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Home My WebLink AboutPermit Building 1987-4-17 "- ,. Job Address '2. 2 5" /0l A1-/A/ 67' l I.egal Oescription /7-c)3-3 r:"3'"<... b:::>/,\ ~I , I I CITY UF SPRIIlGFIElO COIIBlilATlON APPLICATION/PERMIT EilERGY SOURCES: Heat I'Sa ter Hea ter NF0R11AT: .~:l l1..:. 726-3753 Sa. Ftq. I.ialn ~q. ~tg. Access. SQ. Ftq. Other llel.., Add Alter ~eD. --Fence Demo Change/Use Other - - '". ~ IrISPECTIOII LWE '726-3769 . Address Phone ~~ \J \) IN Describe j'Jork(;-.e.. Build Single I ~ /'o,ttached (;araqe) ---- N I C:~-7'LJ?-!/~EYAl/y'/7'~ I I 7b~~c;.Q.)" ~ t.#5<; ~ / I' RanQe Owner PeT-F"zz . .k"",R:r ~ ValuE of I'/ark.: qJ....--v-, =0 Buil(\;na Permit Info: Famil y nes i dence \.Ji th Address Ut~llirl fl:N1 (name) r\l~~ ~~r Phone (address) Y'o,.p.......c eo (1 ics. 'J3 \ (exoires) Construction Lender Structura 1 ~ \ <{ p 'J (7f?() 0( 1'7"11 <. .* y Primary Electrical !1echanical CONTRACTORS (name 1 (addresc:; \ (1 i c:s. no \ ..-r- /" ~ ~ .,...~;>~w.qo0'"{f-r General I/9'JRo/'?.#2'ZL>6N /'-'-....>__ J ~F.-v..: _""'5':)";" . 2$"S6 / '" (pl(lJlrps' (ohnnp n" ) VX?'-=<.?~ /C) -::;>~"8?/ Plumbino F'l~c::~,rical ~,lechanical PLUIIBIIIG ELECTRICAL MECHANICAL 1m. FFF CHARr,E ~lO I=H r~ARr.:1= no I=H r\.l.l1Q(:1= Each single fixture Residence of So. FT. furnace/burner 'to BTlI's IRelocated building (new fix. additional) IS.F. Residence (j bath I Duplex (I bath) each /New circu~ts alts. or extenSlons ISERVICES I Floor furnace and vent Recessed wall C;OrlC-P hprltpr "nrl w'nt -I I I I I Temporary Construction I I Change in existing I re<;. i dpnce I mu"ltifamily, comm. or I Ind1J<:.tritll I Of amps. I r Cor~'I./IND. FEEDERS I I IInstall/alter/relocate I r1i<;.trih fppnprc;. I Of amp~ I I I I I I I TOTAL CHARGES J TOTAL CHARGES I TOTAL CHARGES ~JHEn.E STATE L'\~ REQUIRES that tile 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 Additional bath I ~!a ter Sewe r service Apol iance vent seoa ra te Stationary evap. cooler Vent fan wi th sinole duct Vent system apart heatino or A.C. ~lechanical exhaust hood <lnd duct from J 1 I I i Storm Sewer l100d stove/heater -9-1- I ISSOANCE nF PFR/1lT I HAVE CAREFULLY EXN1INED the completed apr1ication for ~ermit, 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 Soringfield and the Laws of the State of OreC)on pertaining to the work described herein. and that 1m OC l!PAlKY Ivill be made of any structure without the permission of the Ouilding Division. I further certify that my reqistra io wi the Builder's Board is in full force and effect as required by ons 701.055. that if exempt the basis for exemn~i 0 d hereon. and that only subcontractors and employees whn are in comoliance with ORS 701.~d on this or r/ . IIA:-IE(please print):;a/fJ(7~.i?~4 SIr,IIATURE .. ~ DATE!.j-/7-j?7 FO~ OFFICE USE DIlLY 'Sn. Ft... Occy Load SQ. Ftg. Occ.v Group 75-""L.... Sq. Ftg. ~L Type/Canst. Bedrooms Units Zone Flood Plain Stories x Value Access x Value Other!l'C/7'<:=r x Value TOTAL VALUATION C/Sa::>. "'~ Fire Zone SU I LO ING PERI.II T Charges an~ '. Surcharges r;;... ___~~'_:'2.C> :< _ 0 2. Plan Ck. Comm/Ind 65% Bld~ Ppr Fpp Plan Ck. Res - 30%/81 dQ Per Fee I Fence I D~mo I Sidewalk I A/C Pavi ng I Curb Cut I Syste~s Development Charoe (1.5<) PLUI1BING PERMIT Charges and Surcharges . ElECTRIU.L PERI~IT Charges and Surcharges 11ECHANICAL PERMIT Charges and Surcharges Total (omb. rermit I TOTAL 52..