The URL can be used to link to this page

Home My WebLink AboutPermit Building 1980-04-07726-3 HEC HANICAL PERHIT Ci;Y Ji SPRINGFIELD COHBI ilATION APPL I CATION/ PERMIT 726-3753 Job Address Legal Description I er Hea Hea llat Ran.< Owner u€0 6J So. Fte. Access. Add Al ter Pep ther Sq. Ftg 0ther Change/Use So. Ftq. l.la Addres s n9Phone Constructi on der Address Phone Prima S t ructura I Ei ectri ca l Hechan i ca l PLUI.IB I NG ELECTR I CAL MECHAN ICAL Each single fixture Residence of sQ. rr fu rnace/burner to BTU. sRe (n, ng onal) ocated bui I d ew fix. additi New circuits altsor extensions Floor furnace and vent F s i dence Additional bath Dupiex (i bath) each SERV I CES Temporary Constructi on Recessed wal I Ap ol iance venthlater service Sewer in exist'ingge den Chan res i Station coo I er ary evap. ' COrnm. Or Vent fanl fh s'inole ductStormewer0fUen I sys ;ein-aplll-Fjm- neatlncr nr A a c0Ml'1./1N0. FEEDERS l'Jood stove/heater 14ec ha ,I acn exh aus L s.0f nsI 1ta a I ter re I o tca e IGiIATURE So nd 5q TE s r 0c c.y Group x' Val ue 0ccy Load x X 'al Uni ts !1REQU unti I of any Boa rd SITOTAL OFSUANCECHARGES PF Rll YIIOTALHARGCES l^JH ERE TAS AIOT.rLTEL1N GESHARRIESthattheecrt'I ca I rhaswo k beIIno do netbe b anVA'II J 'v E eI tri IcatheaII 0nt"tbeasn ra toc rnbee the'Is e ecl r .Ineddn c lasbyil 1fecCAr"l I po rt 0n f t 1h sus rniSO'I r pe tpe rv an u re tu rne d t0 het iBu dI 1 tDng 'I 'ls onheflc0mDtedendalc,]ac0ap !')ti 0nLrrec rmand i tifu danrrthe ehfcerIhatt reby rte 'lfya hat tandfy a I I 1f nnyaIIori(o rma0eworkfe1 t on'I DE rfongdIan he reonshrmedIaId i stheLa truebeWSIon'InedoSthe acctetaof ordan c wle ht0reoon Lrtan'I n1s 0 ird nheru0eto a enc suctthe 0 +twlreIwokr 'IheCutthocdesirthebed t-vepsrmihe'ire n1snof0 dant hat theIBuI l{0 0cS1n'I di 'I AI.ICCUPIfuDngsion,]wt 'IIl beIaforcertu madendhereffecatirtsthtaIufyreqbredIonnysirt0Rsv07sregtaoIn0155Lubconvt/1 thractoha th B ,luL'I frsdan derI1 stxem0emDthe'llhoyees a0 ba is s riren0I 0nexemDt iin sIcomDwlht tednonDc re0he n707 andwi055'I f hatIbeuedsnI'Ih0 s Iecn ro,j tems5 VEDe Lopmmrge57r l.lAl.lE(pl ease print ) Zone alue TOTAL VALUATIOII Dgmo Fence an Ck an BUILOING PERI,IIT Charges and Surcha rges PLUI,IEING PERMIT Charges and Surcha rges -- lype/Const Ftg. Access Ftg.0ther Ftg. t,ta i nFire Zone a^edrooms Flood Plain (i- .ori es Sidewalk Total Comb. permit ELECTRICAL PERIIIT Charges and Surchs pgp5 A/C Paving Charges and Curb Cut OO EIIERGY SOURCES: ri 7::- I I 0 PERMIT VALIDATiON Perm'it Cl erk COMBINATION APPLICATION/PERI,lII (CAP) i. Appiicant to furnishA. Job AddressB. Legal DescriPtion examD 1 e- 17 03 43 examp l e- 5prr ngl r Tax Lot 100, Lane County Map Reference ?Lot 1. Block 3, 2nd Addition to eld EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. example- heat/electricai ceiling/o?. exampfe- waterheater/electrical/or Square footage or valuation, etc. i. examole- 1250 sq. foot house' 500 2. exampTe- iT new proiect, check new check add, etc. r forced air gas E sol ar sq. foot garage - if addition, iI. F. Building permit information:1. exaipie - construct s'ing1e family house with an ;I#cIea garage 2. examole --rem6del existing garage into family room 3. exa#fe - convert single family res'idence into iltaurant (change of use) G. Value of work ai defined in Section 303 (a) of the Structural SPecialtY Code H. DESIGN TEAM AND CONTRACTORS io-ivoia design or construction delays' Building Oirision Stafi must be able to contact appropriate ;;;;;;;s;rdins desisn information or iob site corrections, etc. Abbr;;iai;d P1umbin9, Mechanical, & Electrical Schedules il- ii..ii-*nere utini< spaces occur-in the description ;;;t;;. ;i ihe Mechanical and Electrical schedules' ift.