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Home My WebLink AboutPermit Building 1989-12-19 CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT EflERGY SOURCES Heat Legal De~criptlOn vacated SP right-of-way as shclw\\ater Heater . on assessor's maps 17-03-22 and -15, between Ranqe , !-!ar:!..-ew-Rd. -.::::::.<'1 :!.:::;~ L\clfri.tiJ-:1 tc Cy-.:.atlCvllullci'\..-:i.Cil P~kE of \lork Owner Svcan B Corpor:::lti C'n Za?~ c~ I'-- - . - - -f--..; BUll(:lnq Perllllt Info Address II.54U.) bCilJyVTew-J:an-e \ Phone 746844r. Famlly ~esldence 1.l1th ~ If Springfield. Oregon 97477 INFORI1ATIDN LINE 726-3753 Sq. Ftq. r1aln ~q Ftg Access Sq. Ftq. Other New Add Alter Pep. --Fence Demo Change/Use --Other -- -- \Jt) ~ ""- \A ~ INSPECTION LINE 726-3769 Job Address , Descrlbe Work(l.e., BUlld Slngle f\ttached Garaoe) Constructlon Lender Removal of A.f>:>roxim:::lh:>'y 7<;()() ('11'h;(' ~T!:n"rl", of gravel from the bed of the SP right-of- way pL~pa~ury LO clean-up or tne site Address DES I GN TEAt~ (name) Phone (address) (llCS no 1 (exPlres) (ohone no ) 1 Pnmary Structural r , Electrlcal i- ; 11echaPl ca 1 ( ;J CONTRACTORS l {namel (address) I (11 cs no (eXOlres) (ohone no.) I . Genera 1 F.v:p S;:mn ::mn (;r::nrel Q0520 Cote""g "Rrl ~11aOl"'l.a ---1::)---- 5G-93-6 7/15/90 4.85-:1..5:1..5 : Pl umbl nq ~ El ectn ca 1 i ~1echaPl ca 1 PLUf1B I NG ELECTRICAL MCCHANICAL NO. FEE CHARGE NO_ FFF (HARGE NO J'FF CHARGE. SQ FT furnace/burner to BTlI's Each slngle flxture Resldence of Relocated bUlldlng (new flX. addltlonal) New clrcults alts or extenslons Floor furnace and vent S F Resldence (1 bath) Duplex (1 bath) each IAddltlOnal bath IHater serVlce I Sewer SERVICES Recessed wall Soace heater and vent Storm Sewer Temporary Constructlon 'Change ln existlng resldence multlfan1l1y, comm. or, Industnal 'Of alnl)S Apollance vent sepa ra te Statlonary evap cooler Vent fan wlth slnale duct Vent syste~ apart from heatlnq or A C Mechanlcal exhaust hood and duct \lood stove/heater CQt111 II ND. FEEDERS Install/alter/relocate dl stn b feeders 10f amps I I I I SSUANCF OF PFRf1IT TOTAL CHARGES TOTAL CHARGES 'TOTAL CHARGES WHERE STATE L'\\~ REQUIRES that tile Electncal work be done by ,an [lectncal Contractor, the electncal [lOrtlOn of thlS perr.llt shall not be vallJ untll the label has been slqned by an Electrlcal Supervlsor and returned to the BUlldlng Dlvlslon I HAVE CAREFULLY EXA~1IN[D t1e completed appllcatlon for permlt, and do hereby certlfy that all lnformatlon hereon lS true and correct, and I further certlfy that any and all work performed shall be done ln accordance wlth the Ordlnances of the Clty of Sprlngfleld and the Laws of the State of Oregon oertalnlnq to the work descrlbed herCln, and that NO OCCUPANCY Wl 1 be made of any structure wlthout the permlsslon of the BUlldlng D1V1Slon. I further certlfy that my reqlstratlon v/lth e ullder's Board lS ln full force and effect as requlred by ORS 701.055, that lf exempt the basls for exemptlon lS note er. n, and that only subcontractors and employees who are In compllance wlth OPS 7nl.055 \1111 be used on thlS pro) Zone TYDe/Cons t. Bedrooms Ston es Un1ts ~ Operations ME1g;rV\TUR~-..:-- -__.;.