-S 2.. . -- . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. legal Description 1. examp]e- Tax lot 100. lane County Map Refe\ence 17 oj 43 2. . ,examD 1 e- loLl. -n1 ack 3. 2nd Add; ti o~-to Spnngtield Estates .. . C. Name. etc._of owner and,construction'lender D. Energy Sources ' - 1. exam~le- heat/electrical ceilinq/or forced air oas 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 new - if addition, check add, etc. F. Building pennH information: 1. examole - construct single family house with an attached garage 2. examole - 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'3D3 (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 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. 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: ~....' ", _,oJ I Ie 'j ., , , PERMIT VALIDATION .... Permit Clerk ~ 1 Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date UiSPECT 1011 LlilE 726-376g - " Cl TV U~. SPR !ill,jF I ElD _ COIfBI:IATlON APPLlCAT_ ION/PERMIT ., EllbRGY SOOR Job Address ,.., 2.L"" XI? ~..,.... ?- : J /Y/ -:;;>/ -Heat - - - I.egal Oe<cription /?-/?"3-73 <": 3--:2.., 6,5"7'\~ Ilater Heater - - --" / I Ranoe 1 L"'lj I ~~ \J I~ Sui Id Single II ~ IIN JtlFORl'AT: .:1 726-3753 So. Ftq. Hal" ~q. ~t~. Access. So. Ftq. Other flew Add fI.1 ter ~eD. --Fence Demo Change/Use Other - - Owner 17 e:T --:? ..z< / .q'" 19''7" ~ ValuE of Hark: qJ~""O BUlhiino Permit Info: Describe l'Jork(i-.e.. Far.lilv l1es;dence Hith ^_ttached r.araoe) 1 E,K?A- '7.0?-I/",/ EY/?~/Tc!' -l /~~:'?"~C.#l9_ ') ~ LAJ5<) /Z? / ( / Phone (address) (lies. no.) Alldrcss Phone Construction lender Address Ut~ H:i(j H.AI1 (name) Primary Structural Electrical t1echan; ca 1 CONTRACTORS (name! General 7;:?lRo/"?#i!EP.-<'-1~ ,R -..,,;/~ (address) flies. no.) -::s:'t&>::>.#r~~.s~,:/ 2:::>.:::>'=:> / / Plumbina Electrical t,lechanical PLUIIBIrlG ELECTRICAL riO. FFE fHARr.F -1'" Fe> I CHARr.F fJO I I I I I Each single fixture Residence of SQ. FT. Relocated building (new fix. additional) New circuits alts. or extensions S.F. Residence (j bath I 10uplex (1 bath) each Additional bath SERVICES ITemporary Construction Change in existing rp~ i dJ'~nI"P multifamily, comm. or Tnt1u<:.triill ~!ater service I I 1 I I CDr11-I./INO. FEEDERS Install/alter/relocate t1i<:.trih fpprlpr<:. Sewer Of -I Storm Sewer amps. Of amps. (exo; res) (ohone no. (pxnirpc;) (ohnnp 00.1 /c)-~~"8?/ V~-:<.?-3ST MECHANICAL furnace/burner 'to BTU's r; I Floor furnace and vent Recessed wall ~n~I"P hp~rpr ~~n ~pnr I Apol iance vent s.eo,arate Stationary evao. cooler ~ . Vent fan \\I; th sinale duct Vent system apart from I- heatina or A.C. Mechanical exhaust hnnri "'nd nIJI"T Il10~d ~tove/~eater I i I I ! ! ISSOANCE OF PFRPlIT 1 TOTAL CHARGES ,I TOTAL CHARGES TOTAL CHARGES I ~/HEP.E STATE L'H REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pemit I' shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXN1INED the completed aprlication for ~ermit, 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 Soringfield and the laws of the State of Ore()on oertaining to the work described herein, and that UC OCCUPAfKY wi 11 be made of any structure without the permission of the Building Division. 