The URL can be used to link to this page

Home My WebLink AboutPermit Building 1990-07-17INSPECTION L 726-37 69 COI1BI NATI ON APPL ICATION/PERMTT 726-37 Job Address to EIIERGY SOURCES Hea t l,later Heater Ra l,q. l.lain--- Sq. Ftg. Access.-- Sq. Ftg. Other_ J{ew_Add-Alter_ReP. _Fence_Demo_Chan ge/ Use 0ther h b \ N l-egal Description Val ue of l/ork:TPzc Bui'lciinq Pernrit Info: Descril Farni'ly Residence llith Attacher i.e., Build Singie I lr\V,6 /Uelil/ :3 .o/tlz*zzz,.tZ FtsttztQ.zl f Construction Lender Address Phone DESIGN TEAI{name address 'I ics. no.exDr res ohone no. Pri Structura l E I ectri ca I Mechani cal name addres s Iics. no-pxn l res nhone no- Genera I ,r2urrz. A'rfi G. ,zgt/'2/*at lu * bzoro /-z -?/ r/r'rraz /ru*o Par,*,.6;t 7 lso-ze ps a/s,hl y'rs- lzr rPl umbi nq ,'rcua r^, Par-, 61,o7r, /d 7y'7-?z/s/fu,/lI''lechanica l a6 r PLUI{BI NG ,/' ELECTRI CAL MEC HAN I CAL FFF NN FFF (^HA AGF NO FFF CHARGF Each singie fixture furnace/burner to BTU' S 3 Relocated building (new fix. additional)7*z-7 New circuits alts or extensions Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal l Snarp hpatpr:nd vpnt Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent se oa rate l,later serv ice Chang resid e in existing ence Stationary evap. coo I er Sewer multifamily, comm. or I ndustri a I 3 Vent fan with sinole duct 7 Storm Sewer 0f amps.Vent systern a heatinq or A. part from c. c0r"1r.1. / rND. FEEDERS Mechanical exhaust hnnd and duct I nsta i I /a I terl rel ocate di stri b. feeders l,lood stove/heater 0f s" ISSUANCF 0F pFRt,tIT TOTAL CHARGES 2?-54 TOTAL CHARGES TOTAL CHARGES ,frsxz.,/E- I,JHERE ST A TE Ll\li REQU I RES tha +the El ec tri c a 'I w0 rk be done by an Electri Electrical Supervi ca 'I Con tractor the e I ectri ca 1 port ion of th vi si on s permit sha I I not be va I I ,l u nt 1 I the I a be 'I ha s been s 'I gned by n s0r a nd retu rned to the Bui I d 'I ng Di H L c0mp apnlication for pe perfo ining Divi si t do hereb.y cert I fy tha t a I I o rma t t cn he reon s true and correct, and I further certify that any and all work of Springfield and the Laws of the State of Oregon oerta of any structure without the permission of the Buiiding Board is in full force and effect as required by ORS 701 only subcontractors and employees who are in comcliance rmed sha 'I I be do ne I n a cc ordance wl th t he 0rd '|nance s of the City'I be madetotheworkdescrIbedhere'I n and that NC OCCUPAI'ICY w'l 1 on. I further certify that my regi tration vrith the BuiIder's .055, that if exempt the basis for exemption is noted hereon, and that wi th 0l1S 701.055 wi lI used on this nroj ect.l,t llAl'lE(please print)?. r. R,q,,\D S IGNATURE 7a zone Lfr,/ ryoe/const. f-1 Units S o. Ftg. l'la i x lue Fire Zone Bedrooms Val ue Flood Plain Sto ri e Va lue ZiErc-4 TOTAL VALUATIOII Acces s BUILDING PERI'IIT Charges and Su rcha rges ,;O Plan Ck. Conrn/Ind 65%/81dq Per Fee Svsterils Deve' charqe (1.51'opment Plan Ck. Res 30%/Bldq Per Fee PLUMBING PERMIT Charges and Surcha rges --ZrEo--Fence Demo ELECTRICAL PERIIIT Charges and Surcharges Sidewal k A/C Pavi ng Total Comb. Permit T,IECHANICAL PERMIT Charges and Surc ha rges --/5-----a---<. Curb Cut TOTAL ///. 7/ ,/ owner ttlglcnv ll^to Naopr*, (,". Address Phone a /u,y/./ PE/ztvfi,4z ) . Residence of SQ. FT. \#.{>) -2 COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100' Lane Ccunty Map Reference 17 03 43 2. example- Lot l. Block 3, 2nd Addition to Sbrinqfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat,/electrical ceiling/o 2. example- waterheater/electrical/or E. Square footage or valuation, etc. r forced air qas sol ai 1. 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 singie family house with an attached garage ?. example - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bui)ding 0ivision Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Eiectnical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate 'item(s) to be installed B. FuIl Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. 