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Home My WebLink AboutPermit Building 1980-3-5 . NOTIFIEDIR 1 8 1980 CITY OF SPRINGFIELD ' CDHBHIATION APPLICATION/PERMIT ElIERGY p:~CES: Heat . 10 \.la ter Hea ter PECTION LINE -3769 '.."'.. .,----.:i INFORlIATION L1Nl 726-3753 Sq. Ftg. 1.lain ~q. Ftg:A,~.'Ws. Sq. ~':"m'Ii~r zes* IlewvAdd v1\l ter ~ep.- --Fence Demo Change/Use Other -- -- Address 9,:; L -!/Jc /'14.JLt!..l') .egal Oe<cription L/)-d;;? SI.cJ'::J .~ Owner ~Il,/"I" ~ Address n., J ; . ~," J J-Ar// Jt9 V~,~) ?orit4h..../r:L !<:',.'" R1'Ii/ "Po.,,/:: , , I $;~jf Range Valu€ of Hork: f:'-/-. ~. (10/) Build;nq Pennit Info: Describe Hork(i-.e.. Family.nesidence With Attached Garaoe) LUidJr~v- /l1/m~~P ~. Ilhone.~.,. ..,r_?Z_";'" (j,((., ,..., I , - Build Single Construction Lender 5T ...r/E /:". ::r: Address DESIGN TEAl.' (name) Primary 5bu,.,;; Structural 5Jd/~ ~ , Electrical ~ II "'~-'" r~echan;cal 5/1h,1> CONTRACTORS lname I -~ Genera 1 s,~... -Q Plumbina 5LJ_~ i> 'I.. Electrical 50 ";" '" \f ~1echa n i ca 1 tf/J V"J.1~~' ".. Pr,'rp.. ('" PLUIIBIIIG Phone (address) (1 ics. no.l (exoires) (ohonp nn. . f1 ies. no. ) (exoirp<;.\ (ohnnp nn \ (address) ;9/)/.<;' 1I1.1tt~ fhAI' ELECTRICAL MECHANICAL NO. FFF rHARr.F NO <>< rI-lQIU::~ NO " Each single fixture j! Residence of furnace/burner to BTU's SQ. FT. ;z...., Relocated 'l.--:~I' (new fix. additlonil) , Floor furnace and vent s~ 1/".ca New circuits alts. I-- or extensions 'Z or. NtJLJ5 SERVICES II$. fJ(J I S.F. Residence (1 bath) Duplex (1 bath) each Additional bath I ~Iater service I Sewer I Storm Sewer I I I I I I I Recessed wall I , SO<lr:p hp<ltpr <Inri vllnt ITempOrary Construction IChange in existing rp<;, i df'nr:p Imultifamily, comm. or Tnnustri<ll Appliance vent seoarate Stationary evap. cooler I Vent fan wi th ~inale duct I Vent system apart from I heatina 'or A.C. I Mechanical exhaust hood and dur:t I ~'Jo~d stov~/heater / 11I.t:.~ &-/~~ I' · I Of amps. COI*I./IND. FEEDERS IInstall/alter/rel~cate r!ic;trih. fF'prlpr, IOf amp~1 I I I ISSOANC, OF PFR!IlT I S.~O TOTAL CHARGES TOTAL CHARGES WHERE STATE L~N REQUIRES shall not be valH until' the ~ /t).aJ TOTAL CHARGES G;) V C) -.... -4J ~ ~I='~ I rI-lQQr.:~ I I I I I I I I It..n? I I /1J.PtJ I~,co that the Electrical work be done by an "Electrical Contractor. the electrical portion of this pernit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAf1INED the completed aprl;cation for permit, and do hereby certify that all infonnation 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 l.!~ws of the State of Oregon pertaining to the work described herein. and that NO eCCUPAfKY 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 ens 701.055. that if exempt the basis for exemption is noted hereon, and that only subcontractors and ,employees \'lho are in compliance with OP.S 7(11.055 \'/ill be used on this project. L IlAI-lE(please print) 1(:~;"JrI ~ 5',t.. ~ ~ 71'. SIGIIATVRE ~/t.p7 t .....,,:Ltv;/:; FOR OFFICE USE O;rLY I 50. Ftg. r1ain Sq. Ft9. Access Sq. Ftg. Other OATE ~khn Zone R- , x Value Value Value TYDe/Const.~AJ' I Bedrooms , Stor,ies Ln- Units Occy Load Occy Group .J=>-~ Fire Zone T7'r' Flood Plain ~ x I x TOTAL VALUATION /~~~~ BUILDING PERfllT Charges anG Surcharges ; tY" Plan Ck. _'c.____.P_~(2(L 65%1B100 Plan Ck. 3.~o 30%/B1do , 10./J0 I Fence -r--h-:4";-1 D~mo _+. t___L~.~JSidewa1k ,I --"'\ ,t<) I A/e Pavi ng ~':'h__j~-,-lZQJ Curb Cut ,(,</ I ~c./. t70 (1 ~36 Systems Development -~ _ Charoe (1.5%) ,}.,~~NI' -.~ 1- Y' ICtlIrIl. t'M1""MBN" 0'-1 p~ I'I-M Ck. I 1---- COIlU11/lod Ppr Fpp Res Per Fee PLut1BING PERMIT Charges and Surcharges - ~S."O ELECTRICAL PERr:IT Cha rges and Surcharges 11ECHANICAL PERHIT Charges and Surcharges I I TOTAL /OIS. '1'1 c,f/oo, 1'1 ~ Total Comb. rermit \ . . " ,. ~~. , , "- COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION , 1. Applicant to furnish A. Job Address B. Legal Description .." 1. example~ Tax Lot 100, Lane County Map Reference II U3 43 2. . exa':'!'le- Lot 1. Block 3, 2nd Addition to Sprlngt'ield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinJ/or forced air qas 2. examole- waterheater/etectrical/or solar E. Square footage or valuation. etc. - I. examDle- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project. check-new - if adJition. check add. etc. F. Building pennit information: 1. example - construct single family house with an attached garlJge , 2. example - 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 the Structural Specialty Code ._H. DESIGN TEAl.! 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 fu 11 schedu 1 es C. BUILDING OIVISION STAFF WILL F1LL 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 Cl erk PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWEO BY: a~JrL name signature daJ 3-//40 ~ I Construction Lender .c;:/ /17L= /,', ::r Address UtS I Gi~ TEAll (name) Primary 5~)~J-6;" Structura 1 C;.,,-,,,"; ~ ' Electrical . ...~ 1_ ff f1echani ca I 5/1bt<- CONTRACTORS {name 1 .~ S. " Genera 1 . fJ._ ~ ~ Plumbinq 5f;"''': ~ '"1- Electrical 5~.' :vM'~. rS t.lechani ca 1 i/,. V' 11 j. \} .;. P;~/'('(7. (~, TOTAL CHARGES WHERE STATE L\H REQUIRES that the Electrical work be done by an shall not be valiJ until the label has been signed by an Electrical ,I I HAVE CAREFUllY EXA!lINEO the completed apr1ication for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work Derformed'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 He 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 anq 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 701.055 will be used on this project. il IWIE(please print) /(:1"';,1 ~ S''':.. ,~. __~___J{P.:.QQ 3,;;ID _ _ _ _ _ _ !t2:..o...Q _ Fence . ,40 Demo __ T____L~.!ZQJSide;;;lk- ~ ,t,.a I A/C Paving ___!,___It..!.QQ_1 Curb Cut I .. "..::'f I . A.. - _ _.. . , . . L'~,...... . PECTlOII LHIE .-3769 o Address 9.;;1.l ):/>C /'''.JL<U') eegal Description L {;l Bi.j- ~ /) -. '. ~,..._ .J " '. '. ~ I ~ Owner jf;.~/'/J'1 (I y:: ,r;; -if" 1..... if Address 9:1/ .J"., /,;" ,__~..) PLUlIBIIiI; . I NO. I I FE E I CHARGF ;l., Each single fixture' .I Re 1 Dca tedbtf'ritt.lflgi (new fix. additiona~) S.F. Residence (1 bath) Duplex (1 bath) I S,d1I/IP.",,, I I I I I each Additional bath Hater service Sewer Storm Sewer I I I I (),c() Zone f?- I Fi re Zone IJ:r Flood Plain /1M Tyoe/Const. 'rz;: /../ Bedroo~s Stari e'~ I BUILDING PERMIT Charges an': Surcharges PLUI1BING PERI11T Charges and Surcharges ELECTRICAL PERI~IT Cha rges and Surcharges I1ECHANICAL PERl1IT Charges and SurcharGes ~ , Z1 ,\. "'lj ~)-:,.~:')~U1'~~ ~f \;-'" . ':' , ..... ~ //:,.t~~.~~:~~~l} . '''~'~,;:~r.: i:':"!:1';:1' . \. (-DI,r:...J R 1 8 1980 CITY OF SPRlilGFIELO CDrIBIilATlON APPLICATION/PERMIT EIIERGY.';;OURCES: Heat~_JO Hater Heater INFORlIATION LWE 726-3753 Sq. Ftq. 1.lain ~q. ,tg. A~9",/s. So. ~4fl'li~rZ5e.41 'flel...vAdd v1t:l ter Rep. Fence_Demo _Change/Use _Other 100 /2 I~ I~ I .