1 further certify that my registraSio wi the Builder's Goard is in full force and effect as required by ORS 701.055, that if exempt the basis for exemoti ~ 0 d hereon. and that only subcontractors and employees who are in comoIiance with OP.S 701.~d on this or _~/ IIA!IE(please print)~/fY 7ff.-<p,//jY SI"I!ATURE _2 .~ - FOP. O,FICE USE ONLY 'Sq. ltain x SQ. Ft~. Access .x -pj-~ Sq. Ftg. Other/l'c",7'<=r:- x Zone ~ L Fire Zone Type/Const. Bedrooms Units Occy load Dcc.y Group Flood Plain Stories BUILDIIIG PERI-liT Charges and Surcharges PLUI1BING PERMIT Charges and Surcharges Plan Ck. 65% BId" Plan Ck. 30%/Bldo I Fence ------------ I Demo .1 Sidewalk ------------ I A/C Paving I Curb Cut I ! TOTAL - - -~ ~'_:2.. c.?. :< _ 0"2. Comm/l nd Ppr Fpp Res Per Fee _ ELECTR ICF.L PERI:IT CharQes and Surcharges I1ECHANICAL PERHIT Charges and Surcharges ------------ - . 'y..'t'.I."t.'i~~...'.~:~-~:..-t.:.:.::::::::..:t, ,~., . .',:,-' ,: ',.:':-~ ... ~.:~. !";:~;~~.~. _,". . -,', .;!,?,:'"~. ;"~,~':-:>: -h.: ,~:. , ..~: ",'-'."~~'~"...'.; .., ..:.....:.. . ...~:,.~~.< Dml.j-/7-ff7 I Value Value Value C/' S"a::::. '" c TOT^L VALUATlDrI Systems Development Charoe (l. 5..) Total Comb. rermit 5'2.-5' 2.. ,.'':''.''.: ".':-"-~;''''>'~''~' ..~.-. ". '. ~"7i-: 0;:' ........ ..:..; ...,'-: .~. . ~ , 'r ~' ; Ill. ~ I. COMBINATION APPLICATION/PERMIT (CAP) I. II. Applicant to furnish A. Job Address B. Legal Description . 1. example- Tax lot 100. Lane County Map Reference ~ 11 OJ 43 2. examole- lot 1. "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 { 2. examole- waterheater/electrical/or solar E. Square footage or valuation. etc. - ( 1. examole- 1250 sq. foot house, 500 sq. foot 9ara~ 2. example- if new project. check new - if additior check add. etc. F. BUilding permit information": 1. examole - construct single family house with an attached garc!lge 2. examole - remodel existing garage into family 1"'0 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 TEM1 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. (' Abbreviated Plumbing. Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules. the appl icant need fill-in only the No. Boxes adjacer ( 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 schedule (, 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 DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOOLES 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 sian 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. 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. r .-a OF SPRINGFIELD .. City Han Sprlngfiald, Oragon Department 01 Public Work. OFFICIAL RECEIPT No. B , .,' IV. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAtlCY: ,~ ( ( 68122 ( Date ~/C I? 19~ ReC'd"From ~flR;' c:; #CZj':A6"y' ":4,y"",? tr;fL~/'>$ L.tfy. ~ Address ~ ~fi'6' I '9? c,/~ Received FOr:CJ~~6Z s;/~........_ ( 7?7>, f-C-J<:?9 - 1 /sr~c. , ,C;-C>..So ~ - r:2J;? _ 5z .S""2. ( C~g ( ~/ \, '" 5-:< .52:' ~ ~~. - ~~~'" ~ ~ AUTHOFU"zED SIGNA fURE "". \, r Amount Received I Permit Clerk ~ D Permit applicant exempt from registration with the Builder's Board because: name Additional Project Information: PLANS REVIEWED BY: signature , . date