-uppficant need iill'in on'ly the No' Boxes adjacent io-tn!'.ppiopriate i tem(s ) to be- insta l led f. iuri iiribine, Necnanicil, and E'lectrical schedules are availaOli at the Building Division 1. To conserve tpuit-on ine"permit form the schedules have been abbreviated 2. i?'in-.-it.nliil-io-ut-inttal'led are not covered on the abbreviailo-itn'aut"s you should consult the full schedules c. BUIL;iNG oiviiion-srnFF r'llILL FILL our ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the;ffi'-il; label must be delivered to the e.lectrical .ont"i.to" for signature bv his electrica'l suoervisor' rn."gil!'ui' t;;;;;;io; ii q authorized i-'sign the electricai label ApPlicant to sign and date llhenever possible, iit-initiur application wiII be used as a worksheet onlv. ui'il!"t"iJiiioi't' s'i lding 0ivision Staff will prepare a typg'*tii*n copy and return it to the applicant at the alrn"'int-ttiul'l permit is issued for his si gnature. Fees and Charges Plan check fees are due and plYable at the time of the aoolication, and no iiltilvii'l'be processed unt'iI these ?::t ;;;'i.iol"-nii [intr ittt and charses are due and puviui.-nir.n the permit is issued' FOR OFFICE USE ONLY - III IV v PROJECT CONDITlONS TO BE SATISFIED BEFORE OCCUPAI{CY : Su eCCkUaradBorS1edua+L thehWnfaoSrtromftre9eLLIanxempP1rm+Le ap p Add"i t'i ona I Proiect Information: PLANS REVIEI,.IED BY: date s i gnature name Iii'l Ti i{EL 726-37 52 Job Address Legal Description EIIERGY SOURCES r Hea Hea l. l,late Rano Owner cf)U€O I . Ftg. Access._ . Ftg. 0ther I'lew Add Al ter 9eP. ther Sq So Oenro Change/ Use Ftq. i''la n Addre s s Phone itdt 'I 1n ing eFani l G Describe WorkAttGa derCons t ruc ti onL Addres s Phone n Pri ma Structura I Ei ectri ca l R,n l'lec ha n i ca I u PI n alirech PLUI1B I NG ELECTRICAL I4ECHAN ICAL Each single fixture Residence of turnace/burner to 8TU' SaocbuteddItnewXL0naNewci rcui ts a i tsor extensions FIoor furnace and yentsResdence SERV I C ES Recessed wa'l I0uplex (l bath) each Additional bath Tenporary Construct j on Apq lance ventl.later service Cha n ng xe t n s ta t onary evaoSewer 0rMUtfam0rnrncv Ve nt fan wtrh to rm 0f tVen temsys a pa rt fromorc0[1]'1./lND. FiEDERS nha c a aexh US t n ta a LC re t0ca e liood stove/heater 0f amo s. ISSUANCE OF PFRIlITIOTAL CHARGES IOTAL CHARGES iOTAL CHARGESL 1t'/I,JHERE S TE ReQu nEs ttha tlr e e tric aha rkw0 betn0vabe do neI nunt5y EI ecteth c Co nba t craSna Ihrbeen e e0 ecgnean ca r5y t 0netrilo 0 fS h 5r rnuperaoPe tndUretrnedLUBtheUdnDsson S IGiIATUREf a*,/t,t/o t't/,< l{Al'lE(p lease print) the fy 0regon the Bui any rd :IC nDC L ED enda ted ac0mo c acco rre t p D o ndan r De rmfu trrthe and ciof3rtthan c rtetandhereb,y th aSoriva t aef.i nrklvongdd fo rmarDEndth on |^ioeL ne eo nrmedshaofws 5the ruebeedonstanete0ccf0rdancethths0redtruct0eartnnnanurewlLUcESfhougheheworkthedecrperms0nbedt:tofherenandBoarhtasndfuDOCCUPAfon9onrcyrcafndffterUmadbeecttheea5Lcertharequredvt0n0DCuby0c1nystrtvnbcotr55req i 0nactha hancit0 rs f Buhe,\rdeemD0en0t swhohereaudS9nc0foretxemDmcanwi0nhnot7oed1C5he reon atvl nd tthabesedun0thl)s ecro.j i .Uni ts Zone 5q /Const c g 0c c.y 6roup x...