HomeMy WebLinkAboutPermit Building 1981-07-08COMB IL
AP
Job Address 242 S. 43r<1, Springfield, Or'
l-egal Description Z Hea
SqURCESGas
Heater Ges
EIIERGY
l,la ter
Ranqe
$e 000.00
Value of l.lork:
Sq. Ftg. Access....-_-
I'ler^r Add Al
-Fence Demo
:0 ther-
Sq. Ftq 0ther
ter_Rep.
Change/Use
tq . l'la i
Owner Robert J. & Donna P. Palmer
ngien
Fani lPh6ng OOneAddress242 S. 43rd, SPringfie 1d
Fire damage restoration per attached
prints,Construction Lender Excel Consolidated, Inc
6--
N
Dn
Phon"4g4-Eugene, Or.Address 2610 w. 5th
name
Pri
Structura I
El ectrical
l'lechanical
n
Excel Consolidated,Inc. 26LO w. 5th, Eugene, or. LO242 8l8L 484-9888
P. O. Box 2517 or.97t+OZ 1t20-L75C 3/3L182 689-3904tric CoEIrical Shamrock E1
ELECTR I CAL I'4EC HAN i CALPLUIlB I NG
furnace/burner to
BTU' sEach si ng1 e fi xture Residence of
SQ FT
New ci rcu i ts al ts
or extensions
Floor furnace
and vent
Re ocated bui1ding
(new fix. additiona l )
Recessed wal ldence
SERV ICES
Duplex (l bath) each
Temporary Construction Apol iance ventAdditional bath
e in existingc Stati onar-v evap.I.later servi ce
t fan withSewermultifamiy , comrn. or
0f amp
Vent system apart
Storm Sewer
c0r4r'1./IND. FEEDERS
i cal exhaust
Instal I /al ter/rel ocate l'lood stove/heater
0f amps.
ISSUANCE OF PFRIlIT
TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES
I^IHERE STATE LAN REQUIRES that tlre Electrical workshall not be valil until the label has been signed by
be done by an Electrical Contractor, the electrical portion of this permit
an Electrical 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 ofof Soringfield and the Laws of the State of 0regon oertaining to the work described herein, and that i'l0 OCCUPAIICY willof any structure without the permission of the Building Division. I further certify that my reqistration vrith the Bui)der's,
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption.is noted hereon, and that
only subcontractors and employees who are in comoliance with 0l?S 701.055 will be used on this Dro.ject.
at al nformation hereonc0mpt, aner oermappcaton
tlAllE (pi ease pri nt)
hereb.y cert
DAIET lB I 8LEXCEL CONSOLTDATED, INC.
S IGiiATURE
i s true
the City
be made
TOTAL VALUAT
x
x VaFtg.0ther0cc.y
T'yoe/Cons t.Value
Flood Plain Stories
Fire Zone Bedrooms 0ccy
Units
Ftg. Access x Value-
Ftg . l'la i
Load So.
c,"o,r-83-so.
Zone
0 pmen tPl an n
57
BUILDING PERMIT
Charges and
Su rcha rges S
3 r F
Re
Pe
an Ck
Bl
FencePLUI^4BING PERMI T
Charges and
Surc ha rges Derno
Sidewal k
ELECTRICP.L PERIiITLharges andSurcha rges Total Cornb. PermitA/C Paving
Curb Cut
!ltc HAN CAL PERI"l ITchargesand(fl rch ar0e TOTAL bl "3b
COMEINATI ON APPLI CATI ON/PERI,IIT ( CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. examole- Tax Lot 100, Lane County lrlap Referei7-0:-"32t .exaTplq: Lot l' Block 3, 2nd Addition tosprtngfield Estates
.C. Name, etc. of owner and construction lender0. Energy Sources
CITY OF SPRINGFIELD
Ciry Hoil
_ Springlield. Oregon
Deportment of publiJ WorksOFFICIAI. RECEIPT
ectri ei iitrca 0r
forced :
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l{0. B 568S0
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F. Buil
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2
i uat on, g
foot house, 500 sq.foot ,project, check new - if add
t
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i!
o
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3
iding permit informa
example - construct
attached garage
example -
examole -
res ta u ran
tion
single family house wit
remodel existi rage i nto fam.ing 9a
famiconvert si ngl e 'ly residence it (change of use)G. Value of work as defined in Section 303 (a) ofStructural S pecialty Code
H . DIS I GN TEAI,I AI{D CONTRACTORS
II.
To avoid design or construction de.lays, BuildinUlvtston Staff must be able to contact appropripersons.regarding design information or jbO iltcorrections, etc.Abbreviated PIumbing, Mechanical, E Ejectrical ScheA. Lxcept r.rhere blank spaces occur in the descriplportion of the l,techanical and Electrical Schedrthe appiicant need fiil-in only the No. Boxes t_ to the appropriate item(s) to Le instailedB. Full Plumbing, Mechanicjl, unO-fi.li"ical Scherare available at the Building Divisionl. To conserve space on the-permit iorm tire srhave been abbreviated2. f! ttre item(s) to be.i nstal.led are not covlthe abbreviated schedules you should consufulI schedulesC. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES
CHARGES ON THE SCHEDULES
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D. As noted on the CAp, the label must be deliverelectrical contractor for signature Uy tris etesupervisor. The general conlractor :i not ari dr,- _to sign the electrical label. ..- --- L'-Applicant to sign and date
I'lhenever possible, the initial application w.i ll bea.worksheet only. Where possibti, aulralnq oiviii 6;will.prepare a type writren .opy ina-.ui;; ;i'i; I'applicant at the time the actuil permii is irsr.j h, ,,,s i gna ture.
Fees and Charges
Plan check fees are due and payable at the time of theapplication,.and-no plans wiit-Ue procesieo until theieTees are paid. All other fees and charges are due andpayable when the permit is .issued.
FOR OFFICE USE ONLY
Am
AY
Rece ived
III SIGNATURE q
i()'
sxELro{.rutrsuLL FitritRs EU6ENE OR graor laat,.a
IV
v Permit Clerk
PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPAI'ICY:
cant exempt from registration with the Builder,s Board because:Permit appl i
Additional Project Information :
PLANS REVIEWED BY:
datenames'i gna tu re
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