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HomeMy WebLinkAboutPermit Building 1990-6-19 jlNSPECTION LINE 726-3769 . . (I 'Y Il:' ;PHJNGfIELO CC~B1i'iATlON APPLICATION/PeRMIT E!lERGY SOURCES: Hea t E>U:vT' Hater Heater ~ Range N""E. INfORllATION LINt 726-3753 Sq, Ftq, I.,ain-I..a: JI1TO ~q. Ftg. Access. Sq. Ftg. Other ~w Add Alter Pep, --Fence Oemo Change/Use Valut. of t./ark' -Other- - $IJ90(),brro'~ I ~AfIEA~/bPIJ ~uilainQ Permit Info: Describe Work{i~e.. Build Single F~mil~ R~sidence With Attached Garaoel I I~ ~ ~ ~ -..t I Ho~/HtJiE,1.. - ~ ~(2.'1'- POVL.-VE&!M-I/BVli.-O . Pho"e ~l' 1Zl'" 1't,f;~S - DlESI"" 8v/41 {namel (addre!sl {lies. no. l (exoires) (ohane no. e>~ ..h1lN!;c)N IN", '-701 OENOC~ gl.-llP, 36-TItfiI;OR,ND,/1os.-n ~/}tI1l;t~ Structural b~N$ EN6-/NEERJNC:r- (!Q. /&'15' ~ 8~VD" Rc.:1(\fII..I.E,Mp, lQi~ r..oJ)'i~N"NIIf ,ElEctrical t3~IJ~ ...i:>ttNSON INC-, ~701 Dei-ftJU!flO( '81.110, 'BE1'lI~A /.(0, WfI7(3111)I/Q3.8t/go BflZNA1ZD ..JoH/oISoN /NC, C,701 fJE:M()t-AA<..'( 154'0, 8e~. M 0 'U>RJ 7 ~1I)lff3 -jl/Q?> (name) faddr:ess'L (1j"51 n~. ~ (exoires) (ohnne no.) ~'1'f~ ~.w' l,j~YE"7"'Y/-!?,/~E#~ General ~o.O.-fllJ!"'" LAI"'P ,5w~4''':2 ~....'TL'-_:D_R. 97"72_~ 1 ,." I Plumbino Electrical Job Address -:1~I,/(} 6A;".:ti&'RY .11[~;.:."6i:./ Lega I Oescri pt i on 'T1\-t. LoT ':i100 - PAIUf.(.. I /7~t!) '?- / ~ ~ <.0 5/ t:)o MA~IOTT Q,f:,.f'. /r;;./h'r/6'C.O /## Address ONE- ~OTT P12IV€' Phone (SOl) WA6HlI\JO'rCN I D, e" 'UIO!>K 3'i"'O-6Z?>'l Owner Construction lender Address OESJGN IEAr-l Primary ~, Mechanical , CONTRACTORS ~1echanical PLUf,\BING ELECTRICAL , FFE I CH~RGE '1(1' Residence of r"A.IlG.E. NO <FF NO.1 Each single fixture 37'tl 7.6".0 ';?~~e) Relocilted builcti.".9_ _"". ,New circuits alts. . (new fWMdll,n&1'Onal~1 : t/ or exu.nsions ~; , ,7~~~~~~ ,S.F. ~__, ffMl SERVICES -.J,N~ _.. ,_\!l!1oJ""~"V..,~~lrtJ.. ,..... ~11 . ~j~,uIl.a:M~f- .-,. r~ ~ Temporary Construction j, . Vi "~I( Change in existing I U1,1"', r.,.~ j dj'T,ce ?~ H multifamily, corm!. or ...., Jnduc;.trial SQ. FT, Z2~ , --m ~."..e<MI- 1f5' Sewer CJ 9~~ /'7 IJI'3 Storm Sewer /~~. I Of I::?~ amps. COMM./INO. FEEOERS Install/alter/relocate di~trih. fppdprc;. \DS '\7.> \)JI'" MECHANICAL ~~1=' r~'1B!iE. ~ furnace/burner to /1.HJ._tf> BTU's ~-7'-r..2" .,. Floor furnace and vent 6..' /9.'-" J ':2.. h Recessed wall 1tI;9-/ ~n~~p np~tpr ~nri vpnt 6.- .6.~ t:, '3 1'.( (.I / f ')_ App 1 i ance: vent ~eoarat~ Stationary evap. eoeler Vent fan with sinole duct Vent system apart from heatina or A.C. Mechanical exhaust hood and duct Wood stove/heater /2.- I.g.- ~... ':l'? N!. t..j,~$tB. <;t ' :3 Of ... / <::w:l amp~ /5....,. Y"$:"" ., ~s .c?...7~ 1FT:> ,~ 'I.~ "7 ";2,2S 4.. ' S'/.~3A5i . / ~~; ~ 1S6-:-"" ;'44; <=m/-<,,1L. ~"",.r,;r,,~...~ ISSUANCF OF PFR!1lT ~E;__..