HomeMy WebLinkAboutPermit Building 1984-10-02iISPECTiON LIIIE
?6-37 69
CITY OF SPRINGFIELD
COIIBI IIATI ON APPL I CATION/ PERMIT 726-37s3
Legal Description
Job Address
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Sq Ftq. 0ther
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s dence
Sq . Ftq . l.la i
llater Heater
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EIIERGY SOURCES:
Hea t Sq. Ftg. Access._
0wner TfE' gnUv,+tran AA,,Y , A 4gp , Aop.
phonelfl,@rAddless v1*ba rir(.6 VLEN
4,56 tq.l'F. OilbtE :gk)qt \w WIZE Miu- ail. f,millro"rsb , &, T1117
Construction Lender 6Odalfico1 erfi.,a,a1 ? arnil\urt|.1 &.bttl%,
04
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Arldres s Phone
DES I GN TEAI,I name address exD r res ohone no.
primary U:tes ,/ 6*tfiEt- Aeoil. frc. AO OAIL 4.3Z.Un
(L
RID
Structura l
E I ectri ca l
Hechanical fu*Ze @ld **2.cE ltGar.r fur- tacp
pYnt rpq nhnnp nnn ame addres s 1 CS. nO.
Generar Fana 4r.*z 4, /7* Dlr * - Elxs,,uz,??q-s2s
Plumbinq
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ELECTRI CAL MECHAN I CALPLUHB I NG
FFFFFF.HARGF NN FFF T.HARGF NO
/e-'t Residence of
FTSQ
furnace/burner to
BTU' suEach single fixture se
Floor furnace
and vent
Relocated building
(new fix. additional)
New circuits alts
or extensions
Recessed wal I
Snaae hcatpr and ventSERV ICES{l bath)
S. F. Residence
6.-/a*7 V4i,7/arubDuplex (1 bath) each
Temporary Constructi on /an Apol iance vent
seDa ra teAdditional bath /
Stati onar-v evap.
cool przd,"Change in existing
resi dencellater service pt
z5''I ndus tri a I
multifamily, corm. or Vent fan with
sinole duct
,*Sewer 7A
/.(Y ?.o'of lilro amps.fl,*a apart from
.c.
Vent system ,
heatinq or AStorm Sewer f,16'ffi*//.vcor,lr.t. /IND. FEEDERS /Mechanical exhaust
hood and duct
lJood stove/heaterInstal l /al ter/re1 ocatedistrih. feeders
4,-*,'z ot 22f, anp*,
/2r//o2
+5€trANTfffTT".fllT'
TOTAL CHARGES 3/..'aTOTAL CHARGES /?o.ooTOTAL CHARGES .?z?.*
HHERE ST,
shall not be
ATE L]\I,I REQUIRES
val i'l unti I the
that the Electricaj work be done by an Electrical Contractor, the electrical portion of this pernit
label has been signed by an Electrical Superv'isor and returned to the Building Division
mEDthecomp1etedapn.|.icationforoermit,anddohereb.ycertifythata.llinformationhereon.istrue
and correct, and I further certif.v that any and all work performed sha1l be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Oreqon oertaining to the work described herein, and that NC 0CCUPAI'ICY will be made
of any structure without the perm'ission of the Building Division. I further certify that my registration vrith the Builder's
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and empioyees who are in comcliance with ORS 701.055 will be used on this project.
r{A}.rE(please printl (srh R-}\ F6Lk€-Q- srclrn T
Ftn
Ftg
Ftg
Vat,la
/+aaa.e
r0the"t / occ.Y Gro
nsto,
TOTAL VALUATI
Fire Zone Bedrooms 0ccy Load.
Uni tsZone lue
Flood Plain Stori
'I ue.
'lue
z4u=t a3 Svsteris Develocment
charqe (1'5t') 'ffi1.4oPlan Ck. Conrn/Ind
65%/81do Per Fee
Plan Ck. Res
30%/Bldo Per Fee
BUILDING PERNIT
Charges anC
Su rcha rges
f"-4_/
t^ r?-{arfrPr4;YfcryFence
Demo
PLUI4BING PERMIT
Charges and
Surc ha rges
zza.*
&
srdewatk {O'
Tota'l Comb. Permit qgl.y{{6.o0
ELECTRICAL PERI|IT
Charges and
Surcharges
__-/4,?:_b
,-t C-t/1-3/'
A/C Paving
Curb Cut 2{ra.?TOTAL
I,IECHANICAL PERMIT
Charges and
Surc ha rges ---3/-:{f-/.26
n
:TORS
I
COMBINATION APPLICATION/PERTlIT (CAP)
I. Applicant to furnishA. Job AddressB. Lega'l Descri ption
l. glaTple- Tax Lot 100, Lane County Map Reference
17 03 43?. example- Lot l. Block 3, Znd Addit.ion toSffingf,ield Estatesq. Name, etc. of owner and construction lenderD. Energy Sources
exampl e-
examp I e-
re foota
d air gas
?
E Squa
1. example--1250 sq. foot house, 500 sq. foot garaget. example- if new project, check new - if addition,dhtiEEF;-dd, etc.F. Building permit information:1. example - construct single family house with and,:tached garage2. l21q4ple --rer6del existing garage into family room3. exaffi'Ie - convert single iarii ty"iesiaence intoFEsTiIFant (change-of"ui")- " -
G. Value of work ai defined .in Section 303 (a) of the. Structural Spec.iaity CodeH. DESIGN TEAI.I AND CONTRACTORS
To avoid design or construction delays, Building0ivision Staff must be able to contalt appropriitepersons.regarding design information or job iitecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedu.les,the applicant need fjll-in only the No. Boxes iajiient_ to-the appropriate item(s) to 6e installedB. Full Plumbing, Mechanical, and Electr.ical Schedulesare avai lable at the Building Divis.ionl. To conserve space on the-permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefu l'l schedu lesC. BUILDING DIVISION STAFF I.IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESq. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by h.is electrical -
supervisor. The general coniractor ii not authorizedto sign the electrical labelApp)icant to sign and date
Whenever possibie, the initial application will be used asa.worksheet only. tJhere possibtb, auiia.ing 0ivision Siaiiwill.prepare a type wr.itten copy ind return it to theapplrcant 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 theapplication, and no plans wiil-be proceised until theserees are paid. All other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY
II.
III
IV.
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($l}Dbx/'l
) \3s4
-fO.l.d- t-I\rnxr
PERMIT VALIDATION
Permit Clerk
lo3to3-l
b3o3Y
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
t applicant exempt from registration with the Builder,s Board because:Permi
Additional Project Information :
na*" l*ye Pq*<;ignarure
PLANS REVIEWED BY:
da t" 7-??*A V