The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 1990-7-13 Ranqe ValuE of Hork' 115~ Pc> BlJllc1nQ Pernnt Info Descrlbe l~ork(l.e., Fam1lv Res1dence W1th ftttached GaraQel - " ~ 1 ,~~~~~l~oN LItlE '_-::_~__~ COMBrrl~H6Norp~~n~~~M7~ERMIT . Job Address (<;-7&z-67: d~7/~ tegal De~CrlJt1on 3 OJ/S _~ li Q~~t:;;() CJt),~DI OwnerS?-r~/Y ?&-/...z;.-c- k#~~7. c-?' ~~s /'3 ~$ Phone ~//~~~~ ->-7:::z?~ ~7'7Yb Co~str~ct1~n~~nde;-~ E!lERGY SOURCES. Heat !'later Heater INFORI1ATION UN!:. 726-3753 Sq. Ftq. rla1n ~q. Ftg. Access. Sq. Ftg. Other r~e\~ Add Alter Pep. --Fence Demo Change/Use -Other -- -- ~ \) ~ \J ~ BU1ld Slngle 5-7: ~/<?f~.o ~~vJ>-5~ C(: /=C /' /"5/CAZ-/: -:5'~ t'// C. 6 I I I I ~~. I I I I I I I ISSUANCf OF PFRf1IT c::?::?-,S-t:P TOTAL CHARGES Electr1cal Contractor, the electr1cal port1on of th1S permit Superv1sor and returned to the BU1ld1ng Dlvls10n I HAVE CAREFULLY EXAI1INED t1e completed apnl1catlon for perm1t, and do hereby cert1fy that all 1nformat1on hereon 1S true and correct, and I further cert1fy that any and all work performed shall be done 1n accordance w1th the Ord1nances of the C1ty of Spr1ngf1eld and the Laws of the State of Oregon oerta1n1ng to the work descr1bed here1n, and that NO OCCUPANCY w1ll be made of any structure w1thout the perm1SS1on of the BU1ld1ng D1V1S1on. I further cert1fy that my reg1strat1on w1th the BU1lder's Board 1S 1n full force and effect as requ1red by ORS 701.055, that 1f exempt the bas1s for exempt10n 1S noted hereon, and that only subcontractors and employees who are 1n comollance w1th ORS 701.055 wlll be used on thlS proJect. NAl1E(please pnnt) llol1a /d ~. Cae; e SIGr~I\TURE Ifo,~ Z ~.R _ DftTE.2I13j9D FOR OFFICE USE ONLY So. Ftc). t1a1n Sq. Ftg. Access Sq. Ftg. Other Address DES I GN TEAt~ (name) Phone (address) Prlmary Structural Electncal 11echanl ca 1 CONTRACTORS (name) (address) Genera 1 Plumb1nQ c:i.~.)'e~ - /l-....PE;<f#'~~ Electncal ;i?b~ L~c:;:.~ - 1 . ~lechanl ca 1 PLUt1BI NG ELECTRICAL NO. FEE CHARGE NO. Each slngle f1xture Res1dence of SO. FT. Relocated bU1ld1ng (new f1X. add1t1onal) New c1rcU1ts alts or extens10ns S.F. Res1dence (l bath) Duplex (1 bath) each Add1t1onal bath IHater serV1ce I Sewer IStorm Sewer I I I I I SERVICES I ITempOrary Construct1on IChange 1n eX1st1ng res1dence Imultlfam1ly, comm. or Industr1al IOf ~~ ICOMM./IND. FEEDERS I Install/alter/relocate dl stn b feeders 10f amps.1 I I I I amps.1 I I TOTAL CHARGES TOTAL CHARGES WHERE STATE L 'H REQUIRES that the Electrlcal work be done by an shall not be val1j untll the label has been slgned by an Electr1cal Zone Tyoe/Const. Bedrooms Unl ts Occy Load Occy Group F1re Zone Flood Pla1n Stones BUILDING PER~1IT Charges anc Surcharges Plan Ck Comm/Ind 65%/BldQ Per Fee Plan Ck. Res 30%/Bldq Per Fee Fence PLU11BING PERMIT Charges and Surcha rges I. D!;!mo I S i dewa 1 k I A/C Pav1 ng I Curb Cut I ELECTRICft.L PERt~IT Charges and Surcharges ___2~S~__ /./3 MECHANICAL PERMIT Charges and Surcharges , (llCS. no ) (ohone no:) (exn1r~~) (llCS no) (~)(l)lr~5\ (ohnn~ no ) =?~/ C) - - /~y'-~=? '3.Y/-:56':i?t,/ MECHANICAL FFE r.HARGF NO. FFF rHARGF furnace/burner to BTU's Floor fu rnace and vent Recessed wall Soace heatpr and vpnt Apol1ance vent separate StatlOnary evap. cooler Vent fan w1th slnale duct I Vent systeM apart heatwQ or A C. I Mechan1cal exhaust hood and duct I Hood stove/heater I I I from x Value Value Value x x TOTAL VALUATION Systems Development Cha rqe (1. 