HomeMy WebLinkAboutPermit Building 1990-01-17Job Address
Legal Description
INSPECT I
726-37 69
L COMBI
Ran
L CA
EIIERGY SOURCES:
Heat
l,later Heater
. Ftg. Access.Sq
Sq . Ftg 0ther
tlai
3Value of l,lork:
c*
ngle:€. to: Des
GaraAddres s Phone
Construction Lender
N
h
vl
Addre s s Phone
Pri ma
Structura I
E i ectri ca l
Mechanical
Genera I
Plumb
MECHAN I CALELECTR I CALPLU}.IB I NG
furnace/burner to
BTU' s
Residence of
FTSQEach single fixture
Floor furnace
and ventNew ci rcui ts al ts
or extensions
Rel ocated bui l ding
(new fix. additional)
Recessed wal I
Soace heater and ventSERV I CESS.F. Residence
( I bath)
Duplex (1 bath) each
Appl iance vent
seoa rateTemporary Constructi onAdditional bath
Stationary evaP
cool erChange in existing
res i dencel,Jater service
Vent fan with
sinole duct0rmultifamily, comm
I ndustri a ISewer
apart from
.c.
Vent systenn
heatino or As.0f amp
Storm Sewer Mechanical exhaust
hood and duct
lJood stove/heaterI ns ta l I /a l ter/ re l ocate
di stri b. feeders
ISSUANCE OF PFRIlIT
S IGNATUREllAl.lE(please print)
Ftg
Ftg
FtgOcc.y Group SqFlood Plain Stories
2-2=td
DA
x
x
temsnd
S
Occy Load
an
an
ts
done by
El ectri,REQU
unti I
HARGEC SALTOTSCHARGETOTALESRGCHATOTAL
s +rmlIIarto1nthi0f,het Ie tr cec peca'I ConI ctortra ponEectractri'Ia beworkRESItthaE1theecL.1NSTATEl.,HERE td 'I s onIthetoIDiBu1andrernedtung1sorSIcauPerv'Is a nIbeahaIbeesngnedthebeIva,JIash1Inot
apr)
and Ci ty
made
performed
ning to thOregon
the Buiof any
Boa rd exemp
055 wi
'Ireon truesn'I tforma on1fatthacertdohereandvonfotcapeEDNtheCARcomp s the0rdnance'IthethnIccoaanrdcewlshaIIdonebeI'I rkwoaIhattanyaIndfurrthecertndtcorrecfy wl I1 beNOCYOCCUPANLtha1rehenIandworedescrbedkItaoftetheSDerta'I 'If Ie ad thend ofLawsofsprng deI r svrihttheIus'|Ltra o'I nrIrtthat'I 1 on fu rthe ce my regId1'l sDI fyng1ssnooftut ruc WIre tthou permithes ha tandthereonnoted1son'Iba'Is fors exemptthet5ttha'I fr'I ORS 07 051andetffecedas'I nI 'Ifu 'l fo rce requ by
'I Lthsed0nu5be'I proj ec1701IInceatwlIh0r?snndIwhoreac0mps'acubcontr rsto aon emp oyees1y
Val ue
Value0ther
Zone TYDe/Const
ToTAL VALUATI0N=__.-
opmen
Fi re Zone Bedrooms
BUILDING PERI.IIT
Charges and
Surcha rges
l4a i n.
Acce
Fence
Demo
PLUMBING PERMIT
Charges and
Surc ha rges
Sl dewal k
Total Comb. PermitA/C Paving
ELECTRICAL PERIlIT
Charges and
Surcha rges
Curb Cut /d,zzTOTAL
MECHANICAL PERMIT
Charges and
Surc harges
Owner
lur
:am
pYnl rpq'Al4 name (address
COMI.!./IND. FEEDERS
0f amps
by
COMBINATION APPLICATION/PERMIT (CAP)
Applicant to furnishA. Job AddressB. Legal DescriPtion1. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, Znd Addition to
SpiTn-q"Fi et a Esta tesC. Name, etc. of owner and construction lenderD. Energy Sources
1. example- heat/electricgl ceili!q/o
2, example- waterheater/electrical/or
E. Square footage or valuation, etc.
L example- 1250 sq. foot house, 500
2. example- if new project, check new
check add, etc.
r forced air gas:sr-
sq. foot garage
- if addition,
F Bui lding perm1. examp lg -
a t tac hed
rit information:
construct single family house with an
gara9e
2. example - remodel existing garage into family room
3. Cxample - convert single family residence into
resTanrant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty CodeH. DESIGN TEAM AND 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 Plumbing, 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 instal'led
B. Ful l Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
t. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be instal'led are not covered on
the abbreviated schedules you should consult the
ful I schedulesC. BUILDING DIVISION STAFF t^IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEOULES
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 electrica1 label.III. Applicant to sign and date
l,Jhenever 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 perm'it is issued for his
s i gna ture.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.
V. FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registratjon with the Bujlder's Board because:
Add'itional Project Information :
PLANS REVIEWED BY:
name /i gnature date /r'2-7a
PERMIT VALIDATION
Legal Description
L INE
Job Address
llater Heater
TCOMBI
Ra
T
EIIERGY SOURCES:
Hea t Access.
0ther
Ftg
Ftg
Ftg
Sq
Sq
14a n
Value of llork:3 3*Owner
'Ir€. r s n9 e
c
scr
Fami'lAddressPhone
Construction Lender
N
vl
Address Phone
name
Prima
Structura I
E I ectri ca I
Mechan i ca I
El ect
MECHANICALELECTRICALPLUI.IBI NG
FFENOFFFCHARGENNFEECHARGEfurnace/burner to
BTU' s
Residence of
FTSQEach single fixture
Floor furnace
and ventNew circuits alts'
or extensions
Relocated building
(new fix. additlonal)
Recessed wal l
Soace heater and letrl-SERV I CES. Residence
Duplex (1 bath) each
Appl iance vent
seoa rateTemporary ConstructionAdditional bath
Stationary evap.
coo l erge in existing
dence
Chan
rpc iHater service
vent ran ii ttr
cinole ductmultifamily, comn. or
I ndustri a ISewer
Vent system apart from
heatinq or A.C.S,0fStorm Sewer Mecha-niael exhaust
hnod and ductCOMI.I./IND. FEEDERS
llood stove/heaterInstal I /al ter/re1 ocate
dist-rih. feeders
0f amps.
ISSUANCE OF PFRITIT
IRES that the Electtical work be done
the label has been signed by an Elect
TOTAL CHARGES
bv an Electrical Contractor' the
.rical Supervisor and returned to
electrical portion of this pernit
the Building Division
TOTAL CHARGES TOTAL CHARGES
I.IHERE STATE L]\I,I REQU
shalI not be valiC untiI
Zone Type/Const. Uni ts Sq'
llAtlE(please print)
Y
s IGNATURE
I nad
'I
I
TOTAL VALUATION
0c cy ValFire
for pe
rrerfohat any
tate of 0regon
the Bui n0
70
t the permi
and effect
of any
Board exemp
055 vri
s true'IatnformaonIhereontthadohereandtfyoncacompof cithe0rdnIancesththewtnaccordanceIsha1Idonebermeda'II workrIcerttapp
andndacorrectIandfurthefy ma
ty
de'I bewl'|
NO OCCUPANCYtthaandbedhenrelInnthtoworkdescriItheofsIIf'Ie andd Lawstheof pertangspr sthethBuIder'I Itrat vrionricertthatI'I onI my regIfurtheiDfydI'I n oftuthouwissstrucre tha tandhenotednreo'Ironti sbassIfoexempthet'|tthat055ItasIred0RsbynIfu'II force requs1 'I tecbeseduthons'I'|projht7010r1s1nI'I wtanceareandIwhos0nubcontrac tos rs oyee compemp1y
!q. FtC. Access
Flood Plain Stories.
Ftg . t'la i
Group Sq. Ftg. 0ther
opmentPlan Ck. Corm/Ind
651/8ldo Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERNIT
Charges and
Surcha rges --{*e--2-2=
Fence
Demo
PLUI.IBING PERMIT
Charges and
Surcha rges
Sl dewa l k
Tota'l Comb. PermitA/C Paving
ELECTRICAL PERI'IIT
Charges and
Surcharges
Curb Cut /6,22TOTAL
I,IECHANICAL PERMIT
Charges and
Surc harges
=
\,,,'v
GITY OF SPRINGFIELD
Clty Hdl
Sprlngiold, Orogon
DeveloPment Services
OFFICIAL RECE!PT
l,ct/7
E
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal DescriPtionl. example- Tax Lot 100, Lane County Map Reference
I7-rT-i[',32. example- Lot 1. Block 3, 2nd Addition to
SpFi ngf i el d Esta tesC. Name, etc. of owner and construction lenderD. Energy Sources
1"5805
1
Rec'd
Address
Received For:
rl.
2.E. Squa
1.
?.
examole- heat/electrical ceilinq/or forced air r
"-
*iiE- ri t.ina;r-e;zaa.rn afio r s oTaF-
re footage or valuation, etc.
example- 1250 sq. foot house, 500 sq. foot garat
;xamiTF lT-new project, checklEw - if additior
check add, etc.F. Building permit information:
examp l e
a t tached
To avoid desi
Division Staf
2. example - remodel existing garage into family rc
3. example - convert single family residence into
EfTaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
- construct single family house with an
9arage
gn or construction delays, Building'f must be able to contact appropriate
I aP-/ttu z-*
persons regarding design information or iob site
corrections, etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechan'ical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjace
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 schedul
have been abbreviated
2. If the item(s) to be installed are not covered o
the abbreviated schedules you should consult the
fulI schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEOULES
D. As noted on the CAP, the label must be delivered to
electrical contractor,for signature by his electrica
supervisor. The general contractor is not authorizer
to sign the electrical label.
III. Applicant to sign and date
l,lhenever possible, the initial application wi'l 1 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 hi5
s i gna ture.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.
V. FOR OFFICE UsE ONLY
Amount Received 4s.>7
eL_
8d6l
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY:
Permit applicant exempt from registrat'ion with the Builder's Board because:
i
Additional Project Information:
PLANS REVIEWED BY:
i gnaturename date /y'2*7a
ft
47r>=go
T
CEN-TEi{ \ .T.ROOFING
& GUTTERING
688-9550
S ran l'lerrel1
C/0 Taco Ile11
1505 Iloltarvk Blvd
Springfield, Oregon 97477
c€
ESTIMATE & AGREEMENT
OATE.
BlD, We hereby propose to lurnish malerial and
labor to complele lhe work outlined herein for the
sum o[,
dollars
) Paymenl to be made as follows,
-l
To
($
L
We hereby submil
-rl 746-v?,rr/
and bid [or'b I
SubJ ect--iloof ent <iil 'Iaco Bcl1
1. Remove roof i-ng as close to t-he shr:ating ari possible
an<1 I{au1 Of f .
2. Install 27ll Fibreglass llase SheeL.
3. Hot l{op Two Plyrs #11 Flbreglass ply Sheers.
4. Hot Mop ll72 i{hite !'ibreglass Granulat,erl ctrp sheerFinish.
5, Three Ycar }{antanance Guaranl-ee.
(r. This is a Class A Flre Rate<l Roof .
7 . Co.sE of above t*rork woulcl be $3,996.00
B . Thank You ilasi.1 D . Crame r:
- D-zn-L
/./
t\ t. ^ t l| ' t,/'ll '\*-I r /.j.ut/.I | ,..1' -\.-
CONTR,ACTOR'S GUARANTEE
Wr guaranloc all malcrial urcd in lhir conlracl lo be as specified abovc
and tho entirc iob to bc dono in a ncal, workmanlikc mann.r. Any varia.
lionr lrom plan or ahcrations rcguiring oxtra labor or material will ba
pcrlormod only upon writton ordcr cnd billcd in addition lo lha sum covared
by thil conlrccl, Agrcomcnls madc with our workmcn arc nol recognized.
ACCEPTANCE OF BID
The abovc spccilications, lcrms and conlracl arc salislaclory,
and (U (wc) hercby aulhorizc lhc perlormancc of this worl.
0A'l
SIGNEDDATE
Wt COMPI.Y WIIH ALL WORKMAN'S COMPTNSAIION & PROPIRIY OAMAGT LIAIILIIY INSURANCT TAWS