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Home My WebLink AboutPermit Fence 1980-07-22iNs 726 -mCOI1BI iIATION APPLICATION/PERMIT llater Heater Ranqe EIIERGY SOURCES Hea t Value of llork _f'lew_AddJ1 ter Rep. -_Fence_Demo Change/Use 0ther lla n Sq. Ftg Sq. Fto Acces s 0ther u3 Owner Legal Descri ption Job Address n scr 'e., Build SingieAddress 4 * I /tl t/ Z- * phone f/t ; JF-.s \AnOConstruction Lender u $\. :-ltn Addres s Phone DES ] GN TEAI.I name address exDt res ohone no. Pri mary c-Structura I El ectri ca l l,lec ha n i ca l addres sCONTRACTORSname (ohone no.(l ics. no. ) (expires) Genera I Pl umbi ng El ectrical Hechani cal PLUIlB I NG ELECTR i CAL MECHAN i CAL N0.FEE CHARGE NO FFF CHARGF NO FFF (^HA PCF Each single fixture Residence of FTSQ furnace/burner to BTLI ' S Relocated building (new fix. additional) New ci rcui ts al ts or extensions Floor furnace and vent S. F. Res i dence(l harh)SERV I C ES Recessed wal I SDace heater and vpnt Dupiex (l bath) each Additional bath Temporary Constructi on Apol i ance vent seDa rate l,later service Change in existing res i dence Stati onar.v evap cool er Sewer multifami ly, I ndu stri a I comm, or Vent fan with sinole duct Storm Sewer 0f .arnps. Vent systern apart from heatinq or A.C. COMI1./IND. FEEDERS l4echanical exhaust hood and duct Instal I /al ter/relocate di st-ri h- feeders l'Jood stove/heater 0f ISSUANCF OF PFRtlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE Lltl REQUIRES that tlte Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be vaiil until the label has been signed by an Electrical Supervisor and returned to the Bujlding Division I HAVE CAREFULLY EXAMINED the completed apnlication for permit, and do here Division. I further certify that m.y reqistration r,rith the Builder's 055, that if exempt the basis for exemption is noted hereon, and that who are in comcliance with 0l?S 701.055 wilI be used on this Dro,ject t,lAl"1E( p1 ease pri nt),8 , erh avJ Ci ty made ng 7Al b.y certify that all inforrnation hereon is true and correct, and I further certif_v Springfield and the Laws of the that any and all work performed shall be done in accordance with the Ordinances of theofState of Oregon oertainin g to the work described herein, and that NC OCCUPAI'ICY will beof any structure without the permis Board is in fulI force and effect a sion of the Buildi s required by ORSonly subcontractors and ernployees r ,To l,t Z7L,C,r'o- /< sIGNATURE Uni ts TOTAL VALUATION---.=._..=-- x x S 0c S 0c c.y Group cy Load Ftg 0ther aluCons t Value Zone Bed rooms Stori es Val ue Flood Plain Fire Zon o. Ftq. l'lain q. Ftg. Acce Plan Ck. Comm/Ind 65%/B1do Per Fee Svs Cha tems Deve rqe (1.5% opmen tBUILDING PERI'IIT Charges and Surcharges , -Ir!-4 Plan Ck. Res 30%/B1dq Per Fee FencePLUMBING PERMIT Charges and Surc ha rges D6mo Sidewal k Total Comb. PermitA/C Paving Curb Cut ELET*]'--'A,L PERI|IT Charg.". and Surcha{es I4ECHA1 ICAL PERMIT Charges and Su rc harge s TOTAL ftffilr lD,(, PERMIT VALIDATION Permi t Cl erk COMBINATION APPLI CATION/PERMIT (CAP) I . Appl i cant to furni shA. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. example-2. exampl e-E. Square footag hea t/e l ectr i ca I iI n or forced air gas wa te er EC or solar e or valuation, e l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if add.ition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage2. exarnple - remodel existing garage into family room3, example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the, Structural Speciaity 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 correcti ons , etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except urhere blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-jn only the No. Boxes adjacentto the appropriate item(s) to be installedB. Ful l Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated?. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful l schedu lesC. BUILDING DIVISiON STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrica'l contractor for signature by his electricalsupervisor. The generai contractor is not authorizedto sign the electricai label. I I I. Appi icant to sign and date Whenever possible, the initial application will be used as a worksheet only. l.Jhere possible, Building Division Staffwi1) prepare a type written copy and return it to theapplicant at the time the actual permit is issued for h.is s i gnature. IV. Fees and Charges Plan check fees are due and payable at the time of theapplr'cation, and no pians will be processed until thesefees are paid. A'll other fees and charges are due andpayable vrhen the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Perm'it applicant exempt from registration with the Builder's Board because Additional Project Information : rl a PLANS REVIEWED BY: da te .lA name gna tu re I s'l IIJSPECT]ON L. E 7 26-37 : )- C()IIBI iIATI ON APPL I CATION/PERMIT 726-3753 Job Address 13 EIIERGY SOURCES Hea t l,Jater Heater Ranqe . Ftq . l'la i n. Sq. Ftg. Access._ Sq. Fto. Other__ _!{ew AddrAl ter_Rep. _Fe nce_Demo_C ha nge/ U s e 0ther l-ega I Descri pt ion .l/ 0wner Val ue of l.lork Address VZ* phone7/t:Hffi o: Descri l,Jork .e., Build Singie S Ga ra Construction Lender J Addres s Phone DES I GN TEAI.,I nanre addres s no exn i res ohone no- Primary Structura l Electlical l'lechani cal n ame address ( I i cs. no. ) (expi res )(ohone no. Pl umbi no Electrical llechanical PLUIlB I NG ELECTR I CAL MEC HAN I CAL N0.FFF C HARGF i'rn FFF C HARCF it0 FFF r:HARGF Each single fixture Residence of SQ. FT furnace/burner to BTU' S Relocated building (new fix. additional ) New ci rcui ts a l ts or extensions Floor furnace and vent S. F. Residence(l bath)SERV iCES Recessed wal l SDace heater and vent Duplex (l bath) each Additional bath Tempora ry Constructi on Apol iance vent seDa ra te l,later servi ce Change in existing rpq i dpncp Stati onar.v evap coo i er Sewer multifamily, comrn. or Indrrctrial Vent fan with sinole duct Storm Sewer 0f .amp s.Vent systern apart from heatino or A.C. COI.lIl./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al terlre l ocate di <tri h fpederc llood stove/heater 0f amps. ISSUAIICF OF PFRI1IT IOTAL CHARGIS TOTAL CHARGES TOTAL CHARGES I^IHERE STATE L,1I.I RE shalI not be valiI unt QUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernit.il the label has been signed by an Electrical SurJervisor and returned to the Building Division I HAVE CAREFULLY EXAIIINED the completed apnlication for oermit, and do hereb.y certify that all inforrnation hereon iiEue and correct, and I further certify that any and a'll work performed shall be done in accoidance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0regon oertaining to the work described herein, and that l{C OCCUPAHCY will be madiof any structure without the permission of the Building Division. I further certify that my reqistration vrith the Builder'sBoard is in full force and effect as required by ORS 701.055, that if exempt the baiis for ixemotion is noted hereon, and thatonly subcontractors and ernployees who are in comcliance with oPS 701.055 r.rill be used on this oroject. IlAtlE(please print),8 , e-h an/L,Lro- /< srGi{ATURE ,Tr l,/ ZZ C! USE Oi{L Zone Const it Ftq. l'lain x V al ue Fire Zo Bed rooms Load Ftg. Access x Va'l ue Flood Plain Stories Group Sq. Ftg .0ther lue TOTAL VALUATION-._.