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HomeMy WebLinkAboutPermit Signage 1990-7-19 r Job Address3;;)(nD (~~ tht(Ja... .ph r/ Legal Description lAx., ..L. 0 1.I.d.:J.OD M.4~ # /7-(5)3 -~~-::<.o f '/ 'o~n:rjllo, 'j,,, 15e~e..; Address q ~d 1 () \+" q c; ::!\'\\l\l"...ho~ c.\.l O(l~. Construction Lender S.LJ-i"J'l".(- ~AJ., i:-:fORltl\nOii UNt 7(6-3753 EHERGY SOURCES: Sq. Ftg. f.~ain '.J ~:ec...-'___ Heat .&/~c... ~q. Ftg. Access,_.._ S' Hater Heater E./I".t',. Sq, Ftg. O:her 8" /V / t9- ...J,.W~AdWlter_p.ep. Range,,__,_'.j----- Fenc. D.mo Change/llse Va I ur of "ark: eIJ I Other - -- r<'> '2l'J. ()('fV \ . . l/,....... Buil<~no Pennit Info: Describe Work(ioe., Bui Id Single IS=~ Family ~esidence With Attached Garaae' C((id.; n., .d..",f"C r::,..O,.,.f .l9-J\J" -'Yc)~ , ,-:I- UeLJ Sfo,....e A*mno,'l AA-)."4,..s t..- 17u.il Ii rW~ N~..u p /7(! of (lies. no.l {exoiresl - (ohone no. J -' lINSPECTtON LINE 726-3769 . CITY U, SPRINGfiELD COIIBlIiATION APPLICATION/PEP.MIT Phon!f9z-hS1tl Address DESIGIl TEAll (name) Phone (address) Primary \y\ lC>Zot1. t) l-~"It.- <4- I.?/'...."'d" JZ.;.i Co ;weeN ^'t; Structural Electrical Mechanical COIlTRACTDRS (name) (address) !lies. no.) Cexoiresl (nhoM no.) Genera I m ~ ".:. (L \) E-FD ~ Pl umbi no ," l'>-V'V\ e. Electrical ~1echanical PLUIIBI NG ELECTRICAL MECHANICAL 110. ~ Each single fixture Relocated building . (new fix. additional) FEE CHARGE tjfl FFF r~ NO. IOEL .cHABJiL 7.5:' 37.sa SQ. FT. furnace/burner to BTU's Residence of New circuits a1t5. or extensions Floor furnace and vent S.F. Residence (] bathl Duplex (1 bath) each Additional bath SERVICES Recessed wa 11 Sn~~p hp~tpr ~nrl vpnt '.4,,' L'/>._ (77 Storm Sewer -;)V. Of amps. App 1 i ance- vent Sp.Dara.tp Stationary evap. cooler Vent fan with s;nole duct Vent system apart from heatina or A.C. Mechanical exhaust hood and duct Wood stove/heater Sewer Temporary Construction Change in existing res j ctence multifamily, camm. or Industrii'll Water service COMfI./IIlO. FEEDERS Install/alter/relocate distrib. feeders Of amps. &Z::711'/~r 6#m~'? . 4 ~~ s:tc<:: z;::>p,-nPhY ~ ~ '7?~,;.#~ h "R/J?7/T. ISSUANC, OF PFR!1lT TOTAL CHARGES ~? SO TOTAL CHARGES TOTAL CHARGES WHERE STATE L'W REQUIRES that the Electr;cal work be done by an.Electrical Contractor, the electrical portion of this permit shall not be val;~ until the label has been signed by.an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXAMINED the completed application for permi~. and do hereby certify that all infotmation 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 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 that only subcontractors and employees who are in compliance with OP.S 70.1.055 will be used on this project. IlAllE(please pdnt) mCt~o" \le"C'oe . SIGIlATURE~/fj,,0. 4-'- DAT~b~<.? FO~ OFFICE USE OIiLY -,-7 \- / " Zone CL.. Type/Canst. 5-N Un;ts Sq. Ftg. 11a,in ~. ~F~lue Fire Zone Bedrooms Occy Load Sq. Ft9.~_~9"'2~~~~ue Flood Plain Stories / Occy Group 8-2 Sq. Ftg. Other<?~;~.!: .&V....~~V..;"e m 1 ,.,~LoLp . fo.ZQ.l1ffALUATlOtl Plan Ck. conm/lnf" 'I y I ~ "'") Systems Development 65S/Bldo Ppr Fpp .; ).____ Charoe (1.5~) PlanCk. Res (i()/\ \...~ -I L..I 30S/Bldo Per Fee \'.1.:. ...LULlllv.. ')YLd210,U. ~ .knA (lQXY\I\.t,-'\{)\t!JL) \!~.:. 2J OO(),txJ BUILDING PERf1IT Charges an': Surcharges _LZ".q,-~<:?____ 7-~? ..__~?-.:.:2~__ r'. ;? 2S Fence PLUIIBING PERMIT Charges and Surcharges O~mo ELECTRICAL PERI~IT .Sidewalk Charges and ------------ Surcharges AIC Paving Total Comb. Permit 11ECHANICAL PERMIT. Charges and Surcharges Curb Cut I I TOTAL t31. t1/ "i . . .. I _ 1..11'-" I . ,oil ", "' COMBINATION APPLICATION(PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. . Job Address B. Legal Description 1. example- Tax Lot 100: lane County Map Reference II 03 4J 2. examele- Lot I. Block 3, 2nd Addition to springtield Estates C. Name. etc. of owner and construction lender O. Energy Sources -I. exam~le- heat/electrical ceiling/or forced air Qas 2. example- waterheater/electrical/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 permit information: 1. exam~le - construct single family house with an attached garage 2. exam~le - remodel existing garage into family room 3. exam~le - 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. 11, 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 OIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEOULES 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 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 ;s issued. '1,IQ,qo (l1 )'1 * V. FOR OFFICE USE ONLY . . Pennit Clerk !lUL PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ~~ .m-A7/~~ 2/C!/~=h'~~-;7?- :::;''7~#P~'?;)54TtG2> , . ~ ?/~ ?L#-~. Pennit applicant exempt from registration with the Builder's Board because: " Addi ti ona 1 .Project. .I!l:f.onnat.i on: , PLANS REVIEWED BY: name signature date /Yz2 - .g, p. -;:... 7:.a.x. / -4/0 ~ 702. )/1'-'" 12.<:.1/. /?/V'~/ - 7/.:53 /I 53- / ec., ~, -;Jg)" ~~7.. .2 '3 ,6.2. 0)0