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Home My WebLink AboutPermit Building 1980-2-4 II'" '\ / "Au" '" . 'l-.t(")TIFIED """," - _-! '1 INSPECTION LINE ,CITY UF S~~INGFIElD . . INFURlIATJON LINt I ~ A 726-376g. . CmmI1lATJON APPLICATJON/PERMrT . 726-3753",J ~ ~ Job Addre,yy.4,'51 LA K '60tJ8\) Loop ~~~~GY SOURCES: ~~: ~~~: ~~~~ss:""o.-~ G Legal Oe<criptionLDT 2) ~u:::;<) hIt-{ A-bD~, Hater Heater Sq. Ftg, Other S llew.AAdd Alter Pep. LAK.";){)NEN, ~I<'_ 13/ LAr<.soN F.~ !..oc>P Ranqe Fence_Demo_Change/Use . " owner't<lo-lMD L g "ftG6Y A,Mowel? V:1f3'OO(!;:O _Other II,~ - Address ,/3/_ J, A ",co i ,-='" \ LP. Phone '''7521,' Buil"ino Permit Info: Descr be Horkl i.e.. Build Single q L r-~ f'J":="'-J 1'1. I Familv ~esidence Hith JI..ttached Garaae) e~ dddA7~L9YI j Construction Lender . 3c::A- . 'r C) is{ Address DESIGN i tAl,' (name) Phone (address 1 (l ics. no.) (exnires) (ohone no.. * r .~ Primary Structural Electrical (name) (address) (l;es. no.) (exoires) (ohnnp no_) Genera 1 Plumbino PLUIIBHIG j NO. Each single fixture Relocated building (new fix. additional) S.F. Residence (] bath) Duplex (1 bath) each I IAdditional bath ~Jater service Sewer Storm Sewer ELECTRICAL MECHANICAL FEE CHARC,F NO FeE rI-lA~(;~ ~Jn. 'eE I nMRr.~ I . I I I I I I.~.OD I I Residence of SQ. FT. furnace/burner to BTlI's ' -- New circuits alts. or extensions :J ~12 AADIl./J. SERVICES IS'iJ. I I I I I / Floor furnace and vent I I I/D~ Jn~O I I I I I Install/alter/relocate I I di~trih. fppdpr~ I Of amps.1 I I I I I I I I ISSUANCE OF PFRillT /0.0/'1 TOTAL CHARGES /O{;!/2 TOTAL CHARGES IStl:71 TOTAL CHARGES I,(.on WHERE STATE Ul~ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division Recessed wa 11 Sn~~p hPntpr nnd vpnt ITemporary Construction IChange in existing rp1'.itleJ"1rP Imultifamily, camm. or Tndustr;;Jl CO~j./IND. FEEDERS amps.1 I Appliance vent seoaratp Stationary evap. cooler Vent fan wi th sinale duct Yen t sys tern apa rt from I heatino or A.C. I MeChanical exhaust hood and duct I 11'IOOd stove/heater I I I s.on IOf , Zone_ 2-/ Fire Zone IIC.. Flood Plain III/J I HAVE CAREFULLY EXMlINED 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 oerformed shall be done in accordance with the Ordinances of the City of Spri n9 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 rm OCCUPAIlCY 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 on~y sUb,~ontractors and employees "ho are in comoliance with OP.S 7n1.055 /lbe used on this project. , , IWIE(please print) ?ea.a u. j. Yy)nUJ-e V 5 IC,ilATURE (3'~j ~]. I1l~Dm ;;J-4-8n .J FO~ OFFICE USE DijLY - 'v (/ . Tyoe/Const.JZ-A!' Units I Sq. Ftg. itain ~.~x_l2. .If)alue 4'~~ Cf::) - Bedrooms Occy load Sq. Ftg. Ac'cess x Value Stories 1 Occ'y Group_R-~ Sq. Ftg. Other x Value MECHANICAL PERMIT Charges and Surcharges BUILDING PER'IIT ' , Plan Ck. CommlInd Charges an~ ,. ______-.3.;Z.~_ 65%1Bldo Per Fee Surcharges a Plan Ck. Res 1.;J.tJ 30%/BI do Per Fee PLUt1BING PERMIT _______ u'.ml Fence Charges and ..LU Surcharges I ~ I D~mo ~~~~~:~C:~/Er _______16!...0Ll.1 Sidewalk Surcharges .ko AIC Paving _______l"-.~f2 Curb Cut In.. TOTAL VALUATION ~33,~ -Syste~s Development Charoe (1.5%) . '"1'(01) (-tl.1./) Total Comb. Permit TOTAL # 7~,tJD . . ~. ;. .,' ~_' . ".