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Home My WebLink AboutPermit Building 1980-8-14 fJ t13Jt=t-7&S -..)/CA-7.! 4:Jo,e<.tJ Address _"/ r.-r, /1_ ~~.~ un-. / _ Ph 7./'''' IBuil";ino Pennit Info: Oeser,be Horkli',e" Build Single ey r r l-/,.-Y-J e,-#"V" J '-C Cf#1 one )(ob'l!.,..,;a.. Famil V R.esidence Hi th .A.ttached Garaoe) Sr::';iZ"AJGF"C.--'e.~ n..e"<9"Gj.,.J ~d , ",0 ..5n)/Z~~ 'lL. Construction Lender ;x!.,-.-J{F ,g-/J-pc:.<!>~GFL'1 t.c>a4Gg- -or- ;fk77Ja>"., 1 INSPECTION LItlE 726-3769 r H Job ,l,jdress, ~ ( t:59.' Legal Description Owner ~I'Y<:' Address U!:.:::I1l:iN tEAr~ Primary Structural Electrical . . G/7l'J. l<J~ I CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT I EilERGY SOURCES: A /. L"."""., Heat €~E'c7: '7,<:' . i Uater Heater EJ(,;;r Range ValuE of Hark: (name) Phone (address) (l ics, no,) r1echanical CONTRACTORS (name) (address) (1ir:o;.. no,) Genera I <:::::::::;,., f":>"-':' 1/--N..fJ tftJe-7&S _ ~a:riJ ~ Plumbina c::5k1' ';,r, P~II'k~""""'? Electrical (! y-- d E' c:..C?~ 7C7Zo'c- ~lechan;cal ~~ ~ a~ PLUI1BIrIG I Relocated building (new fix, additional) IS,F. Residence (] bath I IOuplex (I bath) each IAdditional bath I ~'a ter serv; ce I Sewer Istorm Sewer NO. "3 Each single fixture I ':1' I I I ", ELECTRICAL FEE [HARr,E NO I I Residence of SQ, FT. o:? INew circu~ts a1t5, ;1' or extenslonsA~ 1 .iII..-.... '2 -..J."..... I SERVICES I vs- ~c I I I I I INFORlIATlON LINt 726-3753 Sq, Ftq, 1.lain ~q. Ftg. Access. Sq, Ft9, Other ilew Add Alter P.ep, --Fence Demo Change/Use' -Other- - ~ () \A VJ o FFF r\.jAR~j: rm (exnires) (ohane no.1 ~/Soe ITempOrary Construction IChange in existing rp~ ; dpn(:p Imultifamily, camm. or Tmill<;trial IOf ICOMM./INO. FEEOERS I Install/alter/relocate rli"trih^ fpprlpr" Of amps.1 amps.1 (pxo;rp<;) (ohnnp nn.) MECHANICAL FFF n-lAQ(:J:' I furnace/burner to ACV. BTlI's 60 Floor furnace and vent Recessed wall SOi'll"_P hptltpr .::Inrl vpnt I Appliance vent seaa ra te Stationary evap, cooler Vent fan with sinole duct Vent system apart from heat;na or A.C. Mechanical exhaust hood nnd duct Wood stove/heater I 1300 I I I I /4?- TOTAL CHARGES I s-.~ TOTAL CHARGES IS'. - TOTAL CHARGES /9.- . WHERE STATE L'I~ REQUIRES that the Electrical work be done by an"Electrical Contractor, the electrical portion of this permit , shall not be va1;1 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 performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of OreC:lOn pertaining to the work described herein, and that NO 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 ons 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 7Q1.055 will used on this project. I~Al'IE(please pri nt at AC--tJlZ.L7 c--:s-~ SIG;lATURE ,A'(m OFFICE USE Q;ILY Zone Fire Zone Flood Plain BUILOING PERt,llT Charges an~ Surcharges PLU!~BING PERMIT Cha rges and Surcharges ELECT~L PERI:IT Charges and Surcnarges MECHANICAL PERMIT Charges and Surcharges Tvpe/Const. Bedrooms Stories Units Occy Load Occy Group Sq. Ftg. t1ain Sq. Ft9, Access Sq, Ftg, Other "2-:< 0,," PI an Ck. L_' 65%1Bldn ---- nnS . /. ~ ib~~B~~~ _____LS' Co. I Fence . ~'6 I Demo ~ - I Sidewalk _un ~~c;l AIC Paving ~. 00 I Curb Cut ----- -:~-I . Conm/lnd Ppr Fpf!- R-es Per Fee ISSUANCF OF PFRi1IT ~- t2 /~f,1 j r I / x x Value Value x Value VALUATION,~.txr),CV TOTAL -"~..