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Home My WebLink AboutPermit Building 1985-11-5 (2) S35 ~ Legal Omription //'D 3-- ?; (, - ,,~/-'~j f) 9 (!() ~llrlSPECT 1011 1I11E 726-3769 Job Address INFORllATlON lINl 726-3753 ' Sq, Ftg. 1,Iain ~q. Ftg. Access. Sq. Ftg. Other -1lew _ AddXA 1 ter -,~ep. Fence Demo Change/Use ValuE of Hor~ ~l)L) Other-- Bullciina Permit Info: Describe l4ork(Le.. Build Single Familv nesidence W,t~tt~~h~~ 0araqe\ 'o{I:m::~ /At _ a d'w-e./-<.JaL., , I I CITY UF SPRHIGFIElO COMBIIIATlON APPlICATlON/PERMIT EtlERGY SOURCES: Heat \4a ter Hea ter:~ I Ranqe Owner I~,JM _' /(,v-,P Address /y' ~ I ~W;;;f t1 )yv~~ ~ / (I A~ C(2t/CJ.,S- Construction l~nder Address Ut~IGrl I tAn Primary Structural Electrical Meehan; ca 1 CONTRACTORS Phone '3 ~ /D/5 {name} Phone (address) (lies. no.l lname) (address) (lin. no.) Plumbina General ~A) Electrical ~'echanical ...Jill..... PLUIIB ItIG >>> lJ:liAllllJ "n ELECTRICAL . FrF 'rHARr,F .JJO.-' "Res i dence of Each single fixture SQ, FT. I Relocated building (new fix. additional) IS.F. Residence (1 bath) IDuPlex (1 bath) each IAdditional bath ~!ater service Sewer ~ circu!ts alts. or extg,nslPns T / ~1'i'C~" . I SE'RV ICES I It? o.t I I I '-++ I I I I I I I ~~ ~ \ I~ G1 ~ (exoiresl (ohone no.) Temporary Construction Change in existing l"P~irlpnre Imultifamily, comm. or Tnrfn<.trial 10f I COMl,I,/1 NO, FEEDERS I Install/alter/relocate rlic:.trih fpprlpl"c:. IOf (pxoirpc:.) (ohnnp nn. ~.. MECHANICAL furnace/burner to BTU's t't't' 1..tJ:lAR!iE Floor furnace and vent Recessed wall '\n...('~atpr ...nti 'vpnL _ I' Appl iance vent seoarat~ I Stationary evap. cooler I Vent fan with sinole duct Vent system apart from I heatino or A.C. Mechanical exhaust hnnd And durt /Storm Sewer I I I ~~ I i I I I I I / ISSUANCr OF pmlllT TOTAL CHARGES I TOTAL CHARGES 10."""1 TOTAL CHARGES WHERE STATE lW REQUIRES that the Electrical work be done by an, Electrical Contractor, the electrical portion of this permit shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building Division amps. Wood stove/heater I HAVE CAREFUllY EXN11NED the completed application 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 Springfield and the laws of the State of Oregon pertaining to the work described herein. and that un OCCUPAUCY wnl 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 ons 701.055. that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project. 1lAf.IE(please print) Zone cJ!1, -----, Fire Zone Flood Plain BUILDHIG PERHlT Charges an~ Surcharges PLUI1BING PERMIT Charges and Surcha rges ELECTRICAL PERI~lT Cha rges and Surcharges IIECHANICAl PERMIT Charges and Surchar!)es f fTf.I2. 1<(< Y L ~ ')... f0? SIr,rIATURE FOR OFFICE USE mIL Y Sq, Ftg, Sq. Ftg. Sq, Ftg, (/ Type/Cons t.-5" Bedrooms Stories /~,Units DATE I H,4) C/ Occy load____ _ Occy Group ~:3 ~. t1ain x Value Access x Value Other~~~ Value TOTAL VALUATION ..,.......,~ k. / /r-. e>C> Plan Ck. Conm/lnd -'_~. 65X/Bldo Ppr Fpp -- ----"f::!?-- Plan Ck, Res . 30%IBldo Per Fee i3. (PEG g d... ~<50 Fence ------------1 Oemo 1.:::9. <:>0 I Sidewalk -------~-ro-I A/C Paving L Curb Cut r----------- Syste~s Development CharQe (L5~) //~. I I I ITota1 Comb, rermit I I TOTAL 20.8-0 -' COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I I. Applicant to furnish A. Job Adaress B. legal DescrlPtion 1. example. Tax lot 100. lane County Map Reference '11 03 4J 2. examole. lot 1. Block 3, 2nd Addition to 5prlngfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air Qas 2. example. waterheater/electrical/or solar E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. example. if new project. check-nfw - if addition, c/leck add. etc. F. .Building permit information: 1. examole - construct single family house with an attached garage . .:. ~,. 2. example - 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, DESIGN TEAI'I AIIO 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. II. Abbreviated Pl~mbing, 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. BUILDING DIVISION STAFF WILL FilL OUT ALL FEES ANO 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. - 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 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. '~,1\) / (l , a1 l . ,. V. FOR OFFICE USE ONLY Permi t Cl erk LV PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ! Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: I I I 'x ",,- name Li?J?N~ ~~fSignatur~~~~ ~~~ ~ '. ~~~ ~~ . PLANS REVIEWED BY: ~ date //7S'-~;