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Home My WebLink AboutPermit Building 1982-03-25t.t E COI1BI I{ATi ON APPL I CAT ION/PERMIT -3753 Job Address l-egal Description Owner Ranqe EIIERGY SOURCES: l.Jater Heater Hea t I Value of llorki za/oo.a Sq. Ftg. Access.-._--.-t'^":,ttirZ5iW#- Fence Demo Chanqe/Use --Cther?lrr*U ' Ftq. ilai n too :" 6a* DtmTax .?D.Pho".e?yS.g?4 Builciinq Pernrit Info: De-aribe ltor[fFarnily llesidence l.lith Attached Garaqe :e., Bui'ld Singie Ptnxwa /,or- A.<.Ptilna A*o Construction Lender thv Vcat Dz**,rc S*xrant Addre s s Phone 00 $ 0\ d DES i GN TEAI.,I name (address I ics. no-exni res phone no p"i^u"v Was*xt &*qeaa, z ay,urztuu-s la!f, lu , ;rt€ffE 1fi,qa/-qs// St ructura I l'lechani ca l El ectri cal n ELECTR I CAL C i.,]A RGF NN FFF l csnpnr i.t0 FFF Each single fixture Residence of FTSQ furnace/burner to BTLI' s PLUIJE I IiG I,IECHAN I CAL PI Genera l ectr i ca l ilechan.i ca Relocated building (new fix. additional)New ci rcui ts al tsor extensions Floor furnace and vent S. F. Res i dence(l bath)SERV I CES Recessed wa l I Soace heater and vpnt Duplex (1 bath) each Additional bath Temporary Construct i on Apol iance vent sepa rate l,later service Change in existlnq res i dence Stationary evap cool er Sewei multifami1y, comrn. or I nd us tri a.l Vent fan with sinole duct 8ts'Storm Sewer /a.-/1*t ..F /o,oo 0f amps.Vent systern apart from heatino or A.C. c0r.il.1./IND. FEEDERS iulechani cal exhaust hood and duct I n sta I 1 ,/a I ter/ rei ocatedistrib. feeders lrJood stove/heater amp s.0f ISSUANCF OF PFRIIIT TOTAL CHARGES /o,d'TOTAL CHARGES TOTAL CHARGES I'IHERE STATE LAI'J REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this perriitshall not be valil until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for oermit, and do hereb.y certify tnaiatTiand correct, and i further certif-v that any and all work performed shall be done in accoidance withof Soringfie.ld and the Laws of the State of Oregon oertaining to the work described herein, and thatof any structure without the permission of the Building Division. I further certify that my registr Board is in full force and effect as required by ORS 70i.055, that if exempt the basis for Lxemntiononly subcontractors and ernployees who are in comcliance with OPS 70i.055 r,,rill be used on this nro.jec llAtlE(please print)S I GNATU RE DATE 3JS.\} the 0rdinances of the City ; l{C OCCUPAI'ICY wi I I be made 'ation urith the Builder'sis noted hereon, and that orrnation hereon is true €,L"8 R/4*ZZNaa-?l stgq.*t Val uexSo. Ft Load !qBed ro oms Group Sq. FtS 1ue 24,/Q.6 - Tone k4, <,U.P. TyDe/const.Uni ts }ther 3L&Q Fire Zon Fto. Access x Val ue Flood Plain Stories o. l,lain_ Plan Ck. Comm/ind 65%/81do Per Fee 76.D Systerns Deve Charqe (1.5z opmentBUILDING PERIlIT Charges and Su rcharges Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges .yo 4 Demo SidewalkELECTRICP,L PERIIIT Charges and Surcha rges //8.@ Total Comb. lrermi tAIC Pavinq Curb Cut14ECHAI\ICAL PERMIT Charges and Surc ha rges fl zos. toTOTAL CUII IRACTORS a ridrpc s i''l i ". n^nhnnp nn FFF TOTAL VALUATION- ----10. PERMIT VALIDATION Permjt Cl erk COMBINATION APPLICATION/PERMIT ( CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43?. exampie- Lot 1. Block 3, 2nd Addition to SErlngfield Estates C. Name, etc. of owner and construction lender D. Energy Sources r forced air gas sol ar i. example- heat,/eiectrical ceiling/o2. example- waterheater/electrjcal/or Square footage or valuation, etc.E II. I1I. IV. i. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check new - if addition, EIEEI add, etc.F. Building permit informatiorr:i. example - construct singie family house with an;TEiIA sarage2. example - remodel existin'g garage into family r"oom3. examole - convert single family residence into FesT;-urant ( change of -use )G. Value of work as defined in Section 303 (a) of the Structural SH. DESIGN TEAI,I pecialty Code AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able i.o contaci nppropriate persons regard ing design infc,''ria i-ioir or job si te correcti ons , etc. Abbreviated Plumbing, Mechanical, & Electrical ScheduiesA, Except r.rhere b I ai'rk spaces occl. i n the descri pti onportion of the I'lechanical and Lleci:rica1 Schedules, the applicant need fill-in oniy i::re No. Boxes adjacentto the appropriate item(s) to be installeciB- Full Plurnbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space ol1 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 the ful I schedul esC. BUILDING DIVISION STAFF I.IILL FILL OUT ALL FEES AND CHARGES ON THE SCI]EDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electrical supervisor. The general contractor is not authorizedto sign the electrical label. Applicant to sign and date 9lhenever possible, the initial appiication will be used as a w0rksheet only. l"lhere 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 gnature. Fees and Charges Plan check fees are due and payable at the time of theapplication, 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 PROJECT CONDITiONS TO BE SAIISFiED BEFORE OCCUPAI{CY: Permit appf icant exempt from registration with the Builder's Board because: Addit'ional Project Information: 6ooo, letyaz aAu,.aa7/o^, Faa aF dgaeru wAs P.ilD arv J*D.23./?- PLANS REVIEWED BY: date /O-/>-:t/s i gnaturename INSPECTION LiI.IE 126-37 69 ETiY OF SPRINGFIELD COI1BI iIATiON APPt I CAT ION/PERMIT Job Address l.Jater Heater Range EIIERGY SOURCES Hea t l-ega1 Descri ption ]wner 1fu ^"i ?aA, C-<tzt<rt.a.at &-*.<rr Value of llorki za/oo.a So. Ftq. ilain_ Sq. Ftq. Access.-- So. Fts. 1ther?!-* J'lew_Add Al tef_Pep. Fence Demo Chanqe/Use -Otner=PlvtVq - Phon"flz-nat!:':aa* Dtmnx .?2.scri benfo 'I 'e., Bui ld Singie Plpzarc. br- ,4. c. Pz,ur,va- ./t o Construction Lender lhl Vcat Dn*z.x€ Svstur Address Phone 00 $ 0\ N DES I GN TEAI.,I name address lCS- nO exo i res phone no. .7r€ s^qar/-9s//Pri ma Structura I l{echan i ca l c0r.1TF ACTORS name addres s )(exnlics. no- )rps ohone no- ) Genera I P l umbi nq PLUIlA i IIG ELECTR I CAL MECHAN I CAL Elec ri Each single fixture Residence of FTsQ Reiocated bui ldino (new fix. additjonal ) New circuits alts. or extensions furnace/burner to BTU' s Floor furnace and vent S.F. Residence(1 bath)SERV I C ES Recessed wal I Soace heafpr and vpnt Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent se pa ra te l.iater servi ce Change in existing resi dence Stati onar.v evao. cool er Sewer muitifamily, coffr. or I ndus tri a I Vent fan with sinole duct 8s'storm Sewer /a.-/r,et /o,oo 0f -amps. part from C, Vent system a heating or A. c0r.1t1./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/rei ocate distrib- feeders lllood stove/heater 0f TOTAL CHARGES /O,oo TOTAL CHARGES IOTAL CHARGES WHERE STATEshall not be va Llt'l REQUIRES that the Electnical work be done by an Electrical Contractor, the electrical portion of this permitIil until the label has been signed by an Electrical Supervisor and returned to the Building Divis.io that any and all work performed sha'll be done in accordance with the 0rdinances of the CityState of 0regon oertaining to the work described herein, and that I'lC 0CCUPAIICY will be madi t,lAl.1E(pl ease pri nt),TE 3JSt3sI GiIATURE t f5r I HAVE CAREFULLY EXAIIINED the completed application iorlDermi and hereb.y certify that all inforrnation hereon is trueandcorrect, and I further certiof Soringfield and the Laws of the further certify that my registration yrith the Builder,sssion of the Buildi Division. Iof any structure without the perm.i Board is in full force and effect as required by ORS ng 701 055, that if exempt the basis for exemption is noted hereon, and thatonly subcontractors liance with OPS 701 .055 wilI be used on this pro,jectand ernployees who are in comc 4,L?E RU,"DI 1t LP/,99</.*// oms Occy Load Sq. Ftg. Access x Valu Flood Plain Stories_ Occy Group Sq. Ft Tone R-4, <,0,P. Tyoe/Const -- TOTAL VALUATIOII s. other g'AE!42___)<-E_u ut ue 26r/@ .6 Uni Fire Zo Bedro ts So. Ftg. t,tain Value Plan Ck. Comm/Ind 65%/81do Per Fee 76-D Systems Deve charqe (i.51 opmen tBUILDING PERI'IIT Clrarges and Surcha rges Pl an Ck Re Pe s r30%/81 dq Fe e FencePLUI,IBING PERMIT Charges and Surcha rges .yo Demo Sidewal kELECTRICAL PERI:IT Charges and Surcha rges //8.*Tota'l Comb. PermitA/C Paving Curb Cut IIECHANICAL PERMIT Charges and Siirc harges T0rir i I -=.nr , - El ectri ca i l'iechani ca l arAacF ltt arAocr )trr9 auSDnt ISSUANCF OF PFRI1IT COI'IBINATION APPLICATION/PERI4IT (CAP) Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference T7-03-432. exampie- Lot 1. Block 3, 2nd Addition to Spilry--field EstatesC. Name, etc. of owner and construction lender D. Energy Sources ele ical r forced air ga or solar PERMIT VALIDATION CITY OF SPRINGFIELD CirY Holl Springlield, Oregon Deportmenl of Public Works OFFICIAT RECEIPT ( ( B 58265 ter valuat on, e 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. example- if-ierv project, check-new - if addition, check add, etc.F. Building permit information:1. example - construct single family house rvith an attaclEa garage 2. example - remodel existing garage into family roo3. examcle - convert single family residence into restaurant (change of use)G. Vaiue of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Buiiding Division Staff must be able to contact appropriate persons regarding design infc,rmaLion or job site corrections, etc. .II. Abbreviateo Plumbing, I'lechanical, & Electrical Schedules A. Except vrhere blank spaces occu. in the description portion of the l''leci'axical anci iler:trical Schedules, the applicant need fill-in oniy tle No. Boxes adjacenl to the appropriate item(s) to be installed B. Ful l Plunrbing, ltlechan ica l . and Electrical Schedules are avaiiable at the Bu-jlding Division 1. To conserve space on the permit form the schedules have been abbreviateti2- If the item(s) to be installed are not covered on the abbreviated scheduies you should consult the fui l scnedulesC. BUILDIIIG DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As noted on the CAP, the label must be delivered to th electrical contractor for signature by his electrical supervisor. The generai contractor is not authorized to sign the electrical iabel.III. Applicant to sign and date Hhenever possibie, the initial appiication will be used as a worksheet only. Where possib.le, Building Division Staffwili prepare a type written copy and return it to the applicant at the time the actuai permit is issued for his s i gna tu re.IV. Fees and Charges PIan check fees are due and payable at the time of the app'lication, and no plans wiil 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 PLANS REVIEWED BY: SIGNATURE !xELTON.lUiXiuLL PRlirEis ' Eu6ErE Oh t"ol s65!!_a Perm'it Cl erk l. exampl e- heat/2. exEmilE waterE. SquaiE-ttoGge or l9 {F Received For 8Y ,'' ( ( ( ( ( ( Amounl R r (r +- I\ro PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration wjth the Builder's Board because: Addf tional Proiect Information: 5ro*o, <e aa<r+A17/A.1/ F6i€ aF name Lo*re Pz <<€R si gn ature da te -&/ I Thurston Christian Church 6680 Thurston Road Springfield, OR 97477 503/7 46-4228 l,Ir. Ron Clark Superintendent of Building CITY OF SPRINGT]ELD 225 North 5th Springfield, OR 97477 Enclosure: check for $205.10 Dear ivk. Clark, Enclosed you will find a check for the anpunt of $205.10vrtrich is to obtain a building permit on the r,rcrk we need to do on our parking lot. Due to the wet weather causing delays inour construction, we ask that you give us an extension of tine. This request cones in conjtnction with your conversation r^rith Clyde Randall, Trustee foi Thurston Christian Church. rymru,ilJffi ...CI)t'i\t- -is att, an([ In att I4arch L7, L982 .$juqerelY,\ 1.' )^. td't'i*-, t-,'/tr' ttY) lo'te/ ileanine Thonpson, Secretary TI{T]RSTON CHRTSTIAN CTIIIRCI{