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HomeMy WebLinkAboutPermit Building 1987-11-23 '~~ 1 IrISPECTIO:I L1I1E 726.3769 . Job Address 35;),0 ~t:U-7 Legal Description 170 3. -;).;).=L V r/lJ() ~oo i i I CITY UF SPRIIIGFIELD CDrIBJiIATlON APPLlCATlDNfPERMlT EnERGY SOURCES: Heat Ha ter Hea ter 09 ~ 6 ~ ~ ~ C f).' I! Owner r~.:e. /J~.nL.l/~ Address . t)/) 'A/..w V1 C; 9 rJ ?u;~ Construction lender Phone(p r If i/t/3'3 IflFORt1ATION UilC 726.3753 Sq. Ftg, Hain ~CJ. ~tg. Access. SQ. Ftg. Other Ilel< Add Alter ~eo. Ranqe -Fence Oemo Change/Use Valu, of Hark: / ()/n-v Other-- BuilGinQ Pemlit Info: Describe Work(i~e., Build Single Family ~esidence I-lith /l,qach~d (larao~) ~cI.R.f' t?AG;~ ..ib? ..u , :". J _ c;.;f;;z/;:;~ '-..J-//7 (l~~ tl~ ' (-...4., 1,_ . (lir<=;. no.) (exnires) (ohone no.-) . , Address UL~ J WI I LAll (name) Phone (address) Primary Structural Electrical f1echanical CONTRACTORS (name) nil fYl1) /l ) (address) !lie<=;. no. \.. / ~ (exoi ra..",) (ohonp no_ \ Plumbina Cfh-Of3 z 7c(t.:- 7d94 Genera 1 , Electrical ~1echanical PLUI,1BI IIG ELECTRICAL MECHANICAL 1m. Each single fixture Ftt I f.HAR(;F _NO 75"& ~';lS' ~r=r= C"8Jlii[. -1!lL.... furnace/burner to I 4L {;Wn- BTU's ~~L..c.l:fARG.t '3 Residence of SQ. FT. 6.-- Relocated building (new fix. additional) V" New circuits alts. or extensions .". "..~ _oRE; ISERVICES 1 ~4S'<r I Floor furnace and vent S.F. Residence !l bath) Duplex (1 bath) Recessed wall ~On{'P hPntpr nnn vpnt 1 1 1 1.6--' 1 each Sewer Temporary Construction Change in existing rpsidf'n,p multifamily, comm. or TnnlJ"trial / Appliance vent s.eoa ra te Statio~1. ~~ap. I cooler,l'f~~ e..>.",/r Vent fan with ',iinole duct 1 Vent system apart from heatina or A.C. 1 Mechanical exhaust hood and du,t Wood stove/heater Additional bath ~Iater service I 1 1 I I 1 1 I I TOTAL CHARGES '<OZ. Sb '1 TOTAL CHARGES WHEnE STATE L,\H REQUlnES that tile Electrical work be done by an shall not be valij until the label h~s been signed by an Electrical Storm Sewer Of amps. C0I11.1. II NO. FEEDERS 1 Install/alter/relocate ni"t.rih fppnpr" Of amps. ISSUANCF OF PFR',lT -::?;z~ Se) TOTAL CHARGES M//V /5-:"-';;' Electrical Contractor, the electrical portion of this per~it Supervisor and retur~ed to the Building Division I HAVE CAREFUllY EXMlINED the completed aprlication for permit, and do hereb.v 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 of1Soringfield and the laws'of the State of Oregon pertaining to the work described herein, and that rw OCCUPAllCY ~...ill be made of any structure without the permission of the Building Division. I further certify that my reqistration with the Builderls . Board is in full force and effect as required by ORS 701.055, that if exempt the ba' for~' . tion is noted hereon. and that ~~~~~m~~ee~-:;~~D~~n~t~~0~~11 b se on ~s p j~~'Wea.