~ COMBINATION APPlICATION/PEffi1IT (CAP) .. PERMIT VALIDATION . I. Applicant to furnish A. Job Address B. legal Description 1. example- Tax Lot 100. Lane County Map Reference 1/ 03 43 \ 2. exam~le' lot I. Block 3. 2nd Addition to Sprlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources . . I 1. example- heat/electrical ceiling/or forced air OdS 2. examyJe- 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. chee k add I etc. F. Building permit information: 1; examDle - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exa~le - 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 TEM~ 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. - 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 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. . , .\ ,- , , V. FOR OFFICE USE ONLY Permit Clerk I, . 1 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: \.. name signature ~LD1-" " date /-~S- ~O . COMBINATION APPLICATION/PEffi~IT (CAP) ~ I. Applicant to furnish A. Job Address B. legal Description 1. example- Tax Lot 100, Lane County Map Reference II uj 43 2. . examole- Lot I. Block 3. 2nd Addition to Springfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole. heat/electrical ceilinq/or forced air aas 2. examole- 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-nfw . if addition, check add. etc. 'F. Building permit information: 1. examole - construct single family house with an "attached garage 2. examole - remodel existing garage into family room 3. examole - 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 TEAt-I AiID 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. Abbrev~ated Plu~bin9. Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the ~echanical and Electrical Schedules. the applicant need fill-in only the No. Boxes adjacent to the appropriate item{s) to be installed 8. Full Plumbing, Mechanical, and Electrical Schedules are avallable 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. BUILDI1IG DIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES 0:1 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. - 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 type written copy and return it to the applicant at the time the actual penmit 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. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . ~J ~ " , '. ~ PERMIT ,VALIDATION ;:ITY OF SPRINGFIELD City Hall Springfield', Oregan Department a.f Public Warks OFFICIAL RECEIPT 1\ No. B 5 2 7 0 7 ( "J)- y. 19?(~ ~ From\c'\Q-~ I\r\. <'\ \{~'('y-\U~~,,\{l\\ res. ~~\ ~\\L\(s:'r"'\~\\1\~' -l i,;ved Fori, )()\f\nv l~2~) : -('~ ~/) le.~ ( ~\ D \D.OO - i4fJ(j .40 ( 0) ~'H I~ \~J~O -, q.CJ(), \cJj ( I{\~~ '[}-\ \ <(s,oo LtIG . fl~ ( ( ( ( , ; ount ~ - Received " ( O,~ \fJ\\OO AUTHOIllIZI[O SIGN...TUIIlI[ ...",. ( T'LJ ( ) .HILHlH.TU.....UU ~.'''TI.' . luGI"1 0" .UO, Permit Clerk II Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: , PLANS REVIEWED BY: ~" ''',.. name signature .ell", ~,i.-.,.., .,';:z;/, date / -.:).S~- X'D .\:.~'~,,"... t,_ 'I":~,~tr:-~~';-"'~~ir::~. _ ~ . '1~>:~'~1 ;';'1tnd~\ .~,,': . . " ~"ll' '80 l;;,~lt:;t\J~i('T:F!"H~i.:t')':l'j!~,.,.. ._:::i I INSPECTION L1liE .. 