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HomeMy WebLinkAboutPermit Building 1985-1-15 (2) Job Address/"4t" /I~R.t-"W Leg.l Description /7-03 -:22, 0;2 3t75"' Owner~ .UYAI Sc..Jlmlb~ '])e.v Address!. 11. 'ED"!< < 2-4-.. 1C~"T'lIN~ CA 1l1lSPECTlON lINE 726-3769 Construction lender Address Ul:.::llliN TE.Ar~ Primary Structural Electric.l . . CITY Uf SPRINGfIELD COMBI:IATION APPlICATION/PERMIT E!lERGY SOURCES: Heat Ha ter Hea ter Ranqe ~ I~ 'J V\ INFORtlATION liNe 726-3753 Sq. Ftg, 1,1. i n;/. ~ 7&.0 ~q. Ftg. Access. Sq, Ftg, Other Ilew Add lCA lter Pep, -Fence Demo Change/Use Other- - ( "'/~J PhonE:>22_eo2IS V.1UE of I'lork: /0".2. ,600 core> BuilriinQ Permit Info: Describe Work(i.e.~ Fa~ily ~esidence With Attached Garaae) Build Single UdJl/E- 1(Em6,."EL Gtl/<;7"'/IV6- 'RUn:,~/I//&- Ft!7TZ J/E/v '"7')Q~PtVr~n~ ( tv/A/STdQ~) flies. no.l (exn;resl (ohane no. lnamel Phone f address) Mechanical CONTRACTORS In.mel Gener.l '5C/~1J <;bF.II'~E.. ~p Plumbina Electrical ~1echanical NO, I (address) f1 ir" _ nn \ (pxoi rpc:.) ...... Iqq~ CNl/~AJCe~ . 'fEibl>,AJI'-. w,. (~1J~ 3':'~ / / ~ (ohMP no_ ) V)r, ~ 2I-tJ/~() PLUrlBING ELECTRICAL MECHANICAL HE CHARGF NO-. Residence of tEL..cJiARG.E. NO FFL..cJiARG.E. furnace/burner to BTU's Each single fixture l).F. Reloc.ted building (new fix. .ddition.l) /1>.- SQ, FT, S.F. Residence 11 b.th) Duplex (1 b.th) e.ch Addition.l b.th ;later service Sewer Storm Sewer .:b~A. ',!: ~ New circuits alts. or extensions ~ '2.. &>12 ~fi$c: SERVICES ,s:ec . Floor furnace and vent Recessed wa 11 So~rp hp~tpr ~nrl vpnt Temporary Construction Change in existing rp) j dJIJ1C'P multifamily, camm. or Industrial Appliance vent seoarate Stationary evap. cooler Vent fan wi th sinale duct Vent system apart from I heatino or A.C. Mechanical exhaust hond and rlurt. IOf ICOMI'I.IIND, FEEDERS I Install/alter/relocate rli~trih_ fpprlpr~ IOf I -e~Aft"7\&I_ I I amps. Wood stove/heater ........- &..~'f:'; 'l>IJc..T5 /~- amps. ISSUANCE OF PFRrllT TOTAL CHARGES 1t'/(19, /c:7. 00:> TOTAL CHARGES Is:. ~ TOTAL CHARGES M/N. It:!>, ee> WHERE STATE L\I~ REQUIRES th.t the Electric.l work be done by .n, Electric.l Contr.ctor, the electric.l rortion of this permit shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXN1INED the completed aprlication 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 Soringfield and the laws of the State of OreC)on pertaining to the work described herein, and that UO OCCUPAr~CY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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 emnloyees who are in compliance with~n~O?5 wi be sed on this project. /- :13-as- A~ vl'i! .PAle "''''''7:''''' ~ UAI'iE(ple.se print0s:l<R4 tu_JG-AJ!"E4J SIGUATURE FOr. OhICE USE OmA Sq. Ftg. Sq, FtQ, Sq. Ftg, Zone c: Co Fire Zone Flood Pl.in BUILDING PERIIIT Charges and Surcharges PLU'1BING PERMIT Charges and Surcha rges ELECTRICAL PERI:IT Cha rges and Surcharges flECHANICAL PERMIT Charges and Surcharges om /-/S-8>..r- Tyoe/Const. 5'/Y ~ Units Occy Lo.d Occy Group f1ain x Value Access x Value Otherar.K....~.t V.lue~~,- TOTAL VALUATION Bedrooms Stories I s~:z -">>Q" ""CO Pl.n Ck, Conmllnd ..;.__~L~~~___ 65%/Rldo Pyr F'~~ Pl.n Ck. Res 30%/Bldo Per Fee syste,ms Development Ch.roe (1.5%) N./?. 188_SD II . ~<:> __n/~:..-::~_ .~6 ____is: - .60 Fence Demo Sidewalk A/C P.vi n9 ITotal Comb. Permit q]"38 . erO ~2'G'."S"O _____/~:..~J Curb Cut . '1G' I I I TOTAL . COMBINATION APPLICATION/PERMIT (CAP) 1, Applicant to furnish A, Job Address B, Legal Oescription 1. example- Tax Lot 100, Lane County Map Reference 11 oj 43 2, exa~le- Lot I, Block 3. 2nd Addition to . ~prln9tield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air Qas 2. examole. waterheater/electr;cal/or solar E. Square footage or valuation, etc. - I, examole- 1250 sq, foot house, 500 sq. foot garage 2. example- if new project, check-nfw - if addition, cneck add, etc. F. Building penJlit information: 1. examole - construct single family house with an attached garage ,---. 2. example - remodel existing garage into family room 3. exa~le - 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. [I, Abbreviated Plumbing, Mechan;cal, & 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 I es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES 0, 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. --- [II, 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION ~ 6_(,416;2.,., / 'r~ J) Jy '1 , III ... P,mit Cl",/Li..t.; :":'., Permit applicant exempt from registration with the Builder's Board because:' '. ,Additional Project Information: 1- S~""'AAT~ ;.r:-~'0#~'''7'4S A'ed:>~/~~ ~ 5/6~ ~~n ~~ h~.,'T/d'~~/ ~~ h?.r""".K"/~ , . - -- .. . ,- ~ ~~/?;,NA~ W/ C/TY ~U/~P/~ ;::::}Y/~/C-,19 PLANS REVIEWED BY: L~PN~ ~~~Signature~~ name I ~. '7 . date /-2r.e-s-"