&lc:> Systems Oevelopment .........., Charoe (1.5%) . ITotal Comb, Permit I I TOTAL / tJS': 0'--1 . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address 8. Lega 1 Description 1, example~ Tax Lot 100, lane County Map Reference 17 U3 43 2, example. Lot I, Block 3, 2nd Addition to Springfield Estates . C. Name, etc. of owner and construction lender D. Energy Sources. ,..~' . 1, examole- heat/electrical ce;l;n~/or forced air qas 2. examoJe- waterheater/electrical/or solar E. Square footage or valuation, etc. - I. examole- 1250 sq, foot house, 500 sq, foot garage 2, exam~le- if new project. check~w - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. examole - remodel existing garage into family room 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 TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information Dr 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 fil1.1n only the No. Boxes adjacent to the appropriate item{s} to be installed 8. 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 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. V, FOR OFFICE USE ONLY J' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION Permit Clerk Rermit applicant exempt from regjstration with the ,Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date ~ . . '\ \. ,J . '\.' "; . ~ ,',',',..., .',';1'>"'_"\0 ; "{, ,',I ~.' e I INSPECTION L1IIE 726-3769 CITY Uf SPRINGFIELD COIIBIiIATIOII APPLlCATION/PERMIT ( EilERGY SOURCES: A /. ."'~'P Heat e~t!:<T. /7/< , i t.tater Heater~r Range ValuE of l'lork: Job ~ddreso i ~ legal De5cription Gr"f7'>. iU !'t-L'l I lAP. ..i.! Owner ~f'yc f,( (('J,=;c,&.~ -..)/U,"'7C k.l(,,'Z<.IJ Address <,">.1 1--[' ?J,,~.. Wr>-'] loot.? Ph~neJ4.r",-" , I S~,C, Ai G F/C:,z/J tf/.ec?GD-<.J Construction lender A'(rN~ INFORllATION LINt II 726-3753 So, Ftg, I.lain :q. Ftg. Access. Sq. Ftg, Other Ilew Add Alter Pep, --Fence Demo ChangelUse Other - - ~ () VI W II 0 I /BUilt:inq Permit Info: Descr be \1ork(i..e., Build Single Familv ~esidence IHth JI..ttached Garaqe) ~h-nd /-J Sn/'.A-<r~ ~_ &F/Jo-;p{ocC/(i'l:'J (c)Ct'dC'7<!r -<>I'-- ;(-tS;7i1:m'T> I I I J SSUANCF OF PFRm T IS:- I TOTAL CHARGES IS: ~ TOTAL CHARGES that the Electrical work be done by an. Electrical Contractor, the electrical portion of label has been signed by an Electrical Surervisor and returned to the Building Division Address UESIGN ItAll Phone (address) (lics. no.) (name) Primary Structura 1 Electrical l1echani ca 1 CONTRACTORS (name) (address) Genera I Co<"> (")r< ;HY~0 ((-)&--7'lFS Plumbino ~k..( ';Jr Pt.-~<.,;.. ~-i"''''''''? a y-cf EC:cC';:C~~/C- /~~ (lics. no.) _.5/'k'-77J I El ectri ca 1 ~lechani ca 1 ~i/J./2..t/c" 'l:-- PLUllBlIlG ELECTRICAL NO. FEF CHARGE NO FFF rHARr.F Np. '3 Each single fixture Residence of ~ ISoe SQ, FT, Relocated building (new fix. additional) New circuits alts. or extensionsA_~~ I NSH,- ~ .N4f~ SERVICES IS'" I~d ~. S.F. Residence (J bath) Duplex (1 bath) each Add it i ona 1 ba th Temporary Construction Change in existing re"lidr.nc~ Imultifamily, comm, or Industrial IOf ICOI1l'l./lND. FEEDERS I~~~;~~~~a~;:~~~~locate I Of amps,l Water service Sewer Storm Sewer amps.1 TOTAL CHARGES . WHERE STATE L,'H REQUIRES shall not be vali~ until the (exoi res) (ohone no" (exoire<;) (ohnne nn,) MECHANICAL FH rHAQr,F ~ I furnace/burner to 4-C,-, - BTU's be>- Floor furnace and vent Recessed wall Soace henter and vent I Appliance vent seaa ra te Stationary evan, cooler" . Vent fan wi th sinale duct I Vent system apart heatinq or A.C, I Mechanical exhaust hood and duct 1 \'Jood stove/heater I I I I I I I I 1&- /9.