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Home My WebLink AboutPermit Building 1985-10-10* bf, -)"t -i'' .i.r;f, IIISPECTIT 726-37 69 L c0rlBI APPL I -3753 JobAddressSOZ Y Ran EIlERGY Hea t l-egal Oescription Owner r'Vaiue of l,lork:30m . l.la i n_ Sq. Ftg. Access._ Sq 4 {;.,< 4!noned$6iAddress /-ra d u. //-Describe Work ce .e., Buiid Single OFF/<4 s- ?,??.s,/c yaR Prr>aP Construction Lender Acre6)nz / tsnr-,ua.r<t .* 1--Address Phone F ^t '.-a ' fr4qaentptycs -/ry<. El ectri cal Structura I Pri ma Hechan i ca I CONTRACTORS name addres s lics. no.evn rPq ohone no- 'I d4r PLUIIB I NG ELECTR I CAL -l MECHAN I CAL-) ll0.FFF CHARGF NO FFF rHA PNF NO FFF CHARGF 2?Each single fixture <oaaa /a'Residence of FTsQ furnace/burner to BTU's ySRelocated buiiding (new fix. additional)New ci rcui ts a'l ts. or extensions? aR ,F,OB6 Floor furnace and vent S.F. Residence(1 bath)SERV I CES Recessed wal i Soace heater and vpnt Duplex (1 bath) each /Htlrtr us/r /ue. Additional bath Temporary Constructi on Apol iance vent seoarate [.later servi ce ge in existing dence Chan res i Stationary evap. cooi er Sewer I ndus tri a l multifamily, coffil. or /Vent fan with sinole duct-vno Storm Sewer 0f apart from .c. Vent systern heatinq or A cor4r.r./rND. FEEDERS Mechanical exhaust hood and durt Insta l I /a l ter/rel ocatedistrib. feeders l'Jood stove/heater 0f amps" ISSUANCE OF PFRI1IT TOTAL CHARGES /o.n TOTAL CHARGES a,IOTAL CHARGES iW,Y. ,/A.-o I.,HERE STATE L..1l,l REQUIRES that the Electrical work be doneshall not be vali.l until the label has been signed by an Elect by an Electrical Contractor, the electrical portion of this pernitrical Supervisor and returned to the Building Division IHAVECAREFULLYExA|1INEDthecompletedapp1icationforp and correct, and I further certify that any and all work periormed shall be done in accoidance with the 6rdinances of the Cityof Springfield and the Laws of the State of 0reqon oertaining to the work described herein, and that NC OCCUPAI{CY will be madiof any.structure without the permission of the 6uilding Diviiion. I further certify that my registration vlith the Builder,sBoard is in full force.and effect as required by ORS 701.055, that if exempt the baiis for ixemption is noted hereon, and thatonly subcontractors and ernployees who are in coincliance with Ol?S 701.055 wii'l Ue used on this nroject. I GNATURE a)l,lAl'tE(please pr:nil./)CZn .-t r'l .4a ) /, ' , oms 0ccy Load_ Sq. Ftg ", ---7- 0.., c.orr-E-5q. Ftg S lq. os sto.f @.dr52&n: x zone *?tV) Typelconst ts So. Ftg. l,lai Fire Zone Bedro Access Val ue Flood Plain Stori 0ther x Val Pqrr)ToTAL VALUATIoI|_ Plan Ck. Conrn/Ind 65%/B1do Per Fee ryetos+lq mi ter,ls opmm /y.4.BUILDING PERI'IIT Charges and Surcharges __/Z oo s.oE Plan Ck. Res 30%/Bldo Per Fee FencePLUI,IBING PERMIT Charges and Surcha rges /o.*.{o Dgmo F€€/?.af, Stdewa l kELECTRICAL PERI,:IT Charges and Surcha rges ,60 Total Comb. Permit /68. laA/C Paving Curb CutHECHANICAL PERHIT Charges and Surcharges ___/_4::_.qo /gz ,5TOTAL ttate" ueaie"@ V,9X<fln?i-. COI4BINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1' *gPlg-: Tax Lot 100, Lane county Map Reference17 03 43 2 example- Lot l. Block 3, Znd Addition to5prlngrletd tstates c Name, etc. of owner and construction IenderEnergy SourcesD. I exampl e- examp I e-re foota hea t/e l ectri ca I 2 ili forced air gas wa t e or solarE. Squa ge or valuati on, etcIexample- 1250 so example- if new EIEEr-a'od, etc. foot house,500 sq.foot garage if addition,?proj ect, check new - II. F. Building perm.it information:1. ellrp.te - construct single family house with anattached garage ?. !I9r?1. --rer6del existing garage into family roomJ. example - convert single family residence iniorestaurant (change of use)G. Value of work as defined in Section 303 (a) of the.. Structural Specialty CodeH. DESIGN TEAI,I AND CON1RACTORS To avoid design or.construction de.lays, BuiidingDivision Staff must be able to contait appropriitepersons.regarding design information or jbO iite - corrections, etc.Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion of the Mecha-nical and Electricat Scnehuies,the applicant need fill-.in only the No. Boxes iOiii.nt ^ to-the-appropriate item(s) to 6e installedB. Full Plumbing, Mechanicil, ana Eleiirical Schedulesare available at the Building 0ivision1. To conserve space on the-permit fonn the scheduleshave been abbreviated2. II the item(s) to be installed are not covered onthe abbreviated schedules you shouid consult the.full schedulesC. BUILDING DIVISION STAFF I.IILL 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 electricai - supervisor. The general coniractor ii.not authorizedto sign the electrical IabeiApplicant to sign and date I'lhenever possible, the initiai application will be used asa.worksheet only. lrlhere possibtb, auitOlng Division i[aiiwi1'l.prepare a type written copy ind returi it to theappr'lcant at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no ptans wiil-be proceiied until theserees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III. IV v PERMIT VALIDATION Permit Clerk 6us'4s (nt [?-( b PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from reg'istration with the Builder's Board because: Additional Project Information: PLANS REVIEHED BY: name Si gnatu dat e /a'A-Af,