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Home My WebLink AboutPermit Building 1982-08-03INSPECTION LIIIE. 726-37 69 CITY OF SPRINGFIELD COI1BI |IATI ON APPL I CATION/PERMIT fiT0IXETIIN-rfnE- 726-37 53 to \, \ \0 i Job Address Fou l-egal Description EIIERGY SOURCES Hea liater Heater Ranqe Sq. Ftq . l'lain Sq. Ftg. Access.-- So. Ftg. 0ther__ _llew_Add-A1 ter_Rep. _Fe nce_Demo_Cha nge/ U se 0therVal ue of l,/ork J,,vgowner 3er /%*iwn Addres s /Phone Buil(ing Pernrit Info: Describe Work(Family Residence liith Attached Garaoe re., Build Single turer*,/R ?7f77 %/rr; eZ**- - 3-1";,uiltr" tuiilt Construction 6naer Addres s I t/ name U address lics. no.exDlres phone no. Pri ma ry Structura I Electrical i''lec ha n i ca I 5 I EI ectri ca l ttlechanicai PLUtlB i NG ELECTR I CAL MECHAN I CAL N0.FEE CHARCE NO FFF l^HA PG F I'10 FFF CHARGF Each single fixture Res idence of SQ FT furnace/burner to BTU' s Relocated buildinq (new fix. additional) New circuits alts or extensions Floor furnace and vent S. F. Residence ( I uatt"r)SERV I CES Recessed wal l Soace heater and vpnt Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDarate l.la ter se rv i ce Chan res i ge in existing dence Stationary evap coo l er Sewer multifamily, conm or Industrial Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatino or A.C- cor.ilt./IND. FEEDERS l4echanical exhaust hood and duct Instal l,/al ter/re1 ocate di ctri h fepdprc l'lood stove/heater 0f amps I ')xo*q €g €x1 vEV;z-n /7. ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAT CHARGES TOTAL CHARGES WHERE STATE L.1N REQUIRES that the Electrical work be done by an Electrical Contractor, theshall not be vali'l until the label has been signed by an Electrical Supervisor and returned to electrical portion of this permit the Building Division I HAVE CAREFULLY EXAI1INED the completed application for permit, and do hereby certify that all inforrnation hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0regon oertaining to the work described herein, and that NC 0CCUPAI'ICY will be madeof any structure without the permission of the Building Division. I further certify that my reqistration vrith the Bui'lder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and thatonly subcontractors and employees who are in compliance with 0l?S 701.055 will be used on this project. tlAllE(p1ease'print)S IGIIATURE DATE zon._ !:C_ryoe/Const its s q Ft Ft Ft o. l'lain x Val ue Fire Zone Bed rooms 0ccy Load Sq. p F-? sq. g. Acces g. 0ther s x Valru-paL_uu, TOTAL VALUATI Flood Plain Stories Grou ue nN a BUILDING PERNIT Charges anC Surcharges. G yo Plan Ck. Conrn/Ind 65%/81do Per Fee Svs cha terns (t 0pmen Plan Ck. Res 3l%/Bldo Per Fee PLUI,IBING PERMIT Charges and Surcha rges Fence Dgrno ELECTRICP,L PERIlIT Charges and Surcharges SidewaIk A/C Paving Total Comb. Permit I,IECHANICAL PERMIT Charges and Surc harges Curb Cut TOTAL ,-?4 uL5 I ILAI.I 7 CONTI (e lnne no coMBrNATr0N AppLrcATroN/PERMIT (CAp) I. AppIicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 43 ?. elarnqle- Lot 1. Block 3, Znd Addition to SpringTieta EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION-r CITY OF SPRINGFIELD CitY Hall Springlield, Oregon Department ol Public Works OFFICIAL RECEIPT No.Bi 1s8?- 7// 6-SQ{.t I 59512l. examo]e- heat/electrical ceiling/o2. example- waterheater/eTEEtriEl-florE. Square footage or valuationiEEil- r forced air qa sol ar Date l. example- 1250 sq. foot house, 500 sq. foot garage2. example- iinew project, check-iEw - if additio;, check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. example - remodei existing garage .into family roor3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction delays, Bui)ding Division Staff must be able to contact appropriatepersons regarding design information or job sitecorrections, etc. 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 adjaientto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedulesare available at the Building Divisionl. To conserve space on the permit form the schedu'les have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF l.lILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to thelectrical contractor for signature by his electricalsupervisor. The general contractor is.not authorizedto sign the electrical labelApplicant to sign and date Whenever possible, the initial app)ication will be used asa-worksheet only. Where possible, Bu.i ld.ing D.ivision Staffwill prepare a type written copy and return it to theapplicant at the time the actuai 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 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 //z M*rz 5n Rec'd From Address ( Received Fon ( ( ( <./>e#*z II III IV. PLANS REV EWED BY: Amount Received ta (r; I{r iitocs aatntrns/LtTHoGRAPHERg. EUcENE, oREGol{ Permi t C'lerkv date 8 ' j-tt PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : name (_afiee s'l g nature *-J*s> ( ( { (1.. (, *( F2-€/-3 i i II I I I I I NSPE726-3 L GFI ELD TION/PERMIT INFORI1ATION LINL COIlBI IIATI APPLI CA 7 26-31 53 s \, \ \0 7 Job Address /Jb riloril, Frnr4 EIIERGY SOURCES Hea t l,later Heater Ranqe Sq. Fto. l.lain_ Sq. Ftg. Access...