HomeMy WebLinkAboutPermit Building 1980-11-19L j\#t COMBI APPL I CAT I IT I
^g 726-3753
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Structura I
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Leqal Description
Job Address EilERGYJi0USCES
tteat \-" ttlut.@
Ranoe tr
-
. ltain \157_. Ftg. Access._
So
Sq
Sq
. Ftq
,l ter P.ep.
_Change/Use
. Ftq. 0ther
Owner "lh &i I oo
.e., Build Singlect'i n
CEden Ili thFarni I
liork
lrd
Descri be
AttachedAddres s Phone
'F.,Ml41
Constructi on Lender
Addre s s Phone
'I ics. no.exol res I (ohone no.DES I Gii TEAiI na n:e
l''lechanical
add res s exDl res ( nhonp nnCCr'.lTRA.CT0RS naEe
Cenera l
Pl umbi
2LUI1B I iIG ELECiR I CAL MECIiANICAL
.t i :iE i CHARGE NO FFF CHAPG F i FFF I CHARGF
iach single fixture Residence of
FTSQ
furnace/burner to
BTU' S
Floor furnace
and vent
Reiocareo rlui lding
(new fix'. additionai )
New circuits alts
or extensions
SERV I CES
Recessed wal I
Soace heater and veni
S . F. P.es i rience
( I bath)
Duplex (l bath) each
Temporary Constructi on Apol iance venr
seoa rateAdditional bath
Change in existing
rp< i denrc
Stat'i onar,v evap.
cool er[,later serv ice
Vent fan with
sino'le drrctSewerI ndu stri a i
multifamily, conrn. or
0f amps.Vent systen apart from
heatino or A.C.Storrn Sewer
COI4I.,!. /iND. FEEDERS
Mechanical exhaust
hood and duct
l,lood stove/heaterInstal I /al ter/re.locatedistrib- feeders
0f
ISSIJANCE OF PFRI1IT
TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES
WHERE STATE Lr\t'J REQUIRES that the Slectrical work be done by an Electrical Contractor, the eiectrical portion of this permit
shall not be valil until the label has been signed by an Electrical Supervisor and returned lo the Building Division
llAl.lE(pIease print)IGiIATURE
o
DATE
Oreqon
the 3ui tonany
rd
1I tica foon r ti and hedo ce rti tha t.'Ii tforma on'I hereon 5 truerJermreb-y fycom0pap
nd 1a workI shaoerformed I'I n nceaccorda thwl heL 10rd cesnan theof Ci'IdonbendcorrecaIndrthefucerrtitthaaa tyfy.ny
ofi1rIadndofLawsSthetaf rta n thto worke beddescri ihere n thatand OCCUPAI,ICYilc I II madebeSprtheteng0esftUstrucwitthI'I of0n I di '|Is on hefurt certr .l +tha t Lra +y|t theh u I1 der sIrethouepermS5Difyreg imy
ba is fos r It Ion nos hereonted and tthatheU55tha'I fs'I n,l Ifu I nda e a 'i 0Rs5 texBoa
ng
701 exempforceffectredreqby
I
emp
tri beI edUS on sI t7oIonrIii'I th05510t?sthsubcontactorserxrJandwhosarenwlance Dro.jecvoyeecomD
Y
Group . 0ther xr Val
. Ftg . Access
l'la i nUni tsI---to. Ftg Iu\oel Cons t
Ftg
TOTAL VALUATION
lone
Val ueFire Zone Bedroom
ftooA nlu,ln--------- Stories
S v s teris
Charqe
Deve(i.52 opment
"9?
t+Pl an Ck. Comm/ Ind
551'/B1do Per Fee
BUILDING PERI'IIT
Charges and
Surcha rge s Plan Ck. Res
30%/Bldq Per Fee
Fence
Demo
PLUI4BING PERI'IIT
Charqes and
Surcha rges
OC
Sidewal k
Total Comb. Permit
ELECTRICAL PERI,:IT
Char,oes and
Surcha rges
_zQe_Q__
A/C Paving
Curb Cut
IOTAL 3131+I{ECHATIICAL PERI.IIT
Charges and
Surcharges
-4+
1t bL t1
Z
q,-
coMBINATI0N AppLICATIoN/PERMIT (CAp)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. examole- Tax Lot 100, Lane County Map Reference
I7-Ttr+-3 OF SPRTNGFIELDCITY
\\6
PER}4IT VALIDATION
?, exgrnqle- Lot 1. BIock 3, 2114 1't'' '
S[TingTietd EstatesC. Name. etc. of owner and constructi (1.
D. Energy Sources
1. examole- heat,/electrical ceili,2. exarirciE r.raterhEare-ry-:-TEET?iti-, , _E. squaFE-ioi-t,age or va tuationlGlEl- i -1. examole- 1250 sq. foot house, 5,?. .-nr@ TT-new'project, irr.ir.=,
EIEcr: a-cid, etc.F. 8ui1din1 permit information: {.
1. exancie - construct single familldttrEied oarage2. exar':ole - r ernodel existing garage3. g4,xoiE - converr sing le iarii ly-.e (""
- restauFant (change of-use)G. Value of lvork as ciefined .in Section 30.Structural Specia jty CodeH. DESIGI1 TEA,1l Ai{D CONTRACT0RS
CitY
SPringtield'*tl[,":lil '-'t*"'C-;5521 1
(
To avcid design or construction deiays,Oiv'ision Sraff must be abie to contait apersons regarding design information orcorrectjons,.etc.
Abbreviated Plumbing. iiechanical, & ElectricaA. :,(cept r.rhere blank spaces occur in the delor!ion of rhe i",lechanical and Electrical Ilhe applicanc need fill-in only the No. gc
_ to the aDDroDriate item(s) to be installedB. Ful'l Plunbing, l',lecnanical, and Electrical Iare available at ihe guilding Divisionl. fo conserve space on the permit form th. have been abbreviated?. If the item(s) to be installed are not cthe abbreviated schedules you shouid conful i schedulesC. BUILDIIIG DIYISION STAFF I^,ILL FILL OUT ALL FEE
CHARGES OI{ THE SCHEDULESD. As noted on the CAp, rhe label must be de.livetelectrical contractor for signature by his elesupervisor. The general contractor ii not autto sign the eiectrical labelApplicant to sign and date
l,Jhenever possibje, the initiai appiication will bea.worksheet only. l.Jhere possible, Building Divisiorwiil.prepare a type wr.itten copy and .eturn .it to thapplicanc at the time the actual permit is issuerj fo
s i gnature.
Fees and Charoes
P'lan check fees are due and payable at the time of thapplication. and no plans will be processed until the!lees are oaio. ill other fees and charges are due ano Ipayable wnen the permit is issued. - i
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III.
IV
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graor t65s 6
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vV. FOR OFFiCE USE ONLY Perm'i t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registration with the Builder's Board because:
Additionai Project Information:
PLANS REVIEWED BY:
datenameSignature
Holl (
(
{
(
4.._tf. /nAfrAfAfifAfrhy0 COn )Alyf
.IIOBILE HO.VIES
POST OFFICE BOX 365 t 2238 YEW STREET
FOREST GROVE, OREGON 97 116 . (5031 357-3tZl
1L7 32
I 'olo t-D^TE 06-23-80
oBt 072398 & O8B 072399
IO'crf rttAncrAl SBBVTCEST ItlC.
L197 lalrfleld Avemre
P. O. Bor 2590
Eugene, Oregoa 97402
E'CEUT N,ECTBATIOT 8ALB3
151,5 Ery 99 trorth
trhrgcnc, 0rcgoa 97402
Lr
L
SHIP
TO
s-3t25
Ilertlna cl.on
.O.B. SOISSf,-CBiOfrI
TOTAL
s20r345.00
55.00
205.00
260.00
295.00
25.00
8{+0.00
$21r185.00
229,50
1,936_.64
$19,476.86
ANUFACTURING CO.. INC.
See CrerG 18121 flf OB 854Y11
E.U.D. InrtSoleEtrr Lryrr l14 Cclllng
lr11 Lep ttdtng
Sltdtng Clerr Door lauLlY loon
Etalnleu ltcol fltcheo 81nlr
t rr=
Lerg
lsh
u7
t
clore out allosance
"lL- Ca.aFolG. c^a :. .rwrr{ o^d j. ralra. u,l,r4 lho? rhtl'lla ra lha 6?D, a ha6t aakt.cad hcra'.oDova thorl .For.
Monqloarw.,^C C.-6 1 !^'tt Cv.<hort In'ta ^ol caan F'd o'd 9rt.'or.r o6d,?7
"ltrae
o^d ot 6re oCrG
)t 16-. .,,- r, -,rh.vr pr ,, "r. ., or 't 6.r Co'a ri. - rh,n ' rc i! pu o'cd od ro F, o^r o^d or,
r i6 t:r a. a<tt'^ :. .aa..at al 6'^? tat\'^oE c lt a lsrtia' da'i'la3
.rc. a., r)-rAlt)<.9o.g'c..i,^a ! rr'.r ^ o<<:e6'tt.t t-: ' tea ttcr!,-^ -r rcora '!rd6oo'raF-t6
!^ar :a rc'o.a: di aFS t-,r 1-lorad ic,-'r'..r a' tra '0t ^ "l
ta"'' -Fn Je'c!'r :t c" t'^cla Fr66l lha rco
r.a €.:.a -aon<a I n lha gr<nota gr'<e'^c'aal Peta'ota. a^{ :. .6tea o^O/ar tetraa
c;raat ' .rd<r'€ o '.rrr ,.:€ r' ',r rha la at ee^ dato'd F'etaat lrirt t^orr re6o,^ 'n ta'a 6^d aet'
Cfcla. r.o ia.,-i,aa,-! ro3 -aC,G rha'C.ir :l tca r.!11 te<C?t gnlri tha a^t'rc fr(hoaa p.<a
r<.t,ad F.rc ^ tio'. :a E d ') tet,.. I'n. ,r '
rh. 6F(a tt rh't o9tt'661
All (,orar 3l cny t..d 6erl Oa hOae 'i .t,t,,,a ''rh'i tht* aorr Jl tCalrol a' 6ar<hod'la
. -XlF.lvl
\J';1?,,,, , ,
EHIP VIA
Xor IIEE
xo.
UNIT PRICEDEACRIPT!ON
DUPI.!CATE II.IVCIC=
:;:ii:aTIC:: P?.CC:]i.3.:S iC.? T:i: Cii'i^0F s,ri:::3FiiLi)* tsuiL9i;:G liYisic:i 3.:a :",ii STi.iIr
i;rs'J:cr:c:rs 7zo-37a9 IiiFC.-.,;^'i:c;l i25-3ia3
The fol ic:,rin tc 'red ins ec ti ons re requir r or your ccnstruction att is the responsibil ity
ho i der t,o -ldL ctl nspectron are maCe at the prcper tine,oi che pe Lthat each adCress is reaCable from the street, and that the pernft card is
ioc:teci at the frcni of the proper"y.
1. SITE IiISPECTION: To be made after 11. FRAillriG IllSPECTI0rl: llust be requested
c prior to setup o I arter apProva i of roug h plumbinq, eiec-
3. F'llTIllGS 3 F0iilllA.TiCll: To- be r':rade !2. DRYI'IA.LL Ii\lS?5CTICil: To be made afte:^
:i-5r- :t'cn.^"Jc f,r5 5\,-:1/a teC anci al l diy'xal I
any taping.
i:.-to place,bur pr':'or to
e.\ca va i r on ,
forms
2. UIIDE!?SLAB PLU:'IBII.IG. ELECTRICAL &
iiiEC:ii.ilt c.iL To be niade before any
l./orK 1 s c araA
The Final Buildin
l,'lechanical Inpse
be nrade unti I th
CATI OF OCCUPAIIC
trical & mechanical. All roofinq,
bracinq & chimneys, etc. nlust be con:-
pieted. tlo rvork is tc be concealed
until th'is inspection has been made and
approvq,5...
i:. sEi.rER I,IAT!R & DR,I.IIIACE LIi\ITS:
r1 0r to rt Erencnes.
1.4. SiDiilAl-K E DRiYEiiAY: Reauireci for al I
CCliCfe-Le,Oa'.''l ;l(.1 irl in street right-
h::-: ^ts^r,-.-,'Cf Vef;-iCalS in aC-JE-,,1i t Yt vJ e ilru
co: i:nca '..ri;li U.3. C. Sec;i an 241-5.
5. Ull!Iii-:lCi Pl-'r;:3li.G i l,l:i-,:.lllil'-:
o t: fia:3 pr
of f I coi' insul at'icn or decilinc.
5. PCSi i 35.:ll: To be r:ace prior to
nS;" I acrcii of floor insulaticn
or rJecl:ing.
7 . R0iiG;{ PLU;:3 i;'lc. ELSCTP.ICAL &
i.lFEj'Tiit+: rllo 'rrcrk js -uo oe
coYereo uncil these insceciions
have been mice and aporoved.
g. Fi9[PLACI: Prior to piacing
facing rnacerials.
9. FIRe & SiPir2riTIOil IiALL: Locatsd
& ccnsiruciec acccrcing to plans.
O" IiJSULATIO;i / \./APOI? BAR:?I ER II'ISPTCTi OiI:
To be maJe a;ter all insulatton and
fc:'ns are erected, but prior to
, pcuring ccnc:3!e.' '
1. l'!AS0il.q'/ !lrLLS: Steel I oc:tion, bond
WZ H,\6D
r_-,1
T
Name of pe:-nit holCer
SiEnature t>
BUiLDI;lG DITJiSIC:i A.PPP.0';1:, PLiiilS Sl-ir.LL Rt:':AI:l 0iJ
I.JC.i( i;iJSI 8i CC;;PLII iD iii P.CCCROA;iC: i.JiiH IHOS:
of-"ra-v; to :e maie af'"er- aI I et:c3'.'at-
ing ccmclet: & fcri:: t',crll & sub-case
ma:::'ial in piace.
--\li
I i5. IJCC!STCti ES: After instal lat'ion is
coirlp I ereu -
i5. SPECIAL IiISPICTiCIIS: l'lhen raqtrireC blz
the ilui l dinE CcCe, sPecia I inspec:or tc
be present r'ihen r'tork is in proqress. A
copjz of the spec-ial testinq report to
be furn;sheC tc tne Buildjnq Division.
Struc'"ural Concrete: In excess of 3C00
P.S.I.
Structural l,lel ds : Performed on the icc
Glu-Larn 8eai",ls : Inspection cer"tificate
(by apprcved agency) supplied to BtrilC-
ing Division before beams are placed.
Fj re RetarCant Roofi ng : Before i ns ia I -
I ation-.
Pho n
Da t-,ILM
E SUiLDI;IG SiT: Ai ALL iIi.!ES ' AIID ALL
9.O"IED PL;.;IS
--
requi red lrapor barriers are in pl ace a--.) /-
but beicre any latii, gypsum bcarC or I iti. OTHER It'lsP:CTI0:i:: Malu be requiied in
wall cc,rer-ing is apii:iib, and berore acrcrciarrce t'riln 3uildinq Code, to be
an;z insuraiiSn is ccr:cea jed.
;Xii;?ffi,,;:r3:il;.or bv notjce from
FIIIAL PLui'itsI}IG FIIIP.L iLECTRI CAL iII{AL i'lECHANI CAL FI|'{AL FIRE DTPT.
All projectccncjiticns, such as the installation of street trees, completion of the
requireO lanoscacing, etc., must be staisfiec before the SUILDi:lG'\Fil,lAL can be requested-
FiIIAL BUiLDiiJG
g Inspecticn must be requestec after the Final PlLrmbing, Electr ical and
itioni have been maCe and approved. I'lo occupancl/. of the premi ses can
i,tinul Builciing inscection has been made anC aDoro'red, and a-CERTiFi-
y t-tAS BIr;l ISSUaD B'i THE f,UIltiic Di'/I5iOil AliD POSreD Oii TI-it PR[:\!iSE5.
l'lOTE : /il I manr':c I es and cl e:nou ls are to be arjjusiei at no cos t io the Ci ty-