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Home My WebLink AboutPermit Fence 1980-4-24 . '/IIISPECTlOII L1I1E CITY OF SPRIIIGFIELD 1 726-3769 COI1BIiIATlON APPLlCATlON/PERMIT \ \ ^f '\ v::... C ('\f"'\. ," t ErIEjlGY SOURCES: J'lb Address ~ \ ~-). ,_ t \ \\ ~ ~ \ \ 0, Hea~ _______ LID t i\ '-{)t ~ ega l ~c~.~; 11 ~ ?>4L'2' ~ . Owner, \()A\\\\ \r\ no.mm Address~l m <J./ '-...\\" Phone -C\U \ - \?R?... . INFORllATlON L11" 726-3753 Sq. Ftg. f.la;n :q. Ftg. Access. ~q. Ftg. Other fJPloI Add A I ter f~ep. ::- _~~~~oemO_Change/Use ValUE of ~>;,k<.......... c.s:::> ..."...'{ l J. Bui1'tinQ Permit Info: Describe l-lork{Le.. Familv P.esidence With Attached Garaqe) Build Single Address UE:.~lliN TEAr.' (name) Phone (address) \ --.---0 nf\~ . ~ I\. (\ f'\\ ~ -') \ '-.; (lies. no.) (exo;res) {ohone no. \ Construction Lender Primary Structural Electrical t1echan; ca 1 CONTRACTORS I'"' {namel General,- A X. (\~ \\. (address) flies. no.) (pxo;rps) (ohone no. , PlumbiOQ Electrical ~1echanical PLUIIBIIIG ELECTRICAL MECHANICAL 110.1 lEaCh single fixture Relocated building (new fix. additional) FFF I CHARt,E Nn I J ~~~ I r1-lAR(.';1=" r-ln. I Residence of furnace/burner to SQ. FT. BTU's I H~ I r~AQr.~ New circuits alts. Floor furnace or extensions and vent S.F. Residence (] bath) 10uplex (1 bath) each Additional bath SERVICES Recessed wall ~n~rp hp~tpr ~nrl vpnt Of amps. Appliance vent seoaratf' Stationary evap. cooler Vent fan wi th sinale duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct Wood stove/heater I I I I I I I ~Iater servi ce I Sewer I Storm Sewer Temporary Construction Change in existing rpc: i d_pncp multifamily, comm. or Induc:trial CO~1./IND. FEEDERS Install/alter/relocate dic:trih. fpprlprc;. Of amps. TOTAL CHARGES TOTAL C~RGES WHERE STATE L\W REQUIRES that the Electrical work be done by an shall not be vali~ until the label has been signed by an Electrical ISSUANCf OF PFR'IIT TOTAL CHARGES 'Electrical Contractor, the electrical portion of this permit Supervisor and returned to the BUilding Division I HAVE CAREFULLY EXMlINED the completed ap["llication for permit, and do ~ereb'y certify that all information hereon is true and correct, and I further certify that any and all work performed 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 OCCUPAtKY 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 ORS 701.055 will be used on this project. IWIE(please print) ,-r;.) -A",'V\ LCLV\.,\--\;;V.l SIG;IATURE Cvrt1../1.N\.~~DP.TU-.?U.~ I ) FO~ OFFICE USE miL VII ( J Zone Fi re Zone Flood Plain Type/Const. Bedrooms Stories Units Occy Load Occy Group v Sq. Ftg. Hain Sq. Ft\). Access Sq. Ftg. Other x x Value Value Value x TOTAL VALUATION BUILOING PER~IIT Charges anc Surcharges . \D ~ Plan Ck. ____ _'--____ 65%/Bldo Plan Ck. 30%lBl do Convn/Ind Ppr Fpp Res Per Fee Systems Development CharQe (1.51) , PLU!~BING PERMIT Charges and Syrcharges Fence ------------ I Demo I'Sidewalk ------------ _ I A/C Paving ,; ~ I Curb Cut ----------'--1 Total Comb. Permit ELECTRICAL PER!~IT Cha rges and Surcharges !iECHAN I CAL PERM IT Charges and 5'.'rcl1a(l]es. \ TOTAL , \O,Od ~. .'\ ; ! t -~ \J. . / COMBINATION APPLICATION/PERMIT (CAP) ._~ . I. '. ) .D ,-.\ _/ .J ~ . II. Applicant to furnish A. Job Address B. legal Description 1. example- Tax Lot ]7 03 43 2. example- Lot ]. Block 3, 2nd Addition to Springtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceiling/or forced air qas 2. exa~le- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - ]. example- 1250 sq. foot house, 500 sq. foot garage 2. example~ if new 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. 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. 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. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except ~Ihere 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 O. 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 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 ;s issued. . " \r 100. Lane County Map Reference I I I. IV. V. FOR OFFI CE USE ONL Y ~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: f PERMIT VALIDATION Permit Clerk . I Permit appl i cant exempt from regi strati on wi th the Builder I s Board because: t Additional Project Information: PLANS REVIEWED BY: name signature .. date , --f='-~ ValuE 'of ~rk..:,(,\ c:J:.:) . " 1 . " Bullt:ino Permit Info: Describe \'Jork(Le.. Family I'!esidence Hith .A.ttached l'iaraqe) I I I I I I I I I I I I. ISSUANCE OF PFR'HT I TOTAL CHARGES Electrical Contractor. the electrical portion of this per~;t Supervisor and returned to the Building Division :"fil dSPECTIOIl L1I1E 726-3769 J~~ Address \...J) \ '\ 5 . '1.<>'~'.J""i'''''':<t, <~"'~"''-''', )..,.:.~, Ii"'~~'l:~~ "':~.N V'i1/"'":fM:...~ ...".'~, I ~.:,'(. ~':",~:,~.... ,". CIIY ~F SPRInGFIELD C0I1BI:iATlON APPLICATION/PERMIT EilERGY SOURCES: Heat-..~ ______ Hater Hea.ter----- ~ f .Range C\.\\(\ f'l \ t 0 ' (\ '-{)~ J . '-l \ ~;; Owner, \0, A\\\\ \J"\ \l()).nrcf Address l''.cJ f"(\ \) / ~''j\' . Phone flU \ - \ ')~~,2 Legal Description \ -+0 n'(\\') \- \ Construction lender Address DESIGN lEAn Phone (address) (name) ~. (1 ics. no.) Primary Structura 1 Electrical t~echanical CONTRACTORS~, {name J ~ \r "'" "'- Genera 1 ,. /~ /\. Q ,.1\ \..0 'i\ (address) flies.. no. Plumb;nq Electrical t.lechan; ca 1 PLUIIBIlIG ELECTRICAL liO. FEE I CHARr,F I I I I "0 ," rl-IAR(;F NO_ Residence of Each single fixture SQ. FT. IRelocated building (new fix. additional) I'S.F. Residence (j hath) IDuPlex (1 bath) each IAdditional bath I ~Jater service I Sewer I Storm Sewer New circuits alts. or extensions SERVICES Temporary Construction Change in existing rps.i dpnr:(" Imultifamily, camm. or Inrluc;trit11 IOf I COI.lI.1- /IND. FEEDERS I Install/alter/relocate r1i<;trih. fppdpr<:; amps. Of amps. TOTAL CHARGES TOTAL CH~RGES WHERE STATE L.\IJ REQUIRES that the Electrical work be done by an shall not be valij until the label has been signed by an Electrical j lNFORllATION L1iIt 726-3753 Sq. Ftg. I.lain ~C]. Ftg. Access: --So. Ftg. Other tlpl... Add Alter ~ep. . Fence', Demo Change/Use ---=Other7' - Build Single .\ ~(1\\ ~ \~ ('~~ Q (exo; res) (ohone no. (pxolre<;) (ohnnf'l nn.) MECHANICAL I ~~~ n-lARh~ furnace/burner to BTU's Floor furnace and vent Recessed wall SOn~P hPntpr ~nrl vpnt Appliance vent seoarate Sta t i onary evap. cooler I Vent fan with sinole duct I Vent system apart heatina or A.C. I ~lechan i ca 1 exhaust hood and duct I \']ood stove/heater I I I from I HAVE CAREFULLY EXN1INED the completed application for Dermit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Oregon pertaining to the work described herein, and that rm 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 com~liance with OP.S 701.055 will be used on this project. HAi.IE(please print) ,11) -A'1 Y\ L,^- ,^-,,-t; vA. ) FOr. OFFICE SIGIIATURE 0vtr-fL,\/'''-_______iD-7;\.Oj{~ DAT1~~,?rJ.r( Zone Fire Zone Flood Plain Units Occy Load Occy Group USE OIILY/I oj Sq. Ftg. Hain Sq. FtQ. Access Sq. Ft9. Other Type/Const. Bedrooms Stories BUILDING PER~IT Charges anc Surcharges ___\D,-~~_ Plan Ck. Comm/lnd 65%/Bldo Pf'r Fee Plan Ck. Res 30%/Blda Per Fee Fence PLU'~BING PERMIT Charges and Surcharges Demo ELECTRIU.L PERr~lT 'Sidewalk Cha~esand ------------ Surcharges A/C Pavi.ng_ ~_____r__~'-__I Curb Cut . ' .:.:..!.. u flECHANICft.L. PERr~lT Charges and ;...'. ~ ~~ c ~ x x Value Value Value x TOTAL VALUATION Syste~s .Development Charoe (1.511 . Total Comb. rermit I \ ~ 'jjTAL\ \0.00 ~ \ . .' COMBINATION APPLICATION/PERNIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot IOO? Lane County Map Reference 11 63 43 2. examDle- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinG/or forced air OdS 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - 1. examDle- 1250 sq. foot house, 500 sq. foot garage 2. examole- if new 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 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.) AlIO CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site correct.;ons. etc. 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. BUILDI1iG 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. --- 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 fees a're 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. Ill. IV. V. FOR OFFICE USE ONLY. . ~ '." ,.. . i PE~lIT VALIDATION . I CITY OF SPRINGFIELD I City Hall Springfield. Oregon Department of Public Works . OFFICIAL RECEIPT No. B 5 3 3 2 8 . \ \ i) l\ ~l I 1.--\ - U 191 ,-..../ : From. - )r) L~ \\ \\ -~T\ \ \~ ~N"'!m\ . f Iress\_O \ \~ (~'\\O, \'{S\~ (). (. \ ~ived For: ( ii .\ ( "'('0 ......,\\\\ il. ~. - ,-\ \ \..../ ( ( ~ ~ r-. )unt \' ) 00 Received ,~, J ~\ Gr..\. II'"'' (, " ) ( ,- AUTHORI"Z'[D SlG.......TUAIE '''UTO...TU'''''ULL ~",..Tl"S' lUGU.1 Oil 17.0' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: I Permit applicant exempt from registration with the Builder's Board because: ~ I I I I, Additional Project Information: PLANS REVIEWED BY: name signature I I ,,,. date . :..;"~ '1 ....-........ J