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Home My WebLink AboutPermit Building 1981-10-29e lsl INSPECTION tINE 72&3769 . CITY OF SPRINGFIETD CO}IBINATION APPUCATION/ PENMII INFOR'ITAIION IINE 7283753 995 Sunset kl-egol Descriprion $l Ro EN Wqter Heot 17-03,34-11 T.L. 6202 Add Alter-Rep. --Fence-Demo-Chonge/ U se Other \t' rtg' 4 New Other Sq. Ftg. /rloin Sq. Ftg. Access. Volue of Work: (6n 6Rq 7?hl. Gil lockGeo s;IfiiE'EtriiG6, D";cribe Work (i'e., Build Sinsle Fomily Residence With Alloched Goroge),cdd,.,, 1005 Rainbow Drive Phone S'inqle Familv Residence attached qaraqe w/wood st-ove @ o OlF! Address Phone DESIGN TEAM (nome)(oddres (lics. no.)(ex (t Electrico I r\lechonicol Electricol Mechonicol PTUMBING ETECTRICAI.r'{ECHAN ICAL NO_FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE Eoch sinqle fixture x sd ft. Residence of 1 65?25 nO furnoce/burner to --BTU'S Relocqted buiiding (new fix. odditionol) New circuits, olterotions or extensions 1 Applionce vent sepo role 3.00 x S.F. Residene (l borh)25. 00 SERVtCES Slolionory evop. ooler Duplex (l both) eoch 1 Temporory Consiruction 10 0n 2 Yent fon with single duct ?nn 6nn 1 Additionol bqth 10. 00 Amps. Vent syslem oport from heoting or A.C. 1 Woler service 10. 00 1 Mechonicol exhoust hood ond duct 4. 50 1 Sewer 10.00 1 Wood stove/heoter 5. 00 Storm Sewer FEEDERS Heol Pump Ampr. Air hondler to t0,000 cFA{ Air hondler over t0.000 cf^ rssuANcE oF PERMTT 10 . 0( TOTAI. CHARGES 55. 00 TOTAT CHARGES 35 nn TOTAT CHARGES 28.5( tho Eloctricol controcto?, thc etcctricot portion of rhis permir sholl not bc vqlid until afhe clectricol ponel. I HAVE cAREFUttY EXAMINED the completed opplicotidn for permit, ond do hereby certify thot oll informotion hereon is true ond correct, ond I furthercertify thot ony ond oll work perforred sholl be done in occordonce with the oidinonces of rhe city oi springfield ond the Lows-of the stote of oregonpertoining lo lhe work described herin, ond rhot No occuPANcY will be mode of ony structure wir'hout iie iermission or rh" ir;tii.g,Division. I furthercertlfy thot my registrotion wirh lhe Builder's Boord is in full force ond e{fect os requirej by oRS zor.oss, rhot'if exempt tt" ioJr"ro, exemption is notedheron, ond lhot only subconlroclors ond employees who ore in complionce wirh ORS 7Ol.O-55 will be ued on this proiect. DATE TOTAT YAI.UATION Occv Ftg. r!{oin 4Fire 1553 ? WHERE STATE tAW IEOUIRES rhqr rhc Etccrricol work be donc bylobal hos been signed by on Electricot Controctor snd ottoched to I Bosis for Builder's Boord exemption: NAME (pleose print) Bedrooms Flood Ploin 54,R29.73 FOR OFFICE USE ONTY SIGNATUREl/o zon" R 1 Type/consr. V-N unirs ororp R3 sq. Frg. orher Lood --Sq. Ftg. Access , 35 - 30 vo;,", 10. 00 yo;,. a -lqlss Plon Ck. Comm/lnd 6595/Blds per fee Syslems Development Chorse (1.5%)908. 85 BUITDING PERMIT 8.36 Chorges ond Surchorges Plon Ck. Res 3o%/Bldg Per Fee * 62.70 ).|. Ck. due 62.70* Fence PTUMBING PERMIT Chorges ond Surcho rges 2 20 ____55_no Demo Totol Comb. Permit 10.52 PERMIT 535. 00 Sidewolk 87 ,Chorges ond Surchorges 14.16 MECHANICAT PERAAIT Chorges ond Surchorges Curb Cut 18'28.50 TOTAI.# tss6,g3 576 TET::--TAT'F F --f*, a6q 2R A/C Povino Y COMBINATION APPLICATION/PERXIIT (CAP) l. Applicont lo furnish A. Job Address B. Legol Description I. exomple-tox lot 100, Lone County Mopieference.lT 03 43 2. exomple--Lot l. Block 3, 2nd Addition to Springfield Estotes C. Nome, elc. of owner ond construction lender PERMIT VALIDATION or forced oir gos /orIJ[cr E. Squore footoge or voluotion, elc. I. exomple-1250 sq. foot house.,500 sq. foo.t goroge 2. exomF.iE-i-f new proiecl, check new-if oddition, check odd, etc. F. Building permit informqtion: l. exoirple-conslruct single fomily house with on ottoched goroge 2. exomple-remodel exisling goroge into fomily room 3. efimpl-e-converl single fomily residence into EltoETont (chonge of use) G. Volue of work os defined in Section 303 (o) of the Struclurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division. Sloff must be oble lo conlocl oppropriote Persons