=--- BUILDING PERIIIT Charges and Su rcha rges 0 Esr*,- Plan Ck. Comm/ind 65:i/Bldo Per Fee Sys Cha tems Deve rqe (1.51 i ) opment Plan Ck. Res 30?1/Bldq Per Fee PLUI4BiNG PERMiT Charges and Surc ha rges Fence I D6rno ELECTRICAL PERI1IT Charges ]nd Surc ha rqes Sidewalk A/C Paving Curb Cut Total Cor':b. Permi t rlEC CAL PERMIT Charges and Su rc ha rges T0TAL [0 \Qb t D o0 I l ro*r,*o,oN AppLrcATroN/pERMrT (cAp) I. Applicant to furnish' A. Job Address B. Legal Description l. example- Tax Lot 100, Lane County Map Reference. T7-0:-T3 2. example- Lot 1. Block 3, Znd Addition to SEFfnE-Fjeld Estates C, Name, etc. of owner and construction lenderD. Energy Sources l. example- heat,/electrical ceiling/or forced air g, 2, exarnple- waterheater/electrical/or solar E. SquaFE-T6iTage or valuation,-ETE.l. examole- 1250 sq. foot house, 500 sq. foot garagr 2. .rfiplF TT-new project, check-nEw - if additio; check add, etc.F. Building permit information: i. example - construct single family house with an ;tEiled garage 2. examole - remodel existing garage into family roc3. examoTE - convert single iamily-residence inio restaurant (change of use)G. Value of work as defined in Section 303 (a) of the - Structural Specialty CodeH. DESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site correcti ons , etc. II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except vrhere blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjaceni to the appropriate item(s) to be installed B. FulI Piumbing, Mechanical, and Electrical Schedules are available at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated ?- If the item(s) to be installed are not covered on the abbreviated schedules you shouid consult thefulI schedules C. BUILDI|IG DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to th e'lectrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label.iII. Applicant to sign and date Hhenever possible, the initial application wiII be used as a rrorksheet only. Hhere 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 s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the applicat'ion, and no plans will be processed until these fees are paid. All other fees and charges are due and payable vrhen the permit is issued. V. FOR CFFICE USE O|ILY PERMIT VALIDATION CITY OF SPRINGFIELD I CirY Holl SPringfield, Oregon DePorlmenl of Public Works (' OFFICIAL RECEIPT No. B 54025 't9 \\Rec'd ( Received For t ( ( (.' (r Amou nt Received -(r- -".{ TURE SHEITON.TURTBULL PiINTERS - EUGEf,E Oi Permi t Cl erk L (T: PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAIICY: Perm'it applicant exempt from registration with the Builder's Board because: Additional Project Informat'ion : l, e PLANS REVIEWED BY: da tes i gnaturename i I .:==::'-.-I-iTY OF SPRiNGFIELD C0MBI IIATI 0l'l APPL I CATI0N/ PERI'4 IT 726-3753 Job Address 2 Legal Description Ran l.later Heater EIIERGY SOURCES Hea t Value of l,lork: Sq. Ftg. Access._ Sq. Ftq. Other..--_ _ll ew__-.Ad da1 te r_P.e p . _Fence_Demo_Cha n ge/ U s e 0ther So. Ftq. l4ain Addr6ss 3n, -rnnj- -t Phone q Pernrit Info: Describe l,^lork(i.e., Build Single Residence l,lith Attached Garaqe) Builclin Fami'l y )* Construction Lender I Addres s Phone CA DES I GN TEAI4 name address I ics. no.exDl res phone no. Pri mary Structura I ElectricaI l''!ec han i ca I CON ALI RS n aixe a ddres s 'I ics. no.exni res ohonp nn Genera I Plumbino El ectrical "echan i ca I PLUIlB I IIG ELECTR I CAL MEC HAN I CAL FFF CHARGE NO FFF CHA RCF l,t0 FFF CHARGF Each single fixture furnace/burner to BTLI' s Relocated building (new fix. additional ) New circuits alts or extens.ions Floor furnace and vent S . F. Pes i dence(l bath)SERV I CES Recessed wal I SDace heater and vent Duplex (1 bath) each Additional bath Temporary Construct i on Apol iance vent seDa ra te l,later serv i ce Change in existing res i dence Stationary evap, cool er Sewer multifamily, Tndrrstnial comm. or Vent fan with sinole duct Storm Sewer 0f apart from .c. Vent syster,'r heatinq or A COMI'I. / IND. FEEDERS Mechan'i cal exhaust hood and drrct Instal I /al ter/rel ocate distrih- fppders l'Jood stove/heater 0f ISSUANCE OF PFRIIIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I^JHERE STATE LAI,I REQUIRES that the Electrical workshall not be valil until the label has been signed by be done by an El an Electrical Su ectrical Contractor, the electricai portion of this permit pervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for oermit, and do hereb.y certify that all in and correct, and I further certify that any and all work performed shall be done in accoidance with tof Soringfield and the Laws of the State of Orelron oertaining to the r^rork described herein, and thatof any structure without the permission of the Building Division. I further certir'y that my registraBoard is in full force and effect as required by ORS 701.055, that if exempt the balis for Lxemptiononly subcontractors and ernployees who are in comoliance with 0l?S 7n1.055 will be used on this oroject liAt'lE (pl ease pri nt )S IGNATURE,DATE tion hereon is true he 0rdinances of the City NC 0CCUPAI,ICY will be made tion with the Builder'sis noted hereon, and that ValZoneX x Val lrp0ther T al ue StoriesFlood Plain Group _Sq. Ftg yDelconst. Uni ts So. Ftg. l,lai n Fire Zone Bedrooms Occy Load Ftg. Access x V Plan Ck. Conrn/Ind 65%/B1do Per Fee opmentDeveS vs terns Cha rqe 1 )ti 5t BUILDING PERMIT Cliarges and Su rcharges PIan Ck. Res 30%/Bldq Per Fee S[crr aSauul ta.r>to.40 Fence IPLUI'4BING PERMIT Charges and Su rc ha rges Dgmo Sidewal k 5.OOELECTRICAL PERI1IT Charges and Surcha rges A/C Paving Total Comb. Permit Curb Cut14ECHANICAL PERMIT Charges and Surc harges 15 qoTOTAL 0wner Residence of sQ. FT. (J TOTAL VALUATION---- COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legaj Description 1. example- Tax Lot 100, Lane County 17 03 43?. example- Lot 1. Block 3, 2nd AddiSpringfield EstatesC. Name, etc. of owner and constructionD. Energy Sources 1. example- heat/electricq l cei l ing/r2. exanroTe- waterhEETEilETEETrJcllToE. Square footage or valuation,GTEl- ' Map Reference tion to I ender or forced air gasr solai l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check-new - if add.ition, check add, etc.F. Bui lding pernit information:1. example - construct single fami)y house with an attached garage2. example - remodei existing garage into famiiy room3. exaffilE - convert single iaiily-residence inio resraurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural 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.II. Abbreviateci Piumbing, Mechanical, & E)ectrical ScheduiesA. Except where blank spaces occur in the descriptionporrion of the I'lechanical and Electrical Schedules, the appljcant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Fujl PIumbing, Mechanical, and Eiectrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated?. if the item(s) to be installed are not covered on the abbreviated schedules you shouid consult theful I schedulesC. BUILDING DIVISION STAFF I'IILL FILL OUT ALL FEES AND CHARGES Oil THE SCHEDULESD. As noted on the CAP, the iabel must be delivered to theelectrical contractor for signature by his electricalsupervisor. The generai contractor is not authorizedto sign the eiectrical label.III. Applicant to sign and date- l,Jhenever possibie, the init'ial appl ication wi l'l be used asa worksheet only-. Where possible, Bujlding Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for h.issignature.IV. Fees and Charges PIan check fees are due and payable at the time of theappiication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY Permit applicant exempt from registration with the Builder's Board because: Add'itional Project Information: PLANS REVIEWED BY: name si gnature date