5';) Total COMb. rerm1t I T~T~L ::< 3.65 COMBINATION APPLICATION/PERMIT (CAP) I. Appllcant to furn1sh A. Job Address B. Legal Descr1pt1on 1. ~xample- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot I Block 3, 2nd Add1t1on to Spr1ngf1eld Estates C. Name, etc. of owner and construct1on lender D. Energy Sources 1. example- heat/electr1cal ce1linq/or forced a1r qas - 2~ example-'waterheater/electr1cal!or solar E. Square footage or valuatlon, etc 1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- 1f new proJect, check-new - lf add1t1on, check add, etc. F. BU1ld1ng permlt lnformatlon 1. example - construct slngle fam1ly house wlth an attached garage 2. example - remodel eX1stlng garage 1nto fam1ly room 3. example - convert slngle fam1ly resldence 1nto restaurant (change of use) G. Value of work as deflned ln Section 303 (a) of the Structural Spec1alty Code H. DESIGN TEAM AND CONTRACTORS To avo1d des1gn or construct1on delays, BU1ld1ng D1v1s1on Staff must be able to contact appropr1ate persons regard1ng des1gn lnformat1on or Job slte correct1ons, etc. II. Abbrev1ated Plumblng, Mechanlcal, & Electr1cal Schedules A. Except where blank spaces occur 1n the descr1pt1on port1on of the Mechan1cal and Electr1cal Schedules, the appllcant need f1ll-1n only the No. Boxes adJacent to the appropr1ate 1tem(s) to be 1nstalled B. Full Plumb1ng, Mechanlcal, and Electr1cal Schedules are ava1lable at the BUlld1ng D1vls1on 1. To conserve space on the perm1t form the schedules have been abbrev1ated 2. If the 1tem(s) to be 1nstalled are not covered on the abbrev1ated schedules you should consult the full schedul es C. BUILDING 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 electr1cal contractor for slgnature by h1S electrlcal superv1sor. The general contractor lS not author1zed to slgn the electr1cal label. - III. Appllcant to slgn and date Whenever poss1ble, the 1n1tlal appl1cat1on will be used as a worksheet only. Where poss1ble, BU1ld1ng D1v1s1on Staff w1ll prepare a type wr1tten copy and return lt to the appl1cant at the tlme the actual perm1t lS lssued for hlS slgnature. IV. Fees and Charges Plan check fees are due and payable at the t1me of the appllcat1on, and no plans w1ll be processed unt1l these fees are pa1d All other fees and charges are due and payable when the permlt lS lssued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: , "~ PERMIT VALIDATION -" Permit Clerk Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name ~8~ ?~~ signature 4~ date 7-;/7';70 ~'I INSPECTION LItlE . 726-3769 Job Address c-7b-. L-~ /' ,I ?Z~ ~~~/~ Legal De~criptlon E!lERGY SOURCES: Heat Hater Heater Ranqe INFOR/1ATION LINE 726-3753 Sq. Ftq. 11ain ~q. Ftg. Access. Sq. Ftq. Other Ue\~ Add Alter Pep. --Fence Demo Change/Use Other-- -- J CITY OF SPRINGFIELD COMBIrlATION APPLICATION/PERMIT ownerS~~ ~.?~C- .$#'~~7. C~, ~~s /3 5$ Phone 1 ~'?-~E.A/,..s=:::. /7/-=?.. ~77"Vb Construct1on L~nder ~ ValuE of l'lork. R5~Pc> I Builc;lnQ Pernnt Info: Descrlbe l~ork(l.e.. Family Res1dence Il1th ftttached GaraQe) BU1ld Slngle .~ ~ ~ \J ~ ~-7? 7l#/L ~~.z:> ~v.:;;;>.;>~ " . , I ' .?{: .rc /';?'P' ~~ 5LS'5'".t'// C. 6 Address DES I GN TEAf1 (name) Phone ~dr~~~ \ Cl1!:~. nQ~ (~~[11rp'5) (ohQne no. I Prlmary Structural El ectrl ca 1 Mecham ca 1 CONTRACTORS (name) (address) (lles. oQ.) (p.YI1,rp'S) (Ohnnp. no. ) General PlumblnQ ~1V/...r67j . ::A--/;?E.:t,w,;bl-,A' Electrical 'J?OA/ .?~<!:=-~ , v,.. ~ ?~/5 .!'~ ~ - c:;;;-::> ? .'7'/--~6'R',: ~lechan1 ca 1 PLUllBI NG ELECTRICAL MECHANICAL NO. . I FEE CHARGE NO I" I" I" r I1.ARliEJ Jill..... I"I"L CHARGE Each slngle flxture Resldence of SQ. FT. furnace/burner to BTU's Relocated building (new fix. add1tional) S.F. Res1dence f1 bath) Duplex (1 bath) each AddltlOnal bath New c1rcuits alts. or extensions Floor furnace and vent ISERVICES I Recessed wall Soace heatpr and vpnt Storm Sewer I amps.1 I I Appl1ance vent seoarate StatlOnary evap. cooler I Vent fan W1 th slnole duct I Vent system apart from I heat1no or A.C. Mechan1cal exhaust hoo~ and duet Wood stove/heater ~Iater serV1 ce Sewer ISSUANCf OF PFRf1IT TOTAL CHARGES TOTAL CHARGES WHERE STATE L '\l~ REQUIRES that the Electrical work be done by an shall not be vali1 until the label has been slgned by an Electrical I HAVE CAREFULLY EXN1INED t1e completed apnl1cat1on for permlt. and do hereby certify that all lnformat1on hereon 1S true and correct. and I further