regording design informolion or iob site corrections, etc' ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only the No. Boxes odiocent to the oppropriote item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve sPoce on the permit form the schedules hove been obbrevioted 2. lf the item(s) to be inslolled ore nol covered on the obbrevi- oted sahedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FItL OUT AtL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o . t ".kth"el only. Where possible, 'Building Division Stoff will prepore o typewritten coPy ond return it to the oppliconl ot ih"'ti-" the ocluol permit is issued for his signoture' lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the time of the-opplicotion' ;"; ;;i;^. ,"itt U" processed until these fees ore poid' All . "ttt.. i"Lt ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY D. Energy Sourcesl. exomple-heot/electricol ceilingz' 2. exffiFE-woterT-56Gry ElEctrico I Permit Clerk PRoJECTcoNDITIoNsToBESAIISFIEDBEFoREoCCUPANGY: \.N'.$r\.N Additionol Proiect lnformotion: PLANS REVIEWED BY: sig notu re Cote ? I l?El INFORIAAIION TINE 726^1753CTIY OF SPRINGTIETD COMBIN;iiON APPTICATTON / PER,IAIIINSPECTION TINE 726-3769 995 SunsetJob EN Woler Heot Legol Dercription $l QC -34-11 T.L. 6?02r.7-03 -Add-Alter'-ReP' -Demo-Chonge/Ule -Other \t'rts'Other -Fence Sq. Frg. Moin Volue of Work: hl. G'il lockGeo Describe Wor'k (i.e', Build Si PhonenbowAddress5 I @PO Olt! PhoneAddress (oddress) DESIGN TEAM (lics. (nome) Slructurol Electrico I i{echonicol MECHANICALPTUMBING FEE CHARGE NO.NO.FEE CHAR,GE 2q nn furnoce/burner lo -BTU'S x id fr. Residence of 1 trE?Eoch single fixture 3-00Applionce vent sepqrole1 New circuits, olterotions or exlensions Relocqled building (new fix. odditionol) Sloiionory evop. coo lerSERVICES25.00x S.F. Residence (l borh) AnnVent fon with- _ sinqle duct ?nntn 00 ?1 Temporory ConslruclionDuplex (l borh) eoch Vent syslem oport from heating or A.C,Amps.10. 001Additionol both Mechonicol exhoust hood ond duct 4. 50110.001!etvtce 5. 001Wood siove/heoter10.001Sewer Heot PumpFEEDERSSlorm Sewer Air hondler to r0,000 cFMAmpc, Air hondler over 10,000 crM ISSUANCE OF PERMIT 10.0( TOTAT CHARGES 28.5CTOTAI. CHARGES 35. 00TOTAI. CHARGES 55. 00 \rvHERE SIAIE tAW REeUIRES thor ths Eleckicot work bc done by the Elcctricot Conlroctor, thc clsctricol podion of this permit sholl not bc valid unril o Iobet hos been sigmd by on Electrical Contrsctor ond ottochod to the oleclricol ponel. I HAYE CAREFULIY EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is lrue ond correct, ond I further certify thor ony ond sll work performej sholl be done in ocordqnce with the Ordinonces of the City of Springfield ond the Lows of lhe Stote of Oregon pertoining to tle work described herin, ond thot NO OCCUPANCY will be mode of ony slructure without the permission of the Building,Division. I further terrlfy thlt my regirrrotion wirh the Builder,s Boord is in full force ond effect os required by ORS 701.055, thot if exempt the bosis for exemption is noted h"ron, ond thot mly subcontroctors ond employees who qre in complionce wirh ORS 701.055 will be used on lhis proiect. SIGNATURE DATEoc* Bosis for Builder'r Boord exemptionr NAME (pleose print) FOR OFFICE USE ONLY , 35- 30 vol"" S4-BEJj-,10.00 v"t,. 5,760-00 Ororp R3 Sq. Ftg. Other-a -!6lsg Ftg. Moin 1553. 2s So-Fts. Access 57$-- TYP./conrt. V- N unir" Lood Zone R1 TOTAT VATUATION fire Zone - Bedrooms Flood Ploin fi.5v") DevelopmentSy stem s Chorqe 908. 85 Plon Ck. Comm/lnd 65o25/Bldo Per fee ).l. Ck. due * 62.7062.70*Plon Ck. Res 3o%/Blds Per Fee BUITDING PERMIT 209. 8.36 Chorges ond Surcho rge s r .-#fr Fen ce x,6c ?9Tolol Comb. PermitDemo Chorges ond Surcho rges _55- 00 2.20 10.52sidewolk 87. 65 A/C Povino Chorges ond Surcho rges PERMIT 35. 00 Curb Cut B'$ tss6,e3 (1 ??7 n? MECHANICAT PERMIT Chorges ond Surchorger 28. 