The URL can be used to link to this page

Home My WebLink AboutPermit Curb Cut 1981-8-12 !INSPECTION LINE 126-3;;\9 '-II. ,..... JO~ Add,n~ I Le9cl Description . CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT . INFORMATION LINE 726--3153 Heal Water Healer I Sq. Fig. Mein I Sq. fIg. Acceu. Sq. Ftg. Other + _New_Add _Alter_Rep. I ~'j'._Ch..g./U'. ~ BuildinCJ Permit\tnfo( De,cribe Work. (i.e., Build Singl. F"mily 'Residen~,:,: With _~.!!~Ch'HI Garooe\ ~CLlmo ~ A- ENERGY SOURCES: DESIGN TEAM (address) 0llli) t\ U-t -, " I \~ (~~~) U ~ ~".i"" t -alJ ~ J) J ~ :p I Ronqe _ ::d',::. ~ ~()il~ co,..,v,,;~d~ ~ L "" '" " I Volv. of w~ ~ Phone Address Phone (nomei (phone no.) Primary Structural I Electrical I Mechanical I CONTRACTC1llf\ I G.,,,o; l \.l~ ....;0 (nome) {address} flies. no;) (upirIU) (phono no.1 0"'\1\ 0 "- , plvmbinq 'tlectricol Mechanical PLUMBING ElfCTRICAl MECHANICAL NO_ , 'j p:J: CHARGE i NO. FEE CHARGE NO. FEE OiARG~ \ I Residenc. of furnace/ burner to "lU', Appliance'vent separate Slolionar;, evop. cooler Vent fall with single duct Vent .system apart from heotinq or A.C. Mechanical exhQust hood Qnd dud Each ,inqle fiKture R..::localed building {new fix. additional} S.F. Reliden~e (1 bath) ~q: ft. New circuits, clteratiolls or eXlen'lions SERVICES Duolex (1 balhl each Temporary Construction Additional bath Amps. Woler service Sewer Wood stove I healer Stor.m Sewer FEEDERS Heal Pump Air handler to TO.OOl") CFM Air handler a....r 10.000 (FM Amps. r I TOTAL CHARGES I ISSUANCE OF PERMIT TOTAL CHARGES TOTAL CHARGES WHERE SlATE LAW REQUIRES thr.d th.. Electrical work b. done by the E!eMricol Contractor, the .Iectricol portion of this permit .hall not b. ..,alid until 0 labet has b...n signed by on .Eloctrical Contradar and attached to the elodricol panel. I HAVE CAREFULLY EXAMINED the compleied application for permit, and do hereby certify. that all information h.reon is true and correct, and I fvrthor certify that any and all work. perfarm..d shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the 51010 of Orogon pertaining to the work. described horin. and that NO OCCUPANCY will be mad. of any structure without th. p\rmiuian of the Building Division. I further certify that my registration with Ihe Builder's Boord is in full farca and effect as required by ORS 701.055. that if exempt the. basi, for exemption is noted h~ron, and that only $ubconlractors and ~mploy~es who are in compliance with QRS 701.0.55 will be u$Od on this project. Basis for Builder', Board e"-emption: NAME (plea,. print) _~Q...r hd""~ l...~o"t"e SIGNATURE ~J6Aa... ~ :;j(~l"D FOR OFFICE USE ONLY DATE Zan~ Typ~/Conlt, Unih Sq. Ftg. Main Fire Zone Bedrooms rlccy load Sq. ftg. Accen Flood Plain (Iori.f Oecy Group Sq. Fig. Other BUILDING PERMIT Plan Ck. Comm/lnd I Charges and 65%1 Bldo Por Felt I Surcharge, Pion Ck. Re, I 3o~~1 Bldq Per fee PLUMBING PERMIT I Charges and Fence Svrcnarglls I Demo ElEQRICAL PERMIT I Chargll' and Sidewolk Surchargu I Alc Po...in... MECHANICAL PERMIT I ,5, uO Charges and Curb Cut Surcharge, -------- I x x Value Voluo Volu. TOTAL V ALUA TlON Systems Development Chorae (1.5~;'\ Talal Comb. Permit TOTAL /5, cOd COMBINATION APPLlCATlON/.1IT (CAP) . PERMIT VALlDATION..~ :.;..~ I. Applica~ to furnish A. Job Address B, legal Descri ption , 1, example-tax lot 100, lane County Map Reference 17 03 43 2, example-Lot 1, Block 3, 2nd Addi.tion to Springfield Estates C. Nome. etc. of owner and construction lender D.. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. exam ole-water heater/electrical/or solar E. Square footage or valuation, etc. 1, exomple-1250 sq, foot house, 500 sq. foot garage 2. exampie.if new project. check r:;e;,-if addition, check add, etc. \, F. Building permit information: 1. example-construct single family house with an attached garage 2. example-remodel existing garagf; into family room 3. example-convert single family residence if"!to 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 ovoid design or construction delays, Building Division Stoff must be able to contact appropriate persons regarding design inf~rmation or job site corrections, et~. II. Abbreviated Plumbing, Mechanical & Electrical Sched~les 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 . ore 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 ~overed on the abbrevi. ated schedules you should consult the full schedules BUILDING DIVISION STAFF WilL FILL OUT All FEES AND CHARGES ON THE SCHEDULES C. 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 typewritten copy and return it to the applicant at the time the actual permit is issued for his signaturt. 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 BEFORE OCCUPANCY: , Additional Project Information: PLANS REVIEWED BY, nam,.. ,,:i9notur~ Permit Clerk :.... ,.... ~at... ., ., ~ .....' . llN5PECTlON LINE ...r' !2~69 . " . INFORMATION LINE 726-315J '. CITY OF SPRINGFIELD CQMBINArlCN APPlICAflONJ PERMIT ow." (\ \ ~ (\ l ~ ,nt Add",.\..') 4\n ~( ) (V$) CO.",u,,;~~~ ( ~ . V) PhO"' I ENERGY SOURCES: I Sq. Ftg. MaIn Heal II Sq. ftg. Accen. Water Heater Sq. Ftg. Olh.r Range _Ne....__Add _Alter_Rep. Volu, of W1\') I, ./ ~~0_ChO.9.iU;. '-I K _Olh.r) Buildinq Permit1lnfo: De,cribe War.. (i,e,. Build Single Fcmilv'Re,idence With Attached Goroqel Le'Jol Ducr;plion J:\6.A In.D Q.~\ *1-+ Job ...dd;.." ~ 5ZQ DESIGN TEAM (oddreu) c\~ l"11-t .- I ,,~.t!f0 $ \\ t \ ~ ~ l) (lin.no,) ( -al) ~ Addre" Phone (nome) (e",pinll) (phone no.) Pril':'lcry Slructurol fl.ctricol Mechanical I CONT....crrf\ , \ I Gm,ol \ IQ I Plumbino ---::;.. (nome) (addre,sl , (l:CI. no.) (up;re,) (,)ho"lII noJ 1")1\ 0 l , flectrical CClch ,inql", ';/tlure Rl!locored building (new till. additionoll S.F. il:o!,iden~e (1 balh) Residenu of _,q: h. New circuih, olteraliollS or elllen,ions I FEE I CHARGE NO. FEE I I ..._-1 ! CHARGF .j II I I I ] I II }I I I ;'\echon,col nUMBING ElECTRICAL MECHANICAL NO. f::r;; CHARGE i NO. furnoCII/burner !o aTU', Appliance yent 'lIporote Stationor;' eyap. cooler Vent fall with singie duct Vent system apart from heati~g or A.C. Mechanical ellhaust hood and d~ct SERVICES Ouol~1( n bOlh) eac" Tomporary Construclion Additional balh Amos. Wal.r ,enice Silwer Wood s'aye/healer Slar,m Se.....r FEEDERS Heat Puma Air handler ta 10.000 CFM Air handl.r 0"" 10.000 CFM Amp,. r I TOT At CHARGES I ISSUANCE OF PERMIT I i' I TOT....L CHARGfS TOTAL CHARGES WHERE 5TATE LAW REQUIRES ,hat the Electrical work b. done by the E!e"'rical Conlloaor, the electrical portion of this pelmit shall no. b. valid until 0 lab.1 ha'S been 'Signed by on Electrical Contractor and attached to the electrical panel, I HAVE CAAEFULL '( EXAMINED ,he completed application for permit. and do hereby certify. that all information hereon is true and correct, and I further certify thor any ond 011 work performed shaU be done in accordance with the Ordinances of the City of $prin!lfield and the laws of the State of Oregan pertaining fo ,he worlr. d.scrio.a herin, and that NO OCCUPANCY will be mode of any structure without the permission of the Building Divi,ion. I further CIIrtify Ihat my registration with. Ihe Builder's Board is in full force and ..ffect as required by ORS 701.0.1.1, that if exompt the,basi. for e..emption is noted heron. and that only subcontractors and employees who are in complionce with QRS 701.0'.5 will b. used on this project. NAME (please print)~Q..r ~ll""a.. l...