-. this permit I 3<><> from I HAVE CAREFUllY EXNlINED 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 Dre~on pertaining to the work described herein, and that no OCCUPArKY will be made, of any structure without the permission of the Building Division, t further certify that my registration 'tlith the Builder's Board is in full force and effect as required by ons 701.055, that if exempt the basis for exem~tion is noted hereon, and that only subcontractors and em~loyees who are in compliance with OP.S 7n1.055 will used on this project. IlAI-lE(please printa,;:::VtpIZLJ ~Ut:"'Z'ry SIG;I.~TURE kb~ OFFI CE USE O;lL Y Zone Type/Const. Units Sq. Ftg. riain Fire ZonE' Bedrooms Dccy Load Sq, Ft9, Access Flood Plain Stories Occy Group Sq, Ft9, Other BUILDING PERI-lIT Charges aoc Surcharges , . 7-:< o~' Plan Ck. ____.L__!...___ 65%1Bldo / :<>8 Plan Ck. . 30%/Bldq IS;: 00. I Fence ------ -.-~';'-I D~mo /<::'"" 0'" Sidewalk -----~~---- 6. 0. AIC Paving ~ a (>> Curb Cut -----F-f-"---- -~ I TOTAL Comm/l nd Per Fee Res Per Fee ---<~ --- /!jj t;/-L-t / ~-", / I I x Va 1 ue x Value x Va 1 ue TOTAL VALUATION "'70..ao 'Syste~s Development ' I .... Charqe (1.5") PLUI1BING PERMIT Charges and Surcha rg}s ELECTR I e'AL PERr:IT Cha rges and Surc~arges r1ECHAtlICAL PERIIlT Charges and Surcharges Total Comb. rermit IC/~O'f: -- COMBINATION APPLlCATION/PERMIT (CAP) I. I!. Applicant to furnish A. Job Address B. legal Description 1. examole- Tax lot 100. lane County Map Reference 17 U3 43 2, examDle- Lot 1. Block 3, 2nd Addition to Sprlngtleld Estates C. Name, etc_ of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceiling/or forced air oas 2, exa~~le- 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 permit information: 1, example - construct single family house with an a ttached gar~ge 2. exa~ole - remodel existing garage into family room 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. OESIG~ TEAl.: AIID CO~TRACTORS 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 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. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGeS 011 THE SCHEDULES' D. As noted on the CAP, the label must electrical contractor for Signature supervisor. The general contractor 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, 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, be delivered to the by his electrical is not authorized I I J. ['I, 'I, FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: , I I I I . 11 .",' PERMIT VALIDATION - ~ T Y 0 F S P R I N G FIE L 0 ()/ City Hall Springfield. Oregan '. Department of Public Warks OFFICIAL RECEIPT No. B 5 4 3 21.0 <is - ,4:- 19~O , From ~'K rt\: Q \ ,--'XT\? ~ r{I f S5 l~Y:,?< (\(\ tfl t 'CU t. ~Lp , I' ~. ( ..., \1 'ed For:t1 r\ f\ __ \ ~)E) 00 ( .. !j <i.L~~ I , O?, 1\\\"\\ h. \:-:l .{) 0 \ \' - 'tt/r, - ,(00 O~\~IS (":'),00 I.. 4-CP,:), &,10 \Y\Q C'Jrl \q, 00 ( 407r-,: ,/ to (! f'0hrO{),K(] ( i ,\--.J . \ i) Ou,---r):J- ( Received \ Pl. :.---= dU1'J AUTHOR1Zli:O SIGNATURE ..."., ( .,..(L.TO"'TU,,,,'ULL ~"'NTI["" , I[UGlUOl_ 0" ,'.0' ~ .unt ,. Permit Clerk I I j l ~ I 1 Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature , \ " , date