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HomeMy WebLinkAboutPermit Building 1987-07-13C. t, I II tt, I 7 m COMBI NATI ON APPL ICATION/PERI.IIT 726-3753 Job Address Legal Description EIIERGY SOURCES: Heat l,later Heater Ra n Sq. Ftg. Access._ s N \h l', Value of l,lork: /A f,ae, aowner {y' F /?vs>>= :z= Address n tln ,e., Build Single Construction Lender Address Phone 7 name addre s s exDl res ohone no. Primary Structura l El ectri ca l Mechanical CONT ACTORS n ame a ddrps s lics. no.'exn i rps )nhone nn G"n""u1 ZZtYrrlER Pl umbllq Electrical ? jlj EC :<-n PLUI,IBI NG ELECTR I CAL N0.FFF NHARGF NO FFF CHAPGF NO FFF CHARGF Each single fixture Res idence of sQ FT furnace/burner to BTLI' s Relocated bui lding ( new fi x. addi ti ona I ) few circuits alts. or extensQ ,ar?i ons,,D*E Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wal I Snace hpatpr and venf Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seoa rate tlater service Chan res i ge in existing dence Stationar.v evap. cool er Sewer multifamily, corrn. or IndustriaI Vent fan with sinole duct Storm Sewer 0f s.Vent systern apart from heatino or A-C- COI.II.I. / IND. FEEDERS l4echanical exhaust hood and duct I nsta I I /a I ter/ rel ocatedistrib. feeders l'lood stove/heater 0f .r'amps!a-fra*+ ?4u7P, ISSUANCF OF PFRIlIT TOTAL CHARGES TOTAL CHARGES 27.5>TOTAL CHARGES ,z12ly. ./S.oo -I.IHERE STATE L1Iishall not be vaiiC REQUIRES that the unti l the label has Electrical work be done by an Electrical Contractor, the electrical portion of this permit been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAIIINED the completed apnlication for permit, and do hereb.y certi fy that all information hereon is trueandcorrect, and I further certify that any and all work performed shall be done in acc ordance with the Ordinances of the CityofSoringfield and the Laws of the State of 0regon the Buil oertainin-r; to the work described herein, and that NC 0CCUPAI,ICY will be madeof any structure without the perm Board is in full force and effect only subcontractors and employees ission of di ng 70t Division. I further certify that my reqistration urith the Builder'sas required by ORS 055, that if exempt the s r exemption is noted hereon, and that who are in comcliance with 0l?S 701.055 wilI on this nroject. l{Al'lE (pl ease pri nt eote S IGNA t3 ( Zone____TyDel Con s t.its Sq. Fts. nain*lfzlrsz* /r*F.ius1us fac>.-Fire Zone Bedrooms Load Ftg. Ftg. Access x Value Flood Plain Stories 0cc.y Group 0the Val y2 ft).aa,e .._. J,./ TorAL vALUATlou /2.#q3.--------7-- BUILDING PERI'IIT Charges and Surcharges ---Qr---:- Plan Ck. Conrn/Ind 65%/Bldo Per Fee ,1z,t7rrPt6q7450 vt7a>sYs Cha tems Deverqe ( 1.57 opment /sz+Plan Ck. Res 30%/Bldq Per Fee PLUUEING PERMIT Charges and Su rc ha rges Fence Dgmo ELECTRICAL PERTIIT Charges and Surcha rges v-s8 3 Sidewal k A/C Paving Total Comb. Permit ?7-es I,IECHANICAL PERMIT Charges and Surc ha rges Ae 5 Curb Cut TOTAL 26279 Ftg.0ther MECHAN I CAL r\ PERMIT VALIDATION Permi t Cl erk a, tt 1A i,fl ,\, coMBrNATr0N APPLTCATToN/pERMrT (CAp) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference TfT3-43 C. Name, etc. of owner and construction lenderD. Energy Sources F. Building permit information:l. exampie - construct singie family