HomeMy WebLinkAboutPermit Building 1982-07-20INSPECTIOII LIIIE.
726-37 69
CITY OF SPRiNGFIELD
Cr)I1BI iIATION APPL ICATION/PERMIT
INFORIIATION LiNt
726-3753
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Job Address 302 SheLLey SP, DE EIIERGY SOURCES
Hea t
l.Jater Heater
Ranqe
So. Ftq. l.lain_
Sq. Ftg. Access._
Sq. Ftg. Other_
_l{ew_AddJ1 te r_P.ep .
_Fence_Demo_C han ge/ U se
-other-
Lesal Description L7-03-27-L0 TL #7700
Val ue of llork
$q, sooOwnerPactrust Properties
Address LL20 S.W, Moyryison Phone 224-6 5<^BUF
ui I cii
arni I y
nq Perntit In
Res i dence l'l
fo: Describe llork('ith Attached Garaqe
.e., Build Single
Suite 300 Portland, 0R 97305 )ffice in existinq liarehouse
Construction Lender
Address Phone
DES I GN TEAI.!name address (1 cs. no.exol res phone no
Pri mary
Structura l
El ectr i ca I
Mechan i ca I
CONTRACTORS n ante address I ics, no.'exDl res nhonp no- )
Generaf llot'7 a | /1nno*n L0 Van Bw'en a85-7 aU
Plumbinq
El ectri cal
l'.lechanical
PLUI1B I NG ELECTR I CAL MECHAN ICAL
FEE CHARGF NO FFF CHARG F NO FFF CHARGF
Each single fixture furnace/burner to
BTU' S
Relocated building
(new fix. additional)L
New circuits alts
or extensions L0. 0a
Floor furnace
and vent
S. F. P.es i dence(l bath)SERV I CES
Recessed wal I
Snace heater and vpnt
Duplex ('l bath) each
Additional bath Temporary Construction Apol iance vent
separate
tlater servi ce Change in existing
res i dence
Stationary evap.
cool er
Sewer multifamily, comrn. or
Industrial
Vent fan with
sinole duct
Storm Sewer 0f s.
Vent systern apart from
heatino or A.C.
COMI1./IND, FEEDERS
Mechanical exhaust
hood and duct
Insta'l I /al ter/rel ocatedistrib. feeders tJood stove/heater
0f amp s.
ISSUANCE OF PFRIIIT
TOTAL CHARGES TOTAL CHARGES L0. 0a
I^IHERE STATE LAt,l REQUIRES that the Electrical work be done by an Electrical Contractor,
shall not be vali.l until the label has been signed by an Electrical Supervisor and returned
the electrical portion of this permit
to the Building Division
t comp I e ted ap l-)1 1 dL t 0 n for perm I t an reb.y certify that all information hereon is true
one in accordance with the 0rdinances of the City
cribed herein, and that NC 0CCUPAHCY will be made
certify that my registration with the Builder's
the basis for exemption is noted hereon, and that
be used on this Droject.
a nd c 0 rrec t a nd I fu rther cer t 'I fy tha t a ny a nd a I I wor k pe rfrormed s ha I l be d
of Springfield and the Laws of the State of 0regon oertaining to the work des
of any structure without the permission of the Building Division. I further
Board is in full force and effect as required by ORS 701.055, that if exempt
only subcontractors and ernployees who are in comcliance with 0l1S 701.055 vlill
I'lAt'lE ( pl ease pri nt )S IGiIATURE
FON OFF]C[ USE O|IL
Zone MR st. V-il spkl untts (n Ftg
Ftg
Ftg
l,la i n x 'I ue
Access.
0the r
Value
144 x 3L.25 value
TOTAL VALUATTON 4,500.00 _
BUILDING PERiIIT
Charges anC
Su rcha rges
32. 00
1. 28
Plan Ck. Comm/Ind
65fllBldq Per Fee 20. B0 Paid Svster,ls Deve
Charqe (1.51
opment
Plan Ck. Re
30%/Bl dq Pe
srF ee 7-16-82 #s9438
PLUI4BING PERMIT
Charges and
5u rc ha rges
Fence
Dgmo
ELECTRICAL PERIlIT
Charges and
Surcha rges
1"0. 00
,n
Sidewalk
A/C Pavi ng Tota'l Comb. Permi t
Curb Cut
I$qs. oa
I,IECHAIIICAL PER}4IT
Charges and
Surc ha rge s
TOTAL
Res idence of
s0. FT.
TOTAL CHARGES
-w
Fire Zone Bedrooms Occy Load Sq.
Flood Plain Stories 0...v G.orp B-2 Sq.
PLANS REVIEI,JED BY:
name S1 g natu re aate 7-/b -8)-
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference
17-03-jI32. example- Lot l. Block 3, Znd Addition toS!7Tn!Fie1d EstatesC. Name, etc. of owner and construction IenderD. Energy Sources
PERMIT VALIDATION
#€3/?y'
l.
2.
exampl e-
examo I e-
FE-76-otag
hea t
wate
/el ectrica iti r forced air oas
solart
E Squa e or valuation, etc 3t oo1. example- 12_50 sq. foot house, 500 sq. foot garagez. example-.if new project, check new _ if addition,check add, etc.F. Building permit informat.ion:l. example - construct single family house with anattached garage
?. examp_le - remodei existing garage into family roomJ. example - convert singie family residence into
_ FesGurant (change of-uie)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI.I AND CONTRACTORS
To avoid design or construction de)ays, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electr.ical SchedulesA. Except where blank spaces occur in the descr.iptionportion of the Mechanicaj and Electrical Schedules,the applicant need fijl-in only the No. Boxes adjaient
_ to the appropriate item(s) to be installedB. FulI Plumbing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful l 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 labelApplicant to sign and date
llhenever possible, the initial application wi'll be used asa.worksheet only. l,Jhere possible, Building Division Staffwili prepare a type written copy and returi it to theapplicant at the time the actual permit is issued for hissignature.
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
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Ley s stem rmtst. be Ld Fire ne be
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
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