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Home My WebLink AboutPermit Building 1985-2-11 , . I INSPECTiON LINE 726-3769 Job Address . CITY UF SPRINGffE,D COMBIIIATiON APPLICATiON/PERMIT -.- --~ EIIERGY SOURCES: Heat Hater Heater . INfORlIATiON Ll"t 726-3753 Sq. Ftq. 1.lain ~q. Ftg. Access. Sq. Ftq. Other Hew Add Alter ~ep. -Fence Demo Change/Use Other- - I ~ () ~ \Q ISiS? / "~J:i>A Legal Oescription I ]'c):J-2?-/':) f",''::l. .'9t:!O, . Sr. owner~~/~F/FCD A/~~ Address' /B8? LA~4 ~ ~l./.t::>I ~R-2;> _ e>K' '7:?Y;;Q Construction Lende~ ~ Ranqe_ __ Valu€ of Work: lE'Se>. - BuilriinQ Permit Info: Describe Work(i~e., Build Single Familv Residence With Attached Garaael Address UI:.~lliN TEAH {name) Phone (address) ~r.>""C:7 ":2 7;l_T/7/~_ W~i..~ - /Nr~/t!:Vi? #4V- ~~~/h7=- (1 ics.F no. ) (exo;res) (ohone no. 1 ~ Primary Structura 1 Electrical Hechanical -CONTRACTORS (namel (address) (li~~_ no.) (pxoiresl General:l;bh /f;t1L V~tS~ $7Y ~ S'~<..?~"- t ~~@. Plumbino (ohnnp nn. ) ~::>9.3? Electrical ~'echanical PLUIIBI NG ELECTRICAL MECHANICAL NO. FE'F rHARr.F NO <<L J:IJAJl!i( Jlll.....1 1..llL IJ:IJAJl!i( Each single fixture Residence of SQ. FT. furnace/burner to BTU's Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (] bath) Duplex (1 bath) each SERVICES Recessed wall SOnrp hp~tp~ nnr! vpnt ~Ia tel'" serv; ce \Temporary Construction IChange in existing rp$ j 1p.Jlrp Imultifamily, camm. or Tnrlu<:;triill Storm Sewer Of amps. Appliance vent seoarate Stationary evap. cooler Vent fan wi th s;nole duct Vent system apart from heatino Dr A.C. Mechanical exhaust hnod and duO Additional bath Sewer COMI'I./IND. fEEOERS I Install/alter/relocate rlic:trih. fpprlprc:. IOf amp~1 Wood stove/heater TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be vali~ until the " - lSSUANCf OF PFRtIlT TOTAL CHARGES TOTAL CHARGES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pelT.lit label has been signed by an Electrical Superyisor and returned to the Building Divisio~ I HAVE CAREFUllY EXM1INED 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'rm OCCUPAUCY 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 exemption is noted hereon. and that only subcontractors and employees who are in compliance with OP.S 7Ql.055 will be used on this project. IWIE(please print)Ml!/VD. Ca.~l SO.v Zone--Mi!tJ Fire Zone Flood Plain Tyoe/Const. ~-~ Bedrooms Stories Units Dccy load Occ,V Group-F-2 _S IGNATUR~ j. nk FOn OFFICE USE OIILY Sq. Ftg. Ilain Sq. Ftc]. Access Sq. Ftg. Other ~./~ OA Tr..,l,.::.l/ - J?$" x Value x Value x Value~~- TOTAL VALUATION BUILOING PERNIT Charges and Surcharges /ttJ - Plan Ck. /' . 65%/Rldo ------------'"""i'ian Ck. . ~~ 30%/Bldo Conm/lnd Ppr Fpp R-es Per Fee //.~. Systems Development CharQe (1.5~) #.4 PLuP1BING PERMIT Charges and Surcharges Fence D~mo ELECTRICAL PERI:lT Cha rges and . Surcharges 11ECHANICAL PERMIT Charges and Surcharges '- Sidewalk I A/C Pavi ng I Curb~ Cut I Total Co~b. Permit I TOTAL ! /tf.9'~ - - l . ,. ~ ... .~.. COMBINATION APPLICATION/PERMIT (CAP) " . PERMIT:':VALlDATION I I 1. 1. Appl icant to furnish A. Job Address B. Legal Oescription I. example- Tax Lot 100. Lane County Map Reference 11 03 43 '\ .