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HomeMy WebLinkAboutPermit Building 1980-05-19I 7 ECTIO 37 69 rtLL C C()IlB I iIA AP I CATI RMIT 7?6-3753 Job Address O1c-r E;IERGY SOURCE Heal I 11 dn Ranoe *tt tt - lJa rterteHea Va I ue of l.lork : / $,ooO.49 So. Ftq. I'lain l-egal Description Owner G Sr, Bui lt. i n Fani I v q Pernri t I nfo: Descri be l^lork ( Residence llith Attached Garaqe s., Build SinglePhoncgswJe.Address BLIO ) Er-:oev€,(J ,ln,thLh^A n" /t Po,iln n urxj Construction Lender )/n-;;/^T a*0. Addre s s Phone Io Ews DES I GI{IEIJI--name address ics. no. ) (exnires (ohone no.' Primary t . U-C'.:.zJrs Structural S an \(, Sean r.e-El ectri ca l l'lec ha n i ca l CONTRACTORS n arne address )I ics. no.exo'i res ( ohonp no K.oxtcq,D 5rb 1n Ge \ \o '81 *t4ldFIA A\e..2* I hani ectrical PLUIlB I IJG EL TCTR I CAL MEC HAN I CAL FEF CHARGF N0-;FF l-HA ANF FFF II'I]AACF t Each si ng l e fixture S.oo J>t{ Residence of FTSQ furnace/burner to BTLI' S Relocated bui Iding (new fix. additional ),'r'2 New ci rcui ts al ts.or extens i onsTJ/a o2,t,rqEE Floor furnace and vent S , F. Res i dence(l bath)SERV I C ES Recessed wal I Soace heater and vent Duplex (l bath) each Additional bath Temporary Construction Apol iance vent s eoa ra te l,later service e in existing ENCF Chang resi d Stationary evap coo I er Sewer multifamily, comm. or Tndrrstrial Vent fan with sinole duct 4.1 L.ce Storm Sewer 0f amps.Vent system apart from heatinq or A.C. cor.lr.'r. / rND. FEEDERS :L Mechanical exhaust hood and duct t!',lQ 9,ao Instal I /al terlrel ocatedistrih- fepderc tlood stove/heater 0f amp s. ISSUANCF 0F pFRrlIT /c,oo TOTAL CHARGES TOTAL CHARGES /S,oc TOTAL CHARGES o?S,cC REQUIRES that the Electrical rvork be done by an Electrical Contractor, the electrical portion of this perr,rituntil the label has been signed by an Electricai Supervisor and returned to the Buildin! Divjsion l,lAtlE (p l ease pri nt )S IGiIATU LJHERE STATE Lll,.lshall not be valiJ r 0req the Iany rd f exemp .055 rii E INE t etI iI tica foon r t1edc0mpl-)ap he tcer 'I ttha Ia iI forman 'It 0n nreo 1Dermrebyhe uetrfy nda rrec t a Ind rtherfu tcer 'I ttha a nda Ia workIfyny rrnedoerfo Isha 'I n nceaccorda thvll t 'I oIdonbehe0rdsna nce eth Ic tyfSfiprtedIndaLavlsthefotn9heLOSoftenIonaItothklrorcrtdesherebednIathndtaI'Irtq0circwlCUPANCY mabe deDCtsfruwlcturetthouethIpermIssnoof1UdiIvlDr's on hefurt cer '1rt tha t 'I tS ra I I1InqtonthynButhe der sfym.y re-q S'1 jBoa n II afo rce nd ctffeue '|ed 7asrORS t ba Is foS r t 0nI athereq u 0 055 th ta 1by ex emp s henoted reon nd ttha n I S trubcon torac ans d IvernD se awho 'Ire n I 1 beI0yeIncaw'l nbcrh n 1 edus thon s'I tcomDro.l ecp : USE 0llL Fire zone-Z_pedrooms 0ccy Loaa .f 1i sq Fts. t4ain /-fCC x___Value /,?,&y!& 0t her 4-.< Acce sc Flood Plain ty'q S tories ,/ I Val ue croup #-f- sq TOTAL VALUATIOII / x Val So Ft! Ftg Zon"_Q*- A__tyDelconst. Un.i ts_ Plan Ck. Comm/lnd 65:1/8ldo Per Fee s tems rqe 1 VC 57 opmen tBUILDING PER}IIT Charges anC Su rcha rge s 84tc- Plan Ck. Res 30:1/Bldo Per Fee FencePLUI4BING PERMIT Charges and Surcha rges /, ?