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Home My WebLink AboutPermit Demolition 1982-07-14?6 69 COMBi ON APPLICATI RMIT 726-3 Job Address EIIERGY SOURCES Hea l.later Heater_ e Ftg Ftg Ftq l.la i Sq Sq Access 0ther llew Add Fen -0t 0oNb 5 l-ega l Descri ption l-1 Ir Ci varue of ,.'o'tJ/A Owner Address n t ce I r ngle 'I A v TConstruct i on Lender Addre s s Phone DESIGN TEAI.,I name address I ics. no exD I res ohone no. Pri ma a Structura 1 El ectri cal Hechani cal a Genera I P I umbi Itlechan i PLUIlB I NG ELECTRI CAL MECHAN I CAL N0.FFF CHARGE NO FFF I^ HARGF NO Each single fixture Residence of SQ FT furnace/burner to BTU' S Rel ocated bui 1 dinq (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent 5 , F, P,es i dence(l bath)SERV I CES Recessed wal I Snace heater and vent Duplex (l bath) each Addi ti ona'l bath Temporary Construction Apol iance vent seDa rate l,Jater serv ice C han res i ge in existing dence Stati onar.v evaP, cool er \OASLSewer hoo multifamily, comm. or Indrrstrial Vent fan with sinole duct \ Storm Sewer 0f am ps.Vent system apart from heatinq or A.C. c0r.1r'1./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re l ocate dist-rib. feeders Ilood stove/heater 0f s. ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAI,I REQUIRES tha the Electrical work be done by E l ectri, an Electrical Contractor, the electrical portion of this permit shall not be valil until the label has been signed by an ca1 Supervisor and returned to the Building Division FU LL E c 0mp l e te ap p ti 0n fo r DE rmt t a nd do h ere b,y cert 'I v th a t a I I I n rmation hereon is true 0rdinances of the CitY 0CCUPANCY will be made on vrith the Builder's noted hereon, and that and correct, and I further certify that any and all work rfo rmed s ha I I be done 1 n a cc0 rd an ce wl th t he of S pri n s f 'I e I d an d t he L aws f th s ta te of 0 re g0n oe rta 'I n I n g to th e wor k descr 'I bed he re ,l n an d t ha t r't0 of a ny S t ru ^+u re wl t ho ut the permiss nd effect as ernployees wh ,]0 n of the Bu ,]I d 'I ng D ,l ,]s 'I o n I furt he r ce rt 'I fy t ha t m.y re s I S tra t 1 Bo a rd 1 s 'I n fu I I force a req u 'I red by 0 RS 7 0 05 5 tha t I f exemp t th e ba S 'I S for exempt ,l 0 njonIvsubcontracto rs and are 'I n como I I a nc e wl t h 0t?s 701 0 55 vJl 'I 1 be US ed 0n th 'I s p ro e ct t'lAl'lE(please print)e/nuo; n Slnzqil S I Gi{ATURE *-ilATE v-/4'tra- I Zone Tyoe/ Cons t.its Ft9 Ftg Ftg l'la i n x lue Fire Zone Bedrooms Flood Plain Stories 0c cy Load Access 0the r Val ue 0cc.y Group Sq X Val TOTAL VALUATION BUILDING PERNIT Charges and Su rcha rges Plan Ck. Comm/Ind 65%/Bldq Per Fee Svstems Development C[arqe (1.5. ) Plan Ck. Res 30%/81dq Per Fee PLUi4BING PERMIT Charges and Surcha rges Fence Dgmo \Boo ELECTRICAL PERI1IT Charges and Surcha rges SidewaIk A/C Pavi ng Tota'l Comb. Permit 14ECHANICAL PERMIT Charges and Surcharges Curb Cut TOTAL 40 a 4.-4r" .L? COMEINATION 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 1. Block 3, 2nd Addit.ion toSpringfieid EstatesC. Name, etc. of owner and construction lenderD. Energy Sources E I. example- heat/ejectrical ceilinq/2. examrpl e- wa terhea te-rj efdETFiZaj-/b Square foofage or valuation,-ETEI- or forced air gasr solar To avoid des Division Sta igrffn or construction delays, Building must be able to contactpersons regarding design information orcorrections, etc. l. example- 14IQ sq. foot house, 500 sq. foot garagez. elample- if new project, check new - if addition, check add, etc,F. Building permit information:1. example - construct singte family house with anattached garage ?. examp]e - remodel existing garage into family room3. example - convert single family residence into - restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS appropri a tejob site II.Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descript.ion - portion of the Mechanical and Electrical Schedules,the applicant need fill-in on)y the No. Boxes adjaientto the appropriate item(s) to be instailedB. Full Plumb'ing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the perm.it form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF I"IILL 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 electrica.lsupervisor. The general contractor ii not authorizedto sign the electrical label.Applicant to sign and date Whenever possibie, the initial app'lication wilI be used asa.worksheet on1y. l,Jhere possible, Building Divis.ion Staffwill 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 PIan check fees are due and payable at the time of theapplication, and no plans wil l be processed unt.il thesefees are paid. Ail other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III IV V Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information PLANS REVIEWED BY: name s i gnature date PERMIT VALIDATION INSPECTION L 725-37 69 COIlB I AP ICATION RMIT 726-37 EIIERGY SOURCES Hea t Sq.l.1a i n_Access._ 0ther Job Address !q. Ftg Sq. Ftg l,lettl-egal Description l,Jater Heater Add ter Ranqe -Fe nc c Use Val ue of l,lork -o Owner n it cri ng Addres s il d ce rh Gara LConstruction Lender Address Phone name