-- Sq. Ftg. 0the lleur Add A -Fence Derno -0ther- rlaer-m. - _Change/Use l-egal Description 0wner Value of llork:Jf,OP PhoneAddress n t ce I Desc e., Bu S ng e F A tt Euoer*,2R ?7f77 Cb/,r; shrft,- M c*tJffiJ; Addre s s D6IGN TEAM -name 0 addre s s lics. no exDl res phone no. Pri mary Structura I El ectri cal l''lechani cal n El ectri ca l,lechani ca l PLUIlB I NG ELECTRI CAL MECHANICAL NO FEE CHARGE NN FFF CHARGF NO FFF CHARGF Each single fixture Res idence of SQ FT furnace/burner to BTLI ' S Relocated building (new fix. additional) Floor furnace and vent S . F. Res i dence(l bath)SERV I CES Recessed wal l Snace heatpr and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seoa rate l,later serv ice Change in existing res'i dence Stationary evap cool er Sewer multifamily, cornm, or Industrial Vent fan with sinole duct Storm Sewer 0f .amps. Vent systern apart from heat-ino or A.C. COMI'I./IND. FEEDERS Mechani ca l exhaust hood and duct InstaI I /a l ter/rel ocate di stri b. feeders l'Jood stove/heater 0f amp s. (q1 VZVrn/zj ISSUANCF 0F pFRtlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I^IHERE STATE LAt,l REQUIRES that the Electrical work be shall not be vali'l until the label has been signed by an done by an E1 Electrical Su ectrical Contractor, the electrical portion of this permit pervisor and returned to the Building Division information hereon is true and correct, and I furiher certify thit any ahl ar1 work performed shall be done-in accordance with the 0rdinances of the City oi sp.ingrield and the Laws of the state o? tiiegon oertaining.to the work described herein, and that Nc 0ccuPAI'lcY will be made of any structure without ihe-permission of tne-suifails Diviiion. I further certify that m.y registration_with the Builder's Board.is in full force and efiect as requireJ-uv-oni i6r.oss, tnat if exempt the baiis for exemption is noted hereon, and that only subcontractors and ernployees who are in comcliance with Ol?S 701.055 will be used on this oroiect. t'lAl.lE(please pri nt)S ] GiIATURE DATE zone C'C tyoe/Const. Un 'i ts cy So Load Sq aroup F-? s, Ftg Ftg Ftg l'la i n x alue-_.=- Fire Zone Be drooms 0c Acces s Val ue Flood Plain Stori es Val ue v,fo,* TOTAL VALUATION-- 0the r BUILDING PERMIT Charges and Surc ha rges cE" 7a Plan Ck. Comm/lnd 65%/B1do Per Fee Svstens Development Charqe (1.52) Plan Ck. Res 30%/81dq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERTIIT Charges and Surcharges Sidewal k A/C Paving Curb Cut Total Cornb. Permit I,lECHANICAL PERMIT Charges and Surc ha rges TOTAL ,-# l New circuits alts. or extensions COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Biock 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources Prro rV.?zv 5Yt7> PERMIT VALIDATION ir qas E arage tion, F. Building permit information:1. example a ttac hed - construct single family house with an 9a rage II III IV ?. examp_le - remodel exist.ing garage .into family roomJ. exampte - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fili-in only the No. Boxes adjaientt0 the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedu.lesare available at the Building Division1. To conserve space on the-permit form the scheduleshave been abbreviated?. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUITDING DIVISION STAFF t,lILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by his electricai - supervisor. The general contractor ii not authorizedto sign the electrical iabelAppiicant to sign and date lJhenever possible, the initial appl.ication wil.l be used asa.worksheet on1y. t^lhere possible, Building Division Staiiwill.prepare a type written copy and returi it to theapplicant at the time the actual permit is.issued for nissignature. Fees and Charqes Pian check feis are due and payable at the time of theapplication, and no p)ans wiil be processed until thesetees are paid. All other fees and charges are due andpayable when the perm.it is issued. FOR OFFICE USE ONLYV Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from reg'istration with the Builder,s Board because: Additional Project Information: PLANS RE EWED BY: s'l gna tu re datename loVs€R e?-€'4 8-j-g>, g - 1-te