certify that any and all work oerformed shall be done 1n accordance w1th the Ord1nances of the C1ty of Sprlngf1eld and the Laws of the State of Oregon oertalnlng to the work descrlbed herein, and that UO OCCUPAr~CY will be made of any structure w1thout the perm1ss1on of the BU1ldlng Dlvlslon. I further certlfy that my reg1strat1on wlth the BU1lder's Board lS 1n full force and effect as required by ORS 701.055, that if exempt the bas1s for exempt10n lS noted hereon, and that only subcontractors and employees who are in compl1ance wlth OP.S 701.055 wlll be used on thlS proJect. ''''''(p]"" pd"') /lond Id e. Cue; e SI'PATURE kr~ ~ ~. DATE>>/~.Lfu FOP. OfFICE USE ONLY Zone Tyoe/Const. Un] ts Sq. Ftc). t1ain F1re Zone Bedrooms Occy Load Sq. Ftg. Access Flood Plaln Stories Occy Group Sq. Ftg. Other x Value Value Value x x TOTAL VALUATION BUILDING PER~1IT Charges and Surcharges Plan,Ck. Comm/Ind ____________ ~/Bldo Per I"pp Plan Ck. Res -- 30%/BldQ Per Fee Systems Development Charqe (1. Sr.) PLUI1BING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERrHT Charges and " _ ' Surcharges ___2;;-5:.:-__ Sidewalk /.-'"/:3 A/C Paving Curb Cut Total Comb. rermlt MECHANICAL PERMIT Charges and Surcharges TOTAL ::? 3b.5 ,I - COMBINATION APPLICATION/PERMIT (CAP) I. Appllcant to furnlsh A. Job Address B. Legal Descriptlon 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addltion to Springf1eld Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electr1cal cell1nq/or forced a1r 2. example- waterheater/electr1cal/or solar E. Square footage or valuatlon, etc. 1. example- 1250 sq. foot house, 500 sq. foot garal 2. example- lf new proJect, check-new - lf add1t1ol check add, etc. F. BUlld1ng permlt informatlon: 1. example - construct slngle family house with an attached garage 2. example - remodel eXlsting garage lnto family rt 3. example - convert single famlly residence lnto restaurant (change of use) G. Value of work as deflned in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avold des1gn or constructlon delays, Buildlng D1v1s1on Staff must be able to contact approprlate persons regarding deslgn informatlon or Job slte corrections, etc. II. Abbrevlated Plumblng, Mechan1cal, & Electrlcal Schedules A. Except where blank spaces occur in the descrlpt10n portlon of the Mechan1cal and Electr1cal Schedules, the applicant need flll-1n only the No. Boxes adjace to the appropriate item(s) to be lnstalled B. Full Plumblng, Mechanical, and Electrlcal Schedules are available at the Building Div1s1on 1. To conserve space on the permit form the schedul have been abbrevlated 2. If the ltem(s) to be 1nstalled are not covered 0 the abbrevlated schedules you should consult the full schedul es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to electr1cal contractor for slgnature by his electrical supervisor. The general contractor is not author1zed to slgn the electrical label. --- III. Applicant to slgn and date Whenever posslble, the initial appl1cation will be used as a worksheet only. Where poss1ble, BUlld1ng Divis10n Staff wlll prepare a type written copy and return lt to the applicant at the time the actual perm1t is issued for hlS slgnature. IV. Fees and Charges Plan check fees are due and payable at the t1me of the applicatlon, and no plans will be processed until these fees are pa1d. All other fees and charges are due and payable when the permlt lS issued. V. FOR OFFICE USE ONLY CITY OF SPRINGFIELD - City Hall Springfield, Oregon Development Services OFFICIAL RECEIPT 17704 Date ,bL ~ /=? 19 ~C:> Rec'dFrom;-~7?~H_. -:;?6~""""'r/~~ ~ -., >,. Address ?~~~~- Co Received For~~e--"c./c?/~/~~' c~_ . ~ '<.2.-5>0 /- /:5" ( 7 P/.R-c. / 2'"3: ~3 ~#' ff/~%/<:y-~ Amount Received ""':< '?""_ 6 "'3' !!L ~~ r- FrantlEr BUSINESS FORMS INC 150313428149 BOO6 Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: / - 2:>/ ~ ~ signature 4~, ~ ~~. date 7"/7":70 name ~/7~ r A".t:.~~, - r ~~~ -