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Home My WebLink AboutPermit Building 1978-07-18INSPECTION LINE 726-37 69 m COMBI NATI ON APPL ICATION/PERI'IIT INFORI1ATION LINE 726-37 53 z.o N) oo N)rJ Job Address 1263 North 6th Street Sources accsy atter heater ew rfenceI'I t 'I o n lue of work: 5 c ha nge u se ot he r Lesa1 oescription TaX LOt 10400, Lane COUnt.y Map Reference 17 03 26 43 Owner (name/address/phone) 1 ng permi r wo I le fam Construct 14 X 16 bedroom addition 7 47 -7 457 to existing S.F. Residence Construction Lender (name/address/phone) DT,5 I GN TEAI4 name address lics. no.exoi res ohone no. Pri ma ry Jerry Carl'in Construction 1266 North 7th St 24G00 7 47 -5977 Str uctura I El ectri ca I l'techanica l name addres s I i cs. no.exoi res ohone no. ) G I 7 47 -5977 i El ectrical l,lechanical PLUIIB I NG 14ECHAN I CAL ELECTR I CAL ilO.FEE CHARGE NO FFF CHARGF NO FFF I^HARGF Each single fixture furnace/burner to BTLI ' S Residence of SQ FT Relocated buiiding (new fix. additional ) Fl oor furnace and vent New circuits alts or extensions S . F. Res i dence(l bath) Recessed wal I Soace heater and vent SERV I CES Duplex (l bath) each Additional bath Apol iance vent s eoa ra t-e Temporary Constructi on l.Jater service Statj onary evap cool er Cha res nge in existing i dence Sewer Vent fan with sinole duct multifamily, conrn. or Tndrrctrial Storm Sewer Vent system apart from heatinq or A,C.0f s Mechan.ical exhaust hood and duct COMI.I,/IND. FEEDERS tJood stove/heater Instal 1 /al ter/re1 ocate distrib- feeders 0f V New circuits, alts nr pvtpns i ons 15. C 0 ISSUANCE OF PERIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES 15.00 IIHERE STATE LAW REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valid until the label has been siqned by an Electrical Supervisor and returned to the Building Division. I HAVE CAREFTILLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the Cityof Sprinofield and the Laws of the State of Oregon pertaininq to the work described herein, and that N0 0CCUPANCY will be made of any structure without the permission of the Buildinq Division NAI'IE ( pl ease pri nt )S IGNATURE FOR OFFICE USE OIILY zones R-l/FZ [ [ Ftood Plain N0 ndrms ladd Type Const R-3 Stories 1 u.it. V-N _ sq Ftg Sq Ftg 224 Value Va lue 5,000. 00 Occy Load Occy Group ACC BUILDING PERI'IIT Charqes and Surcharges 32. 00-1.N Plan Ck. Comm/lnd 65illBldo Per Fee Storm Sewer Connec Plan Ck. Res 30%/Bldq Per Fee Pa"id 9 . 60 0t her PLUI4BING PERMIT Charges and Surcha rges Fence 0ther Sprinkier System 0ther ELECTRICP,L PERI,!IT Charges and Surcha rges J5-00___ .60 Demo Total Comb. Permit 58.48 A/C Paving SDC I1ECHANICAL PERMIT Charges and Surc harges Curb Cut TOTAL SidewaIk 7 .e., COMBINATION APPLICATION/PERMIT (CAP) L App l i cant to furni shA. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION BP EP 4% 32.00 t.2B 1. example- heat2, example- wate Square footage or electricai ceil i or forced air gas 'r sOlar 4% Check Fee 15.00 .60earec tr ca E val uation,etc l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new * if addition, check add, etc.F. Bui lding permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence intoiEsTiliant (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, Buitding Division Staff must be able to contact appropr.iate persons 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 appiicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult theful 1 scheduiesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectricai contractor for signature by his electricalsupervisor. The general contractor is not author.izedto sign the electrical label. Applicant to sign and date Whenever possible, the initial application will be used asa.worksheet only. Where possible, Building Div.ision Staffwill prepare a type written copy and return 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 wilI be processed unt.iI thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY Pl an TOTAL minus (pa'id )9. 60 58.48 plan check fee -9.60 TOTAL AMOUNT DUE 48.88 II III IV Perm'it Cl er PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Additional Project Information : PLANS REVIEWED BY: name s't g na tu re da te