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 thefulI schedulesC. BUILDING DIVISION STAFF HILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the Iabel must be de'livered to the electrical contractor for supervisor. The general signature by his electrical contractor is .not authorized to sign the electrical label III. Applicant to sign and date l'lhenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION r--l')5# \ll: C Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registratjon with the Builder's Board because Additional Project Information PLANS REViEWED BY: name i gnatur date ?D INSPECTION LINE 726-37 69 COMB I AP IT Job Address 2 Lega1 Description I \41 EIIERGY SOURCES Hea t Ran l,later Heater 0wner ' Value of llork:.7/ 7557- Sq. Ftg. Access._ Sq. Ftg. 0ther_ I'lew Add Al ter Rep. nce_Demo_C ha nge/ U se her-Fe_ot Sq. Fto. l.lai Address17-O 'V) vn "{scr l^lo dence ,a n Ni .e., Build Single Eu<%'-av, */ar Constructi on Lender ,/t*< ?,qzz;s ,D E(/;r7 vAddressPhone N u DESIGN TEAI4 name address exot res phone no. Pri ma ry Structura I E i ectri ca l Mec han i ca I RACTORS n ame a ddres s lics- no-exD l res nhonp no Genera I Pl umbinq E l ectri cal PLUI{B I NG ELECTRICAL \ MECHAN I CAL r---1 FEF NO FEF CHARGF NO FFF CHAPGF .D-Each single fixture Residence of SQ. rr Z furnace/burner to BTU' s I Relocated bui ldino (new fix. additional ) New circuits altsor extensions Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal l Soace heater and vpnt Duplex (l bath) each Additional bath Temporary Construct i on Apol iance vent sepa rate tlater service ge in existing dence C han res i Stationary evap. coo I er Sewer Industrial multifamily, corm. or Vent fan with sinole duct Storm Sewer .amps.0f Vent systenn apart from heatinq or A.C. COMM./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/rel ocatedistrib. feeders l,Jood stove/heater 0f ampi ISSUANCF OF PFRt,IIT TOTAL CHARGES JqIAL cHARGEs/z/r/ - ,1f * WHERE STATE Lt\W REQUIRES that the Electrical work be doshall not be valiC until the label has been s.igned by an E1 ne by an Electrical Contectrical Supervisor and ractor, the electrical portion of this permit returned to the Building Division n is truef the City'I I be made ui I der' s, and that !- lt(-Z o ngfie struc the permi nd effect fy the ( DA FULLY completed apD cat on for Dermit, and do certify that all tion hereoand correct, and I further certi that any and al I work DeState of oregon pertaini rformed shall be done i n accordance with the Ordinances oof Spri Id and the Laws of ng to the work descri bed herein, and that I'lC 0CCUPAI{CY w.iof any ture without ssion of the Building Div ision. I further ce rtify that m.y registration r.rith the BBoard is in full force a as required by ORS 701.055, that if exempt the basis for exemption is noted hereononly subcontractors and empl oyees who are in comoliance with ORS 701 055 wi l I be used on tJrwt4a, ?. *foaavs ot) llAl'tE(please prinil fr ,ocg Q S I6NATU cy Load Sq. Ftg. Access x Val,, *ou@n rti. o*"r@i^tFlood Plain S tories UC 0c nsCo t Fi re Zone Bedrooms ToTAL VALUATI0N.- ue?FSa^ Uni tsZone Ftg. t,lain xr Val PIan Ck. Comm/Ind 65%/Bldq Per Fee Systerns Deve Charqe (1.5?opmentBUILOING PERMIT Charges and Surcharges PIan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges Dgmo Sidewal k ELECTRICAL PERIjIT Charges and Surc ha rges A/C Paving Total Comb. I'ermi t Curb Cut I,IECHANICAL PERMIT Charges and Surc ha rges ---/,r--/f.>tTOTAL 0:thA TOTAL CHARGES t14.'et' , PA.;Q, COMBINATION APPLICATION/PERMIT (CAP) I. Appl'icant to furnishA. Job AddressB. Legal Description1, examp'le- Tax Lot 100, Lane County Map Referencb 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpFiilTield EstatesC. Name, etc. of owner and-construction lenderD. Energy Sources1. example- heat/electrical ceiling/o2. ExamE-l e- waterfiEEteiTETEEtiJ cil7orE. SguaiE Tootage or valuation, etc. r forced air gas sol ar 1. example- 1250 sq. foot house, 500 sq. foot garage2. 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 existing garage into family room3. example - convert single family residence into restauiant (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, Bui)ding Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be instal ledB. Fu'li PIumbing, 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 schedulesC. 