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HomeMy WebLinkAboutPermit Building 1990-12-17 Job Address. Cf7 J .'rus::, Wf11 Legal Descnpt,onI7-E:l'3---:.:-:c_2..., t:!:'6~~ Owner ~2:~;P ~r~.s. l:rn. I'" 1- Addres~::>1 .I//./'..~.z:p ..4.;g Phone - , , /~,,~ /At. q~~'L, _ ~r"M'_~ /' _, ;J......y.~ ,,/.c!';Z~ ~~-..,:.-'" INSPECTION LIrIE 726-3769 Address DESIGN TEAM Iname) Primary ~~Ez:..> Structural Electrical . t- INFORltATlON LINE 726-3753 Sq. Ftg. 1.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Demo Change/Use Other- - CITY Of SPRINGFIELD COMBIIIATlON APPLICATION/PERMIT EIIERGY SOURCES: Heat Hater Heater Range ValuE of Hark: ",-, ",- BuiTciinQ Pennit Info: Describe Hork(Le.. Build Single Familv nesidence With Attached G~raa~) SU_~=-"'A7_~ t4;rb~ M"9 h~7l"'C:: ~ ~ .2:> Phone (address) I no.\ (l;es. no.) (exoiresl Jl ahone ~ A:K4_ r~echanical CONTRACTORS (name) laddress) -z> ./'"' ~.w~~,,#T..7 General n/~t./~ ~~_...._-", ~ ~- ., . . ,.,-- Plumbina Electrical ~1echani ca 1 ND. 9'9 Each single fixture Relocated building (new fix. additional) S.F. Residence (l bath) Dup 1 ex (1 ba th) Additional.bath IWater service I Sewer IStorm sew~r I I I", I I I llir;. r9.) l o4G\rJ I (~xoirp~' (o~nnp nn )______ Alp>lq~ , I PLUI.IB I NG ELECTRI CAL MECHANICAL FEF rHARGF Nn~ ~~~ r~~ Nn J:'J:'!:' rllllRGL Residence of furnace/burner to BTU's ~~... SQ, FT. New circuits alts. or "extensions Floor furnace and vent each "I I /. I I I I I I ISERVICES I Recessed wall Sn~rp hp~tpr ~nrl vpnt !remporary Construction IChange in existing r~)jdJ".nr:p Imultifamily, camm. or Industrial IOf amps. ICOMM./IND. FEEDERS Install/alter/relocate distrib. fpprlerc; Appliance vent seoarate Stationary evap. cooler Vent fan with sinale duct Vent system apart from heatina or A.C. Mechanical exhaust hond and dtJr:t. Wood stove/heater Of amps.! TOTAL CHARGES WHERE STATE L~H REQUIRES shall not be vali~ until the 89~."~ TOTAL CHARGES that the Electrical work be done by an label has been signed by an Electrical ISSUANCE OF PFRllIT TOTAL CHARGES "Electrical Contractor, the electrical portion of this pe~it Supervisor and returned to the Building Division 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 Oregon pertaining to the work described herein, and that" HO OCCUPAllCY 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 frJoce nd effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon, and that only subcontractor an employees who are in comoliance with ORS 7nl.055 will be used on this project. IlAIlE(please print) . / SIr,IIATURE DATE I FOP. OFFICE USE OiIL Y Zone C::::~ I Type/const~-(~.:5~Units Sq. Ftg. 11ain x Value Fire Zone / Bedrooms . Occy Load Sq. Ft!). Access x Value Stories "'3 Occ.Y Group R-j Sq. Ftg. Oth:~" ,,,,"'" . .... ~A/":: Y Value-","~_,- ~;~ / TOTAL VALUATION ____2/-'~~ ~~~~Bi~~ ~~:.'"'~~d 'I ~ frS % m~~~'<~~~~lopment ,,?~,-:> Plan Ck. Res /5.. ~ 30%/Bldo Per Fee _____8...7&...... Fence .1 4/'1. :6bI Demo I I I Flood Plain BUILDING PWIIT Charges and Surcharges PLur~BING PERMIT Charges and Surcharges ELECTRICAL PERlm Charges and Surch~~g~s MECHANICAL PERMIT Charges and Surcharges 'Sidewalk ......:- ivc Paving..~ . ...... .. .--~ . '.." I Curb C~t ---uu-nul To~\ Comb. rermi ~ _ /263.15" , TOTAL -Z/~~.I5' t. . ",/ COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDA~ION I I 1. I. Applicant to furnish A, Job Address B. Legal Description '. ...., , ~..... . 1. example- Tax Lot 100, Lane County Map.Reference II oj 43 2. example- Lot 1. Block 3, 2nd Addition to :>pnngtield Estates '. _. '. .. C:';' Name; etc. of ownerJandCOl;structilfn 'lende'r. . D. Energy Sources ~ ~." . ".. 1. examele- heat/electrical ,ceilinq/or"forced ai~.Qas . 2. exa~le~ waterheater/electrical/or solar E. Square footage or valuation, etc. - 1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project. check-new - if addition, check: add, etc. F. Building pennit information: 'I. example - construct single family house with an attached garage 2. exam~le - remodel existing garage into family room 3. exam~le - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of"t~~ Structural Specialty Code . '. , H. DESIGN TE~l 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 ftem(s) to be Installed are not covered on the abbreviated schedules you should consult the fu 11 schedu 1 es 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 sfgn 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. 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. , ., .' . . " '" , ". -. . ' . .':, ..... ~ . . ..,' '. .t.... " ;:..' . ,'-';">" ,~- ~ ""\, ~ '\ . ' .. ~ . " ',,, \ " , '. - -',:. ~#":.' .. . ~ .... : .' . , . .' '- ~'... ~ .-. .... , . . V. FOR OFFICE USE ONLY jJf ~b3 If .,' ! )'/~'7"~ 11 /'8Q13 Permit Clerk .a!~' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .... .; ~. " ,,', Permit applicant exempt from registration with the Builder's Board because: .,:.;: .~ . , ..:....!,~..~:-. .. - - . ,.:J " .Additi.~na 1 Proj\lc1; I~!0,nn?t.i9~: .' , , . >. . , .... ._.... . - r~::-~' ,..: '. '.. ~. '.- ~ "':, .' " PLANS REVIEWED BY: n~~e'.Ld'R;.G ~~~_Signature~. ~,,_~ ~J9 . -~ r. . ;~-:. ".'..-':. da te /':7::>"?--~ '# .' ',,'.' I