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Home My WebLink AboutPermit Plumbing 1989-10-9 . .... CITY OF SPRINGFIELD III' COMBINATION APPLICATION/PERMIT EIIERGY SOURCES: Heat Hater Ileater Ran~e INFORllATlON LINe 726-37S3 Sq. Ftg. I~ain ~q. Ftg. Access. Sq. Ftg. Other Irew Add A Iter P.ep. --Fence Demo Change/Use -Other - - ~ ~ W ValUE of Hork: 09 . . 00. %0", / Builti;na Permit Info: Oeser be l~ork(Le.. Build Single Far:lilv nesidence Hith Attached C1araqe' G? rlf-d t;\.' q" u/V,k".. <J~~, ~'d <<..1, I. I, 0 ~or Cq CUIJtr ~olc../ .-4/.:50 ~~~ DESIGN TEAr~ {namel (address' flies. no.) ";l'~S/ /h..(?'W'~~ ~7l: 4-/7 primary.)?~'=~~~I!fZ;..W'.. ~c-_..,__i::7fl.~ ~.:;:> / ,~ -,.,- Structura 1 ~ . -j IrISPECTlON LINE 726- 37 69 " Job Address "'" -::z /.r"' ./" -/ 'i " C=~/"'~ /;VALe;,.- Legal De5cription ~r-, ?-dT"y/ -6<rL"""#~_'_, ___"..-:/A'-"'- ~~A", Owner ';tler~r$ #0 k/~ Address,).OSI lit II -I";:J /J... Phone I? n! dt/I'19 ell-Ir"f Construction Lender ,I{.;O 1IJ.e- P600;2.... Address Phone Electrical f1echani Cd 1 CONTRACTORS lnamel General ~'C^,,-ItC."'" (exn; res) fohone no. /9/"" )~/ - i).:Jz:S / - '" (address \ L? f;' on H' tf +0", i/Y'" C...'VS .e~dJ,,,.). C<-r.f- P,a:>:J- (1 ics. no.) (~xnires\ (ohone no. \ "'i.fJ.:1-:,-g-9 { Plumbinfl Electrical ~lechanical PLUl1BIIIG NO. FEE CHARGE NO Each single fixture Residence of Relocated building (new fix. additional) New circuits alts. or extensions S.F. Residence f1 bathl Duplex (l bath) each SERVICES ELECTRICAL MECHANICAL FFF r~4Pr.F NO_ <FF CHARGE. SQ. FT. furnace/burner to BTU's Floor furnace and vent Recessed wall Sn~~e he~tpr ~nd vp~t amps. Appliance vent seoaro1te Stationary evap. cooler Vent fan with sinale duct Vent system apart from heatino or A.C. Mechanical exhaust hood <lnd duct Wood stove/heater (:lc' ~Iater service 171?' Sewer .3i:!:?- Temporary Construction Change in existing resjdence multifamily, corrm. or Industrial Additional bath / y~- /lC? - ~R'h~ ~?'C~ ?s<> Of COMI.I./lND. FEEDERS Install/alter/relocate d;~trih_ fpedpr~ Ikl/) Storm Sewer Of amps.l ISSUANCF OF PFR'IIT TOTAL CHARGES /9.7.5'> TOTAL CHARGES WHERE STATE L"~ REQUIRES that the Electrical work be done by an Electrical shall not be valiJ until the label has been signed by an Electrical Supervisor TOTAL CHARGES Contractor, the electrical portion of this permit and returned to the Building Division I HAVE CAREFULLY EXM1INED 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 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 st~ucture 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 7nl.055 will be used on this project. SIGilATURE ~~ ~ FO~ OrF! CE USE OIIL Y _ S~. Ft~.~ IWIE(please print) Ro~ e.r.;r k; fi}6- Zone c:: c.. Fire Zone Flood Plain Type/Cons t. Bedrooms Stories Units Occy Load Dcc.y Group BUILDING PERMIT Charges an~ Surcharges Plan CIe. Comm/Ind 65%/Bldo P~r Fee ------------ Plan CIc. Res 30%/Bldo Per Fee ___.l:..$?-=<;e:> Fence ~:?~ D~mo PLU'~BING PERMIT Charges and Surcha rges ELECTRICAL PERIHT Charges and Surcha rges Sidewalk AIC Paving ____________1 Curb Cut I ~ 11ECHANICAL PERMIT Charges and Surcharges DATE /""-!'-zf7' x Value~~~ Value Value ~h-~ VALUATION //h~-- t S~. Ftn. AC*SS ~. vr,". ~:-'tf9~ m er x x &n-# 11fr::7S0 /.K'3. 9?h-.21 . TOTAL Systems Development Charoe (1.5~) /h.5'7,5'.::::> 2?A~k'6"M-? ) ~A"....,0',;,-w~ . ~m?/r/t'>' r- 7<1. /7 ~2"'-' <:<n!> , ~2f. 88 Total Comb. Permit TOTAL 226;3: 5'5 . . " ,. ~ COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Appl icant to furnish A. Job Address B. legal Description 1. example. Tax Lot 100. lane County Map Reference II 03 43 2. example- Lot I. Block 3. 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilin~/or forced air Qas 2. examyle- waterheaterjelectrical/or solar E. Square footage or valuation, etc. 1. examDle- 1250 sq. foot house. 500 sq. foot garage ....2. exam~,le-. if new project. checknew' - if addition', . check add, etc. -~ .' F. Building permit 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 ~. 