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Home My WebLink AboutPermit Building 1991-03-28IN 72 CITY OF SPRINGFIELD COI,IB I IIATI ON APPL I CATI ON/ PERMIT 726-37 Job Address Hea Ranqe EIIERGY SCURCES l,later Heate!"Legal Description I rnflFn 1"Hff{'}lr;r;POwnerlpr ne: Sq. Ftg. Acce:s._ Sq. Ftq 0ther l,ler', Add A -Fence Oerno gel U se l ter_Pep. Chan -0ther- . Ftq. lla Farni I dence U Des .e., Builci SingleAddress\{t Snr Phone 1 \ -s5S-- 5 Addres s Phone addres s lics. no.exoi resDt,5I GN TEAI.I name e Pri mary Structura I ElectricaI MechanicaI addres s 'lics. no^)CONTRACTORS name exo i res ohone no. Genera l Plumbinq El ectrical I''lechani ca l ELECTRI CAL I,IECHAN I CALPLUtlB I NG FFF C HARGF NN FFF CHARGF NO FFF CHARGENO /o 650 Residence of SQ. FT furnace/burner to BTU' sEach single fixture New circuits alts. or extensions Floor furnace and vent Relocated building (new fix. additional ) SERV I CES Recessed wa l I Soace heat-er and vent S. F. P.esidence ( I bath) Duplex (l bath) each Apoi iance vent spoa rateAdditional bath Temporary Constructi on Stationary evap cool er(€o 6n e in existing ence Chang resid'l.later servi ce (tu 2,?,254 Industrial multifami1y, comm. or /o Vent fan with sinole duct'sa*aa ?s.e 0f amps.Vent systern apart from heatino or A.C,Storm Sewer /.5 %.COMI.I./IND. FEEDERS a Mechanical exhaust hood and duct#lzzekn ?urE /o.4I Uood stove/heaterInstal I /a l ter/rel ocate distnib. feeders 0f amps 'futfr.'D3E,"z.B/42 C* .<.'*z 1fu*,rry ./.q -/2.G,7/)/3^eISSUANCE OF PFRI1IT ?6.o*TOTAL CHARGESTOTAL CHARGES I^/HERE STATE LAt.l REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division .1e'TOTAL CHARGES icationforoermit,anddohereb.vcertifythatallinformationhereon.istrue and correct, and I further certify that any and all nork performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that NC 0CCUPAIICY will be made of any structure without the permission of the Building Division. I further certify that m.y registration vrith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the bas'is for exemption is noted hereon, and that only subcontractors and ernployees who are in comcliance with 0l?S 7n1.055 will be used on this nroiect. DATE c :ZT*2IliAt'lE(pl ease pri n'S IGNATUREs6 ZrUii Ur t1u!.USEIi{TV lfiN I Fire Zone Bedrooms 0ccy Flood Plajn Stories 2 \cct &-6.q x o6 # x 72b uune*47p.3dFtq. l'la lue ',n 729Tyoe/ Cons t t<- t fr.Units F. sn l.oaa 42- _ sq erorp k / s,1 Val ue TOTAL VALUATI Zone Ftg.0ther, Ftg. Acce rqe ( 1.51 Sys Cha tems Deve opment 46/3. //Plan Ck. Conrn/Ind 55%/Bldo Per Fee 5AE.&5 L*27?ar.a-,bzvzaqs< Z BUILDING PER}IIT Charges and Surcha rges Plan Ck. Res 30%/Bldq Per Fee ,ErhJo>M:zFence5'.ae v6.{6 PLUI4BING PERMIT Charges and Surcha rges Dgmo z ?.f,aSidewal k ,60 , Total Comb. Permit /gqz.f6 -8-€A,z{--- ,7 7S_ z6 aa77 A/C Paving 62.* ELECTRICAL PERI|IT Charges and Surcha rges Curb Cut ry'/4-50 45i2.2?TOTAL I4ECHANICAL PERMIT Charges and Surc ha rges ___:za,_7__ 3-Bo t n \ (81 Dr^ D Lb, COMBINATION APPLICATION/PERNIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 432. elaqple- Lot 1. Block 3, 2nd Addition toSEFinlField EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. examoi e-2. ErartE:E. Square foota hea t/e I ectri ca 'i I in or forced air gas wa e sol ar ge or valuation, II. 1. example- 1250 sq. foot house, 500 sq. foot garage2. elample- if new project, check-new - it adAition, check add, etc.F. Building permit information:1. erample - construct single family house with anattached garage ?. examp_le - remodel existing garage into family room3. example - convert single family res.idence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. OESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropr.iitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanica'1, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Eiectrical Schedules,the applicant need fill-in only the No. Boxes adjaient _ to the appropriate item(s) to be installedB. Ful I PIumbing, Mechanical, and Electrical Schedulesare availab'le 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 thefu'l I schedul esC. BUILDING DIVISION STAFF I,JILL 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 electrical - supervisor. The general contractor ii not authorizedto sign the electrical labelApplicant to sign and date l,lhenever possibie, the initial application wilt be used asa.worksheet only. Where possible, Building Division Staiiwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for hissi gnature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will 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. V J# \qtfD PERMIT VALIDATION Permi t Cl erk 12EJ\ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name date i-//-7/si gna tu sPrilt{GFIELO r-- --{ 225 PI}TU SI'REBT SPRTNGFIEU), OREGON 97477 INSPECTI0H REQIBSTT 726-3769 OPPICE: 726-3759 1. IOCATION OF INSTALI.,ATIONeqao ZL(?4 P H 6t+6rrt 'T *T , JOB DESCRIPTION a Ofu )T /Tpr tU17 *rrzuctz Permits are non-transferable and expireif vork is not -started vlthin L80 daysof lssuance or if vork ls suspended for 180 days. ELECTRICAL PEPJTIT APPLICATION City Job Nurnber Z) 3. COHPI,ETB PEE SCIIEDTII,B BELOS A. Nev Residential-Single or Hulti-Family per dvelllng unlt. Service Included: Items Cost 1500 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof S 15.00 Frnh Mrnrrf I rl llama ^- - Ho<iular Dvelling Service or Feeder $ 35.00 Sum 2. COTIIRACTOR INSTALI,,ATION ONLY B. Services or Feeders (L0 Branch Circuits Electrical Contrac to, L)tZ € &-rzu c s ar; (E*Xi i ll ;, In s t a I ra t i o n' Ar t e ra t i o n s Address lO UX / / /4q Ci ty l4/n Phone A6S*.aq Supervisor License Number 7;53 9 601 amps to 1.000 amps Over 1000 amps/volts Reconnect OnlyExpiration Date /O - / - 7Z L 10C amps or less 101 amps to 400 amps -401 amps to 600 amps a $ $ $ $ $ UU 00 00 00 00 00 35. 60. 90. 13Q 300 J) Address Ci ty Phone Constr Contr. Number 517r& Expiration Date 5^3-nt Signature of Supervislng Electrician 0 0vners Name Bo* S /, <aL/D. Branch Circuits Temporary Services or FeedersInstallation, Alteration or Reloeation 2oo amps or ress -1 g 3s.oo /Ea 0ver 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see rrBrr above Nev, Alteration or Extension Per Panel One Circuit Two to ten Circuits Each Addt,l ten orportion thereof l'iiscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 36.00 Signa1 Circuit or Iimited energy panel_ $ 36.00 SIiBTOIAL OF ABO\r8 35.,}C 5Z State Surcharge TOTAL $ 3s.00 $ s0.00 $ 1s.00OV'i{ER INSTALI,ATIOII The installation is being made on property I ovn vhich is not intendedfor sale, lease or rent. Oyners Signature: DATE: I?r,(.I,TTTPN 5 l.?f32,ts I,EGAL DBSCRTPTION sPriltrGFrELO ..Lt-w 1.OF ON iElectrical Contractor Arlrlroec ci Phone Supervisor License Number Expiration Date constr contr. Number 5 6 Expiration Date 5,6 qt Signature of Supervising Electrician a IJ Address ELECTRICAL PERHIT APPLTCATIOH Ci ty .Iob Nunber 3. COHPIJTE FEE SCEEDTiI^E BELOS A. Nev Residential-Single or Multi-Family per dvelling unit. Service Included: I tems Cos t $ 8s.00 Sum r-J0B DESCRIPTION \ n\q\gc$ KC\r1 \!\DL , Perml," .r"m expireif vork ls not started vithin 190 daysof lssuance or if vork ls suspended fori80 days. 2. CO}fIRACI'OR INSTALI.JITION ONLY 1500 sq.ft. or ]ess Each additi.onal 500 sq. ft or portion thereof Ernh Manrrfr.l !{nr,a ^. - Hodular Dveliing Service or Feeder $ 15.00 $ 35.00 B. Services or Feeders (10 Branch Cireuits included). Instal}ation, Alterations or Relocation: 10C amps or less 101 amps to 400 amps -401 amps to 600 amps 601 amps to 1000 amps- over 1000 amps/volts -Reconnect Only C. Temporary Services or FeedersInstallation, Alteration or Relocation t8E $ 3s.00 $ 60.00 $ e0.00 $130.00 $300.00 $ 3s.00 200 amps or less $ 35.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 vofts see rrgn sf,f,ft- Ci Oi]HER The installation is being made onproperty I own vhich is not intendedfor sa1e, lease or rent. Ovners Signature: DATE: Phone to %.3 D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit Tvo to ten Circuits Each Addt,I ten orportion thereof B. Miscellaneous (Service/feeder not included) -Each installaiion Pump or irrigation S 36.00 Signal Circuit or Iimited energy panel $ 36.00 SUBTOTAL OT ABO\TE 5Z State Surcharge IUllu, s 3s.00 $ s0.00 $ 1s.00 RECEI}'ED BY: 5 225 PIEI'E STREBT SPRTNGFIEID, oRBGoN 97477 IIiSPECT'IOH REQUEST: 726-3769 0FFICB: 726-3759 Qtnr Qt.