- FOr. OF F I CE USE or~L Y\'" /'" Sr Ft'l /1aln Sq Ft~. Access Sq. Ftq. Other DATE 4~ IW1E(please pnnt) Timothy D. Hovet, ,. x Value Value Value Flre Zone Flood Plaln Occy Load Occy Group x x PLUI1BING PERMIT Charges and Surcharges Plan Ck. Comm/Ind 65%/Bldo Per Fee Plan Ck Res 30%/Bldq Per Fee Fence 00 4lJ TOTAL VALUATION I BUILDING PER~1IT Charges and Surcharges Systems Development , C ha rqe (1. 51,) Domo ELECTRICAL PERfUT Sidewalk Charges and ------------ Surcharges A/C Pavlng Total Comb rermlt MECHANICAL PERMIT Charges and Surcharges Curb Cut ------------ ~eAP~~~1;\~ /80.':><1> I TOTAL ~2Ci, 00 ( . COMBINATION APPLICATION/PERMIT (CAP) I. PERMIT VALIDATION II. Appl1cant to furn1sh A Job Address B. Legal DeSCrlptlOn 1 example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Add1t1on to Spr1ngf1eld Estates C . Name, etc. of owner and construct1on lender D. Energy Sources 1 example- heat/electr1cal ce1l1ng/or forced a1r gas 2. example- waterhealer/electr1cal!or solar E. Square footage or valuat1on, etc 1. example- 1250 sq foot house, 500 sq foot garage 2 example- 1f new proJect, checkr:Jew - 1f add1t1'on, check add, etc. F. BU1ld1ng perm1t 1nformatlOn 1. example - construct Slngle fam1ly house w1th an a ttached garage 2. example - remodel eX1st1ng garage 1nto fannly ,room 3. example - convert slnSjle'lallllly resluenCe~lnl.O: restaurant (change of use) G. Value of work as def1ned 1n Sectlon 303 (a) of the Structural Speclalty Code H DESIGN TEAM AND CONTRACTORS To avold deslgn or construct1on delays, BU1ld1ng Dlv1s1on Staff must be able to contact appropr1ate persons regard1ng des1gn lnformat1on or Job slte correct1ons, etc Abbrev1ated Plumblng, Mechan1cal, & Electr1cal Schedules A. Except where blank spaces occur 1n the descr1pt1on port1on of the Mechanlral and Electrlcal Schedules, the appl1cant need f1ll-1n only the No Boxes adJacent to the approprlate 1telll(s) to be 1nstalled B. Full Plumb1ng, Mechan1cal, and Electr1cal Schedules are ava1lable at the BU1ldlng D1V1Slon 1. To conserve space on the perm1t form the schedules have been abbrevlated 2. If the 1tem(s) to be 1nstalled are not covered on the abbrev1ated 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 electr1cal contractor for slgnature superVlsor. The general contractor to slgn the electrlcal label. Appl1cant to slgn and date Whenever poss1ble, the 1nltlal'appl1catlOn'Wl11 be used as a worksheet only. Where posslble, BUlldlng D1v1s1on Staff w1ll prepare a tyoe wrltten cory and return lt to the appl1cant at the t1me the actual permlt 1S lssued for h1S slgnature. Fees and Charges Plan check fees are due and payable at the t1me of the' appl1cat1on, and no plans wlll be processed unt11 these fees are pald. All other fees and charges are due and payable when the perm1t 1S 1ssued r C1er0\v:D,-/J .~ ~- C;D ~ \~~c:s " I be delivered to the by h1S electr1cal 1S not author1zed III IV. V. FOR OFFICE USE ONLY Permit PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: ~-- - - -- -- --- ----.. - --; 1 -1 Additional Project Information: PLANS REVIEWED BY: ?2-~ Signature~~ date/-:;;:~2<7'--~' . /,,( ~ /' .........~k...w.~nol.........~'_a=;..........",.I;'>t(r.U"mr<:l/~I~........ n name L.o/fA/2: