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HomeMy WebLinkAboutPermit Building 1985-3-7 '. ,.""" , INSPECTION LIIIE ( , C'iTY OF SP, ,NGFIELD i 726-3769 COMBINATION A?!'I..CATION/PERMlT Job Address 3 Y 2 ? ''$~W1J.AJ --:JhJ1IMRiJM ~ ~~;~r,y ~~ES: Legal Description /?()~~ 2~ _?~ I~ater Heater . Ranqe Owner V~ ~~';;;.IAaJfJ Val~~;;;\~~ Address 0 "/0 ~ Phone '-.('''/ BUllG'na 'P~nl1t Info: Describe Workli.e., Build Single :J:...e,...." oJ4.. 912,0/ ~";; ~~d;-=1' M~ Construction Lender ::r. lB. 5 ~rtfl. - J' '. ct1.~;JAA ...f/..~ ", f ;.' ~/~ (,(7. (tOI) (j Address /tJ/() WJIS '1h /I? .SOU hu.&,., Phone"J"''(b( UI:.SlliN rEAr~ warne} (address) flies. no.) (exlJires) Primary L/"'rd ; f1,Aler. )../ A. j ic:('t4Jr. Structural ~Aj /I. Vd,"r; Ac,nr Electrical 'h);/~b'" I'Led ,r""'3/II~t'r..~ Mechanical ~N 1()erum / F/u..nILL..A!>Sb< CONTRACTORS name)' (address) Clir:c;.. nn , &./'n'/<;!rOYld i~. box ~;l) J:u,;"~/L( jj (j.QI) Plumbina 1'?.i/"j/ i77..e.d 92/J/ SAI./ndprs ijd. .<C<Jrmrllrd) /Jfe ;P.'f(/JA 1'. J ,I 17. a;. Electrical ~Jo/ //,,:w {"In:, 3L't:t:J ,f,U'tOO' Rc;i ,c,,~~"H~.jjA." 'Jt)-//~r / - t/ Genera 1 ~1echan;cal 110. $ Each Single fixture .- INFORl1ATION UNe 726-3753 Sq. Ftq. 1'lain~j'?R'~ ~Q. ~tg. Access. /,Sq. Ftg. Other ':1'1 'IT,tt. ~___Add_A1ter --,~ep. 1)" __Fence__Oemo__Change/Use _Other rt ~ ~ \\) -j lX:l (ohane no.) 1 . (f?/')/] .!'.?'}. 7:1:J1 I. J (J1t2/ ) ntJ. .3/ '1H' (".XI);rpc;.\ fohnnp no \ . '>.'??- $'JtJf'J 9.1'7- t'1'J- /292 PLUI1BING \ ELECTRICAL MECHANICAL FEF CHARr" J'n FCC rH'IRG.!:I~1 I c.E.L1..cHARG.E , ~-~ Residence of furnace/burner to BTU's SQ. FT. each 1'New circuits alts. . or, extensions '2" diZ~~,c ISERVICES 1 ~.- I 1 I' Relocated building (new fix. additional) Floor furnace and vent / ,//~ C/H'/r Appl iance vent seoaratp Stationary evap. cool",r .., I Vent fan with :::/_1" ce. , slnale dllct ;.A.~. I Vent system apart from I I heating or A.C. I' I Mechanical exhaust 1 I"/.~' hood ann duct y.. ~ I ~'Jood stove/heater I 1- g~;~~~w~_~ / ~ 1<',". II - I-I I TOTAL CMARGES 75". -I TOTAL CHARGES ,~-I TOTAL CHARGES -::j'ttJ. SO WHERE STATE L~W REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this penoit shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division S.F. Residence 11 bath) I Duplex (1 bath) IAdditional bath I ~/ater service I Sewer lstorm Sewer I I I -I I I ~- I I I 1 1 Recessed wa 11 Soarp hp~tpr illlrl \Ipnt lTe~porary Construction IChange in existing rp'} i qp'.nrp Imultifamily, CQlTITI. or lnrlustrial 10f ICOMM./IND. FEEDERS Install/alter/relocate 1 n;<;t.rih_ fpp(1l:>rc;. amps.[ Of amps. -I 1 I J.,SC'1t^m:r Qr nrrUIT I HAVE CAREFULLY EXNlINED the completed application for permit, and do hereby certify that all information hereon ;s 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 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 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 ORS 7~1.055 will be used on this project. Fire Zone Flood Plain BUILDING PERmT Charges and Surcharges PLUI~B ING PERMIT Charges and Surcharges ELECTRICP,L PERIHT Cha rges and Surcharges /1ECHANICAL PERMIT Charges and Surcharges TYDe/Canst.~~1\I Bedrooms Stories SIGIIATURE #, () ~~akwtl A../ FOR OFFICE USE DiU ~ J Sa. Ftg. f1ain A.PD 929;6x II Value~~.- 1 Sq. Ft~. Access x Value Sq. Ftg. Other KENk>l:)e~ Value!a,dit:JV.- . If 0 <.J '3 t;)~. n /1 i g~ TOTAL VALUATION/ ,~_. -- -r _,,-?r-;:;;,O ,JII ')/ Systems Development ~'"').;", _ I D\~' m. Charae t1.5~) D ~. 1 I I I DATE 3-'}-f?L l / Units Occy Load ~;:> Occy Group - 8 :fl,/-' - Plan Ck. COllllllInd t::::"c . . 65%/Rldo Pf'r Ff'P ------,/'-u'D- Plan Ck. Res /7 . 7_ 30%lBlda Per Fee _____~ - I Fence "3.'- D~.o ;(~. ~ Sidewalk -------~o-I A/C Paving 3<!J. $"l!> I Curb Cut ------/~~-~-I I I, I ITotal Comb. rermit 1>e?/. Bo loir:9:> , I 1 TOTAL .- ~ ;~ ,\ .'...,.".", COMBINATION APPlICAT~ON/PERMIT (CAP) " I. Applicant to furnish A. Job Address B. legal Description 1. example~ Tax Lot 100. Lane County Map Reference 11 U3 43 2. example- lot 1, Block 3, 2nd Addition to spr,ngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinQ/or forced air,qas 2. examDle- waterheater/electrlca(/or solar E. Square footage or valuation, etc. - l. example- 1250 sq. foot house, 500 sq. foot garage 2:. exam~le- if new project. check-nfw - if addition, check add. etc. F.. Building pennit information: i. example - construct single family house with an attached garage 2, examele - remodel existing garage into family room 3, exa~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. DESIGN TEAM AND CONTRACTORS To ,avoid' design or construction delays. Sui lding '. ~ Division Staff must be able to contact appropriate persons regarding design information or job site . . corrections. etc, II, Abbreviated Plumbing, Meehanical, & 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 Electrieal 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. 8UIlDING DIVISION STAFF WIll FIll OUT All FEES AND .CHARGES ON THE SCHEDULES D. As noted '0" 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. --- Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where' possible. Building ~ivision 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 \.5 issued. " V. FOR OFFICE USE ONLY" I I I. , , iq " PROJECT CONDITIONS TO BE'SATISFIED BEFORE OCCUPANCY: . . " 'PERMIT VALIDATION a_A _'L ~ b~J91 ;~,- " fQ ) ~O~'? J) ~l ,J I I Permit clerk~,A/ /'7/ Permit applicant 'exempt from registration with the Builder's Board because: ,". , . , ., .., Ag~itional Project Information: ..,.. "", " PLANS REVIEWED BY: '.' .' '0' ~ ',' ", ::'n~~e_~~ ,;q~~ Signatu~~ .;.., - , I da te 3'7'.5"~,)) . , ,0