CONTRACTORS enamel (addreslil f1 ics. no. ) (exo; res) (ohone no.\ ~ (1 i c<';.. no.l (pxoirpc;) (nhonp nn \ Primary Structural Electrical Genera 1 (')\uYl...QY Plumbina ; Electrical Hechan; ca 1 PLUIIBIrIG ELECTRICAL MECHANICAL NO.1 lEaCh single fixture IRelocated building (new fix. additional) IS. F. Res; dence (] bath I Duplex (I bath) each Add it i ana I ba th I ~Iater serv; ce I Sewer FFF rHARGE Nn ~~~ I r~AR~~ NO J:J:~ rUlll:U:~ Residence of SQ. FT. furnace/burner to BTlI's INew circu~ts alts. or extenslOns I SERVICES I Floor fu rnace and vent Storm Sewer I I I I I I I -t I I I I I ISSUANCF OF PFRl1IT I TOTAL CHARGES I TOTAL CHARGES that the Electrical work be done by an,-Electrical Contractor, the electrical rortion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division I I ITempOrary Construction I Change in existing I rps.1 df'nC':p' multifamily, comm. or I Indu~trial " Recessed wall ~o~~p hp~tpr ~nrl vpnt IOf ICOI~1./IND. FEEDERS I Install/alter/relocate di<;trih. fppdprs Of amps.1 amps.1 I I Appliance vent s~oarat.p Stationary evap. cooler Vent fan wi th sinale duct Vent system apart from I heatina or A.C. I Mechanical exhaust hood ;lnd dur t. I Hood stove/heater I I I TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be vali1 until the 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 that any and all work performed 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 flO OCCUPAUCY will be made of any st~ucture 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 ORS 701.055 will be used on this project. IWIE(please printjl\.i"r{;').... IAJ': I,.." ~ Plfl:.-....oit- SIGIIATURE'7n..a:iZ:...-\tJ~~ DATE~ho FOP. OEF I CE USE OIIL Y Zone Fire Zone Flood Plain Tyoe/Canst. Bedrooms Stories Units Occy load Occ.y Group Sf!. Ftg. t1ain Sq. Ft(]. Access Sq. Ftg. Other , x Value Value Value x TOTAL VALUATION BUILDING PERfIlT Charges anC: Surcharges 'u 5~ Q Q? __ J ~~~~B~~~ 20' . I Plan Ck. , 30%/Blda I Fence ------------1 D~'!lo 'Sidewalk CarrmfInd P",r I='~e Res Per Fee 'Systems_ Development Charqe O.5~) . PLU'1BING PERMIT Charges and Surcharges ELECTRICAL PERI:IT Cha rges and Surcharges AIC 'Paving I Curb Cut ------------ I ITotal Comb. Permit 11ECHANICAL PERMIT Charges and Surcharges I I TOTAL 5.2.0 /' I . ~: ,. . .' .: COMBINATION APPLICATION/PERMIT (CAP) . I. Applicant to furnish A. Job Address B. legal Description 1. example- Tax Lot 100. lane County Map Reference 17 uj 43 2. exam~le- Lot I. Block 3, 2nd Addition to Sprlngtield Estates , C. Name, etc. of owner and construction lender D. Energy Sources 1. examyle- heat/electrical ceilin210r forced air qas 2. examoJe- waterheater/electrlcal/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" permit information: 1. . exa'mole" - construct single family house .with an attached garage 2. examqle - 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. OESIGN TEAM ANO 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 ~lechanical 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 Wt'LL FILL OUT ALL FEES AND CHARGES 011 THE SCHEOULES O. As noted on the CAP, the label must electrical contractor for signature supervisor. The general contractor 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. II. be delivered to the by his electrical is.not authorized Ill. IV. V. FOR OFFICE USE ON,Y PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .. PERMIT VALIDATION ~--_. I .. Permi t Cl erk ~ Permit applicant exempt from registration with the Builder's Board because:' Additional Project Information: PLANS REVIEWED BY: name s fgnature ; ------------l ; date . II CITY OF SPRl1lGFIElO CO/IBHlATION APPliCATION/PERMIT EilERr,y SOURCES, Heat Hater Heater 'j IrISPECTIOII 1I11E 726- 37 69 Job Address 7-, ~ ~ I . IIlFORlIATION UN, 726-3753 Sa. Ftg. r.lain ~q. !='tg. Access. Sq. Ftg. Other Ilel< Add Alter rep. --Fence Demo Change/Use Other -- -- J-J ..iJ N (jI .~ legal De5cription Owner Htly:tLn Add re ss S C'-'VY\....L. 6Vlt~~ Phone Ranqe Va30~rki:Jol Bullc;ina Pennit Info: Describe Hork(Le., Build Single Fam.il y f'les; dence IH th ~.ttached r,a raqe 1 :J-i'LVI rDOYt., Cll0 IFv C'JOu/\ s (' ~I'IL.Q.Y'CtD I --..:. Construction lender 'l~7 -5422. rHt1illiL .lflL_-' .1 Residence of SQ. FT. INew circuits alts. or extensions I I I I I I I I I I TOTAL CHARGES J TOTAL CH^RGES WHERE STATE L\II REQUIRES that the Electrical work be done by an shall not be vali~ until the label has been signed by an Electrical Address U"IGU I ,All (name) Primary Structura 1 Electrical Hechan; Cd 1 CONTRACTORS (name) Genera 1 nlUYL~Y Plumbino Electrical nechanical PlU1lBIrIG 110. FFF Each single fixture Relocated building (new fix. additional) S.F. Residence (1 bathl Duplex (1 bath) each Additional bath ~!ater service Sewe r Storm Sewer Phone (address) j (ohone no. J l1ies. no. 1 (exoiresl (address) f1ir:~. no.) (pxoirpc;l (ohnnp no ELECTRICAL I I--EEL.. JJlABGE.' "0 I I I / Recessed wall So~rp np~tpr ~nrl vpnt ~ . MECHANICAL furnace/burner to BTU's OOLIJ:lJABliE. Floor furnace and vent SERVICES ITemporary Construction IChange in existing rp~; rlJ'PiP Imultifamily, comm. or Tnd(J~tri.1l I' Appl iance vent c:;p.oaratp I Stationary evap. cooler I' Vent fan wi th sincle duct Vent system apart from I heatina or A.C. Mechanical exhaust hood .1nd rlUl"'t I Uood stove/heater 1 I 1 Of amps COMl'I.1l NO. FEEDERS IInstall/alter/relocate ,rlic;trih f~pdprc; Of amps.1 f- ISSUANCF OF PFR!IlT TOTAL CH^RGES Electrical Contractor. the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFULLY EXMlINEO the completed apfllication for permit. and do hereby certify that all information hereon is true and correct. and I further certify that any and all work Derformed shall be done in accordance with the Ordinances of the City of Sari ng fi e 1 d and the Laws of the Sta te of Ore~on perta i n i ng to the. work descri bed herei n, and tha t IW OCCUPAHCY wi 11 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. Units Occy Load Occy Group S lGiMTURE'?n~ 4i.lL<-;-~......LfL FO~ OFFICE USE OiJL Y Sq. Ftg. f1ain Sq. Ft~. Access Sq. Ftg. Other om ~9ho I I , I W.W"j:, ~ 6rc~,.olt- Sidewalk ------------ lAIC 'Paving ___________J Curb Cut I IINIE(please print)~~ r. L')-- Zone Fi re Zone Flood Plain TypelCons t. Bedrooms Stories BUILDING PERflIT Charges an, Surcharges : 500 -- ,~20---- PlU'1BIIIG PERMIT Cha rges and Surcharges ELECTRICAL PERI~IT Charges and Surcharges /lECHAII I CAl PERMIT Charges and Surcharges , Value Value Value x x TOT^l VAlUATlO/I Plan Ck. Comm/lnd 65%/8ldo Ppr ~~e Plan Ck. R-es 30%/81 do Per Fee Fence Systems Development Cha roe (1. 5~) Demo Total Comb. rermit : TOTAL 5.2.0 ._-- '-~_.~----.-.~ . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. examole- Tax Lot 100. Lane County Map '1/ U3 43 2. examole- Lot 1. Block 3, 2nd Addition Sprlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources . (,' 1. examole- heat/electrical ceilinq/or fOI 2. examDle- waterheater/electrical/or sole E. Square footage or valuation, etc. 1. examole- 1250 sq. foot house. 500 sq. f 2. examole- if new project. checknew - if G'i check add. etc. F. Building permit information: 1. examole - construct single family hOUSE attached garage ( 2. examole - remodel existing garage into 3. examole - convert single family residen restaurant (change of use) G. Value of work as defined in Section 303 (a) (t\ Structural Specialty Code H. DESIGN TEA;'; AND CONTRACTORS To avoid design or construction delays, Bui Division Staff must be able to contact appr ~a' persons regarding design information or jOb corrections. etc. Abbreviated Plu~bing, Mechanical. & Electrical A. Except I.there blank spaces occur in the desC' ~~( portion of the r'lechanical and Electri'cal Scl the applicant need fill-in only the No. Boxl to the aopropriate item(s) to be installed B. Full Plumbing, ~lechanical, and Electrical 51 ~U'l are available at the Building Division 1. To conserve space on the permit form th! have been abbreviated 2. If the item{s) to be installed are not { fe the abbreviated schedules you should cor full schedules C. BUILDIiiG DIVISIO~ STAFF WILL FILL OUT ALL FE CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must electrical contractor for signature supervisor. The general contractor to sign the electrical label. Applicant to sign and date Whenever possible, the initial application will a worksheet only. .Where possible. Building Divi wi 11 prepa re a type \'Iri t ten copy and return it t ,ne a~plicant at" the time the actual permit is issue i'c'" slgnature. t,' 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. IL be delh by his E is .not a ilL rv. V. FOR OFFrCE USE ON~Y , ."....."' ._ " ,...... .......h.'..a..... .,.,~_.'"....... .. ( I CITY OF PI:RMTT VAl TnATTnN SPRINGFIELD / \. City Hall Springfiald, Oregon Department of Public Works OFFICIAL RECEIPT ~ ( ( B 54729C Date q ~ ?9 19SJ ~O. Rec'd F~o;;;;11(UL1.W./ &and .f'- Add;ess ~ :Jjc'~t !Yvh // Received For: 8P ?1cJI') I 5'.00 ~O ( Received5 20 ('J1QJ2)? / lI.p L.... , AVTHORIZ'[D SIGNATURE 5HnTO"'TU"~"ULL ~",..T["S . [UG["O;. 0.. .'..01 Amount ( ~. "",., ( Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: I I I I Additional Project Information: PLANS REVIEWED BY: name signa tu re date .......,........ ". ( ( ( ( ( ( ( ( ( \, ,'. f '" --~