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Home My WebLink AboutPermit Building 1989-11-01LI 726-3753 Z{ :€. r Oc COMBI t c &G t ) Sq. Ftg l,lew , Change/Use -Otner Hea Sq. 0ther Add Al ter _Rep. -FeniE Demo ng e Va1 ue 1of t,lork: ]@tfr mlFa '| Ranqe l-egal Descri ption Job Address i dence tli th { Owner Addres s EIIERGY SOURCES TI T !q. Ftg. Access._ l{ater lleater E c..rtr'";il 1..d.",r/, /4 \s h Address Phone exD l res ohone no.addressDESIGN TEAI4 name Pri ma Structura l /AT E I ectri ca I \a in,l'lechani cal exDl res 'tnl L ohone no.name a ddres s I(lics. no.)CONTRACTORS l)nosu tAr*rraorcze,/ 6. 2w 2/^-rt @sosGenera I U P1 I d -ifc, b'?-?o -30{? I'tec ha n i ca I MECHAN I CALELECTR I CALPLUTIB I NG FFF CIIARGFFFFCHARGFNNFFFCHARGFNO furnace/burner to BTLI, S".sa,?/t{ a Residence of FTsQ6Each single fixture 29/2.2ry-1D -./t/Y Fl oor furnace and vent New circuits alts or extensions Relotated bui Iding (new fix. additional) Recessed wal i Snacp hpatpr and vpntSERV I CESS. F. Residence(l bath) Duplex (l bath) each Apol iance vent seDa rateTemporary Constructi onAdditional bath Stationary evap cool er ge in.existing dpncp C han rps iIlater service 1s'lA,DI Vent fan with sinole duct9',i?zzc multifamily, conrn. or I ndus tri a IISewer Vent system apart from heatinq or A.C.m.*0f amps./Storm Sewer 7ao' COMTI,/IND. FTEDERS Mechanical exhaust hood and duct l,Jood stove/heaterInstal I /al ter/re l ocate di stri b. feeders 4.zz 'gz</41 /r,'{2. Z*rz. 4,G,'C27. ZrrrZ .>>>z.z 7:-Z/-y <F?a4nard ,ZV/t/4rZ:zze.DZ ISSIIANCF OF PFRIlIT v TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES ?ds* WHERE STATE L,lN REQUIRES that tlte Electr shalI not be vali,l until the label has been ical work be done by an Electrical Contractor, the electrical portion of this permit signed by an Electrical Supervisor and returned to the Building Division S IGIIATUREl,lAtlE(please print)4 ,rmation hereon is true Ordinances of the City | 0CCUPAI,ICY wi I I be made on vrith the Builder's noted hereon, and thatof any Board ntcertthaadodantfyhetetedacontherebycompapppe ,fo hehabedoneanordaccncewlthLrmedLrrecandcfu rther ert t tha a nda a wor Derkdanfyny NCatthnwodrkscerherebednand,f 0n art to theoteStatheofwsLathedSfieandof0regpenqprin9 ath t tras trutctWhou tt the ss 0n f0 het Bu di Di sV1 0n certfurthersureng fy m.y reg s0nforsSsa701ORS055tthaetfpermi 'f ect red xemptsnfuforcendaefrequby no th ecthwl7011s0055l,/ lonsutracbcontorandal.lho re ceannvempoyeescomp 3-q<4 bKPlan Ck. Corm/Ind 65%/8ldq Per Fee ,/?Pzr-a,> traPlan Ck. Res 30%/Bldq Per Fee BUILDING PERI.IIT Charges and Surcha rges ---ZZ?-.5b- Zrvtev- Az*a /52./2FencePLUI4BING PERMIT Charges and Surcha rges ___?2.t-_=_ .2{DEmo Sldewal k Total Comb. Permit /2??.2 7A/C Paving 4*o*2A-So ELECTRICAL PERI1IT Charges and Surcha rges Curb Cut 5?zz.s=TOTAL I,IECHANICAL PERMIT Charges and Surc ha rges \one1Qy'QL_Jyoe /Const.zaY Units Fire Zone Bedrooms 0ccy Load Flood Plain Stori Sq. Ftg -/E ?3;tue?5Vr-*a, l,lain Ftg. Arces Val ue Sq.FtE - -/-' -*6',a1ue-aaz 5 TOTAL VALUATI terns opmen 51. 0c c.y Grou /472.;a 0f amps. -a) _ I I'I 'I COMBINATION APPLICATION/PERHIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County 17 03 43 ?. example- Lot 1. Block 3, 2nd Addit S[ffig-field EstatesC. Name, etc. of owner and construction ID. Energy Sources 1. example- heat/electrical ceiling/o2. example- waterheater/electrical/or E. Square footage or valuation, etc. Map Reference ion to ender r forced air gas@ 1. glarp_l_e_: 1250 sq. foot house, 500 sq. foot garage 2. exampie- if new project, check new - if addition, ifiec[-add, etc.F. Building permit information:l. example - conltruct single family house with an attached garage 2. example - remodel existing garage jnto family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. OESIGN 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 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. Ful I Plumbing, Mechanical, and Electrical Schedules are available 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 theful I schedulesC. BUILDING DIVISION STAFF I.'ILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. 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 possible, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his signature.IV. 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 and payable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION 3&3qo *r\[e\CS Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name si gnature date -q6 INS 7?6 ON E CiTY OF SPRINGFIELD COMB] NATION APPL]CATION/PERMIT 726-3753 Job Address EIIERGY SOURCES Hea t l,later Heater Ranq tq n_ Sq. Ftg. Access.