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HomeMy WebLinkAboutPermit Demolition 1987-3-23 '1 INSPECTION L1IIE 726.3769 . , ~""- ~~ .1 CITY OF SPRINGFIELD C0I1BllIATION APPLICATION/PERMIT E!IERGY SOURCES: Heat Hater Heater Ranf;e ValuE of Hark: INFORlIATION LINE 7?fi_:Uli,:l _____ "'_ "'L Sq, Ftq, 1,Iain ~q. Ftg. Access. Sq. Ftg, Other lie" iJ.d,d A Her Rep, Fence~emo__Change/Use Other Job Addr~ss 895 Fairview, Springfield Legal Description \"\ 0'3 L -, .~ \ I Q ()() cP --' o Q....) o 6" Owner Benchmark In"estments, Inc. Address313 Oakway Mall, Eugene ph-'-85-898 l Buil"ino Permit Info: Describe Horkli,e.. Build Single ~ Familv nesidence With Attached Garaae1 Construction Lender Address UE"uN i EAII {name} Primary Structura 1 Electrical Phone (address 1 Tear down existing electrical, water, removed. flies. no.) structure. All etc. have been (exoiresl (ohane no.') Meehan; ca 1 CONTRACTORS (name) (addr.ss) General \:-\nnlO, Q,(\\.\S"\ ~ t~m l\. Plumbina Electrical ~'echan; ca 1 PLUI18ItIG NO.1 -----lEach single fixture I Relocated building (new fix. additional) Is.F. Residence (j bath) IDuPlex (1 bath) each IAdditional bath I ~Jater serv; ce Sewer Storm Sewer TOTAL CHARGES , WHERE STATE L~W REQUIRES shall not be valiJ until the (lics. nn.) (pxoirps) (nhnnp nn, , ELECTRICAL MECHANICAL FFF NO I I..EEL J:JiARG.E. NO I Residence of SQ. FT, INew circu!ts alts. or extenSlons I SERVICES I ITemporary Construction I Change -i n..ex i s ti ng rps i d_pnrp multifamily, comm. or Tnr111c:.tr;al Appliance vent seoaratp lstati onaryevap. cooler Vent fan wi th sinole duct Vent system apart from heatina or A.C- Mechanical exhaust hnod and dlJf"t ! r:HJ\Rr;F: FFF rlJAllGf. furnace/burner to BTU's Floor furnace and vent Recessed wa 11 C\r'l~rr:> hr:>:lt,:... :Inn lion" I I I I I I I I I I I Of amps. COI~'I.IIND, FEEDERS Install/alter/relocate rlic:.trih fpprlprc:. Wood stove/heater Of amps.! I I I ISSUANCE OF PFRtIlT TOTAL CHARGES TOTAL CHARGES that tile Electrical work be done by an Electrical Contractor, the electrical por"tion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXM1INED 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 Ore~on pertaining to the work described herein, and that 1m OCCUPAIKY 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 ORS 701.055 will be used on this project. C r'roJ,? 'r:;f,."Arp.... SIGIIATURE.L~ ' Or:: ?~,;J..?-f) IWIE(please print) yj 1.J.._ "- DATE . , v FO~ OfFICE USE DilLY C- Zone Tvpe/Const. Uni ts Sq. Ftg. f1ain , Value Fi re Zone Bedrooms Occy Load Sq. Ft~, Access , Value Flood Plain Stories Occy Group Sq, Ftg, Other , Value TOTAL VALUATION BUILDING PERJ.\IT Plan Ck, Comm/lnd Shstems Development Charges an;:: 65%/Bldo Ppr Fpp C aroe (1.5%) Surcharges ------------fiTan Ck. R"es 30%/Bldo Per Fee PLU'1BING PERMIT _lCL.~~____ Fence I Charges and Surcha rges .~) D~mo \ OU I ELECTRICAL PERI:IT 'Sidewalk I Charges and ------------ Surcharges A/e Paving ITotal Comb, Permit 11ECHANICAL PERMIT I Curb Cut I (,I~D Charges and ~ Surcharges ------------1 I TOTAL '" .' , ~4' _ ~.~".:"'-..:, , , . "~ "~l ~ ':~;,'. ~]:l"." ,-'" - " COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION ~ I. Applicant bO furnish A, Job Address B. legal Description 1. example- Tax Lot 100, lane County Map Referen~e 17 oj 43 2. example- Lot!. Block 3, 2nd Addition to' Sprlngtield Estates. C. Name. etc. of owner and construction lender D. Energy Sources .' .1. examele- heat/electrical ceiling/or forced air qas 2. examJle- waterheater/electrlcal/or solar - E. Square footage or valuation, etc. - I. examOle. 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. exam~le - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. examyle - 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 TEN! 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. _ ',_ --= Ill. 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 Permi t Cl erk , 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 date . J IrISPECTIOII LitlE 725-3769 Job Address Legal Description . ~,,' ,",',II '!~; CIT{.<OF SPRWGFIElO.H.J4~~~. C0I1BIriATION APPLICATION/PERMIT'. ' E!lERGY SOURCES: Heat Hater Heater cP ---- o V o () INFORlIATION LINE 725-3753 Sq. Ftg, I,'ain ~q. !