~ -." 2. examEle- Lot I. Block 3. 2nd Addition to -.'".:' .... Spr.lngtield Estates' ~,''''.;.......' ." C. Name. etc. of owner and construction lender 0.,: Energy Squrces . . . ').. <", 1. exam~le- heat/electrical ceilinq/or forced air qas 2. examole. waterheater/electrlcal/or solar E. Square footage or valuation, etc. - I. examEle- 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 garoge 2. examEle - 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) o~~the. p" t' t Structural Speci'alty..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. 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. BUILOING OIVISION 5TAFF WILL FILL OUT ALL FEES ANO CHARGE5 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 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 Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: J-~776"~L. ~M/7 ~ CJrf#':1JI~r ~ 11 ~~~A"'~ M,..V-Aoa~r....~ yo . dF~i:.VT-1 ~. '.Permit applicant exempt. from registration with the Builder's Board 'because: . ( . . ...,' '. .. .'.;Additi ona 1 Project Infonnati on: ,. ~ " ,. '...:. PLANS REVIEWED BY: name?41T~E")t.~GA>signature~~_. ?:;i;--ra~e I 2-//-gC . cln OF SPRliIGFIELO'. COMBINATION APPLICATION/PERMIT E!IERGY SOURCES: Heat t~ater Heater ELECTRICAL , '1L I J:'~J:' I rljAR{i[, NO Residence of INew circuits alts. Floor furnace or extensions and vent /SERVICES -H- Recessed wall I _ ~~ hp"tpl'" rlnrl-Y.eD..t- I I I I I . I-H I Apoliance vent ' Temporary Constructlon seoar.:ltp -----lcha~ge in existing I Stationary evap. rp'i J qr,nr:p coo 1 er Imultifamily, COIml. or I I I Vent fan with Indll~tri"l sinole duct IOf amps.1 I I Vent system apart from heHino or A.C. I I I' Meehan i ca 1 exhaus t COMI.I./INO. FEEDERS hood and duot "Install/alter/relocate I I I Hood stove/heater rli"trih_ fpprlpro;. , I j I I I SSUANCf OF PFR!llT TOTAL CHARGES TOTAL CHARGES I TOTAL CHARGES WHERE STATE L'\l-l REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this pemit sha)l not be vali1 un~il the label has been signed by an Electrical Supervisor and returned to the Building Division IIIISPECTlON LItlE 726-3769 . Job Address l~"? ~~k-1l $::r. Legal De5cription I .7'c)~-2"./c::) ~'::i! _~tS:)/ . Owner c;;5'~/~ F7 GeD AlGsv-<\ Address -/Bg? L4~4 ~ ~l./L:U ?:pEJ;-p - ~- ~/Y.>? Construction lender ) Address Ut~ 1l:ir~ r tAn (name) Phone (address) Primary Structural Electrical Mechanical CONTRACTORS fn~m~1 General .:lIb>ft /fAL ~ Plumbina [address) El ectrica 1 ~'echanical PLUIIBI NG -1ill.." FF~ rHARr..f Each Single fixture IRelocated building (new fix. additional) Is.F. Residence 11 bath \ -----louPlex (1 bath) each IAdditional bath -----I~ater service I Sewer IStorm Sewer , I I -----I Of , INFORlIATlON ll.'< 726-3753 Sq. Ftq. Hain ~q. ftg. Access. So. Ftg. Other New Add Alter ~ep. Fence_Demo _Change/Use _Other % I~ ~ ~ Ranqe ValUE of Hork: ~~(>. - BuilciinQ Permit Info: Describe \~ork.( i.e.. Familv nes;dence Hith A.ttached Garaae) Build Single ~trrRoc'" J ;~__T/7/d'_ w:~t...<; ~ /Nr,.e)q.r~ H4V- lf~~/.I't7=- (1 ics." no. 1 (exoiresl (ahane no.