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Home My WebLink AboutPermit Building 1986-08-29@ TION LIIIE 69 C c0t'18 IIIATION APPLICATI ERMIT ON 726-37 Job Address i l,later Heater Ranqe ilSltt JelBcrs l-egal 0escription 7'o o tooo Owner ST Value of l.lork:ilfrce sg. Ftg. A..uF- Sq. Fto. Othe" : _llew Add- AtTffi- _Fe nc e_Demo_C h-n gel U s e0ther Ftq. t1a n Address Phone I ng leF 'F7 e., BuiInq Pernri f?es i den th At l,io rk Ga ra nfo: Descr Nlr<d/{tPro 4/12 7/ 74Eb Addres s Phone me Bs C, --) Structura l Pri ma Electrical llechani ca l El ectri l.!echa n P ,r,*: \) \ N-ELECTRTCAL L)\N MEC HAN I CAL \)\ N Each single fixture Residence of SQ. FT furnace/burner to BTtl' s Relocated bui ldinq (new fix. additional ) New ci rcui ts al tsor extensions Fl oor furnace and vent S. F. P.esidentE(l bath)SERVICES Recessed wai I Soace heater and vrnf Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seDa rate l,later servi ce Change i n exi sti ng resi dence Stati onar-v evap cool er Sewer multifami )y, com'r. or Industrial Vent fan with sinole duct Storm Sewer 0f .amps. Vent systen apart from heatinq or A.C. COI4I.!./IND. FEEDERS Mechanica'l exhaust hood and ductInsta l I /a I ter/re l ocatedistrih. feeders l.lood stove/heater 0f ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES l.lAllE(p1ease print)I (rqA,e.b Do/q HA L EXAM ntr Ithe e ted 'I1 tca oni rcomDap!-)'iDerm t an icert fhe re b.v ath at II ni forma ivt 0n reohe n s trueicorrndectdanfuIrrtheticerthaatand1awoIrkfynyperformedhasIIdonebeiaccnceordathwtI0rdthenas'|the I tyifefidIandSprngtLawsheLofheSttao0freoonIrta1nDEcrlbednIhereandhatr{ct CUPAIIC Y0c w1 II eb demafturetructw1suthothepermiissnoohetUBIiidDivlngce'Irt tha t 'I +s tra 'Ifym.y reg on thvJl Buthe l1 der s any rd '|Boa c n'I ifu I fo arce nd effe asct 'I red ORSreq u 7n 1 505by the ba 'Iq s rfo ex t oni IemD s henoted re0n th aand t1onsubcvrsntractondaIn'IIreawhoemp ncea thWIcomc be us ed thon sI ecrojp t I REQUIRES that the Electrical work be dountil the label has been signed by an El ne b-y an Electrical Contracectrical Supervisor and ret tor, .the electrical portion of this perm.it urned to the Building Division TOTAL CHARGES IGiIATURE FICE g to the work dession. I further , that if exempt 0l?S 701 .055 vri I Ie HHERE STATE LlN shal l not be val i.l Plan Ck. Conrn/lnd 65%/Bldo Per Fee KZSZ I Svs Cha tbr:rs Deverqe (t.511 opmentL\L\ tI-J---r\:re--Plan Ck. Res 30%/81do Per Fee \ Fence Dgmo S i dewal k Total Comb. lermitA/C Paving Curb Cut zBr\GTOTAL / Cons t its Ftq. l{a i Value Val ue Value Fire Zone Flood Plain S tori es BUILDING PERI.IIT Clrarges anC Su rcha rges PLUt4BING PERMiT Charges and Surcha rges LECTRICA.L PERI1IT harges and 'Jrcharges CHANICAL PEP.MIT arges and rcha rges Load ' Ftg . Ftg Acces s. 0ther xGroup 4 TOTAL VALUATION 't Constructinn Lender ( addres s pxn i rpc ( nhnne nn COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot .100, Lane County Map Reference I7-TT,I32. examole- Lot l. Block 3, 2nd Addition toS[Fiffiietd EstatesC. Name, etc. of owner and construct.ion lenderD. Energy Sources1. examole- heat2. ExamilE wateE. squaFe Tiotage or PERMIT VALIDATION /electrical ceiIi a ter ec ca or va luat 0Dt e c.1. examole- 1250 sq. foot house, 500 sq. foot garage2. erdrreTe- lT-Tew project, check-new - if additio;, check add, etc.F. Building permit information:i. example - construct single family house with an;TtachEd gardge2. example. - remodel existing garage into family room3. exampl e- - convert s i ngl e iaii ly-res i oence i niorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design