---=- Sq. Ftq. Other_ _l{ ew_Ad d_A I te r_Re p . _Fe n ce_Demo_C ha n g e / U s e 0ther "6s fr -$ l-ega1 Description Va I ue of l,Jork :ill*Owner Addres Phon n Farni I s 'o: -Descri be llork(i.e., Build Singleth Attached Garaqe) D Ier> S€.,r,)',c,o . Construction Lender G@ A".,.,o Sr,,, utic,o. Addre s s Phone name addres s 'I ics . no. l phone no Structura I El ectri cal I'lechani cal name addres s (tcs. no.exoires)ohone no- ) Ge ical nical PLUIlB I NG ELECTR I CAL MECHAN I CAL N0.FFF CHARGE NO FFF IHARGF NO FFF CHARGF Each single fixture Residence of SQ. FT furnace/burner to BTU' S Relocated building (new fix. additional)New circuits alts or extensions Floor furnace and vent S. F, Res idence(l bath)SERVICES |f .urr Vvt 'ias )Recessed wal I Soace heater and vpnt Duplex (l bath) each Additional bath Temporary Constructi on l.\ cra Apol iance vent sepa ra te l,later servi ce Change in existing res i dence Stationary evap coo I er Sewer multifamjly, comm. or Industrial Vent fan with sinole duct Storm Sewer 0f F-or)s -)<o/)Vent systern a heatinq or A. part from c. COITl./IND. FEEDERS Mechani cal exhaust hood and ductInstal I /a l ter/rel ocatedistrib. feeders l'Jood stove/heater of :@ ISSUANCF OF PFRi,IIT TOTAL CHARGES ToTAL CHARGE s 6(l)) ,50 TOTAL CHARGES WHERE STATE LAt,l REQUIRES that t e EIectshaII not be vali,l untiI the Iabel has been rical work be done by an Electri signed by an Electrical Supervi cal s0r Contractor, the electrical portion of this oernitand returned to the Building Division CARE t he comp eted ap l-)I I c a t on Derm I t an do he re b.y ce rt fy tha t I I i t 1 he 'Iandc0rrtandIfurthercert'I f_v tha t nd I I k a n on reon s t rue f a ny a a $/or DC rfrormed s ha 1 I be don e 1 n a cco rd an ce WI th t he 0rd i of t he ci ty0sprlng fi e 'I d a nd th e La ws of the S ta te of 0regon Derta 'I ,l to th na nc e s f t ruc n n g e wor k descr I bed h ere 1 n an d th at NC OCCUPAI,IC 'I I I be madeanysturewtthoutthepermiss'I n of the Bu I I d 'I ng D 1 'I s 'I on I fur ther ert -I I th t IBoardIsInfuI1forcendeffect1 c a m.y reg s trat I 0n l,/ l th t he U I I de r SaasrequredbyORS70t055that'I f e xempt t he ba s 'I s f ti 'I noted hereononIvsubc0ntracto rs an d ernr)I oye who I I r ex emp 0n s and th atesarencomDIanLEwlth0t?s 7 0 05 5 I 1 I be u s e d 0n th ,l s p ro,j ect t,lAl"lE ( pl ease pri nt)IGNA DATE FI Zone /Const Units 5q Ftq. l,lain Ftg. Acce Fire Zone Bedrooms Occy Val Load S q.lueFlood Plain Stories 0cc.y Group Sq. Ftg. 0ther x Va lu e TOTAL VALUATION BUILDING PERNIT Charges and Surcha rges Plan Ck. Comn/Ind 65%/81dq Per Fee Svs Cha tems Derqe ( l.VE 5/ opment PIan Ck. Res ]pfulB1ds Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence D6mo ELECTRICAL PERI,IIT Charges and 5,r.rcha rges _li) sa___gb?Sldewalk A/C Paving Tota'l Comb. Permi t IlECHAI.IICAL PERMIT Charges and Surcha rges Curb Cut TOTAL tlls tZ Pri mar.y COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION I Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SpTr'ng-Fie1d Estates C. Name, etc. of owner and construction IenderD. Energy Sources d* 1. 2.E. Squl. 2. exampl e- examp I e- are foota hea t/air gas ,av hb water ge or example- 1250 sq. foot house, 500 sq. foot garage example- if new project, check new - if addition, check add, etc.F. Bui lding permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into restaurant (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 0ivision Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the description portion of the Mechanical and Electrica'l Schedules, the applicant need fill-in only the No. Boxes adjacent to theB. FulI PI appropriate item(s) to be installed umbing, Mechanical, and Electrical Schedules III are available at the Building Division 1, 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 thefull schedulesC. BUILDING DIVISION STAFF I,JILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEDULES 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 electiical label Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possibie, Building Division Staff wil'l prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnatu re.IV. Fees and Charges Plan check fees are due and apPl ication, and no Plans wi p I ayable at the time of the 1 be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. FOR OFFICE USE ONLY )'T'qrt V Permit Clerk PROJECT CONDITiONS TO BE SATISFIED BEFORE OCCUPAIICY: permit applicant exempt from registration with the Builder's Board because: Additional Proiect Information: PLANS REV I EI,JED BY : name s i gnature date