'CITY -UF..SP.RIIIGFIElD..., :. .,: . 726-3769" COIIBIrIATIOfl APPLICATIOfI/PERMrT ' . ~ Job Addross 4.-:S I LA K .'f,()f\J Ef0 Loo p ~~~~r,Y SOURCES; Legal De,criPtionL"r 2 J l\L~ -~ hOT l-I A:'tJ:)~, l'later Heater Range_ LA/("x~aI ~K'. 43/ LAt<.saN Fr\l kcc.? I, Val1" of Hork:''' "Owner Klcl-lMD La ?f:;G6Y A,MoLUeR.. ~3oo0 - Addr.<< '/7) J, A,/" ......, ,'lP Ph '.l7~2J'" 6uil(:ino Permit Info: Oe,cribe l'/ork(i.e., q L.J .1_,...., f-.::::.OA..)t=.tJ\"J ~ one 1'1 ....) _) Far.nlv nesldence '\'h:th A.ttached (;araoe) f2Ul.. /fdriA7-lC9'v-\ I . 38\ . ole:) ts\ INFORIIATlON UNl 726-3753 Sq. Ftq. 1.la;n :::>,.,.., a...,.,'" ~q. ~tg. Acc'ess. Sq 0 Ftq. Other ~~e\<J.zAdd_Al ter _~ep. Fence' Demo Change/Use Other- - Build Single c4 o 8 10 Construction lender Address Ol,lGN HAil (name) Phone I address 1 (l ic,. no.) (exniresl (Dhone no. Primary Structural Electrical (name) (address) nics. no. \ (exnirps) (ohonp nn ) Genera 1 Plumbina PlUl16l1iG ELECTRICAL MECHANICAL NO. i lEaCh single fixture I Relocated building (new fix. additional) IS.F. Residence (1 bathl IDuplex (1 bath) each ) Additional bath Hater service FFf CHARGE NO I Residence of I F"H I rHARf-F' NO. I IF'F'F' I rHAIU';F' SQ. FT. furnace/burner to BTlI's .r....... New circuits alts. or extens ions :~1.',,-~ '..M,}!?!"! /.~q..1 .,J Floor furnace and vent SERVICES Recessed wall So~cP hp~tpr rlnrl vpnt Sewer I /~ !!2 I I /.'j~O ITempOrary Construction IChange in existing re~idp'nce Imultifamily, camm. or Inl'1l1strial 10f ICOI'II'I./lND. FEEDERS I Install/alter/relocate distrib. feeders Of amp,. I amps.1 from TOTAL CHARGES WHEnE STATE l~W REQUIRES shall not be valij until the I /O{2!l 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 I 1/ I I I I /~col Appliance vent Sf'oaratp Stationary evan. cooler ~ . I Vent fan with i sinale duct Vent system apart heatinq or A.C. Mechanical exhaust hood and duct I I I I 1:1, "r, . ..-,u Storm Sewer Wood stove/heater IS:M I I I ISSUANCf OF PFR!iIT 10,00" I J.M TOTAL CHARGES thi s permit I HAVE CAREFULLY EXN1WED the completed application for germit, 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 IlO 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 force' and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employee' who are in compliance with OP.S 701.055 ~be used on this oroject. NAIIE(pleaseprint) ?f?,\CjL\J. m()U}~V SIGII.~TURE (3Q..Gn.,J ~ J, rYJ~DATE d~4-!3n - ../ FOP. OFFICE USE OIILY , "( L . Tyoe/Con,t. 'Z-Ji Units! So. Ftg. Ilain ::<:4-c,. -15-x Bedrooms ~ Occy load Sq. Ft9. Access x Flood Plain I</'? Stor;es.l Occy Group /?-~ Sq. Ftg. Other x /?-.1 )2. . lnalue 41 SZ';;'; CD Zone Fi re Zone .!..LL Value Value 6UIlDIIIG PERIHT ____u_.3.J.,~2_ Plan Ck. CommlI nd Charges an~ 65%/6Ida Pf'r Fpp Surcharges J.;;tp' Plan Ck. Re' 30%/61da Per Fee PlUl16ING PERMIT _____u.10'-CQ Fence Charges and Surcharges ,7!/j "~ D~mo ~".,.... ",' " .. ELECTR I C~.L PER~IT IS.o,") Sidewalk Cha rges and . ------------ Surcharges .!.-=D A/C Paving /lEr.HANI CAl PERil IT _______"-i{:Q{:L Curb Cut Charges and Surcharges ,n... TOTAL VALUATION fl<13,q? Syste~s Development Charoe (1.51,) '1,( oD ! - tJ/r. () .',: \ ITotal Comb. rermit I I TOTAL ;j 7~,tJD . " f