( nn-!---'g--- D6mo Si dewa I kELECTRICAL PERI,:IT Charges and Surcha rges ao , {rA Total Cornb. IermitA/C Pavi ng Curb CutI,IECHAN I CAL PERM IT Charxes and AS,po- /,DO r-crl1 f /---:' 5.31..5{-#/Ls s,- ".t Sq Acces s 0the r Van $i:v<.v.r 3AS-3oS! s t COI.IBINATI ON APPLI CAT] ON/PERI'II T ( CAP ) I . Appt i cant to furni sh A. Job Address B. Legal DescriPt'ion l. example- Tax Lot 100, Lane County l4ap Re l7l3-T3 2. examole- Lot 1. Block 3, ?nd Addition to SFFingTield Estates C. llame, etc. of owner and construction lender D. EnergY Sources PERMIT VALIDATION OF SPRINGFIELDC trv ? o l. exanro l e- heat/ 2. ExamcTe- rvater e'l ectrical ceili a r e ec tr ca on, CirY Holl Springfield, Oregon o"o.ri-"it of Public works--SrFtclAt REcEIPT No. B Ior forcer soTar 53656oE. SquareT6otage or valuati 1. exanole- i250 sq. foo ?. example- -if new proje check add, etc.3 ^,19 t house, 500 sct, check new q. foo: - if a< c. {: te irlr-0 II F. Building permit information: 1. examole - construct single family house wi attached garage ?. example - remodel existing garage into fam 3. examole - convert single family resjdence iEsTi-urant (change of use) G. Value of work as defined in Section 303 (a) of Structural Speciaity Code H. DESIGN TEAI'I AND CONTRACTORS To avoid design or construction delays, Buildin Divjsion Staff must be able to contact appropri persons regarding design information or job sit corrections, etc. Abbreviated Plumbing, Mechanical, & E'lectrica l SchetA. Except ,irhere blank spaces occur in the descript'portion of the l'lechanical and Electrical Schedul the applicant need fill-in only the No. Boxes acto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedu are ava i lable at the Bui lding Division1. To conserve space on the permit form the sch, have been abbreviated 2. If the item(s) to be installed are not coverr the abbreviated scheduies you should consult fu l I schedulesC, BUILDING DIVISION STAFF t^IILL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered electricai contractor for signature by his electr suoervisor. The general contractor is not author' to sign the electrical label.III. Applicant to sign and date !,lhenever possible, the initial application will be use a r,rorksheet on1y. Where possible, Building Division Swill prepare a type written copy and return it to the applicant at the time the actual permit is issued for 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 thes fees are paid. All other fees and charges are due and payable yrhen the permit is issued. V. FOR OFFICE USE ONLY - PLANS REVIEI,JED BY: BY I €t- SHaLron luiaouLL PililERS Permit Clerk da te ddIt d ro ived F Ll oo o I t { ( 'a.l-, {t 4O c9*1 ( ) ( ( ( ln (" Zidl ,.t 1u it4 lat jJ. oo SC, Amoun ( ^u7HOR ,-zeo t,c*^tu"g PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: )-l {J L Permjt applicant exempt from registration with the Builder's Board because: Addjtional Project Informatjon: name SI snature l2^ A)-il, Y cQtt-