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Home My WebLink AboutPermit Building 1990-4-6 , CITY OF SPRINGFIELD ... INFOR/IATIDN LJN, COMBIIIATION APPLICATION/PERMIT. 726-3753 EIIERGY SOURCES: Sq. Ftq. l'lain~~"; Heat ~q. Ftg. Access. Hater Heater Sq. Ftg. Other Ilew Add Alter Rep. Ranqe --Fence Demo Change/Use ValuE of Hork: ~Other~~_...rE OwnerE.N?~;q/v/Y? 5/2>~ /A/<:::'. ;"'2.~,t:OZI 7-"l~/'""A. Address -n /> -=/ /./ -, ;; Phone Bui IGino Permit Info: Describe \/ork(Le., Build Single - r:~. c;:;,J~X _~~~ /' Familv nesidence 'iith JI..ttached GaraQe) ~v/-.:~~_ ~(P4VEV.~U.'~ 7%'9b/1 hr.J:R/"""~~/Y-~?-ICd~?'u'''P''/11 Construction Lender 0Y7'L.h/?~. ,?9~...~/~ _~#".p...//r.-: Address Phone ~h e~77f'/~.dc... ~ c:;-~ Ul:.::iHiN H.Ar~ (name) (address) -. flies. no.) (~xr)ires) (~h(.lne no. I . Ct , , J INSPECTION LINE 726-3769 Job Address ~~61:? ~-=>dr6EW-Al r' Legal Description /7~~-'2'::i?~. ,tP ~""'.:::::> Primary Structural ~ ~ N '\I 1:;>G:5::>.e:: /?J7.t2.. Electrical ~7RA::: Ah.%>/V> /.-u--. Lv",.QI'<A"'/</'rL>A/.-R 974''':; / '~#,/.4-9-~. Mechanical ~"<-,,y.E~/'~~n. ~-" ~~_~~. CONTRACTORS lname) . '(adil'ress) , (lies, nn. I General ~ $C:')-R?B'"3 lOhnnp no,) (pxnirpc;.) io/z,'llq[) 4'0 1~l~\<!J \\ \I~/C{() ~C\(\<iliili ~\\M~ t;-/C'"~ /"'.../_90,v' JSC/-/~ $.:{;- ~?"!!&"?V'>0 DCyj"f"\ \()!,~\ [C{{) hQ If\J(\n~(', . Plumbina Electrical";:; A~T>io/<::. ~R~. / A<:- ~Iechani~al #AWt/..-c"?--1"'fr/CE L:?.. PLUllB I NG NO. 25" Each single fixture FEF fHAPf.F ELECTRICAL MECHANICAL Nn FFF CH'IRJiE. Nn >FF 'JJA1lliE. Residence of furnace/burner to SQ. FT. C ZLM-"'''''2.. BTU' s 7- $a 1'5.' A: , New circuits alts. Floor furnace ..-- or extensions and vent '" "'''''-''''''''''A''/ Z?_~ SERVICES Recessed wa 11 ~o~rp hPntpr ~nrl vpnt Relocated buildin9 (new fix. additional) z~ 1#7.9 S.F. Residence (l bathl Duplex (1 bath) each Additional bath ~Ja ter servi ce Sewer Storm Sewer I Temporary Construction Change in existing rpo; i rtence multifamily, corrm. or Indu"trial Of /2a:> amps. COffi~./INO. FEEDERS Install/alter/relocate dic;.trih. fppdprc;. Appliance- vent s~oa ra te Stationaryevap. cooli=!f Vent fan with sinole duct Vent system apart from hea t; no or A. C. Mechanical exhaust hood and dud. "'.- ~.. <r.:9> 9-- /0 '96. ,9; '::< Wood stove/heater 2. Of":2<!>d> ':4 "2.~ J /~C> amp~ 22'.f"/'~. - 7 ~a..~ '-;>-~7S:- ($:- ..= :a:S2:> ISSUANCf OF PFRtllT TOTAL CHARGES /8.? S-e::P TOTAL CHARGES '2'5'7. "'" TOTAL CHARGES g;;: 50 WHERE STATE L'I~ REQUIRES that the Electrical work be done by an. Electrical Contractor, the electrical portion of this pemit shall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXAMINED 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 oerformed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Ore1]on pertaining to the work described herein, and that rm 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 for e and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon. and that only subcontra tors d employees who are in comoliance with Op.~ Wij b..~sed :.::.rjecy /., ......... HAIIE(please prin a~0 C STE.\..>-1f\rf-_slr",,,"",..v-C_X / DATil! Ire FO~ o'r'FN>E USE 0Ul Y 'Tyoe/Const."?...1./. ?~nits S~. Ft~~i_n.i'Z<2'?7;?"""'4l ~~ Value~. ""QO 6edrooms - Occy Load /~'2 Sq. Ftg.~ /a75"1 x -">/_ = Va)ue~.~q/ l7~.&b<: - . Storie.s~ Occ,Y Groupft.2 Sq. Ftg, "llt~ <<;,...nl"(~~ Value- 5~~ TOTAL VALUATION":. ~~",;;:z/ Zone cc. Fi re Zone Flood Plain BUILDING PER/lIT Charges an~ Surcharges PLUt1BING PERMIT Charges and Surcharges ELECTRICAL PERI:IT Charges and Surcharge,S MECHANICAL PERMIT Charges and Surcharges . /} .cl/. 4:". . Plan Ck. ConmlInd _~L?;...'P':':1'~__ 65~/Blrlo P"'r Fp.,. ,c- Plan Ck. Res /"2:7.8? 30%lBl do Per Fee ___/~7.S~_ Fence ~. ~~ DfIIllO ___-:g~.,.c> Sidewalk /2.9G" A/C Paving ____l!Z.?:.&?__ Curb Cut &/. ?l'!; (t!'.~~.7-::; "Systems Development Charqe (1.5~) /9 "q";lq. ~2. , Total Comb. Permit . -'7-:Zd'!!. tt:'L-j I TOTAL 1'2 ~ /b~: o~ e COMBINATION APPLICATION/PERMIT (CAP) I. Appl icant to furnish .A. Job Address B. ,Legal Description 1. exa~le- Tax Lot 100. lane County Map Reference II 03 43 2. exam~le- Lot 1. Block 3. 2nd Addition to Springfield Estates , : '. C. Name. etc. of owner and construction lender , D. Energy Sources . .. . 1.', exam!? 1 e- hea tie 1 ec'tri ca 1 ceil i ng/or 'forced air Qas 2. examole-.waterheater/electrlcal/or sola~ E. Square foota'ge or valuation, etc. . - 1. example- 1250 sq. foot house. 500 sq, foot garage 2. example- if new project, check new - if addition, check. add, etc. F. Building permit information: 1. examole - construct single family house with an attached garage . ~'.... . 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) 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 penmit' 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 aworksheet 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: , . , . . \ ; ~ \ ,- t ._ I . PERMIT VAlIDATION " .- , . . , G~~ u!~ loJ\<j~ *\U2~G Per~i t Cl erk HI no ) . ~ Permit applicant exempt from registration with the Builder's Board because: '. Additional Project Infonnation:' .. .-...;:'.. - ,. , , PLANS REVIEWED BY: '. , .,.. . <"name '.6~A"N~ ~~ ~ signature 4",. q~~ 'date ',/--5-9.:::> L /~J- ,. /" -i. . . ~ - ~ ... ~.; .. , CITY U, SPRINGfIELD COMB IilA TI ON APPLl CATION/ PERM IT E!IERGY SOURCES: Heat \-la ter Hea ter Range ~ INfORltATION liNt 726-3753 Sq. ftg. Hain ~q. Ftg. Access. Sq. ftg. Other !lew Add Alter Rep. --Fence Demo Change/Use -Other- - I ~ () - U ~ I INSPECTION LINE 726- 37 69 Job Address .::l S? oC> Legal Description ~a,-r.AA JCM, (f Owner. R,^^,~".",-",. T--'^r Address ValUE of Hork: Phone Builriina Pernlit Info: Describe Work(i.e., Build Single Fa~ilv Residence With Attached Garaoe) Construction Lender Address UI:.~HjN II:.AH (name) Phone (address) 81p1'_ '0.V'(Y'\',1- flics. no.' (exoires) (ohonp no" I Primary Structural Electrical 61p,,;tlo": JA---. ,~( /1,(;:J 5 ~ /o~ ew......""l.,..., 0.... <1-) c $(/-/(33 Mechanical CONTRACTORS (name) (address\ flir:o;." no.) (plCr:drp,,) (ohnnp \'In. ) Genera 1 Plumbino PLU!IBING (36) SF' /bY].., w'ht~ e",\'" DA'r- ELECTRICAL <.)-fc:. 10 II let?) to -16J"? Electrical fl~iwl' IJdY'....... 'V( ~'echanical MECHANICAL NO. FFF f.HARr.E NO ~~~ r1iARG.E. NO H~ rl-l~ 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 (1 bath) Duplex (1 bath) each Additional bath Sewer ISERVICES I ITempOrary Construction IChange in existing rps i de"ce Imu-l"ti-f"amily, COnIn. or t"r1ustr;al I Of /2.0 D amps. COI~fl.1I NO. FEEDERS Install/alter/relocate di"trih" feeder" Recessed wall ~n~r:p hprltpr ~nd vpnt Storm Sewer Appl iance- vent seoarate Stationary evap. cooler Vent fan with sinale r1uct Vent system apart from hea t i no or A. C. Mechanical exhaust hood and duc_t Wood stove/heater Water service Of amps. TOTAL CHARGES TOTAL CHARGES , WHERE STATE LAli REQUIRES that the Electrical work be done by an shall not be vali1 until the label has been signed by an Electrical ISSUANCf OF PFR!1lT TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division . I HAVE CAREFULLY EXAMINED 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 rw 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 7nl.055 will be used on this project. 1lAf.IE(please print) SIGrIATURE{j~ ~.. -/F1i'lIS C " D~.TE J-C-'!fl lone Fire Zone Flood Plain Tvpe/Const. Bedrooms Stories fO~ OfFICE USE OHLY Units Sq. Ftg. riain Occy Load Sq. Ftg. Access Occy Group Sq. Ftg. Other / x x Value Value Value x TOTAL VALUATION BUILDING PER~1lT Charges anC: Surcharges Plan Ck. Comm/lnd 65%/Blda Ppr Fpp ------------""""P"fan Ck. R-es 30%/BldQ Per Fee Fence Systems Development CharQe (!.5~) PLU'1BING PERMIT Cha rges and Surcharges -1\ 0 \}0 0\\0"r'~1 \.X,.,.c.. AIC Paving /(\ t- ~ ~\v\: total Comb. Permit Curb Cut, ~ ~,-"J~'2,I:::O U.lAOyt '.' , TOTAL -, ~YIll{'I ~ Sidewalk Demo !l r, ~~~~Jnl> . ELECTR I CAL PERI~IT Charges and Surcha rges /1ECHANICAL PERMIT Charges and Surcharges e COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A, Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II oj q3 2, exam~le- Lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ceilinQ/or forced air Qas 2. exa"!ple- waterheater/electrica(tor solar E. Square footage or valuation, etc. ------ I. example- 1250 sq. foot house. 500 sq. foot garage 2. examp.le- if new project. check-new - if addition. cheel< add. etc. F. Building pennit information: 1. example - construct single family house with an attached garage 2. examole - remodel existing garage into family room 3. examjle - 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 TEN4 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. --- 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: , ., , ,.,:\'- , .. .- ~ ... PERMIT VALIDATION. ,0-."1, -{5.W ~e" :rlv\OiD Permi t Cl erk \:\ p I ~6 ] Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWEO BY: name signature. date