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Home My WebLink AboutPermit Building 1979-12-26IN IL COMB I iiAT I APPL I Job Address l/ ,O Lc- 5/. JVap. l-egal Descri p tionl!66 &oq 4 f,<,,€Faz? aacasts EIIERGY Hea Ran Sq. Fto. l''lain. 50. Fto. Access. Sq. Ftq. othe, 4A- _l'lew_Add_AlteTZEp. - _Fence_Demo_C hange/ U se 0ther fi t,lt Ut N -L,N Value of l,lork: St zsoo. ojOwner Addre s s //"ro cl,JtzC ;m n t l^lo r Farni'l l;€ I Build Single ,aAuUnaZ oEE4 ,?ataco € rssrrNQ .*addd cE' Construction Lender tfiryT€ VA 542€lut,Addres s Phone DEs I GN TEAI.1 name address exDt res ohone no. Pri ma ry /1/gZA/?E /NDoyp/*, lfra4pap 87/7 //-/?/a 7/4tc4s //lla ltStructura I El ectri cal 6tltU,*d Ecerdc' Eaaatrtc, Al&artaa'E Pzq a ?.i'lechanical CONTRACTORS name add res s I i cs. no.exDl res ohone no. Genera I &(&AvZ€ avt2()St2tt8. Sm'pvilU 8?7 /t-l?la 74/6r'3 Pl umb i nq tUE4oaaBtE Pc*r €c.68*tE El ectri cal fiutcoczs 6(8e,,aa J'. l'lechan ical PLUI4BI NG ELECTRICAL 14EC HAN I CAL FFF CHARGF NO FFF l^HA PG F NO FFF I'HA PC F I Each single fixture oa3 Residence of SQ. FT furnace/burner to BTU' S Relocated building (new fix. additional )L-/New ci rcui ts al ts or extensions /e Fl oor furnace and vent S . F. Res i dence ( I iratn )SERV I C ES Recessed wal I Snaatr heatpr and vpnt Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seDa rate l,Jater servi ce Chan res i ge i n exi sti ng dence Stationary evap cool er Sewer multifamily,comm. 0r Inductria l /Vent fan with sinole duct J"o Storm Sewer 0f s.Vent systern apart from heatinq or A.C. COMI.I./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re1 ocate di ctri h fppdprc ['lood stove/heater 0f S. ISSUANCF 0F PFRI1IT 3ao TOTAL CHARGES 3 €82 TOTAL CHARGES lsda TOTAL CHARGES m I^IHERE STATE Llll REQUIRES that the Electrical r^rork be done by an Electrical Contractor, the electrical portion of this permit shall not be valiC until the label has been signed by an Eiectrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for permit, and do hereb,y certify that all information hereon is true and correct, and I further certif-v that any and all work performed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0reeon oertaining to the work described herein, and that NC 0CCUPAI{CY will be madeof any structure without the permission of the Buildinq Division. I further cert ify that my reoistration r,rith the Builder's basis for exemption is noted hereon, and that used on this project. Board'is in full force and effect as required by ORS 701.055, that if exe only subcontractors and ernployees l^iho are in comcliance with 0l?S 7ni.055 the .z<-I'lAt'1E(please pri nt)T FOP. OFFlCE USE OiII Zone__________Tyoe/Const. Units So.Ftg Ftg Ftg . l,lain llOO x Value Fi re Zone Bed roomsr 0ccy Load Sq . Access lOO x-__----va lue Flood Plain Stories 0cc.y Gro 0t her x Val ue TOTAL VALUATI 6@ BUILDING PERI{IT Charges and Su rcha rges lE;o9 Plan Ck. Comm/Ind 65%/E1dq Per Fee Svster,ls Deve charqe (1.5c opment Plan Ck. Res 30"4/B1dq Per Fee 2D,4n- PLUI4BiNG PERMIT Charges anC Surcha rges 1._o_o_ Fence D6mo ELECTRlCI.I. PERTI]T Charges and Su rcha rges /.5.P_Sidewalk A/C Pavi ng Curb Cut Total Comb. Permit I,IECHANICAL PERt.,lIT Charges and Su rc ha rge s €._08_ t)o IOTAL (g, n-zo) #ttt.o/ 26-3753 Itater HeaterSS4ES;-- Phone COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. B1ock 3, Znd Addition to' Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION I. exampl e-2, exampl e-E. Square foota heat/el ectrical cei I i n r forced air gas sol arwaeatereca0r ge or valuat on hexampl e-1250 sqif new foot ouse, 500 sq. foot garage 2 examp I e- check add project, check new - if addition, F. Building perm 1, example - attached , etc.it information: construct singie family house with an garage 2. example - remodel existing garage into family room3, example - convert single family residence intorestaurant (change of use)G. Vaiue of work as defined in Section 303 (a) of the H Structural Specialty Code DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bui)dingDivision Staff must be able to contact appropriate persons regarding design information or job site correcti ons , etc.II.Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Ful 1 P1 umbing, Mechanical , and Electrical Schedulesare avai lable at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. if the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF WiLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for s'ignature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label Appi icant to sign and date l,Jhenever possible, the initial application wilI be used asa worksheet only. llhere possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the tjme the actual permit is issued for hissignature. Fees and Charges Plan check fees are due and payable at the time of theappiication, and no plans r.Ji1) be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III IV Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registrat'ion t,rlith the Bujlder's Board because: Additional Project Information PLANS REVIEl^lED BY: name s i gnature da te /*-;|tr-Z' IIISPECTION LIIiE 726-37 69 D D PERMII N T c0rlB I TION APPLICATIO 72 * (.N UI r- N Job Address t/ rc //LL 5f. 5e*a.il:["iP4Ee t,ta tei Hea terlfCl€ C.- Ranqe Er*Eo Sq. Sq. Sq. Ftq. l.lain Ftg. Acce Ftq.othe er., Add A ence Derno r'/'odt ss.l#a -,l terz-P€p. _Change/Use ll, -Fr-0ther- Lega1 Descrigtion/66 ./4/ I ,f,rn €EaLA aEza*S Vai ue of l,Jork: $/ 8,Sff). ogOwne r Address /U//4 Jv Phone n scr l.lo Fami l idence llith At c Ga ra e., Build Singie ,@rrCeAeC € U/,*r/r?J+ .*d/€d EE' Construction Lender i\ddre s s Phone name addres s lics. no.exo i res ohone no, Pri ma rVc.(atZE 5#ate*pz gZ/Z //-7{d-tcdS St ruc tura I E*gEPe,E I ectri ca I llec ha n i ca I r/4i3L8 P1 a'l ,. n an'e address expi res )ohone no. Genera I i{egAe€ euddsdtt8 SFtT -/73o 7i#r6{3 Plumbi I .Sctttotzs fr PLUIlBI IiG ELECTR I CAL I'4EC HAN I CAL il0 FEE CHARGF NO FFF CHAPCF NO FFF C HARG F Each single fixture Residence of SQ. FT furnace/burner to BTLI' S Relocated buiIdinq (new fix. additional ) New ci rcui ts al ts or extensions t-<u Floor furnace and vent S . F. Pes i dence(t bath)SERV I CES Recessed wal I Space heater and vent Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent sepa ra te l,later servi ce Change in existing res i dence Stati onary evap cool er Sewer multifamily, comrn. or Industrial Vent fan with sinole duct -1 Os Storm Sewer 0f Vent systenn apart from heatinq or A.C. COI,III./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/rel ocate di stri b. feeders l'lood stove/heater 0f ISSUANCE 0F PFRiIIT Zoo TOTAL CHARGES TOTAL CHARGES t -o-C./'-)TOTAL CHARGES .*l I,IHERE sha I I not STATE LltJ REQUIRES that the Electrical work be done by an E1be valil until the label has been signed by an Electr-ical Su ectrical Contractor, the electrical portion of this pernjtpervisor and returned to the Building Division HAVE EXAlllNID the comp eted apnl i cati on r Dermit, and do hereb.y certi fy that a I information hereon .is trueand correct, and I further certifvof Soringfield and the Laws of the that any and all work p erformed shall be done in acc ordance with the Ordinances of the Ci ty madeof any structure without the Board is in full force and eonly subcontractors and empi permi State of 0reqron oe ssion of the Bui'l di rtaining to the work described ng Division. i further certify 7C1.055, that if exempt the bal herein, and that NC 0CCUPAHCY will be ffect as required tha t m.y reqistration with the Builder,sb-v oRS is for exemption is noted hereon, and thatoyees who are in comclia nce wi th 0l?S 701.055 rv.i I I used on th i s oro,j ec t I,lAl,lE ( pl ease pri nt)S I GiIA T -z<- E Zone Tyoe/Const its S o. Ftg. l,la i n ./'Ar)ValFire Zone Bedrooms Load Ftg. Acces Ftg. 0ther x a lue Flood PIai Stories 0c c.y Group Sq -Value T0TAL V,tLi.trTIOtl ,:-n^4 BUILDING PERI,lIT Charges anC Surcharges ii Plan Ck. Comm/Ind 65:l/Bldq Per Fee Svs Cha tems Deve rqe (1.51 oprnen t Plan Ck. Res 30""/B1dq Per Fee ?),,;t.,ii@ PLUI4B]NG PERMIT Charges anrl Surcha rges ELECTRICAL PERIIIT Charges and Su rcha rges a '-=J- t Fence Dgmo Sidewalk A/C Pavi ng Curb Cut Total Comb. ler;'r'i t I{ECHANICAL PERI.IIT Charges and Su rc ha rges t I ,ta:t_ ,.".1 a.l: -:i, TOTAL t'f I /< r,r.t / /\)' tJ':' Sar,glut , GN I tAr't RACTORS Y do ":-uni^dcli, ,"r"i**'lr #*,1*.-.COI4BINATION APPLICATION/PERMIT (CAP) I. Appiicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3. Znd Addition toSpringfield EstatesC. Name, etc, of owner and construction lenderD, Energy Sources L'F 5 b a.B5 rl r< o Cl o t9 1. 2.t, Squa 1. 2. exarnole- heat/electrical cei I inq/o exano I e- waterheaier/el ectni cal /orre f66t6gs or valuation- etc-.- examole- 1250 sq. foot house, 500 sq. foot garage example- if new project, check new - if addition, check add, etc, r forced air oas !e.l-qr F. Building permit information:1. exar,rple - construct sing)e family house vrith an aTtaclEo garage2. exanole - remodel existing garage into family room3. exarnolE - convert single iamily-resiaence into iEsTi-urant ( change of - use )G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI.| AND COIITRACTORS . To avoid design or construction de)ays, Bui lding Division Staff must be able to ccntact appropriate persons regarding design inforrnation or job site corrections, etc. Abbreviated Plumbing, i'lechanical, & Elec:rical Sch:i.rlesA. Except r.rhere blank sDaces occur in the descrictionportion of the I'lechanical and Elec:rical Schedules, the applicant need fill-in only:he ilo. Boxes adjrcen! to the appropriate item(s) to be instal'ledB. FulI Plumbing, l''lechanical, and Eiectr"ical Schecju'l es are avai'lable at the Building Division1. To conserve space on the perrnit form the scheCules have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUiLDING DIVISION STAFF t^JILL FILL OUT ALL FEES AND 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. Applicant to sign and date Whenever possible, the initiai application will be used as a worksheet only. Hhere 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 s i gna ture. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans ni11 be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. FOR OFFICE USE ONLY II III IV q nl ,Y €oa erao, !a!r,.! V Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: permit applicant exempt from registration with the Builder's Board because: Additional Proiect Informat'ion : name date /*',*,,r-? ?s'r g nature '// PLANS REVIEWED BY