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HomeMy WebLinkAboutPermit Building 1985-7-26 (2) " . J~ .' lIlSPECTION LINE 726-376g 1'/ fl,o CITY OF SPRINGFIELD COMBHlATION APPLICATION/PERMIT E!IERGY SOURCES: Heat Nater Heater Ranqe Valu. of Work: " t:!),:::>.o. - ' , BUllrilnQ Permit Info: Describe Work i.e,. Familv nesidence With Attached ~araQel CcN<-n:?"..J.c?' ~~~X If'~ ~ J/.;r:A/.c~ ;)"72::>P~~ -<-J?~€ -----'Relocated building New circuits alts. I . (new fix. additional) or extensions IS, F , Residence ,. I SERVICES ,., (] bath) , IDuPlex (1 bath) each I I I IAdditional bath I ITemporary Construction I IWater service I IChange in existing I rpc; j qem"p I Sewer I Imultifamily, camm. or I TndlJc;.trial IStorm Spw",,, I IOf amps.1 -----I ...- I 'CO~1,/INO, FEEDERS I I I Install/alter/relocate n;~trih_ fppnpr~ I I IOf amps.1 I I I I I I I I I ISSUANC, OF PFR!lIT TOTAL CHARGES J TOTAL CH^RGES I TOTAL CHARGES WHERE STATE L.\I; REQUIRES that the Electrical work be done by an Electrical Contractor. the electrical portion of this permit shall not be vali~ until the label has been signed. by an E~ectr;cal Supervisor and returned to ,the Bu~ld;ng Division Job Address 't!L7/ /J/-<~KC:; R~:z::> legal Description /7.~Z-:2$-oO. ~.J:<o.:::. . Owner L..AR~~ p. ..:.< r~w.~~~# Address U<9// ~::iANK <' ~ ~3t,(,Sl <;l?ip/M<~~ /':>Ae". 9 7'>171:4 Construction Lender ' .Address Ut~ I uN r E.Ar~ Phone (address) (n~1 nics, no,) Primary /?f/V.A/ .--Z:> Structural Electrical Mechanical CONTRACTORS {namel r addr~s<; \ (lice;.. nn.' Genera 1 """'t;",<"",.-Z? > - Plumbino Electrical ~1~~h~ni r:a 1 PlUllB I NG ELECTRICAL .- NO. FFF .1lO......1 Residence of [HARGF OL=F I . I I I I I I I I I I I Each Single fixture 5Q, FT, NFORltA TI O~ ll, t 726-3753 Sq, Ftg, 1,Iain ~q, ~tg, Access ,j:3 26 Sq, Ftg, Other Xilew_Add_Alter -,~ep, Fence Demo Change/Use Other - - ~ ~ ~ I~ Build Single (exo;res) I Cohoneno.J (plCflirpc:\ ('lhnnp ""('t,) MECHANICAL furnace/burner to BTU's ill I I ' I I I " I I I I , I I I I I Floor furnace and vent Recessed wall ~o~rp hp~tpr ~nrl ~pnt I App 1 i ante vent seoarate I Stationary evap. cooler I Vent fan with sinale duct I Vent system apart from I heatino or A.C. I Mechanical exhaust hond and duct I Uood stove/heater I HAVE CAREFULLY EXM1INED the completed application for permitt and do hereby certify that all information hereon is true" and correct, and I further certify that any and all work Derformed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Oref)on pertaining to the work described herein, and that UO OCCUPAUCY will be made of any structure without the permission of the Building Division. I further certify that"my registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon. and ~hat o"nly subcontractors and employees who are in compliance with OP.S 7Ql.055 will be used on this project. "_ , D, St~'LU'~:<r~I"NATU~E' Y!o;;{J.11M.~~~TE ?~~ 6-'$- Fon OFFICE USE iiilL Y /, llAJ.lE(~lease print)_[ a,/, IC... 1/ '-, Tyoe/Const. ~..~ Bedrooms Stories lone M-{I Fire Zone Flood Plain / Units Sq. Ftg, riain x Value Occy load Sq, Ftg. Access~~ x Value~~~. OC> Occy Group B-1 Sq, Ftg. Other x Value- ., ...' , ,'. TOT^L VALUATION .., BUIlOING PERHIT Charges and Surcharges PlUf1BING PERMIT Charges and Surcha rges Plan Ck, Comm/lnd 65%/Bldo Ppr Fpp Plan Ck'. R'es 30~/Bldo Per Fee I Fence I De"" L I Sidewalk r-----------, A/C Paving L ' -, I Curb Cut I --------=1 hstems Development C aroe tl. 5~) r '-. I I I I I I I ITotal Comb, Permit I I I I TOTAL , L'2- ---.....:;}~-~---- ,2.t:>g ElECTRICft,l PERI:IT Cha rges and Surcharges 11ECHANICAl PERMIT, Charges and Surcharges /50. ...-* S~.~B :::z ~'r:-';c.8 I . . I, f ,I " ,."', " COMBINATION APPLICAT~ON/PERMIT (CAP) I, Applicant to furnish A, Job Address B. legal Description .:' I, example~ Tax Lot 100. Lane County Map Reference II OJ 43 ., 2, exam~le- Lot I, 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 oas 2. example- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - I, example- 1250 sq, foot house, 500 sq, foot garage 2. example- if new project. check-niw - if addition, chee k. add. etc. F. Building pennit information: 1. example - construct single family house with an attaChed garage 2. example - remodel existing garage into family fOom 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. DESIGN TEAM 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 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 signa ture. 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. . ..' . . 'PERMIT VALIDATION \ I I . ,., ,.0 ..... . ,'. ;, ..'/\ ~V\ \.10 \~ ~JY b{ },< .> , . ( Ot ~ 6 ~st?1 ~ Qy) 1 V. FOR OFFICE USE ONLY Pennit Cl erk 1,/ PRDJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: IN -. ' /":.. ..;.>~,,<V~7"'f~.N e.~ A .V&4'/4:: L~ ~7'6R.AIIrrT ~y~~~~p~~~ ~~ ~~"'~br> $~ ?HE c::,7'Y~ ~DF' -I ~~!"~..,~~~ ~~....~'^"'/~.... .~~----,v. Pennit applicant exempt from registration with the Builder's Board because: -rN/~ P4!i.P.JW/T" /..,;: FbP ~3.'~6 F_ &,v..#ne ~~. ~ ,~~~ ~~c. ! -. .' I.' Additional Project Infonnation: ~/7;~~AL p~~, i ..p~~./--'"'S ,~tc: ~~&:Y..Y/.>E/? ~liP 7'~3<:",,!-F~. E/;::-~""~''''~<!!f~ O."c. .' ~., . M#""~A-~'~L ~~~.~~ 'j:::-'>:'R'- n.;-s """~rJ<:?'U)I/"&. PLANS REVIEWED BY: n~me..i-~#e ~~ Signature~~ '" ~~ ..----.d~te f .... ,- . 7-<>}' ~S- , '-' ....