- "........ ~ 'tI c.' ,- 17 . _-:p.r;_:.h:,,'r/~~ ) at/pI: (<'~v I\:~.J .-:- "" . l I. I. Ranl"je ValUE of Hork: F:d-.. 4.N?(' Buildna PermiClnfo: Oescnbe \'/ork(l.e" Familv nesidence I-lith Attached Garaael ,ad,Vft~v- /lM'J1.0&fJ '. ... "hone. ..., . .....?E~~. c;.ut'.... '?-, Build Single Phone (address) (lies. no.l (exnires) (ohone no. (address] flies. no.) (exoirps' (IJh('l'lp .u' \ :'l/'/.<;" i1lu{' -~ -lLn..../ 0/) I ELECTRICAL , ~FF . fHARr.F NO MECHANICAL NO I I Res i dence of SQ. FT. INew circu~ts alts. I-- or extenSl0ns 'Z. Oft.. /'~#Je.6 ISERVICES I . 1=1=1=' I nlARr,F I I I I furnace/burner to BTU'.s It;. fJ() Floor furnace and vent Recessed wa 11 Snacp hpatpr anrl vpnt lTemporary Construction IChange in existing rec;"i (tenrp Imultifamily, comm. or Tnrluc;,tr;al 10f I COI~.1. /I NO. FEEDERS Instal1/alter/rel~cate rlic;,trih_ fpprlprc;, amps.1 I Appl iance vent seDarate I Stationary evap. cooler I Vent fan with I sinale duct Vent system apart from I' heatina or A.C. ~lechan i ca 1 exhaus t I hood and duct I Hood s tove/hea ter I / I j/,L.Z &.../.?L I I I I:~,IYJ I I Of amps.1 . TOTAL CHARGES I - ISSUANC, OF PFRmT I S.VQ I TOTAL CHARGES Electrical Contractor. the electrical portion of Supervisor and returned to the Building Division IIJ.tJ(J /I"",DQ this permit Units Occy Load Occ'y Group SIr,iIATURE'_~.,(~;::7 t.-c~,u:l:;' FO~ OFFICE USE OillY / Sq. Ftg. ria;n Sq. Fttj. Access Sq. Ftg. Other om ~kkn 'Z.~ x Val ue Value Value x P-"', x TOTAL VALUATION /~.~~ Plan Ck. 65%1Bldo Plan Ck. 30%lBl do J,c..(.co f\( 1 ~36IsYste. ms Oevelopment "\,--,:\ . . . Charoe (1.5%) ,"\\t:oN" I(qc:] I _/~.tA OIE?- P"I(M~'" . c,J./ P{. iI-N C.-t'. - r:lS.t./O ConvnlI nd Per Fee R.es Per Fee .,,--,-,-~ --_: -. " , \ , Total Comb. rermit I as. 'if'l 1"/00,1'1 ~ I -lTOTAl _.\ - ". " "r..'# !." COMBINATION APPLICATION/PE~1IT (CAP) t. Applicant to furnish A. Job Address B. legal Description 1. example. Tax Lot 100. Lane County Map Reference 1I 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. example- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house. 500 sq. foot garage 2. examole- if new project. check-new - if adJition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. exa~ole - 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) of the Structural Specialty Code ..H. OES I G;, TEA;,! ArID 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 Pluffibing, 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" " PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . .J \. i ' '.. -W'9'<A I , \ \ \ ITY OF SPRINGFIELD <I PERMIT VALIDATION City Hall Springfield, Oregan Department of Public Works OFFICIAL RECEIPT No. B 531 7 3 Q I ?J . 0 \ 19U) ~ · From ~ffirOO. ~\l'\jSY\_~_) lSsq~\~~e[\ .~ -- mCO led For:t'~~ "Q ZO . t '\ l~lJ ' I. \\ i1 . \f)OO 0\JS .J. - 'i\(' \ l\q~y \ \ () t) \~l\ :- \~CO , c.t;/r'"\.1 nO- ""PC: ~\ '--' \ \ n ~ lh/r, .l d-\ - nrL% ') \\\\\HtJ1) ( , \ Rf ') \..\0 ( \0 _ ( ," '~c".~ \'0 .~ -. AUTHORi'lEO S'GN"TUR~ ( ...~~~O".TU""'ULL ."''''1.'''5 . O:uG""O:, g.. .,.0' ..."., :1 ( ( ( ( ( Permit Clerk ." Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: , '" .' I ~ l I 1 ()oL i - / J..JA__. .>.....i-1../JA'...7}.;.-t?_ name signature dale 3 -//,.l!o