house with an attached garage 2. example - remodel existing garage into fami)y room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, 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. Full Plumbing, Mechanical, and Electrical Schedules are avaiiable at the Building Divisionl. To conserve space on the permit form the schedules. have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the fu l I schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label.III. Applicant to sign and date Whenever possibie, the initiai application wilI be used asa worksheet only. Where possible, Building D.ivision Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed untii these fees are paid. A'll other fees and charges are due and ,'payable when the permit is issued. V. FOR OFFICE USE ONLY ,, , . exampl e-. example- quare foota example- 1250 sq example- if new EIEEk-add, etc. aragesi 2 air gas foot house, 500 sq. footproject, check new - if add ti on, Lot I. Block 3, 2nd Addition toeld Estates examp 1 e- SEmnsfi I 2E. S 1 2 ..PNO'EC' CONDITIONS TO BE SATISFIED BEFORE OCOSPAftEII /5SC>4'Z<€ 2F T2EZMT2^: , Kaceryea q-/ -gZ 7- lVzc> Orus.,< 4- 5P.u <7<a F4*e7 aR B-o*.-4@rR Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: s i gnaturename .da & 8-a-97 E*,aro*z xtR 8 ?o {sz t?/1 rta,*4t<.( FY- C&Eare he alread DECLARATION OF PRIVATE EASEMENT KNOI, ALL MEN BY THESE PRESENTS, that the undersiqned, hereb.v cal'led Qrantors, are hereby declarino that the following described nrorrertv is a Dermanent n,on excLusive driveway easement. Investments, otrvners of property occupied by Heritage Restaurantreby granted non-exclusive access to a certain l5'5" easementy established on west side of property described be1ow. The easement shail be used for the purpcse of no.n.exclusive aCCeSS dr.rteuay serving the fol lowing described property: Beginning at the most Southerly Southeast corner of Block 7 of Mohawk First addition, 3s platted and recorde lat Records, running thenc lot at No ,t 500 e et 10.0 County P ng the N .0 feet;f Mohawk 5 page 23 of volume 15, Lane 4TrInJest I51.0 feet alo North 29o L3t East I3O to the lnlesterly line o feet along said lnlester ortherl thence Road;to the on y1 So the poi ine of trMrr stree uth 5Oo47 ' East nce South 29o L3 nt of begginning d et I I rth henc 5I.0 fe lnlest I in Springfield, 1a n Coun 1y line ty, 0reg Y'A-1-](r ) , t9 t 2 befora me, St,aGl oersonal l.y STATE OF CREGON ss. County of Lane BE iT REl,lEl'tBEtiED, That on this an day r5 of dl ) ) w'ithin instrument anC ackn:wledged to me that {i,xt(.uiea' tiie same ,Ita I r{L tt th ) the undersicined, a-Notary ai:i:earerj Lire w'itnin r,amed kiit'v,;ii to i'ne ;O De 1\g icjen and voluntarili'. TTST I!4CNY I.'I{TR[OF e da.,i ano yrar las rr l:)'..t i;C .*irT- e-r,-. c'.r t ef-in e f iee l.y have hereunto set m.y hand and aif ixed m3' li'f icial Lruve wri tten. Publ'i in nt.,y" e n sea I . ,. 7''k, u QT reg.);r l'ly Comrtssion expires :2 /au /di) I /lt Cor.t,z{{J 6 ? t J ar'a slm Iit ll a -i t- { I I E lrlHF 0r {fJ j' t srrfi s/// "*F (7,', t'*. .h rl,. *'o - %\ &\*?rc.aa ,{r' 5 I I {f s .i* (, $ \ tdti rr: ,fr$ '21'( E) nt* : F"rsI tI T} * BGOO 7 rcqt 9S$ e - -:k;IJa T s800 t esoo' ,ta o ri1, : I I -!: I t { II Ilr t1 il l il t ti it il. I I'I it il