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Home My WebLink AboutPermit Building 1980-10-17 1 i. \~, ....... , '\ . I IriSPECTIOll LIIiE 726.3769 Job Abdress ,:;;-73 ./f,'(::)&A..lf/~i CITY OF SPRINGFIELD COtlBHIATION APPLICATION/PERMIT .l. ,/ J , ., EIIERGY SOUflCES: r' d . Hea t e./I' f ,t;('( . """'./.(1) 'l!.r (-later Heater e /,)( .,11'1(' , Ranqe elN fdf. I Vd}UE of I-/orki; '-l?50d, cJ_ Legal Oe5cription ~/~ !??r;-~';-l-! r ,() (--;;4,///(:/2- ,,.-/,,(~.--'<;.. ,~'/7-02..-.'5<;--23 In 4U(V) Owner/7,1j--;-I-~;J )/-----J: (y/r: I/o' Address )-'"") ? L' .'; y"'--., /-=;-, J -;/) '- /_'.' ,.'-/.J\.,j :JI-"..:~_,J ,....:;. .' Construction Lender Address DESIGII TEAI'I Primary SL.ructural Electrical !1echanical CONTRACTORS /FL{,~~ Phone I) _:~.:j I . INFORltATlON UN, 726-37S3 Sq. Ftc,. 1.1ain ~q. f'tg. Access. Sa. Ftq. Other ~(O 1U --1lew__Add__Alter__Pep. __Fence__Demo~Change/Use Other CfJ 0- 10 if IU II Buildln<] Permit Info: Describe Hork(Le. t Familv nesldence With Attached Garaae) /Jm1,/1.i /l J j f'j A if /~Lff)1 (name) Phone (address) (l ics. no.) ~-i , 'VIA ~.I'-- ( (name) (address) (1 ics. no. " Genera 1 /. J'" ,..," Plumbino'-' C; ..'-I,. -c' ,).::.~,. Electrical /~"'J ...--:,~~__/-,A,;:::;! , 1..-4- 1.I.v , /, -." . t..t/C'_L-.L/,.\ ^,j . n ' :S ["1"'''-' -'lr' p l-J I J' . I '6;;' 11040, 17"'1 '~echanical :i;J.' ()~- Lo-<~A ,'J1re PLUI1BIrIG ELECTRICAL FF~ rH!1RGE: Nn ~F~ rHARr.F NO. Residence of Each single fixture SQ. FT. Relocated building (new flx. additional) S. F. Res i dence (1 bath) Duplex (1 bath) each I Additional bath Water service Sewer Storm Sewer 10, "'.;' 10.oClI I I I I I I Of amps. I I COI1fl.!II1D. FEEDERS I I Install/alter/relocate I rlistrib. feeners I Of amps. I I I I I I I I ISSUANCE OF PFR!IIT /D.O!] TOTAL CHARGES iD,O<J I TOTAL CHARGES that the Electrical work be done by an Electrical Contractor, the electrical portion of label has been signed by an Ele~trical Supervisor and returned to the Building Division -' New circuits alts. or extensions ISERVICES I ro.o'i !OOq: Temporary Construction Change in existing ,~ res i d~nr:~ multifamlly, corrrn. or Tndu"trial TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the I HAVE CAREFULLY EXAMINED the comr1eted application for Dermit. 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 ngfi e 1 d and the laws of the Sta te of Ore<Jon oertai n i n9 to the work descri bed here; n. and tha t IW OCCUPAlKY 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 ORS 701.055, that if exempt the basis for exemotion is noted hereon, and that only sU.bcontractors and em~loyees "ho are in compliance with OP.S 701.D5SJ be used on this,rrO.iect. IIAl.IE(please print)4/1)J)-.J-~.J 'j' J (l/E-./I: mlll:fDRK_ /)'~""-<-1 ~~ FOP. OFFICE USE OIIL Y I II I Sq. Ftg, r1ain / U Sq. Ft(J. Acce,ss Sq. Ft9. Other Zaney 1 Fire Zone - Flood Plain BUILDING PERMIT Charges and Surcharges PLUl1BING PERI11T Charges and . Surcharges ELECTRICP.L PERI:IT Cha rges and Surcharges 11ECHAfiICAL PERMIT Charges and Surcharges ,. Tyoe/Cons t. \L 1\1 Bedrooms Units Occy Load Occy Group Q~ Stories "" ()O . Plan Ck. _ _ ~_L~ _:. _ _ _ _ _ 65'VBl do ;;20 Plan Ck. , 30%/Bl dn __L6~~~_____1 Fence ,49 ID~mo L V,Dr;? I Sidewalk -- -~Y5?-----1 A/C Paving ,/ cD __L-::J.!...~--::_____ Curb Cut -,:/ 'I'~g CommlI nd Ppr Fee Res Ppr Fee b o D Build Single Ii./) fJ1 ./ hL.. tf-');JA fJO.L (J J (exoires) (ohone no. (exoires) (ohnnp no,) 7'-17-QQ/(i!1 72G, -A"'S.<"('" MECHAN I CAL . I I='n' rj..lARf,F furnace/burner to BTU's Floor furnace and vent I -I I I Recessed wa 11 SOrt~P he~tpr rtnn vpnt Appliance vent spoaratp Stationarv evao. cooler ~ , I Vent fan with sinole duct I Vent system apart heatino or A.C. I Mechanical exhaust hood .lnd nlJrt from t/,S!? Lj,Sf. Wood stove/heater I I I /o.~ /<..//,E thi s p.emi t Dm/c)-/ J-f4 I x Va 1 ue x Value x Value TOTH VALUATlO'rff ,..:::;00,0';1 Syste~s Development Charae (1. 5%) Total Comb. Permit ~!6'i? .-.fJ Jf" Oe ~ I' - I I I TOTAL . '. ;;I" COMBINATfONAPPLlCATfON/PEfUotlT .(CAP) " f " I. Applicant to furnish A. Job Address B. Legal Description 1." example- Tax Lot 100. Lane'County Map. Reference II 03 43 2. ' examole- Lot 1. Block 3. 2nd Addition to' sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinQ/or forced, (0, 2.examole- waterheater/electrlcaljor solar E. Square footage or valuation, etc. .- 1. examo.!e- 1250 sq. foot house.' 500 sq. foot. I"'n 2. examole- if new project. check-new - if add Q check add. etc. F. Building pernit .information: 1. examole - construct single family house \>lit .... attached garage 2. examole - remodel existing garage into fam; 3. examDle .'convert single family residence i restaurant (Change of use) G. Value' of work as defined in Section 303 (a) of Structural Specialty Code H. DESIGN TEM1 AND CONTRACTORS To avoid design or construction delays. Buildin Oi~ision Staff must be able to contact appropri ~ persons regarding design information or job sit corrections. etc. II. Abbreviated Plumbing. Mechanical. & Electrical Sche A. ~xcept where blank spaces occur in the descript ( portion of the Mechanical and Electrical Schedu the applicant need fill-in only the No. Boxes a to the appropriate item(s) to be installed B. Full Plumbing. Mechanical, and Electrical Sched € are avaiiable at the Building Division 1. To conserve space on the permit form the sc have been abbreviated 2. If the item(s) to be installed are not cove (01 the abbreviated schedules you should consul full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES CHARGES ON THE SCHEDULES ( O. As noted on the CAP. the label must be delivere electrical" contractor for signature by his elee supervisor. The general contractor is not auth to sign the electrical label. - ( .. Applicant to sign and date Whenever possible. the initial application wiil be a worr.sheet only. Where possible. Building Oivisio will prepar.e a type written copy and return it to t. ( applicant at the time the actual permit is .issued f..; signa ture. IV. Fees and Charges Plan check fees are due and payable at the time of ( application. and no plans will be processed until t ' fees are paid. All other fees and charges are due payable when the permit is issued. II!. V. FOR OFFICE USE ONLY +- . . ,. ....'". . I ," ... .." ,~, ~ . "-' .." 1 l j 1 , ~, . , I . ~ PERMIT VALIDATION CITY OF ~:, \.:..j ,.1 . i' ~ SPRINGFIELD . City Hall Springfield. Oregan Department of Public Works OFFICIAL RECEIPT \. No. <-I0^ .L{ 0 M PlIA - ',J, sy _ "t"'{a. Ii . , . ~ .... Amount R!ceived --r) I Jill_it> -: f. A , b "- . ,-.....' 7">'1-\... ~ "' (J ,"",~,:",,:~':'::':.~~~D ::~::.'UD:'''''' ....,. \, Date 10.1- if c; 19 t,.., (') ( Received For:, 1<,;/: i~/I/~J A 1'l4ti 1- It:' f?. A I () "'~ , Ee"",- A...J~~ G.u'd...J,':'.'j 1../0/,., ~.....hJ L./OJ,.., ~(p(.J.II'Ii-n.1 - 00 -- - .~o to."'!! .LlO I {'),ClS! \. !'l PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .IL.., Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: na~ ~off=f~ signatu, " .:t . . " B G 5 4 ~ 414 4 G. Q ,3 '8 \0 ill G <8 ((I 1 -, I I. I. 1 ~ i I tJdl.e I () -; 7- f<. 0 -#.. '. .,. " , N , " . ~\,T7~f-~;MI'J:),~ ;:N":~;~l,"'~'<.1""'1't' \,'i~., ~ ""'. ;~, , .' ',. f. " '"i"' , ~..'. ',. ':.' . '," . ( , ,'-.-l COMBINATION APPLICATION/PERMIT (CAP) I. PERMIT VALIDATION I!. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II 03 43 2. example. Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name, etc. of owner and construction lender O. Energy Sources 1. examQle- heat/electrical ceilinqjor forced air qas 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~~ - if addition, check add, etc. F. Building pernit information: 1. example ~ 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 TEAr.1 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 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. BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEOULES 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. --- Applicant to sign and date Whenever possible. the initial application will be. used as a worksheet only. Where possible. Building Oivision 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. , ; ! I" ,;.. ~ \ \t. Ill. IV. V. FOR OFFICE USE ONLY Permit Clerk ,'I , PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: .. Additional Project Information: , PLANS REVIEWED BY: na~,~ signatu,c JaZ" /(5 -/7-R 0 ,. .' . " . I INSPECTION LIIIE CITY OF SPRINGFIELD 726-3769 COt1BIIIATION APPLICATION/PERMIT Job Abdress 57-3 LfKSt!J,,);;"' ~ .L.(' ~~~~GY sou Legal Oescription ~ ~1-T 1-/ f ,,) c:;;,.f,{:,/Jc.iZ... I.jater Heater e ~/J.. ___ '/7-02.. -.~~~2,~ In, 4U(}1) Range Owner //ifTHo J )/ J (Vie: //0 Address.....)-73 LA-rSoJii:J .I.? Phone~~~ / \ ....""'",~,1. \' Construction Lender Address a,SI"!1 I,AH Primary Sl.ructural Electrical !1echani ca 1 CONTRACTORS {name} ~ \ Y\r\~ [name) VgJ,UE of Horkl> '1?..,50Cl, "_ BuiloinQ Permit Info: Describe Work(i.e., Build Single Family nes;dence With Attached Garaae) fl m1LJi /) J J.f'j Ii/) fJ1 / hL... j I! I.AL m1 . Phone (address) (lies. no.l [address) (lir.e;. nn.) Genera 1 Plumbino~ .I/,/G:5e.G'- Electrical C)H--;-1'1tT~ 4/C:L..;),>;..) ~~echanical :;0. PLUltB IrIG FEE [HARr,E Each single fixture IRelocated building (new fix. additional) S.F. Residence (] bath) Ouplex (1 bath) each I App 1 i ance vent Sfoarate I Stationary evap. cooler I Vent fan with sinale duct I Vent system apart from I I heatino or A.C. I I Mechanical exhaust f/~1 -'Sf' hood and duct. '-f, -- 'Ii"- I I ~'Jood stove/heater I I I I I I I I I I I ISSUANCE OF PFRIIIT /o.~ TOTAL CHARGES /0.01} TOTAL CHARGES / D,091 TOTAL CHARGES /4 S!:! WHERE STATE LAH REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this permit shall not be vali~ until the label ha~ been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXN1INED 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 oerformed shall be done in accordance.with the Ordinances of the City of Springfield and the Laws of the State of OreC:lOn pertaining to the work described herein. and that llO OCCUPAI~CY 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 s~bcontractors and employees who are in comoliance with OP.S 70I.055~ be used on this,prOject. / IWIE(please print)4;dll-/-~.J)' J (7/e.-/1o SJr,;lAfUIllK l~ ~ FOP. ofFICE USE O1~L Y / (I ( Sq. Ftg. 11ain U Sq. Ft~. Acce.ss Sq. Ftg. Other I Additional bath Water service Sewer Storm Sewer Zone_k> , Fi re Zone - Flood Plain BUILDING PERMIT Charges and Surcharges PLU'16ING PERMIT Charges and Surcharges ELECTRICAL PERI:IT Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges ~ 00 - Plan Ck. Conm/Ind ::._.L. - 65%/Rldo Ppr Fee -- --,9.0----'Pian Ck. Res I 30%/Bl dq Per Fee _-t6-,~!!.._____ fence .'-19 _ _L{Q,DS! L.{6 . ~ __L'''j,_~_____ Curb Cut .~ - I vo.~ IO.~ I TYDe/Cons t. --3b..1\1 Bedrooms Stories ~ ./ ~f)..,,~~/rJ . ()~- Igg/(n'/cJ,,:kJ Lp-~A 6;,e ELECTRICAL Nn I IResidence of SQ. FT. ' I New circu~ts alts. I or ex tens lOns FCC rHARh!= NO. 10, 0.;' 10. (/Cl I I I I I SERVICES ITempOrary Construction IChange in existing rp<;.iden(':~ . ImUltifamily, comm. or Tncfustrial IOf ICOHH./IND. FEEDERS Install/alter/relocate di<;.trih. fppcfprc; amps. Of amps. . Units Occy Load Occ'y Group 12."<... tNFORllATION LINt 726-3753 Sq. ft9. 1.lain ~q. Ftg. Access. Sq. ftg. Other ~Go q7 New Add Alter Rep. --fence Demo Change/Use -Other - - Cj) G o (t u t?l/lA Il O.R / (j ; (exoi res) (ohone no.'). (exoi res) (ohonp- no. ) 7<11- 09~t!/ 72(.. -7._"'<;'.<.;- HECHANICAL l=I='!= I r!.-lli.lU:l= furnace/burner to BTU's Floor furnace and vent Recessed wall ~o~~p hp~tp~ ~nrl vpnt DATE / c) - / 7-?1 , x Value x Va 1 ue x Value TOTAL VALUATIO'!1f ,.<::;OD,O'j 6 o Systems Development Cha roe (1. 5r.) D D~mo ~ Sidewalk I A/C Paving Total Comb. Permit L/! /) ~ 1'- TOTAL I"" '-f /. o.!> '.,