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.IIL Applicant to sign and date I'lhenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signature.IV. Fees and Charges Plan check fees are due and payab'le at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION firortr/s/73 driv, ///tr /4 77- Permi t Cl er PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAI{CY: Perm'it applicant exempt from registration wjth the Builder's Board because Addi t'ional Proiect Informati on : PLANS REVIEI^IED BY : i gnature date B-Z**" (antt'&qA, I 7 L COMB I ERMIIAP PL I CATI O 726-3753 N N w Job Address EIIERGY SOURCES: Hea + l,Jater Heater Ranqe Sq. Fto. Sq. Ftg. Sq. Ftg. l,ler.t Ad l.la i n Acces s . _ 0therd Alfer Aeil- hange/ Use Legal Description owner D- I Va I ue of l./ork : /GE>D;*N\E Addres s Phone BLilc.inq Pernrit Info: Describe [,Jork( Fanni ly llesidence l,li th Attached Garaqe .e., Build Single Construction Lender e,n Addre s s Phone a name address (lics. no.l exDt res ohone no. Prima Struc tura I E I ectri ca I l,lechanical c0r IRACTORS n ame addres s 'I i cs. no. '( exo i res ohone no. P cal hani PLUIlBI NG EL ECTR I CAL MECHAN I CAL FFF C HARGE NO-FFF l^HARCF NO FFF CHARGF Each single fixture furnace/burner to --- BTLI' S Relocated buildinq (new fix. additioiat)New ci rcui ts al ts.or extensions2-afr -47a- FIoor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal l Soace heatpr and vpnf Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent sepa rate llater service Change in existing res i dence Stationar.v evap cool er Sewer multifamily, comn, or I ndus tri a I Vent fan with sinole duct Storm Sewer 0f s.Vent system , heatinq or A apart from .c. coMr.t./IND. FEEDERS Mechanical exhaust hood and duct I nsta I I /a I terlrel ocatedistrib. feeders l'Jood stove/heater 0f ISSUANCE OF PFRIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAI,Ishall not be valiC REQUIRES that the Electrical work be done byuntil the label has been signed by an Electri an Electrical ca1 Supervisor Contractor, the electrical portion of this peniit and returned to the Building Division HAV L Y E XAH I t completed apn cation for oermit, and do here b.y ce rt 'I t th t 1 I t ,l hand correct, and I fu rther certify that any and alI work State of Oregon oertai ssion of the Buiiding Das required by ORS 701. v a a n rrna 0n e re0n 'I s t ru e of Soringfield and th Der fo rmed s ha I I be do ne I n a cc orda nce th t he 0rd I na nces of the Cr'tyeLawsofthenIngtotheworkdescr,l bed here i n a nd th a t ilc 0cc UPAI'ICY I I I be madeofanyst ruc tu re wt thou t the perm and effect empl oyees ,l 'I '|I fu heBoard'I ,l fu I I fo s on rt r cer ti fy tha t m.y req I s tr,a t 1 n v/l t h the u I I de r ssnrce055that'|f t th ba 'I fo0nIvsubcontrac tors d ex emp e s s r exempt I on I S no ted hereon an d t ha tanwhoare'I n comD I I an ce w1 th OPS 7nL 0 EE l,/ l '| 1 be ed 0n t h 'I roj ectsp l,lAtlE(please print)\S IGIIATURE s-\DAT Zone Tyoe/Const Uni ts Ftq. l'lain x lueFire Zone Bedrooms Occy Load Ftg. Access Val ueFlood Plain 0c c.y Gro x Value ToTAL VALUATI0N_ to ri es Ftg.0ther BUILDING PERiIIT Charges and Su rcha rges Plan Ck. Conrn/lna - 65%/81dq Per Fee Svs Cha tems De VE 5"troe (1 opment Plan Ck. Res 30%/Bldq Per Fee PLUIIBING PERMiT Charges and Surc ha rges Fence Demo ELECTRICAL PERI1IT Charges and Surcha rges /- r7 Sidewalk A/C Pav i ng Curb Cut Total Comb. I'ermit I,IECHANICAL PERHIT Charges and Surc harges TOTAL z3G 555 5\s-v:F{ Residence of SQ. FT. _22=r?_ -/a-t\ COI'IBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. elample- Tax t_ot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. exampl e-2. exampl e-E. Square foota heat/el ectrical a1 wa e ec or r ge or valuat oll,l. example- 1250 sq. foot house, 500 sq. foot garage2. grar,rple- JTi-ew project, check-new - if adOition, EIEEFadd, etc.F. Building permit information:1. example - construct single family house with an attached garage ?. example - remodel existing garage into family room3. example - convert single family residence into reltaurant (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 site corrections, etc.II. Abbreviated P'lumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fi'll-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 the ful 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 the electrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label.III. Applicant to sign and date lrihenever possible, the initial appl'ication wi1l be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans wiII be processed untiI these fees are paid. A'll other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION /gD8? //4 /rtz>. Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from reg'istration with the Builder's Board because Add'it'ional Proiect Informat'ion : PLANS REVIEWED BY: name sig nature date ?-2o 1r,