jnformation or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electr.ica'l Schedules,the applicant need fil l-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Buiiding Div.i s.ion1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labei must be delivered to theelectrical contractor for signature by his e'lectricalsupervisor. The general contractor is not authorizedto sign the electrical Iabel.III. Applicant to sign and date llhenever possible, the initial applicat.ion will be used asa worksheet oniy. Hhere possible, Bui lding Division Staffwili prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges PIan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. AII other fees and charges are due andpayable yrhen the permit is issued. V. FOR OFFICE USE ONLY L Permi t Clerk kbbaffiz U'7q'gL PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Informatfon: PLANS REVIEWED BY: dateS1gnatur I NSP 726- m COHBI NATI ON APPL ICATION/PERMIT Job Address o EIIERGY SOURCES Hea t llater Heater Ranrle_ n Sq. Ftg Sq. Ftg . Access . 0ther oo 6-' C\ C*l Legal Description uu"'o1,"19€o 0wn eddress/ ,/Z Og //, _*f{ - ynone/f Builtlino Permit Info: Describe l^lork(' Far:r'i Iy Residence I'lith Attached Garaqd .e., Build Single l/s2 u Constructi on Lender Addre s s Phone DESIGN TEAI.I name addre s s 'I CS. nO.exot res ohone no. Pri mary Structura I El ectri cal Mechanical CONT IACTORS n ame addres s I i cs. no.exot res nhnnp no, ) Genera I Pl umb i I hnn l.lechan i cal PLUI{B I NG ELECTR I CAL MECHAN I CAL FEE CHARGE NO FFF THARGF NO FFF CHARGF 5 Each single fixture 7ta t7e Residence of SQ FT furnace/burner to BTU' s Relocated building (new fix. additional)t/New circuits alts. or extensionsz aR )va36 7za Floor furnace and vent S.F. P.esidence(l bath)SERV I CES Recessed wal I Soace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent sFoa ra te [^later servi ce Change in existing resi dcnce Stationary evap cool er Sewer multifami ly, comm 0r I ndustri a I t/-Vent fan with sinole duct 3.* Storm Sewer 0f amps.Vent system apart from heatino or A.C. cor.ff'l./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocatedistrib. feeders l'lood stove/heater 0f s. ISSUANCE OF PFRI.IIT TOTAL CHARGES TOTAL CHARGES 2?54 T0TAL CHARGES 1fi12l17csotft /S* WHERE STATE Ll\W REQUIRES that the Electrical work shall not be valiC until the label has been signed by be done by an Electrical Contractor, the electrical portion of this permit an Electrical Supervisor and returned to the Building Division I HA E E t c0mp eted apnl i ca and al I 0regon the Buil tion for oermit an d hereb.y cert 1 fy t ha t a 'I I 1 nf,orma t 'I 0 n hereo n s true a nd co rrec t and I further cert 'I fy t ha t any of of work performed shall be done in accordance with the Ordinances of the City of S pri ng fi e I d and the Laws o f the Sta te 0e rtaining ng Divis 701.055, ce wi th to the wo r k de sc rl be d here i n a nd th a t NC 0 CC UP,AI,ICY wl I I be made of a ny t ru ctu re wt t ho ut the pe rmt s s 'I on di 'I on I fu rther xempt 5 wilI certi fy tha t my reg 'I s trat I on vrl th the ul I d er s Bo ard ,l s 'I n fu I I force a nd effe ct a s requ 'I red by ORS th a 'I f t he ba S 'I s f o r exemp ti 0n 'I s not ed hereon an d t ha t 0n I v s bcon trac tor s and emp I oye es who a re 'I n comD I 'I an 0l?s 7 0 05 be u sed n th 'I s proj ec t t'lAl.lE( pl ease pri nt)SLn e "J IGNA TE Tone$4*AoE_rwe/const. S'I uni ts an Ftg. t'lai Val ue Fire Zone Rc drooms 0ccy Load Access x Value orn""Wuu.tu"-3G.ooFlood Plain Stories eroup ty'-3 sq. Fts TOTAL VALUATION-Q-rr-8u BUILDING PERI'IIT Charges and S urc ha rges -s/ Plan Ck. Comm/Ind 65%/B1dq Per Fee terns opment Plan Ck. Res 30%/81dq Per Fee PLUMBING PERMIT Charges and Surcha rges ___z .f,a / .,ro Fence D6mo ELECTRICAL PERI,IIT Charges and Surcha rges ?Z -&_Sidewal k A/C Paving Tota'l Comb. Permi t HECHANICAL PERMIT Charges and Surc harges 6a Curb Cut TOTAL //8.al 1 ( ?q.n< t4,loss_-6_e-=5:o__ ----/-f.?