re Pri ma Structura l El ectri cal l'lechani ca l Elect chanical PLUtlBI NG ELECTR I CAL MECHAN I CAL Each single fixture Residence of SQ FT furnace/burner to BTLI, S Relocated building (new fix. additional ) New circuits alts or extens i ons Floor furnace and vent S. F. Residence ( I bath)SERV ICES Recessed wal l snace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent se Da rate l,later servi ce Change in existing res i dence Stationary evap cool er \Sewer ho,multifamiiy, cornm Industrial or Vent fan with sinole duct \ Storm Sewer 0f part fromVent systenn a heatinq or A. COMI,1./IND. FEEDERS Mechanical exhaust hood and duct I nsta l I /al terl re l ocate distrib. feelers-llood stove/heater 0f s. ISSUANCF OF PFRI{IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES th tlt LI ectr 1 ca 'I t^I0 rk be do ne by a E 'I e ct r1 c a I Co ntra c to r the e 1 EC tri ca 1 por +,l on of t hi s pe rml t I^JHERE STATE LI\I,I RE shal] not be valiI unt QUI RESil the a e 'I s 1 d ret d t he Bui I d 1 ng Di '|s 'I on 1 a be I ha s be en s .I gn ed by a n E 1 ctr 'I c a uDe s or an u rne I I 'I t'i on r perm 1 +a nd he re b.y ce rt 'I fy t ha t I I I rma t 'I on hereo n s true he City be made der' s nd that L E XAIl I t comp ap l')ca accorda wl t h the 0rd '|o f tand correct of Soringfi, of any stru Board is in only subcon and I f rt her certify Laws of thet the permi and effect empl oyees that any and alI work State of Oregon oertai ssion of the Building D D e rfo rme d sha I I be don e 'I n nc e n ances U th work d rl bed here 1 n a nd th a L NC OCCUPAI'IC 'I I I e I d and th e n I ng to e CS c 14l th t he Bu I Ictuwlthou'I s I I frurt he r cer ti fy th a t m.y reg 'I s tra t 1 0nre 5 tha 'I f t t he ba 'l fo exemp t 1 on 'I s n oted he re on afuI1foasrequ'I red by ORS 7 0 05 t exemp srcsed th 'I proJ ttctrsandr.rho a re 'I n como I i a nce w1 t h 0l?s 701 05 5 i I I be u o n S ecrao e/nuo; rt Sltszon/S IGi.IATURE ,TE /-/l'tral,lAtlE(please print) FFI Zone________Type/ Co n s t Uni ts Sn Ftg Ftg Ftg l,la i n Val ue Fi re Zone_$edrooms.Load Acce s s 0the r al ue Flood P'lain Stories 0cc'Y Group Sq x Val u TOTAL VALUATION.-- Pl an omm/ I nd s tems opment BUILDING PERNIT Charges and Surcharges rqe 1.51 P an S 3 BI Per PLUi4BING PERMIT Charges and Surcha rges Fence Derno \Boo ELECTRICAL PERI,IIT Charges and Surcha rges Sidewalk A/C Pavi ng Curb Cut Total Connb. Permit TOTAL I,IECHA}IICAL PEP.MIT Charges and Surcha rge s 40 Bhonei<nnI DOt\b! COMBINATION APPLICATION/PERHIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. g3Efl_C-: Tax Lot 100, Lane County Map Refe:17 03 432. example- Lot l. Block 3, Znd Addition toSpringfield Estatesq. Name, etc. of owner and construction lender0. Energy Sources example- heat/ examp'l e- wa terre footage or PERMIT VALIDATION CITY OF SPRINGFIELD City Hall Spdnglield, Oregon Department ol Publlc Works OFFICIAL RECEIPT No. B ce 0 x( I eie cei I in r forcedt.lI. - sq. foot- if adc 2E. Squa 2 valuat OD' r or {o4?q\., v -l' I- tr/ L I rf ( I I ( ( 1250 s, It new exampl e-q. foot house, 500 examp I e- check add project, check-i-ew, etc Building permit information I F (Bec'd Received For: l. example - construct single family house witattached garage ?. example - remodel existing garage into famiJ. example - convert single family residence iiEsTtlFant (change of"use)- "" " G. Va'lue of work as defined in Section 303 (a) of.. Structural Speciaity CodeH. DESIGN TEAI4 AND CON1RACTORS To avoid design or construction delays, Buildin,Division Staff must be able to contait'upp"opii,persons.regarding design information or 3bU iit,corrections, etc. Abbreviated P)umbing, Mechanical, & Electrical ScherA. Lxcept where blank spaces occur in the descript.portion of the Mechan.ical and Electrical Schedulthe applicant need fill-in only the No. Boxes ac_ t0-the appropriate item(s) to be installed8. Full ptumbing, Mechanical; and Ete;arica.l Schedr.are available at the Building Divisionl. To conserve space on the-perm.it form the schhave been abbreviated2. If the item(s) to be installed are not coverthe abbreviated schedules you should consuitfull schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be de.liveredelectrical contractor for signature by his electsupervisor. The general coniractor ii not authoto sign the electrical labelApplicant to sign and date Whenever possible, the initia'l application wi.l.l be u:a.worksheet only. Where possibl!, Bui.lding Divisionyfl Ir.prepare a type written copy and return it to thrapplicant at the time the actuai permit is issuea iois i gna ture. Fees and Charges Plan.check fees are due and payable at the time of tlapplication, and no plans w.iil-be proceiied until theserees are paid. All other fees and charges are due andPayable when the permit is issued. FOR OFFICE USE ONLY ( (.n ( ( * 1 II III. IV lt ,/a'.\f/ Amount Beceived ( ( ( (al \EiIOOS PRINTER!'/LITHOGRAPHER9. EUGENE. OREGON V name Permit Clerk date PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: cant exempt from registration with the Builder,s Board because:Permit appl i Additional Project Information : s'l gna tu re ( PLANS REVIEWED BY: