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HomeMy WebLinkAboutPermit Building 1982-02-26ON LII.IE ::- =:=-CtTY 0F ,iRIr -,- ELD COHBI I'IATI ON APPLI CATION/PERMIT 7?6-37 Job Address Legal Description Ran llater Heater EIIERGY SOURCES Hea t Sq. Ftg. Access._ Sq. Ftg. Other-- l,lew Add Al ter P.eP. 1-ence_o-mo C ha-n gel U s e 0ther Sq. Fto tn Owner Value of l.lork:"t'{irlcop nq Pernrit Info: Describe Work(i.e., Build Single Residence t,lith Attached Garaqe) Bui lcii t Fami I yAddressPhone Construction Lender \ Addre s s Phone exn reqDLsiGN TLAI'I name addre s s I ics. no Pri mary Structura I El ectri ca l HechanicaI a ddres s 'Iics- no-exD l res ohone no.CONTRACTORS n ame Genera I Pl umbi El ectri cal ttlechanical ELECTRI CALPLUIlB I NG 14EC HAN I CAL FEF CHARGF NO FFF CHARGF ti0 -FFF CHARGF Each single fixture Residence of FTSQ furnace/burner to BTU' S I I Relocated bui ldino (new fix. additioial)New circuits alts or extensions Floor furnace and vent S. F. Residence(l bath)SERV ICES Recessed wal I Soace heat-er and vent Duplex (l bath) each Apol iance vent spoa ra tpAdditional bath Temporary Constructi on $later service e in existing ence Chang resid Stationary evap cool er multifamily, comm. or I ndustri a I Vent fan with sinole ductSewer Vent system apart from heatino or A-C.Storm Sewer 0f amps. Mechanical exhaust hood and ductcoMH./IND. FEEDERS I n stal I /a I ter/ re I ocate distrih- feeders tJood stove/heater 0f amp s. ISSUANCF OF PFRI1IT TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES I.IHERE ST. shall not be ATE Lr\l{ REQUIRES that the Electrical workvalil until the label has been signed by be done by an Electri ' an Electrical Contractor, the electrical portion of this permit cal Supervisor and returned to the Building Division 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 0reeon oertaining to the work described herein, and that l,l0 0CCUPAI'ICY'will be madeof 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 exemptonly subcontractors and emp'loyees who are in compliance with 0l?S 701.055 will l{Al.lE(pl ease p'ri nt)DA.TE I tion hereon s trueap!')fy that acathereb.y certonpermt, an certify that my registration with the Builder's the basis for exemption is noted hereon, and that used on this + I GIIATURE nthe comp Ftg Ftg Ftg its 0ther TOTAL VALUATION - x al S q.Load S q qq Val Cons t. Group Val ue Zone Fire Zone Bedrooms Flood Plain Stories l{a i n Acce Plan Ck. Connn/Ind 65%/B1dq Per Fee tems Deverqe t1.5% Svs Cha opmentBUILDING PERI',IIT Charges and Surcharges Plan Ck. Res 30%/81do Per Fee FencePLUI"IBING PERMIT Charges and Surc ha rges Demo Sidewal kELECTRICAL PERI1IT Charges and Surcha rges Total Comb. Permit Curb CutT,IECHANICAL PERMIT Charges and Surc harges (3.5\TOTAL ( rnnF no A/C Paving COMBINATION APPLICATION/PERMIT ( CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot 1. Block 3, Znd Addition to SEii'n-sField EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. example- heat2. eGmil-e- wateE. Square footage or ,/electrical cei I i or forced air gas r solareareeo valuat oI.|t II 1. example- 1250 sq. foot house, 500 sq. foot garage2. axa;rple- if new project, checkrr-ew - if addition, EIEEI-i-dd, 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 into iEiTi-urant ( change of - use )G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the description b portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be instailedFull 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 instal'led are not covered on the abbreviated schedules you should consult thefull schedules BUILDING DIVISION STAFF I.IILL FILL OUT ALL FEES ANDc CHARGES ON THE SCHEDULESD. As noted on the CAP, the label mustelectrical contractor for signaturesupervisor. The general contractorto sign the electrical label. be de'livered to the by his electricalis not authorized III.Appl icant to sign and date Whenever possible, the initial app)ication will be. used asa worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna tu re. 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. Alt other fees and charges are due and payabie when the permit is 'issued. FOR OFFICE USE ONLY IV V PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Perm'it appl icant exempt from registrat'ion w'ith the Builder's Board because: Additional Project information : PLANS REVIEWED BY: name S1 gn ature date CITY 0 SPt(i1'.FIELD COHBI iIATION APPLICA I ION/PERMIT 726-3753 Job Address EIIERGY SOURCES Hea t l,later Heater Ranq Fto. l.la i n_ Sq. Ftg. Access._ Sq. Fto. 0ther_ l,lew Add Al ter Pep. ]]ence_Oerno Cha-nge/Use 0ther Legal Description Value of l,lork:'" "' "\3tT)oo Owner N) Addrds s Phone Bui lc Farni'l tI Desc l^/o 'e., Build Single Construction Lender oe Address Phone \ name addre s s exDt res ohone no- Structura'l El ectri ca I Hechani cal name & PI '| PLUIlB I NG ELECTR I CAL MECHAN I CAL FFF CHARGE NO FFF CHAPGF un FFF CHARGF Each single fixture furnace/burner to BTU' s Relocated buildino (new fix. additioial)New ci rcui ts al tsor extensions Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wal i Space heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seoa rate Llater service Cha res nge in existing i dence Stationary evap. cool er Sewer multifami)y, comm. or I ndus tri a I Vent fan with sinole duct Storm Sewer 0f s.Vent systern heatjlnq or A apart from .c. c01.1t1./IND. FEEDERS Mechanical exhaust -hqod and ductInstal l /al ter/re l ocate =distri b. f eeders t'Jood stove/heater 0f -amp$ ISSUANCE OF PFRTIIT TOIAL CHARGES TOTAL CHARGES TOTAL CHARGES I.IHERE STATE 1.1I.' REQUIRES sha'l I not be va'l iJ until the that the Electri cal work be done by an E ectrical Contractor, the el ectrical port ion of this perni tIabeIhabeens'I gned by a n El ect r'l ca '|Superv 'I s0r and retu rned t0 +L he ut I di ng Di vl s 'I 0n EX/u1 comp a p!')c at o n for perm t and do he reby ce rt 'I fy tha t a 'I n +t is true the CityI be made ilder's and that and correct, aof Springfieldof any structu Board is in fu nd I fu rt he ti fy on nrcerthat any and a1 State of Oreoon 'I wo rk performed sha ,l I be done 'I n a cc0 rdance WI th t he 0rdi ofandtheLawsftherta'|'I na nce s wl t ho t the pe g to the wor k de sc r 'I bed here 'I and tha t NC OCCUPAI,ICY wl .I re u Pe rmi s s '|o of the Building Divi by ORS 701.055 s I 0n I fu rther cert 1 fy tha t I trati u/r thI'I force a nd effec t a s requ l red that if exempt my reg s on the Bu on Iy s u bcon trac tors a nd empl who 'I the basis for exemition is noted hereonoyeesarencomoIIancewlth0t?s 701 055 l,/ l 'I I ed on th I 5 p I'lAl.lE ( pl ease pii nt )A ,3 IGiIATUnE Zone___________Type/ Cons t.ts Ftg. l,lain xlva 'lue Fire Zone Bed r0oms Load Sq. Ftg. Acces ValueFlood Plain Stori es 0c c.y Group Sq. FtS x Value ToTAL VALUATIoil_ . 0ther BUILDING PERNIT Charges and Surcha rges ___fa-qa__.32- Plan Ck. Conrn/Ind 65%181dq Per Fee Syster;rs Deve Charqe (1.51 opment Plan Ck. Res 30%/Bldq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERI|IT Charges and Surcha rges Sldewal k A/C Paving Total Comb. Permit I,IECHANICAL PERMIT Charges and Surcharges Curb Cut IOTAL (3.5\ Residence of SQ. FT. COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish a A. Job AddressB. Legal DescriPtion1. example- Tax Lot 100, Lane County Map Refe 17T5-43 ( 2. example- Lot 1. Block 3, 2nd Addition to SFffiETieta Estates C. Name,'etc] of owner and construction lender D. Energy Sources ( i. q!ryfg- heat/e lectricg l cei l i lslor fqrced 2. "--*fi.- waterhaEF@/or 99.19 E. squaE-footage or valuation.' etc' rl--.i.rpi.-"izso tq. foot house,, !99 tq'.lo:!. (1! ?. erdmpie]l?-new proiect' check new - if ad( EfiecF-add, etc. CITY oF^-i[ninrGFtelo CitY Holl SPringfield, Oregon Deoorrmeit of Public Works OFFICIAL RECEIPT No. B O () 58124 ) a :f 'l 0 (t ( l l ( { ( F F. Building Permit information: -i: ex"tple - construct sing'le family house wil eTTIcIea garage 2. example - ."*od.l existing garage into fami ;: ffi - convert single iamily residence i resT;urant (change of use) G. Value of work as Jefined in Section 303 (a) of Structural SPecialtY Code H. DESIGN TEAI'I AND CONTRACTORS io-ivoia design oi construction delays' Buildin 6ivision Stafi must be able to contact appropri ;;;;;;; .A;rding oelign'information or iob sit corrections, etc' nUUreriuieJ Plumbing, Mechanical, & Electrical Sche' ;:-' E;;;;i-vlneie utinr spaces occur-'in.the descript ;;;ii;" ;i ihe Mechanical and Electrical schedu Itte appticant need fill-in only the No' Boxes at i"'tn!-upp""priate item(s) to .be-installedB. irti'Frrfi6i.i, Ne-nanicil, and Electrical schedt are availabli at the Building Division 1. To conserve spiit on the permit form the scl have been abbreviated ?. ii'irt.-it.*(s) to be installed are not cover lhe abbreviit6d-schedules you shou'ld consult rh Rece ived For: Ii III IV. ( e ( / ful'l schedules C. BUILDiNG OiVTSTON-STNFF }IILL FILL OUT ALL FEES A - . iinneEs oN THE ScHEDULES D. nt"..t.a-o, ine cnF, ine labe'l must be delivered electrical contractor for signature by his elect srp.irlio". The general coniractor is not autho Cto' siqn the electrical label ' Applicant to sign and date ffi;;;;;;-p;;sibie, the initial application will be u ;";;;k;;.;i-onlv.' unere possible' Buildins Division t' will prepare a typg r.iit't' copy and return it to th' \ ippiitunt at the time'the actuii permit'is issued fot*- s i gna ture. Fees and Chargesi,i;;;;.k i.ii ur" due and Pqyable at the time of the .piiillii"t'-and no piini wiil be processed until these i![i ii. iiio. Arl bi;;; iees and charses are due and iiiioi. when the Perm'it is issued' FOR OFFICE USE ONLY Amoun t Received -1 SIGTATURE EUGENE OI 07'OI siaLton iutx!uL!'iriTERS Permi t Cl erk v PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCU PAI{CY : eSubecardroasBun D I't dehet1Whtjt0ns't ratfromtregexc1na+LI empePIrmtapp Addi t ional Proiect Information: PLANS REVIEI^IED BY: date name s'l gnature l I I 1 I i,, i i : ; I INS 726 LI CNY OF SPRINGFTELD- COHBI I{ATI ON APPL ICATION/PERMIT 726-3753 Job Address 0flroLl-ega1 Description EIIERGY SOURCES- Heat il..Z,{L,.o,a Ran l,,ater Heater ) P n-D+ 21- to Sq. Ftg. Access._ Sq. Ftg. 0ther__ J{ew_Add_Al ter_Pep. _Fence_Demo Change/Use 0therValue of l,lork:frg, gaa, ooOwne r Farn i I nq Re n9tIfoDersc S'I Hi rh AtAddr€ss Construction Lender v :b0 \) lu N Addres s Phone name addres s exD l res phone no Pri St ructura l El ectri ca I l''lec ha n i ca I n ame addrpss 'I i cs. no.exot res ohone no- ) Genera I Pl umb i nq El ec r1 PLUt{BI NG ELECTRI CAL MECHAN ICAL N0.FFF CHARGE NO FFF .HA ACF NO FFF l^HAAGF Each single fixture Residence of SQ. FT furnace/burner to BTU' s Relocated building (new fix. additiona'l)New ci rcui ts al ts or extensions /0 M - Fl oor furnace and vent S. F. Residence(i bath)S ERV I CES Recessed wal l Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent sepa ra te tlater service ge in existing dence C han res i Stati onar.v evap coo i er Sewer multifamily, comm. or Industria l Vent fan with sinqle duct Storm Sewer 0f amps.Vent systern apart from heatinq or A.C. COMII./IND. FEEDERS Mechanical exhaust hood and ductInstaI l,/a l ter/re1 ocatedislrib. feeders l,lood stove/heater 0f s./4,&v ISSUANCF OF PFRI1JT TOTAL CHARGES TOTAL CHARGES o Llt.l REQUi'l unti I t^,H EER TESTA I RES hat t the Itr tec carl 'I work donbe e EI tri Ianeccby Co rant rctoa t ehe ecI 'Itr csha a I 'Irt n finItobepoo Ith s rnlVAI tthelbeah'I pebeenas'I dne an E 'IIby ec ,ltr ac s1 'I sor nda tureupe edrn tto Buhe 1 I d ,l Di vl s 0nng TOTAL CHARGES llAl.lE(please print 2 fyExAtlNEDtcompactonapprmtanheDErtce hat tndreb.y a n tformacotrrec hen reon sand tru ecerfurthe r t f ndatthaav a wo kr rformed hasDE donebe n ccoa anrdcS0 wl tth 0rd iheed ncena ofDTng fi a thnd citheLaweofthe tySteta ny of n0reoe rta n to thegong wor dek rsc bed here n thand L NOt OCCUPA t,rc w1strtuuc be madewtrethouLthermlpess0ofnButhedDisvlonfurthercertthtany rdBoa fy trassnm.y reg t tdI0n theth Bfu u rde sfo rce nda fectef sa requ red 0Rsby n9 70 tha t t505 t the Sba rfoexemp ononexempt nos he reontedsbcon and ath tvtotracarsndernpawhoreoyeesnncacomDw1ehtOPS701550t,r I be us t h s ectProj Zone TOTAL VALUATION k nd Res r TyoelCons t S q X Val Up an an its lue l{a i Load i 0cc.y Group Deve 1 qq-opment Fire Zone Bedrooms Flood Plain Stories Ftg Ftg Ftg BUILDING PERI,IIT Charges and Su rcha rges x Val ue . Access . 0ther FencePLUI4B ING PERI4I T Charges and Su rcha rge s Demo SidewalkELECTRICAL PERI1IT Charges and Surcha rges t8.!_o_ A/C Paving Total Comb. Permit Curb Cut 14ECHANICAL PERMIT Charges and Surcha rges -----/G.QQ-TOTAL AF2 i PERMIT VALIDATION 8fro83 Permi t Cl erk COMBINATION APPLICATION/PERMIT (CAP) I . App l i cant to furni shA. Job AddressB. Legal DescriptionI. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition to Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. 2.E. Squa exampl e- examp I e- re footag ri r gqshea t wate II IIi IV. eor1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- 'if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. example - remodel ex'isting garage into famiiy room 3. example - convert single family residence into EsTaIFant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be ab'le to contact appropriate persons regarding design information or job site corrections, etc. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be installed B. Fu'lI Plumbing, Mechanical, and Electrical Schedules are avai lable at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label. Applicant to sign and date Whenever possible, the initial application wilI be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applilani at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check feis are due and payable at the time of the application, and no plans will be processed until these tbls are paia. All other fees and charges are due and payable when the Permit is issued. FOR OFFICE USE ONLYV PRoJECTC0NDITIONST0BESATISFIEDBEF0REoCCUPANCY ubeca SCerdSaBordhetuB1wnt1hSirattoftromextregaIC1anrmPetemp'i p p Additional Proiect Information: PLANS REVIEWED BY: -/4J.Ldat name sign ature I I