-?- t' COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot I00, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpilngfield EstatesC. Name, etc. of owner and construction lender PERMIT VALIDATION D. Energy Sources1. example- heat/2. ExamEl-e- waterE. Square footage or el rt ca iti or forced air qas rf So larare val uat on, etc 1. examp_le- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check-new - if additio;, check add, etc.F. Building permit information:1. example - construct single fanily house with anattached garage ?. examp_le - remodel existing garage into family room3. example - convert single family-residence iniorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bu.ildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc.II. Abbreviated P)umbing, Mechanical, & Electrical SchedulesA. Except where blank spaces ociur in the description--portion of the Mechanical and Electrical Schedules,the applicant need fill-in oniy the No. Boxes adjaient - t0 the appropriate item(s) to be installedB. Full Plumbing, Mechan.ical, and Electrical Schedulesare available at the Building Divisionl. To conserve space on the perm.it form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consu.lt thefull schedulesC. BUILDING DIVISION STAFF WILL 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 electricalsupervisor. The general contractor ii not authorizedto sign the electrical labelIII. Applicant to sign and date l,Jhenever possibie, the initial application wi.ll be used asa.worksheet onjy. Where possible, Building Division Staffwil) prepare a type written copy and return it to theapplicant at the time the actual permit is issued io" tris s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the t.ime of theapplication, and no plans will be processed unt.il thesefees are paid. All other fees and charges are due andpayable when the permit is .issued. V. FOR OFFICE USE ONLY \v&b1 p Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name s'l g nature date' 7-zz-g€ m COHBI IIATI ON APPL ICATION/PERHIT 3t Job Address o EIIERGY SOURCES: Hea t I'later Heater Range 5q . Ftg . l'lai n_ Sq. Ftg. Access._ Sq. Ftg. Other_ J{ew-__rAdd___1A I GEAe pl_ _Fence_Demo_Change/ U s e -other-0wne 'ut" ou,"b-p,o Bui lci inq [ermit Info: Describe l,lork( FamiIy llesidence tlith Attached Garaqe .e., Build Singlenaa'""/ //73 C5 /J, _flfi'" ynone/L /ls2 1Construction Lender oos C\ O Addres s Phone addres s tcs- no.exo'i res ohone no.DES I GN TEAI1 name Pri mary Structura I E I ectri ca I Mechani cal ACTORS n ame addres s l i cs, no.exot res Dhone no. I I ta-nt l.lechani cal MECHAN I CALELECTR I CALPLUIlB I NG FFF .HAAGF NO FFF CHARGFFEECHARGENO Residence of SQ. FT furnace/burner to BTLI' S5Each single fixture 73 37v Relocated bui lding (new fix. additional )t/New ci rcui ts ai ts. or extensions? eR ,VanE 72.e Floor furnace and vent SERV I C ES Recessed wal 1 Soace heater and vent S, F. Residence(l bath) Duplex (1 bath) each Apol iance vent sFDarateTemporary Construct.i onAdditional bath Stati onar5, evap cool er ge in existing dence C han resil.later servi ce ./-Vent fan with sinole drrct 3.*Industrial multifamily, comm. orSewer 0f Vent systern apart from heatinq or A.C.Storm Sewer c0Mr.1./IND. FEEDERS i\4echan icai exhaust hood and duct Instal I /ai ter/rel ocate di <fri h fcpdprc liood stove/heater ISSUANCF OF PFRI1IT TOTAL CHARGES yv)1ry1Vtx.,y7 /S*TOTAL CHARGES 2?.56TOTAL CHARGES WHERE STATE LAN shall not be valiC REQUIRES that tlre Electrical work be done by an Electrical Contractor, the electrical portion of this perrilit until the labe'l has been signed by an Electrical Supervisor and returned to the Building Division EFULLY EXAMINED the completed application for oermit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all work Derformed shall be done in accordance with the Ordinances of the City of Soringfield and the Laws of the State of 0rer-ron nertaining to the work described herein, and that NC OCCUPANCY will be made of any structure without the permission of the Building Division. I further certify that m.y registration vrith the Builder'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 that only subcontractors and ernployees who are in comcliance with OPS 70i.055 will be used on this project. I'lAllE (pl ease pri nt iGI{ATUR DATE I HAVE CAR AISD J \ Ftg Ftg Ftg Access x Val ue othe? iE777&/v ualue 31W:> 'sa l'la i n TOTAL VALUATION Q- r r- 8c- 0c c.y Grou X ValnstS:L Uni ts Fire Zone Bedrooms Occy Load Zone lsq p y'-3 sqFlood Plain Stories opment rge 51 Plan Ck. Comm/lnd 65'/"/B1do Per Fee BUILDING PERI.IIT Charges and Surc ha rges .sq.Src Plan Ck. Res 30%/81dq Per Fee Fence Dgmo PLUI4BING PERMIT Charges and Surcha rges ---ZZ.*--/.so SldewaIk Tota'l Comb. Perm i tA/C Paving ELECTRICAL PERI,IIT Charges and Surcha rges 2 Curb Cut //a.olTOTAL I,IECHAN I CAL PERMIT Charges and Surcha rges 6o Lesal Descri ption 17-63.28-4 4 . r) IZOO i rr, .l t/t 0f amps COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. elample- Tax Lot 100, Lane County l"lap Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources eiectrical c or forced air gas 2 ea ter e ec or solarE. Squa valuat on, etc II 1. examp_le- 1?50 sq. foot house, 500 sq. foot garage2. g5!e_19: if new project. check-new - if additio;,check add, etc.F. Building permit information:1. example - construct singie fanily house with anattached garage2-. examp_le - remodel existing garage .into family room3. example - convert single fam.ily-residence into - restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Speciaity CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construct.ion delays, BuildingD'ivision Staff must be able to contatt appropriitepersons regarding design information or job s.itecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA, Except where blank spaces occur in the descriptton--portion of the Mechanical and Electrical Schedu'les,the applicant need fill-in only the No. Boxes adjacent _ to 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 scheduies you should consult thefull schedulesC. BUILDING DIVISION STAFF hIILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labei must be delivered to theelectrical contractor for s.ignature by his electricalsupervisor. The general contractor ii not authorizedto sign the elect;^ical iabelApplicant to sign and date lJhenever possibie, the initial applicat.ion wjll be used asa.worksheet only. Where possible, Building Division Staiiwili.prepare a type written copy and returi .it to theapplicant 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 plans will be processed until thesetees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III. IV. V PERMIT VALIDAIION b1 p Permit Clerk dN fiw PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name s'l gnature date 7.2