='tg. Access. Sq. Ftg, Other lie" Add Alter Pep, Fence:>>emo_Change/use _Other 895 Fairview, Springfield Range Valu, of Hark: Owner Benchmark Investments, Inc. dd II E ph.L85-, 898 I Buili:ino Permit Info: Describe Hork(Le" Build Single A rcss3l3 Oakway Ma , ugene,..... Familv nesidence IHth A,ttached Garaoe) Construction lender Address Ut:::d uN H.A1.1 Primary Structura 1 Electrical (name) Phone (address) Tear down existing lelectricalt water, Iremoved. (lies.no.l (ohane no. structure.. All etc. have been (exoires) Mechanical CONTRACTORS lnamel laddress) Generai ~~'U\i.o ,<2l'\\CI-'l..U'\ 0 (~~ l\. Plumbina Electrical Mechanical NO, (lics, no.) (exo;res) (ohane no.) PLUlIBIrlG ELECTRICAL MECHANICAL <.ELIJ:l!AB.IiE. NO, ... rullRliE. furnace/burner to BTU's I Floor fu rnace and vent I Recessed wall I ~n~rp hPAtpr Anrl Vl'l-nt I I I I App 1; ante vent I c;po<'Jrat,p I I Stationa!"j' evap. I cooler, I I Vent fan wi th I ~inole duct I I Vent system apart from I heatino or A.C. I I ~lechanical exhaust hood and duct I IIJOOd stove/heater I I I I I I I ISSUANCE OF PFRI1lT I TOTAL CHARGES FEF rHARr.F JIll Residence of Each single fixture SQ, n, Relocated building (new fix. additional) I I I I TOTAL CHARGES I TOTAL CHARGES WHERE STATE LW REQUIRES that the Electrical work be done by an shall not be vali~ until the label has been signed by an Electrical S.F. Residence (J bath) I Duplex (l bath) IAdditional bath l\olater service I Sewer I Storm Sewer I I I I I I each [New circu!ts alts. or extenSlons I SERVICES I ITempOrary Construction Change in existing rp~ j dp~nrp multifamily, comm. or TnnlJ"t.ri.:tl Of amps.1 ICOI~'I./lNO, FEEDERS I l'Install/alter/relocate I dic;trih. fppdpr" I Of amps.1 I Electrical Contractor, the electrical portion of this permit 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 performed 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 Oregon pe rta i ni ng to the work descri bed herei n, and tha t IW OCCUPAr~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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in complian~e with OP.S 7nl.055 will be used on this project. NAHE(please print) Zone Fire Zone Flood Plain BUILDING PERmT Charges an~ Surcharges PLUt1BING PERMIT Cha rges and Surcharges ELECTRIC~,L PERI:IT Cha rges and Surcharges t1ECHAN I CAL PERMIT Charges and Surcharges C Crc>!; SJGII^TURE---e..~ FO~ OFFICE USE DilLY C' Sq. Ftg. riain Sq. Ft9. Access Sq, Etg, Other ,0/ /)0~~'" DATE 5' .,;l7-!) s:-J",u.r Tyoe/Const, Bedrooms Stories Units Occy Load Occy Group x x Value Value Value x TOTAL VALUATION ~ I Plan Ck. CorrunlInd ___________ 65%/Bldo Ppr Fpl? , Plan CL Res , 30%/Bl do Per Fee lD 00 I Eence - ~~-')---- Demo ISystems Development ' Charoe tI,5~) 1 I \ 06 I I, I I (,I~D Sidewalk ------------ 1 A/C Paving Curb Cut ITotal Comb. Permit I I TOTAL .- -_. --. ~ u~,-. .Jia .......,.~ . ~, '~ " .~ ~ . " : , , " .~ ~ . . . I . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A, Job Address B, Legal Description' I. example- Tax Lot 100, Lane County Map Refe. (. II 03 43 2. examole. Lot 1, Block 3, 2nd Addition to ~prlngfield Estates C. Name, etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ceilin%r forced 2. examole- waterneatertelectricalior solar E. Square footage or valuation, etc, - ( 1. examole- 1250 sq, foot house, 500 sq, foot 2. examole- if new project, check"""'iiew - if. add check add, etc. F. Building permit information: C 1. example - construct single family house ~it a ttached garage 2. examole - remodel existing garage into fami 3. examOle - 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 TEAI'I AND CONTRACTORS \, To avoid design or construction delays, Build;n! Division Staff must be.able to1contact.appropr,i; persons regarding design lnfonnation or jOb Sitl corrections, etc. ( II. Abbreviated Plumbing, Mechanical, & Electrical Sche! " A. Except where blank spaces Occur in the descript" portion of the Mechanical and Electrical Schedu: the applicant need fill-in only the No. Boxes ae (er, to the appropriate item(s) to be installed B. Full Plumbing. Mechanical, and Electrical Schedl ' are available at the Building Division 'I. To conserve space on the permit fonn the sct ,de: have been abbreviated 2. If the item(s) to be installed are not cover the abbreviated schedules you should consult full schedules ( C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A " CHARGES ON THE SCHEDULES D. As noted on the CAP. the label must be delivered electrical contractor for signature by his elect ~I supervisor. The general contractor is not autho .. '-rl 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. I I I. V, FOR OFFICE USE ONLY ~, " .,.." i '- '. CITY OF SPRINGFIELD City Hall Springfield. Oregon Department of Public Work. OFF I C I A l RECEfPT ". ( ( No. B 5612711 :) 'rl.D 19~ \ ' Rec'd Fron\. ~S\('. t\ ("(\(. ~ t' Address A\~ (\:;Cur lJ.)(\~( Date :1 ,I ~ Received For: : .~ G ( fuffi~ \OU . \ ~'(ffi ~() ~O 4 -. \ ~I L.\O 4 4 \ \ A:D ~\}'tA ) AUTHOIIIIZl:D SIGNATURe 'HIUO"'TU""'ULL "''''''TI'''. IUGI"I. 0" ,..0' (' U-4 , Amount Received 4 -!lL ..~".. (. ( Pe,rmit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 'j ,.", " ; Permit-applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature ,; I . date ...._:... ....,...._1..._ ... ....