-) nics no.) (pxnirp"l (ohnnp nn l_ MECHANICAL SQ. FT. furnace/burner to BTU's I ~~~ I ru~ . amps. I HAVE CAREFULLY EXN1INED 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 OreC]on pertaining to the work described herein. and that. NO OCCUPAllCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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 701.055 will be used on this project. SIGrlATUR#'j. /.__ FO~ OFFICE USE miry Sq. Ftg. llain Sq. Ftg. Access Sq. Ftg. Other IIAI-IE(please print}~!\JD.. L'o.Y'" I SoAl Zone ---1tIJ lVJ Fire Zone Flood Plain Tyoe/Const. ~-~ Bedrooms Stories Units Occy Load Occy Group-l?- 2 BUILDING PERMIT Charges and Surcharges PLU'~BING PERMIT Charges and Surcharges Plan Ck. Comm/Ind 65%/Bld~ ~pr ~PP Plan Ck. Res 30~/Bldo Per Fee I Fence I DeRlO I Sidewalk I A/C Paving I Curb Cut I ____t~:.~__ .o/~ ELECTRICAL PERI:IT Cha rges and Surcha rges I1ECHANICAL PERMiT Charges and Surcharges t.;;, I.~ OAT~.::.l/ - J?o x Value x Va 1 ue x Value--'fI{St!>.- TOTAL VALUATIOII #.JIf . Systems Development Charoe (1.5~) b-.# Total Comb. rermit : TOTAL /tf'9'<::7 I ( fiiJ&Y OF SPRINGFIELD _ Clly Hell Springfield, Oregon Department 01 Public Worke OFFICIAL RECEIPT e c .t' COMBINATION APPLICATION/PERMIT (CAP) ( No.8 Date ~/.3 /1. 19~ ~. , Rec'd From _~/'1/.6'4P/Ec..D Address I~'? t.Av~ 64234 I I 1. I. Applicant to furnish A. Job Address' B. Legal Description ( 1. example- Tax Lot 100, Lane County Map Reference 1/ Uj-43 2. example- Lot I. Block 3, 2nd Addition to Springfield Estates' C. Name. etc. of owner and construction lender D..' Energy Sources "" 1. examele- heat/electrical ceilinqjor forced air 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation. etc. - 1. examole- 1250 sq. foot house. 500 sq. foot gara 2. example- if new project. check-new - if additio check. add. etc. F: Building permit information: 1. example - construct single family house with an attached garage 2. exam~le - remodel existing garage into family r ( 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. 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 Schedule 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 adjac ' 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 schedu ( have been abbreviated . ~v .-_ 2. If the item(s) to be installed are not covered, the abbreviated SChedules you should consult thr full schedules f C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND I -' "- CHARGES ON THE SCHEOULES _ ;. - .. O. 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 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 penmit is issued. ~ s;c... ( Received For: -14 B-!)6/~)7 ( ( ~? ~ ~6_ It!). ce. . t.j<::J 7 & /~. V t:::> ( ( <::::/~ ~ ~ ~ 'Amount Received~a 9'<=> j "~r' Z($--?,/ ~. ,)1 - ~UTl-lORiZEO SlGNATUAE \. L., ,_ .''''''''~~~ ~rll'_ ,.... H\(I:WU.'..... . V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: J-#~_77er~~L. _;7d..~/W/7 .pi ~CSH6 dF,,?c::.v~~ ~ q~tf'~r _~ ..4'1sTA'a_~.rf~ yo' . Permit applicant exempt from registration with the Builder's Board because: '.:Additional Project Information: PLANS REVIEWED BY: name~J?.N#T ~~F~5ignature 4:.1'9",:- -??- 7ate ";2-//-e'L