Loading...
HomeMy WebLinkAboutPermit Building 1987-9-11 '''SPECTIOIl LUlE n6--3769 '.. CI lY UF SPRIfIGFIELU CorlB IIIAT! ON APPLI CA T ION/PERMIT - 3523 ~~$hnf, I Legal Description I r -()~ - '22..- L -rL-:/:L [DC') I , I Job Address fNFOR'lAT:~:1 Ll,.:' 726-3753 So. Ftq. r'la 1 n 1_\.f:X) ~q. ~t!l. Access. So, FtQ, Other _He\...~J.l ter _~eo. Fence Demo Change/Use ValUl!f.~.co Other-- uilt;ino Permit Info: Describe Horkti-.e., Build Single Far.lilv nesidence Hith I\.ttached (;araClel 1 /JcV{,+,;n'v () 12.9, ~ -kf-. --k r:zc..r dO :e.X~N-~'-\Q ~c..Jc......t-L I 1 ics. ~~~~r;1~hjAQs Hater Heater _~II'uJ" RanQe Owner --S'1~C\.'" D, Co.~-hl\~ ' Address 340.5'" ClOdd.., \.XG:S~r, -"hone7%-, ~r~.~:e.lc( 'rf}~1(11 Cj71-'77 Construction Lend~ ~A . Address lJl:.Sl(jrl TeN! Primary Structural Electrical ~1echanical CON'RAClUR, Genf>r~ 1 Plumbino Electrical Hechanical --.iill..:...1 {name -::'\.\(,Ol,~\ ,\:>, Corp, ( t(f'J() Vh l-kxrNi.s ~S~.O ("7::ct,;-r'1 I i-Ia. clvi oJ '] - :name) ~t:l"'^ P-. f)/'<,r V\{)\Q, IIQcJMa(.to\, ~',l(IDs t-Lo(' lI\.OY~ LL'Jt-e.o( a.0oUG 2,.r-,lIo'1 L..e E:,t P.u ed, I:r:EE HA '.Jill.....' Each single fixture . Residence of sq, FT, Relocated-b-uij"di~g- -""'"I New circuits alts., (new fix. additional) ~ or extensions '2 c>P ~"~E' IS,F, Residence I ISERVICES (I bathl Duplex (1 bath) each I I I I t- ,'T' I I I I I I I PLUliBlliG ELECTR1CAL ITemporary Construction Change in existing rps- ; rl..~n{"p multifamily, camm. or InrlIJ<:.trii'll IOf I COI~'1. /I NO, FEEDERS IInstall/alter/relocate I di<:.trih. fpprlprc:. IOf I I I I TOTAL CHARGES I TOTAL CHMGES l'lIlmE STATE L.,\IJ REQUIRES that tile Electr;cal work be done by an shall not be vali~ until the label has been signed by an Electrical Additional bath Ha ter serv; ce Sewer Storm Sel-Jer -I , I I I I I I I I I I I I I I 72. :5<=> I rOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division amps.1 amp~1 I I I )D-I'""Ptc (0/07 MECHANICAL II furnace/burner "to BTlI's Floor furnace and vent I Recessed wa 11 S"ilCP hP,:Itpr ;!Inri I I Apo Ii ance vent spoariltp I Stationary evap. cooler I Vent fan l<Jith sinale duct I Ven t sys ter.1 apa rt /1~atin(1 or A.C. I ~lechanica 1 exhaust hood ilnd duct Wood stove/heater ISSUArJcr OF ,PFR'HT i I 001 01 IE) I '~i V\I ! I 7-Ir "2-/f(j(j{j I 'A>r ;C}2,R J . . I ._ .)ohone no.) : 7t/tr!Jtl/C/ I i 31.(S; 087c.j I/pnt I I [' I I I I I I I I from I HAVE CAREFUllY EXAtlINED the completed application for ,oermit, and do hereby 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 of Soringfie1d and the laws of the State of Ore~on pertaining to the work described herein, and that flD OCCUPArKY \<Jill be made of any. structure without the permission of the ~uilding Division. I further certify that my registration with the Builder's Goard 1S in full force and effect as required by ons 701.055, that if exempt the basis for exemntion is noted hereon, and that only subcontractors and employees \<Jho are in comoliance with OP.S 7111.055 l.d11" be used on this nroject. lIM1E(please print) Zone C/'. Fire Zone Flood Plain BUILOIIIG PERI.IIT Charges an.:' Surcharges PLUI1BIIIG PERMIT Charges and Surcharges ,ELECTRICAL rERr~1T Cha rqes and Surcharges 11ECHAN I CAL PERI11T Charges and Surcharges ~ 5 Ir:jJATURE ~4_g6..'-"',I" O~.TE 1-11-rf'7 FOr. OFFICE USE UiiLr Units Sq. Ftn, 'lain , Value Occy Load So, Ft~, Access x Val ue Occy Group A-"3 Sq, Ftg, Other Ap7J /'"3'2 'if Value 4/,<)a::>, ..." jrotal (omb. Permit I TOTAL i2.Juu A, !2tkr-& Type/Canst. ~-/Y Bed ro oms .Stories "'7 Plan Ck. Comm/lnd 65X/Bldo Ppr F~p Plan Ck. Res 30%/0100 Per Fe~ I Fence I Demo I Sidewalk I A/C Paving I Curb Cut -----------"', ---2~'_.2~__ -::z - 53 ------------ -__22'2":'__ 1./ '"3 TOTAL VALUATIOtl Syste~s Development Charoe (I.Sn ~7,i""6 7G,66 I 'It(- /0 . ill COMBINATION APPLICATION/PERMIT (CAP) I. I!. Applicant 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 Sprlngfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. exam~le. heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/eleccrlcal/or solar E. Square footage or valuation, etc. ------ 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. exampJe~ Tflnew project, check-new _ if addition, check add. etc. F. Building permit information': 1. examole - construct single family house with an attached garage 2. examole - remodel existing garage into family room 3. examole. convert single famlly residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. OESIGN TEAI'I AND 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. Abbreviated Plumbing, ~lechanical, & Electrical Schedules A. Except 'there 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, Nechan;cal, 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 AND 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. - , 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. Fees and Charges Plan check rees are due and payable at the time of the appl icalion, 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. J II. IV, V, FOR OFFICE USE ONLY I' PROJECT CONDITIONS TD BE SATISFIED BEFORE OCCUPANCY'~ . . " '. , . PERMIT VALIDATION ! . {0275" q/tt/o1 -''1' I Permit Clerk ~ Permit applicant exempt from registration with the Builder's Board because: ... 1 'Additional Project 'Inforinat'io~: PLANS REVIEWED BY: name ~R.N~ ~c<; ~ .' , " Signature~~ , , (" date 9~'2 :<-8"/ . 1 ~