~~~~€ IIAIlE(pleaseprint) RUbY jO:)OIJ)J;;Jl., SIGIIATVRE /.-j:( 'Ar?//' om If-23-%} -~. I FO~ OfFICE USE - , Sq. Ftg. Hain x Value Sq. Ftg. Access.LtDJ? ::?~t::> ~ __Value--3_~_ _. 8- ~ Sq. Ftg. Other~~E2 '.. _'_ Value_ Z::;i:=.:..-=:' TOTAL VALUATION /~.~..eo Zone G C Tyoe/Const. Bedrooms <5"-1V Units Occy load Occ'y Group Fi re Zone PLU'1BING PERMIT Char.,ges and Surcharges / V~ ~~ 2':?7 BUILDING PERfllT . \\d.86 SO 'Plan Ck. Charges an': B~"" ---- 65%/Bldo Surcharges t!) '=" Plan Ck. ~ . ~ 30%/BldQ I \0, ~-..:> 0 Fence Q.~~ /;7:3 - D~mo ~~ Sidewalk Zd~/ 2'-z0~/-~-1 AIC Paving __ _ .I.22~"'::-,'J Curb Cut . 7'1> I Stories Flood Plain CorrrnlI nd Pp" ~..~ Res--I Per Fee q.:;l.-V1IO(3S I 5.... ~ Syste, ms Development 0<._>3 'CharQe (1.5~) , 4'-z.~ I I I I ~O. '70 I ELECTRICAL PERI~lT Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges TOTAL ?-.?(). 2.0 /..&-g-c:rtJ" ~(::,r2.. '2.0 -? '"?'-:->. ~I '/- Total Comb. Permit -- . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. legal Description 1. examole- Tax Lot 100. Lane County Map Reference 11 03 43 2. example. Lot 1. Block 3. 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole. heat/electrical ceilinq/or forced air QdS 2. examole- waterheater/electrical/or solar E. Square footage or valuation. etc. - 1. examDle. 1250 sq. foot house. 500 sq. foot garage 2. exam~le- if new project, check new - 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. 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. DES I GN TEAl,! AIIO CONTRACTORS . I,To avoid,design or construction delays, Building Divislon 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 Mechani~al 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. I f the i tem{ s) to be ins ta,ll ed a re 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 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. - ApPl.icant..to.: s.ign'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. ." .. II. .'. l. , .,' IJ I. IV. V. FOR OFFICE USE ONLY 1/ "1 . ~ . PERMIT VALIDATION / {J S fG 11-~3-'{1 " Permit Clerk Cu ',~. \ PROJECT CONDITIONS TO BE SATISFIED BEFORE ~':"" (....'7/77/.7"' />:Se>#-'/C.IF.' : ... . . . ....' . . .... ~~'. ! I , Z;>FV~cC>;P~E/Tr ..kA"F~/.;77~;l7:r ~T::> /9H~ i ~ =-'i"~h'.A?./E i , /Vc:-~Z> ~4#FZ> <; Fe .71:.rt'Y 0.......P/E , '-1.I?//779 ! -, ! .~ :-.-,;- 7?-> ~,,</'7. ,~ "7> /-- L7'7 ~/ ..r- . ,~'_. ~~'"~ '",f" 'f', ,; /55~,1!!Y"Cc. , ~-J J z:?",#//,-"./' c:..r--r-, ., Permit applicant exempt from registration with the Bujlder's Board because: 'J,' .:..: . .. -, . - r "-:-'-Ad'd'i'ti,o,na 1 project::I nfonnat ion: , ,} 1 PLANS REVIEWED BY: '\, \name . '. . . /~#tE/l~~Signa~Ure~$_~ '.,' < . ..... , t- . ' .. " " . .," -~ - ." " .... '.-'" " .\ " '-;;;-.,:'- ,..' , , " ,.,c~_~~'date /" .' ."\ '7- .:? /"-8 ? '..