-.--Va lue Xr Value Load i'la i n Acce s s 0the r Ftg Ftg Ftg. Fire Zone_ _BedroomsFlood Plain c+: cori es ,x Va I ue_ TOIAL VALUATIOII - ter,ts rge VE an Conrn/ind opmeo t BUILDING PERI,IIT Charges anC Surcha rges an Q'I Per k Fence PLUI4BING PERMII Charges and Surcha rges Dgno Sidewalk ELSCTRICiL PERI:ITLnarges and Su rcha rges A/C paving Total Comb Permi t rI:i_' I r,'.-., \_., - vL ,l )i )r Kl.iur 11LJ CCHBI iIAilON CPPL ICATiONi PSRMIT sQ. rr. I I I i iadd I ) L s e0a ra te EI SI I 1 I COMBINATION APPLICATION/PERI,IIT (CAP) II Applicant to furnishA. Job AddressB. Legal 0escriPtionl. example- Tax Lot 100' Lane County Map Reference t-m3--T32. examole- Lot 1. B'lock 3, 2nd Addition to-SIffiield Estates C. Name, etc. of owner and construction lender ClTY OF SPRINGFIELD ,l CitY Holl SPringfield, Oregon o"ooirn"-nt of Public Works_ OFFICIAL RECEIPT ,l No. B 5:'? ?3 I D. Energy Sources1. g.rrPfg- heat/electrical cei l ing/o 2. examcle- wateriEEiEil@or E. SquaiEE6tge or valuation, etc' 1. examole--1250 sq. foot house' 500 2. exanple- if new proJect' cnecK new EhEffidd, etc' 19r forced air gas e d:sl-{. sq. foot garage - if addition, f C ( ( F. Building Permit information: i. eiifipi. - construct single family house with an attached garaoe ?. examole --."roael existing garage into family room 3: ffi - convert single family residence into ;6EFant (change of use) G. Value of work as aefineO in Section 303 (a) of the Structural SPec'iaItY Code H. OESIGII TEA|VI AND CONTRACiORS ii-irdio design or construction delays' Building oiriiiorr Siafi must be able to contact appropriate ;;;;;;;' .A;rainq-Jesign information or job sit'e correc:ions, etc. Abbreviatei Plumbing, i'lechanical ' & Electrical Schedules A:" il;;;;-rneie utint iptttt occulin the descript:on il;:;;. ;i in. r'rttninita l and- E'lectrical schedu les ' the aoolicant ne;; ;;ji-i" onlv the No' Boxes adiacent io-ri.".ro"opriaie item(s ) to be- instal led B. iiii' irriui^i, I'rilnititil' ano-Electrical schedules ....u.ilaOli at the 3uilding Division i' To ccnsenre tittt"ot.ine'pe"'it form the scnedules have been abbreviated ?.i?'In-.-il.,it)-it-o-t-installedarenotcoveredon '.he abbreviailo-ttnto'f ts you should consulr- :he ful I schedul es C. SUILDING OIVISIOil STAFF ,}lILL FILL OUT ALL FEES AND iinaces oN iHE ScHEDULES 0. As noted on the ;ffi'"il; label must be delivered to the e'lec:rical .ont'll'l""iit iltnu."utt bv his "1::::l:il;;;;;;i;;..--rire-general conlractor is E! authorrzed io-iiqn ihe electrical label ApPlic:nt to sign and date 'rhenever possible, ii"-inititi application wiII be used as a worksneet onlv. tili:tt";;t;;ui!' s'irains 0ivision siarr wili preoare a type'*tiitln copy and return it to the aoolicant at the a:t"'itt"'tti'li p"*it is issuerj for his si-onarure. Fees and Charges Plan check fees are due and plYable at the time of the aool icaiion, and no ijltt -iii'be ptocessed unti I :hese ?:;; .;;'i.i.l'-nii 6tn"" ttts and charees are due and oui.oi.-*r,.n the permit is issued' FOR OFFICE USE ONLY '- , iv'ed For: ounl ived Perni t Cl erk D ( ( ( ( ( 5IGN Lo.^t o" "oo' SHEL'OI'TUiNBULL PiIiIEiS IV. PROJECT CONDITlONS TO BE SATiSFIED BEFORE OCCUPAIICY a SuebrdoaBS1IidrutJh+eh+LnraILtSierromYf+Et X1Ian empcairm+L p pP Add'iti onal Proi ect Informat'ion: PLANS REVIE'IED BY: da te s i gnature name i