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HomeMy WebLinkAboutPermit Building 1990-3-30 ~-----=-=-- J I NFORl~ATlON LI NE 726-3753 Sq, Ftq. I~ain ?--:zqq ~q. Ftg. Access. S9,' Ftg. Other ~Ilew Add Alter Pep. Range _ Fence Demo Change/Use #';)~1-~ln~~ $9S: ~ Other- - ~~A=: '8,.. &i'd'/:;.p--D -B'ulltifnQ penlllt Info: Descr be Work{Le., Build Single Fa~ilv Residence With Attached Garaae' jlNSPECTlON LINE 726-3769 . C TY F SPR NGFIELD COMBINATION APPllCATION/PERMIT EIIERGY SOURCES: Heat l~ater Heater Job Address -::f'2:2C> ~7F~...... 57. . . Legal Oescription P~r CJ"'" (.c:>:r- 17~-::::?2--::?C>. CJ27"0/ r Owner 6P -I ~A"/'?/€ urE~~ 1 .. . ~ ^ddrcss~~ ~__.-:>-/...v. ;P-~/?7 #/-L.?~. , -, r Construction Lender /tf n:Jt;/1?I~99 Address..dM?- lo~r) - ~ Phone DE~I(jN TtA'f., lnamef (address' Phone ...-,;7 :;-'/: ~ ";7;:>9:::., 'i l ~ 0~/ "RoLr-~..,s.lJQ:::/- .~.?;-V~,~-r-j(~', 5"/r~ f~~~~4C~//~ . ,I . flies. no. \ !exnires1 (Qhone no.\ -:< Of -::;:Q' 'S--- amps '3';:'.'5'; ~- h, I ' '26> e:> ,;;?;?~ eL~. U/<7?;z"A-C'7_=>-R: ;l;...../L 126m/-</" ~~~~ '?-,1/:7": r TOTAL CHARGES -:<~'7.~"O TOTAL CHARGES /.57. ScP TOTAL CHARGES '7<'9: 5'0 WHERE STATE l,'li REQUIRES that tile Electrical work be done by an' Electrical Contractor,: the electrical portion of this pemit shall not be vali~ until the label has been signed by an Electrical Supervisor and returne~ to the Building Division I HAVE CARE FULL Y EXNlI NED the completed apr 1 i ca t i on for permit, and do hereby cert ify tha t a 11 i nformat i on hereon is true and correct, and I further certify that any and all work nerformed 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 UO 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.~ 7QI.055 will be used on this project. SIGIIATURE2d~()/?..r! (;)~ FOr. OFFICE USE OfILY- Zone C:::c. Type/Const. 6-A'/ Units Sq. Ftg. liain "72?<1 x~~"" value/tl;&9.:5.BO' Fire Zone Bedrooms Occy Load~.? Sq. Ft~. Access x Value Flood Plain Stories / Occy Group A-:5 Sq. Ftg. Othcr~~W'~ Value ~r?~.,e> ~ -;?/. r--_ /':. _ -,., A~_... -1Z~ TOTAL VALUATlOII/~::<:95:~ ,-,?,,4#/)cv/~~e~<;O ~~~/' r~/' 7S:A5:., . BUILOING PERNIT 1/':/ CJrZli' (Plan Ck. CorrmlInd . ISystems DevejOPl!)ent 1 Charges anc ____~<?-'____ ~l~o Ppr F.. ?,!2.-9'1"? /-/"'-,.,;charqe (L5t ' -:2''278. ~q Surcharges csO Plan Ck. Res ' ~~_ 30~/Bldo Per Fee Primary Structural Electrical r1echani ca 1 CONTRACTORS Inamel General ,J:!-, p>3"~ P1umbino Electrical (addre~s ' flies. no.' Hechanical - ELECTRICAL PLUIIB I NG ~ FFF CHARGE NO . ::-r:r: Residence of ~~ Each single fixture ~.,.., 7.S2/61:?'" SQ. FT. Relocated building New circuits alts. (new fix. additional) or extensions rH'JUiF NO, S.F. Residence (J bath! Duplex (I bath) each Additional bath ~~ ~Iater servi ce ~ /'/tJ' Sewer //.I)' Storm Sewer I / ~""'R"""""~\4~' SERVICES ;z (~ I I Temporary Construction Change in existing rps.ir'p""'rt'_ multifamily, corrm. or Inl'llJ~tr;al ~- ~."'" "'5'5""" / Of 7.<50 'I 75""'1 ';< ~ amps. COMfI./INO. FEEDERS Install/alter/relocate di<;.t.rih. fppders IIAI,IE(pleasc print) P'D/JJARO WT=I3E 11. . PlU'~B ING PERMIT Charges and Surcharges _ _ _..g,6~7. 5,;> >Fence / '9. '"7~c D","" ___________-' sldewalk~6,'h,;?#:s:?9/?/Y AIC Paving -:239. cot!:> n__~~~~_ Curb Cut::se~h,z:;~9/'3/~ -2.r& ELECTRICAL PERIHT Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges (exoiresl (ohonp nn. , MECHANICAL r:r:r: . fl-lARG.E. furnace/burner to 2 ':>/A<>_""oc> BTU's Floor furnace and vent 7.5iP/~ Recessed wall Snarp hpatpr ~nd vp~t 2:::;f?J':l ///1' /~ Appliance vent seoa ra te Stationary evap. cooler Vent fan with sinole duct Vent system apart from heatina or A.C.Jt?~ Mechanical exhaust hond and duct Wood stove/heater 6. - 12. COl -;;? 0" ,:;/. ?;..oc ~~ f~ 7..,e. ~arc G7T .5C> ~l I SSUANCE OF PFR!1lT DATE ::'-30-90 ;lZ;/V57.?/?E'/-.r? 6'P ?LR-,If;? .?"-=W<""w-~"?A<.Y - -:zo. ~~ Total Comb. Permit /.1?'''3.f?t::.. TOTAL -'3'3/1. BZ . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT. VALIDAT)ON I. Applicant to furnish A. Job Address B. Legal Oescription _ - \:' :",".' 1. example- Tax Lot 100. Lane County Map Reference 17 oj 4'3 2. exam~le- Lot I. Block 3, 2nd Addition to springtield Estates' C. Name, etc. of owner and construction lender O. Energy Sources , 1. exam~le. heat/electrical ceilinq/or forced air Qas 2. examole- 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-new - if addition, check add, etc. F. Building pennit information: 1. example - construct single family house with an attached garage 2. example - 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. OESIGN TEAM ANO 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. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES. ON THE SCHEOULES 0: 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 b~ used as a worksheet only, Where possible, Building Division Staff wi 11 prepare a type wri tten copy' and feturn 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 f~es are paid. All other fees and, charges are due and payable when the permit is issued. '- , ,~,-. :'~.' .'.....-. \ *- ! tt:/6S f) 880.QO . Cleek KiroJ V. FOR OFFICE USE ONLY Permit PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt, from registration with the Builder's Board because: ,..' ", I :'" Add.i.tional Project Infonnation: -.' . ~ " '. PLANS REVIEWED BY: "1' .. name ~~#E h~~ft ~ign'ature /2.-=~~~date // ' -p-r~: /-"7fr7~