- ~;:";;'-'-""""'r~/.IO<o/" TOTAL CHARGES 2 /?2:r:.'" TOTAL CHARGES ~ 9;6,", ,<).?; _' TOTAL CHARGES IYy'. :- WHERE STATE LAW REQUIRES that the Electrical work be done by an Electrical Contractor. the electrical portion of this permit shall not be valiJ until. the label has been signed by. an Electrical Supe~visor and returned to the Building Division 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 oerformed shall be done in accordance with the Ordinances of the City af Spr; ngfi e 1 d and the Laws of the State' of Oregon pe-rta i n i n9 to the work descri bed herei n I and tha t IW OCCUPArKY wi 11 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 a~e in compliance with ORS 7Ql.055 will be used on this project. SIG1IATURE ~tR.~,JI; FO~ OFFICE USE OiIL Y TYO~/const'~-/AIf~,nits So. Ftg. flain ~.~,Q x Value /. 7~"'l'~ Bedrooms Occy Load -:::?~-r- Sq. Ftg. Access x Value. S"tories '""3 Occy Group ;:2-/ Sq. Ftg. Other&V/#'<:' x Value 23::?~~ \ . ..,. _ .J:; /' A..,., _ TOTAL VALUATlOtl2..oI-'i: L)OO d.,.,/,,~~r- f?#:.<;/ ~W.:!='~ ree=- ......~R);) /t> 2~~.~.5 ' , BUILDING PER/lIT ., ~'~1,a 75" 'Plan Ck. Conm/lnd '''';;(e< -9'4/ ""L7rYl"Systems Develo~ment _ Charges an~ __;,(...:2 J.J____ 65%/Bldo p.pr Fpp :Z.77.}. ~~ Charoe (1.5~) _2"25". S Plan Ck Res' -- ~ ~.~~..... . urcharges J 65: 8"1 30%/BI d~ Per Fee I :t?fi"Fi:>AL:> A:;.~ ,7?L#_' V..(d"Y\ ( ~~~~~~~Ga~~RMIT ____~$_'Z~'_~ Fence I,pv~~~ /- _~.-@ :_ Surcharges 1'I/.'2~ 0flll10 \q~oo IWIE(please print) ~ 'R,Luf6e.'f ;1L Zone ..c L Fi re Z6ne Flood Plain ELECTRICAL PERI~IT Cha rges and .v~'JP~~7AC'O 11ECHAN I CAL PERMIT Charges and Surcharges S'" -2"6. "So 5 1 dewa I k ------ ---:--1 ;'2./!.~ A/C Paving ___"L"!h.~~_ Curb Cut 7..Z0 I .7,3,iP. ~ om (r It( -'/ tJ Total Comb. Permit 7 3~ '3.1., /_ ?-.. \CA. TOTAL -" ~'::J-" , '1..\I/, _I f'. . ~7;~8'1. 5'6 . .,.1 , ., COMBINATION APPLICATION/PERMIT (CAP) L Applicant to furnish A. Job Address B. Legal Oescription 1. example- Tax Lot 100. Lane County Map Reference 11 03 43 2. example- Lot I. Block 3, 2nd Addition to >prlngtield Estates , C. Name. etc. of owner and construction lender O. Energy Sources 1. exam21e- heat/electrical ceilin~/or forced air Q8S 2. example- waterheater/electr1cal/or ~ E. Square footage or valuation, etc. I I. example- 1250 sq. foot house, 500 sq. foot garage 2. examp,le- if new project. check. new - if addition, cneck add, etc. F. Building pennit ';nformation: 1. examele - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exam21e - convert single family'residence into' restaurant (change of use) G. Value of work as defined in Section 303 (a).ofthe 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 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 fu 11 schedu 1 es C. BUILOING OIVISION STAFF WILL FILL OUT ALL.FEES ANO CHARGES ON THE SCHEOULES 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. V. FOR OFFICE USE ONLY . .. I' >._ ...1 ,., " . ':' -i , . PERMIT VALIDATION ?r, \CO~C\~ - .,4 ~ -~. l . .. .' >> Permit Clerk ~~ PROJECT CONDITIONS TO BE SATISFIED BEFORE -QCCUPAN&f: ?<:'"'I"h'?/ r /,;55~4'#<:~" ''/c..--i/'kF-</r-; ;:;;/~-vC'c:> Z:;~lreLZn -- ~~--=-,,~_.--:,-'-~~/Y/ /;;!.~.:3 \..:::;~~ ; / / ( , 2 - Ve/?/r:'r // ~?;?~=/ ,%~,.;.-r- C5>/' ~b::::J:;pS? YCZ:>/,49n.-,l/ ??~I!~7:;> .;gy &;f:,/;". ~t'7/~ ~~ ~/d~) /~~I " Permit applicant'exempt from registration with the Builder~s Board because: Additional Project Information: ,',",' PLANS REVIEWED BY: . I . .. name /-L>;q~E ft ~~ Signature~~.';.,:~. ~., ~ . - r I date 7-/~'-9~ ,~