~oyce SIGN...TURE _~tJ" )MAA.. ~',-:N~~~ fOR OFFICE USE ONI.Y DATE Basi, for Builder', Board .",emption! Zone F.re Zone flood Plain Typ./Const, Bedrooms C,lori.' Unih .... '~y Load nccy Group Sq, Ftg. Main c,q. FIg, Accel' Sq. Ftg. Other x Value Value Value I x TOTAL VAI.UATlON BUilDING P~RMIT Charges and Sl"Ircharge' Plan Ck. Comm/lnd 65%/ alda Per Fef! PIon Cll.. Res :30~ol aide Per Fee System, Development Choute f I.S~~: PLUMBING PERMIT Charges and 5urchorges Demo TOlal Comb. P-ermit I j I 1 I MECHANICAL PERMIT Chorg.. ond Surcharges I I I ! I ---------1 Fence ElECHICAl PERMIT Chorg.. and Sl,lrcnargel Sidewalk Curb Cui QUO I I I TOTAl. /5. Cod AI C Pavino I. Applica~ to furnish A. Job Address B. legal Description 1. examole-tax lot 100, Lane County Map Reference 17 03 43 2_ example-Lot 1, Block 3, 2nd Addition to Springfield Estates C. Name. etc. of owner and construction lender D.. Energy Sources 1. example-heat/electrical ceilinq/or forced air q 2. examole-woter heater/electrical/or solar E. Square footage or valuation, etc. 1, examole-1250 sq, foot house, 500 sq, foot gore 2. exompie-if new project, check ;:;ew.if addition. add. etc:. F. Building permit information: 1. examole-construct single family house with an I garage 2. example-remodel existing gorag~ into family rc 3. exampie-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 Oi, Stoff must be able to contact appropriate persons rt (fa design inf~rmctian or job site corrections. etc. COMBINATION APPLICATION/PER. (CAP) II. Abbrevjot~d Plumbing. M~chonical & Electrical Schedul A: Except where.blenk spaces occur in the description F of the Mechanical and Electrical Schedules, the oppl need fill.in only fhe No. Boxes adjacent to the apprc item(s) to be installed B, Full Plumbing, Mechanical, and Electrical Schedules ore available at the Building Division . 1. To conserve space on the permit form the schedul hove been abbreviated '2. If the item(s) to be installed ore not covered on th aled schedules yau shauld consult the full schedul C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULES III. Applicant to sign and date Whenever possible, the initial application will be used a~ worksheet only. Where possible, Building Division Stoff \I prepare a typewritten copy and return it to the applicant the time the octual permit is issued for his signatur&. IV. Fees and Charges Plan check fees are due and payable at the time of the 01 and no plans will be processed until these fees are paid. , other fees and charges are due and poyable when the pe is issued. -I-- V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY, "emf'" "ignaturo . PERMIT V ALIDA TION -( ~: i , CITY OF SPRINGFIELD (' Date I>> I 57063 Rec'd ,(>" Address Received For: ! 'I ,( tic C' '-~\ ~') 0,lt-r, ( ( > C]J Amou_l}t~eceived \0, \9.0 --- r--t\ f'Y~ ~ A'\r'fHORIZIED SIGNATURE ,...""TO....""'....... ..'..rl[..... EUG"..l, Oil ....0. ...."." ( ( I Permit Clery , I I I I I -I a t,..