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. BUILDING OIVISION STAFF WILL FILL OUT ALL FEES ANO 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 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. , '.. .'. .'.\ ',. \..- .oJ..... V. FOR OFFICE USE ONLY Permit Clerk . I PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .) Permit applicant. exempt from registration with the Builder's Board'because: (. -Additional Project Information: PLANS REVIEWED BY: name ~7JA/E 7}-~?f Signatur~~ / /' i...& tV date /c:J ~t6 -97 J I INSPECTION LINE 726-3769 . CITY Uf SPRINGflELO COMBINATION APPLICATION/PERMIT EIIERGY SOURCES: Heat I~ater Ileater . IHFORl1ATlON LINt 726-3753 Sq. Ftq. '.Iain ~q. Ftg. Access. Sq. Ftq. Other Ilew Add Alter Pep. --Fence Oemo Change/Use Other -- -- ~ " ~ W '. Job Address g 3/<) 6,4.~ vv,,4.~ legal Description ?"r- _ LdT~. <60//".##4.-" .._....--'/;9-""- ;:>......"..,., , Owner ~1e6l~r$: #0 fe..1.., Address.). OJI II,! II-".:J JJ,... I? e J cf, Na e /II,' J P G 00 ;L. Ran~e ValuE. of Hork: c 9 I . ,00. '5'", BUlhiinQ Permit Info: Describe I~orkli'.e," Build Single Familv l1esidence Hith Mtached l';araoel G:.r-+d INq" 'VV~"'''i'J_c.,~'d "...1,;. 1'0 ~o,.. c q c<.-v, r #o/c../ At. ~o ~~..-:;;;; UlSIGU TEAr.' {nameJ (address) (lies. no.) ~~S/ /'J'....(;-~~ ~fi:"4-/7 Primory;1j'r-:J'S~~_;tI~~.. If~_~.~ ~/ / ,~ ,,~ Structural . . Phone Cons true t; on Lel~der ,vO,U.e... Adllrcss Phone (exo; res) (phone no. ~/~ )-::7-?/- u ..>&$/ " Electrical l1echclnical CONTRACTORS (name) General ,f,c Ae.lt(.,<-<.. (address 1. # f ,J.oJ-' w.n hr' t/r C... ,,j~ ;:?'~d.J, ~~ C..r. f. pur>:J- (1 ics. no.) (exrlir~c:. ) (ohonp. no.l "'%:1-:,-;,,8/ Pl umb i IH1 Electrical Hcchanical PLUflBllIG ELECTRICAL MECHANICAL NO. FEF CIIARr:F Nn I_FFr CHI\RG.E Jlll..... rrr C"1lJlG.E. SQ. fT. furnace/burner to BTU's Each single fixture Residence of Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. P.esidence (J bath) Duplex (1 bath) each SERVICES Recessed wall Sn~rp hp~tpr ~~rl vpnt b1l:;~ Storm Sewer Y't? .... I/CJ. - ~.K"h~ ~ ?,C~ /-5&> Of amps. Appliance vent spoaralp Stationary evap. cooler Vent fan wi th sinole duel Vent system apart from healinq or A.C. Mechanical exhaust hood .1nd dur:l Wood stove/heater Additional bath (~' Ilater 17,p' Sewer service ~- Temporary Construction Change in existing rp~j4rnc:e multifamily, conm. or Industrial / COMfI./!ND. FEEDERS Install/aller/relocate rli~trih_ fpprlpr~ Of amps. ISStlANCF Or PFR111T TOTAL CHARGES WHEnE STATE L\H REQUIRES shall not be vali1 until the /8.7. S?> TOTAL CHARGES that tile Electrical work be done by an label has been signed by an Electrical TOTAL CHARGES Electrical Contractor. the electrical portion of this permit Supervisor and returned to the Building ~ivision 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 Orel)on pertaining to the work described herein, and that IlO OCCUPAr~CY will be made of any st~ucture 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 7QI.055 will be used on this project. IWIE(please print) !Po jJ &-1' k; AJ c;... Zone c:: c:... Fire Zone_ Flood Plain Tyne/Const. Bedrooms Stories Units Occy Load Occy Group SIr.ilATURE ~~ ~ FOP. orFICE IISE OIJLY_ S~. rLg.~~ SQ. FtC1. AC*SS_ ~ lr.?R:'-' ?-.".... fl. .tg: at er OATE /tJrf -zf'f BUILDING PERNIT Plan Ck. Conm/! nd Charges ane: ------------ 65%1Blde Per Fpp Surcharges Pian Ck. Res 30%lBl de Per Fee PLU'~BING PERMIT _n.L$/~2.~ Fence Charges and Surcharges ~ :?g. O/lfllO ELECTRICAL PERInI Sidewalk Cha rges and ------------ Surcharges MC Paving 'iECIIANICAL PERMIT Curb Cut Charges and ------------ SlJrchar~es &:Pr# 1~S(1' /K3. 9~~-.21 x Value~~~ x Value x Value ~h. ~ TOTAL VALUAT1orl.//1-~- syste,ms Development Charoe (1.5~ ;1~,~~ ,<)'~ '8.4_L/l~~/i;::? ~ f#P3;,..-V/~ ~m fY/7/G.:r 7</. /7 ~"2'5:""""" Total Comb. rermi t ."2/. 88 I 2253.5"5 . , I TOTAL J, // be?-fJl~t?/a+Ep t:.--""~~~Jn+EU5~s . K~....8i!. .:?>/V~~ aWEU r .' . :A8 03M3I^3~ SN~ld ,'.', :uoqEUUOjUI pafOJd lEUO~HPP~., :asnEJaq. 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