50 1 14 TOTAT ETECTRICAT NO. ,| So- --rF(. _ I 't 4n COMBINATION APPLICATION/PERMIT (CAP) l. Applicont to furnish A. Job Addresr B. Legol Description D. Energy Sources E. Squore footoge or voluotion, elc. I. exomple-tox lot 100, Lone County Mop Reference I7 03 432. exomple-Lot I. Block 3,2nd Addition ro Springfie' '- t?C. No."", "t.. of owner ond construction lender L PERMIT VAIIDATION ITY OF SPRINGFIELD CirY Holl SPringfield, Oregon Deportment oI Publlc Workr OFFICIAL TECEIPT No. B 57550 Amount Recei' I. exomple-h.orlglg.r.i.ol *!!nglor forced oir gos 2. exo mE;-wote rTreTi-r-ffiilo I / "@. (. (I l. exomple-l 250 sq. foot house, 500 sq. foot gorogr 2. exomFlE-iTIEw proiect, check-new-if oddition, ch Aa-d, etc. F. Building permit informotion:l. exomple-conslruct single fomily house with on otl goroge 2. exomple-remodel existing goroge into fomily roor 3. exfipfe-converl single fomily residence into reltou?Ent (chonge of use) G. Volue of work os defined in Seclion 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONIRACTORS To ovoid design or construction deloys, Building Divis Stoff must be oble lo contoct oppropriote persons reg design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description po ' of the Mechonicol ond Electricol Schedules, the opplic, need fill-in only the No. Boxes odiocent to the opprop item(s) to be instolled ' B. Full Plumbing, Mechqnicol, ond Electricol Schedules ore ovoiloble ot the Building Division I. To conserve spoce on the permit form the schedule: ' hove been obbrevioled 2. lf rhe item(s) to be instolled ore nol covered on the oted schedules you should consult the full schedule: C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os r worksheet only. Where possible, Building Division Sroff wi prepore o lypewrilten coPy ond relurn it to the opplicont < the time the octuol permit is issued for his signolure. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot lhe time of the op1 (ot' ond no plons will be processed unlil lhese fees ore poid. Aqt other fees ond chorges ore due ond poyoble when lhe peri ') is issued. I V. FOR OFFICE USE ONLY t AUTHORTZEO SIGNATURE sHELION_YUiN'uLL FllNlEtS EU6EXE Oi 0"ol ( ( ( ( Rec'd (t (t (t( ('l F I {: l'l (l ( t ( (, PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additi,onol Proiect lnformolion: PTANS REVIEWED BY: dotenome Sept 21, 1981Dan Smi th signorure a Permit Clerk CITY OF SPRINGFIELD--BUILDING DIVISION 346 MAIN ST. 726.3753 (BUSINESS\ 726_3769 (TNSPECTIONS) APPLICATION FOR ELECTRICAL I,ABEL(S) BY A BUILDING O!{NER The Electrical Safety Law of the State of Oregon does not require a person to obtain a license as an electrician and/or electrical contractor to make an electrician in- stallation on property which is owned by himself or a member of his jmmediate farnily which is not intended for sale, Iease, or rent. (PLEASE PRINT) APPLICANT'S NA.I4E gtcbn ADDRESS PHONE ADDRESS FOR PROPOSED WORK BUILDING OWNER (IF OTHEP THAN APPLICANT) ADDRESS PHONE f certify that all of the above information is true and correct, and that no portion of any wiring system requiring a labe1 as applied for herein and intended'to be con- cealed by any permanent portion of the building or stnrcture shatrl be concealed until inspected and approved. When the instatlation of the system is compLete, an additional and final inspection shall be made. Inspections are generally required for at least the following cond.itions and or stages of construction: 7 8 9 4 5 6 I 2 3 Temporary Service Underground Service Service Rough Electric Cable Heat New Circuits or Extensions Mobile Home Connections Signs Swimming Pools I further certify that I wilt notify the Building Division when any of the above ELEC- TRICAI INSPECTIONS are ready, that all work will be done in accordance with the Electri- cal Safety Law of the State of Oregonr a.Dd that if not the building olrner, I am a member of his or her immedj.ate family. Signature Date TNSPECTTON REgUESTS SHOULD BE UADE ON THE BUTLDTNG DTVISTONTS 24 HOUR A DAY TNSPECTTON LINE. THE INSPECTION NUMBER TS 726-3769. INSPECTION REOUESTS WHICH ARE CAILED IN BE- FOR 7 A.M. WILL BE MADE ON THE SAI\48 DAY. LABEL NUMBERS LABEL TSSUANCE FEE RECEIVED BY FOR OFFICE ggE ONLY DATE 50 # G-e-c,/ L f- Jl7 s7-r'.t 7