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Home My WebLink AboutPermit Building 1985-1-14 JT"frg b/rr/<"E ~ C-J/c....Dr~ _ 1IIIJ . CITY UF SPRINGfiELD CDMBIIIATlON APPLlCATlDN/PERMIT - INFDRlIATlON UNt . 726-3753 Sq, ftg. 1'lain~"'~2 ~q. Ftg. Access. :?.,~ S9' Ftg, Other ~lew~Add__Alter-"~ep. Fence Demo Change/Use Other - - 00 " IJ G\ 1 'IINSPECTlDN LINE 726-3769 Job Address 3t;.20' C;~7'G)VAY ~ Legal De,cription ~LJ?/~tJt? ."l......~.... ~ , 1J.. 12~. 18~. /~ 'i'Z~ owner5~ t!); ~e<S6N Address Phone EilERGY SOURCES: Heat l~ater Heater Range___ ____ ValuE of Work: 923.,~ ...-=- Buildint! Pennit "Info: Descr,be Work(;.,e. I Family Residence With Attached Garaoel Build Single .~~ 1l.C/<e tt::JtR<FS" ~"""t!" ~ Construction lender ~~ 7>.1\ -' _~,~y y~V. ~~F/~ ..,. Address Phone Jl6Y/c:'(,~ ~/#T~A.N""'E ~~;z.. Ul:.::iHiN TEAr., (name) (address) (lies. no.) (exo;res) (ahoM no. I Primary ?HE lfi:tg.ll/~EJP &.:,u~ ~L. L.:.~ Ec..tS~. ~/ -/~/~ Structural.~/CL, J':,t:), &y ~ "B077~.~. ~ Electrical&.7~~B~~A".l) 14~c./.6/!!;t:?M<.R:-~~Y .<~. tE~",. t1echanical 11 .., ., CONTRACTORS I name I General \\f\{'\<:\" ~~ Plumbina Electrical ~lechanical NO. 33 Each'single fixture (addrF!ssl (lies. no.' (F!xoirpc;.\ ~M Ff>~II\<\tY\ \CJ\trt [Do ' J ~ PLUIIB I NG HF fHARGE NO s~ f65:~ ' Residence of Relocated building (new fix. additional) New circuits alts. or extensions 14~n~l\t;2.2. ELECTRICAL MECHANICAL ~~F r~~ NO ~ J:'n= r~.;&GL SQ. fT. furnace/burner to BTU', 2. r luur tu rnace F~;:~A".In ~.9~- o,,~u--.I..~l:t:'-~.di~"~GO -...._. C;l)ilfP hp;!Itpl'" ;!Inri vpnt . ~~ ~- I q I 7 ,f~~ ?~.p ,6.- StZ- I I /J'I.4llIt "Apol iance vent Temporary Construction ,~ seoaratp I ~.#&' Change in existing I 1 Stationary evap. ~. rpsidf>JH~P cooler 1 '2L"'..... Imultifamily. COITITI. or I I 7 Vent ran with 12_1",/'_ ~. Tndllt;.tr;al Slno1e duet 1;iI~. .. I "5'.- / IDf~ ~amps.1 I,,_.'i/lventsystemapartfrom "=,,,,1,0._ - ~- ~ heatlno or A.C. ,. "0 ~~?AW ~ s:~ ICOMil./lND. FEEDERS I I ;z I~~~~a:~~a~u~~haust ~~?-- L ~~ .~". hJA1' I~~~;~~~/a~;:~~~~locate I I ~Iood stove/heater I I ~k""~ - I Is-- 4 Of f/ot? amp~~p'--t/~ j,.-::;"/"a..~I.~I6'.~ I I 12~ 1:4s:-!~~~ 4R~CE~ 1.:S'>~1.. I I i ~ ~S-- I 1?l'6:1" ~#e~..14 I G.- I I :< /6>e:> ,10 VP..<1~-""'t . 1[[UAilE[ M "e"m. .., TOTAL CHARGES -::rS-r.-- TOTAL CHARGES ~~-t TOTAL CHARGES / ~:7. ::5'l:::> WHERE STATE L,\H REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this pernit shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division IS.F. Residence (1 bath) IDuPlex (1 bath) I Ad,ditional bath ::?~t~later service , 2.ii:l1 Sewer J~'IStorm Sewer SERVICES each I HAVE CAREFUllY EXAtlINED 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 NO OCCUPAHCY 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 7Q1.055 will be used on this project. iWIE(please printlJ7i:mmy _ \ AfQ.,\ Sfl!.t SIGNATURE~ I ~O,mmv(-4-.M~ 6.~TE /-/1 ->.<:5 ,,- fOr. OFFICE USE OIJL Y [' II I \ Zone GL Tyoe/Const. Units Sq. ftg. 11ain~.I<:;P/Jf'c:li- valuee;>~9~ <"le> Fire Zone Bedrooms Occy load Sq. Ft9. Access x Value flood Plain Storie' Occ.v Group Sq. ftg. Other'"':':>/o?'"E x Value 9c::'..-. <!",. :' TOTAL VALUATION~~9~~" 5' . BUILDING PER~IIT Charges and Surcharges :.T PLU'1BING PERMIT Charges and Surcharges ELECTR I CAL PERi~IT Charges and Surcharges 11ECHANICAL PERMIT Charges and Surcharges /_ .~ Plan Ck. COlTlTllInd ___~_~_(.'____ 65%/Bldo P.l'r Fee u,., 80 Plan Ck. Res rp. '7. 30%lBldQ Per Fee ___~~.5,-~-' Fence .u___ jq. <Z~ D~mo __;Z~'5:~,,:S1dewalk _ ~ _ SiP I A/C ~aving ::.. I '3 7. S"c I C~rb Cut n----5"~?~-1 2/$/P ~ cJ-f? ~ syste. ms Development W""SY~::?5:?;'CharQe t1.5~) , l~g5"g.re> ~~~.f;h~ -$1.9<' 1 1 U7.4h> ITotOl Comb. rermi t ~~.~~ , I I TOTAL 'ZZ'2/. <1'1 . - .. COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County-Map Reference II oj 43 2. example- Lot I. Block 3, 2nd Addition to sprlligtield Estates ' C. Name. etc. of owner and construction lender D. Energy Sources . 1: example- heat/electrical cei1in...Q/or forced air Qas 2. exam~le- waterheater/electrical/ar solar E. Square footage or valuation, etc. ~ . I. examole- 1250 sq. foot house. 500 sq. foot garage 2. example- if new projec~. check Anew - if addjtion, check add, etc. ., . F. Building pennit information: I ' . 1. example - construct-single family house with an . attached garage 2. example. remodel ex;sting.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. DESIGN TEAM 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. II. 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. BUILDING DIVISION 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. --- III. Applicant to sign and date Whenever possible, the initjal 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 wh~n the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE,SATISFIED BEFORE OCCUPANCY: 'I . PERMH ,vAl:IDAJION ~0J1i .. ~ ~\L~eJfuL~ 'b~L0ltL,~ ~ ~'s\nTh .ir ~V'{UfLt I -- \4-BS cti (041 H.o ~ Permi t c~erkGi~ o Permit applicant exempt from registration with the Builder's Board because: .~ '. ..... ,". "Add-itional Project Infonn.atJon: . , ':0 '\. ~'": :..;. ./:, ~ ,~ . .. .\' t.. " \-. . ~ ~~ >. \ ....... -..\ PLANS REVIEWED BY: . C" ;~'nariieL'e:>RNE' "f.?~~' Signature#:.?~;::~ 0#7 date ., , . ,;..''', ,0 ,0 JT4rg "'IIlISPECTION LIIIE 726-3769 :7.:> . Orr/<~. c:.-/<-?,:)rC'><G; _ CITY UF SPRUlGFIELD COMBIIIATIDN APPLICATION/PERMIT . INFORllATlON UN" '. 726-3753 Sq. Ftg. 1'lain~~~2 ~q, Ftg. Access. j>"~ 59' Ftg. Other Elew"':"Add_Alter_~ep. Fence Demo Change/Use Other- - Job Address 3(;20' c;ArtE WAY ~ Legal oescriPtionlE~~./~~() ~ H"'N~ ~ , t:t....j2t:X}. 18~. /9~ -j' Z/~ Owner' ~rA1'~ t'); ~e<56.N Address 00 " \} 10\ ~nr .~c/C<= ~.q~~r ~~;i~ ~ Construction Lender .a~A yo ~v. tt'.FF'/<::F!: .." Address Phone /I&/~~€ ~t9/.N.r~A~"""E _c;A~;D. UI:.~ll.iN TEAr., (name) (address) flies. no.1 (exo;res) (ohane no.) Primary tHE ~.II/~~P &"U.P ~~<. ~oP. ~. ~-AM:~ StructuradNDv I/. /J~/CL. r:.b, &,y 81<y"~ E~ 'iO.7'.7'~. ~.- 97.i$9 Electrical.8<<2,"....)~UH.li'4R.l.) .I'.4<<''''l.c.:~M<R:,'''Ni:Y S"~, e:~<Sb~ Mechanical If ... .., CONTRACTORS (name) General \\ ~(\ N\ <:\' ~~ Plumbino ~_0.n Pu.JtPS 'Iechanical 'U~ r'} Electrical NO. Phone E!IERGY SOURCES: Heat Hater Heater Ran~e ValuE of l'lork: 923.,~ 00 Bullciinl1 Permit "Info: Describe Work.(Le., Familv nesidence With Attached Garaael (addresc;,) (lics. no.) (pxo;rpd l:\ \<\.() R? r-:\f\ \< \ i Y\ D\ \ rl ED 0 ' - J ~ Nn__l. I Res i dence of SQ. FT. INew circuits alts. or extensions PLUIIBING Each-.single fixture FEE I rHARr,E .!'~ ~5.''''' 33 Relocated building (new fix, additional) (ohnnp I'1..n..' ~ '14'1 Ato12. ELECTRICAL MECHANICAL l...Ef.LiJ:.liARliE ....llil.... Fr> rlJARliE. furnace/burner to BTU's .luur Turnace Z. ...~ .^'~~ ~ _ /~~....- FAX L/A~,", .,.- I /- I /J ........... '..,=",'>S""""l~ 1 -, "o~r~ hp~tpl" "nrl vpnt ';:-0 <'S'--- I I 7~~~p 6.-ISIZ- J' ITempOrary Construction I it~,~~~~~~;~~e-vent 1 IChange in existing 1 I Stationaryevap. I ~~ rp~;d.fl'l(,P r.noler 1'2r..... Imultifamily, COIllll, or I I 7 V~nt fan with 2_ "'/.'j .iJC1. lnduc;triil.l Slnole duct ~ ~4 .. 11'5.- / Of~ ~ amps.1 /.L"'oC"'/I'vent.system apart from 1f.Y? N~. r' t::lIV"" 7. heatlna or A.C. '0 I <"---- IL'"""'" COM1.I./IND. FEEOERS I '"7 I Mechanical exhaust I/./~ 03_ ---.::. ~/~.7'..ov ~ oJ. .4 hnnn and duct 17-""--1 /. L"&l...-,~,.....__...b 1 ._. Install/alter/relocate I 1\,jOOdstove/heater 1 V~,..-........-~..,... dic:trih fpprlprc: 1?E"'~ . Is- 410f ~e>o amps.2S:"""'~-t/~ ~~Sa..~ .~16.~ - I / I ' ::2 n:::> .'JS:- -::z~~ .~R ~~?~ I. 5i:> r~.1.;. Iii ~':l!:S- I ~"t I~#et'~ I 16.- I ~ I /61> to" VP..- ~'1 . [[E~AflEr Ar prRm - TOTAL CHARGES -..,:.;>.,. ..- TOTAL CHARGES ~~~_ . '1 TOTAL CHARGES / '3'7.. s-c==> WHERF. STATE LAW REQUIRES that tile Electrical work be done by an Electrical Contractor, the electrical rortion of this permit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXN1INED the completed aprl;cation for permit, 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 Springfield and the laws of the State of Oregon pertaining to the work described herein, and that NO 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 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 701.055 will be used on this project. IlAf.lE(please print~ _..~ ~~ S()J SIGrl^TURE, / \r~..G ~ !.l..L""---JlATE / - /./. -~ FOr. OFFICE USE OlIL Y ; 1" I Sn. Ftg. liain j'5&/<:p/~ valueB;;>f9~ ~ Sq. Ftn. Access )( Value Sq. Ft~. Other'""")/?-G x Value 9~ < . .. '" TOTAL VALUATIOII.'lR~ 9~~ co ~ S.F. Residence (1 bath) Ouplex (1 bath) IAdditional bath '2~r~!ater service , ....so1 Sewer ~ Storm Sewer Zone GL Fire Zone Flood Plain BUILDING PERIIIT Charges and Surcharges PLoP1BING PERMIT Charges and Surcha rges ELECTRICAL PERI~IT Charges and Surcharges liECHAN I CAL PERMIT Charges and SurCharges each ISERVICES I Tvpe/Const. Bedrooms Stories Units Occy load Occy Group 7 /" ., A 41<> Plan Ck. Conm!lnd c. .. , . 65%/R1~o Ppr Fpp -----~-jl' ~~~~Ri~~. ~.~~ F~~ '355, - I Fence ----/".-i~--I D~mo __A~S:- .1 Sidewalk "7.SO I A/C ~aving . ___LzZ_~~_ Curb Cut 5",~c:? ~/t'? ,);::>. ~ - syste. rns Development W""Jl'.Y~f5:<;'CharQe (J,5~) 1785'S $'"e. . ~,",,yr.:>I'U~ IP i:: . C>(/E.i?A<:::.r- 1 1 I I U7. ~ Total COMb. rermit I' I I TOTAL - tv. "1<:' 2~.8L. "Z2':Z1.9'1 . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Add re55 B. Legal Oescription 1. example- Tax Lot 100, Lane County Map Reference II 03 4J 2. exam~le- Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceiling/or forced air Qas 2. examole- waterheater{electrlcal/or solar E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. examole- if new project. check-new - if addition. cnec k add, etc. ' , F. Building permit information: 1. exam~le - construct single family house with an attached garage 2. examole - remodel existing garage into family foom 3. examyle - 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. Building Division Staff must be able to contact appropriate persons regarding design information or jOb site corrections, etc. II. 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 fonm 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 DIVISION 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. --- Ill. Applicant to sign and date Whenever possible. the initial application will b~ 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. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFDRE OCCUPANCY: . PERMIT VALIDATION ol& ~ ~ ' ~\L~~~ btJL ~lLL 'tlL.. ~ -\0 S~ 1r .~VWJLt I--'~ 8S -;ti 041 } to Permi t Clerk~~ Permit applicant exempt from registration with the Builder's Board because: .. ,AddHional Project Information: ,.'.' ,_ :. '0.. , ... . .... ..... .. ~ .,., PLANS REVIEWED BY: -name~e>HNE' 7i'~~ , ~ signatur~LS: ~. " .'" . . \ ::.7..... " '::. r -: (~~ - date ~ 'b 7