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Home My WebLink AboutBuilding Building 1983-05-13INSPECTION LIITE 726-37 69 CiTY OF SPRINGFIELD COMBI NATION APPLI CATION/PERMIT 726-37 Job Address 1r3 ) LegaI Description \?()dA(O SL,IU l,later Heater NlfF /VAn/r= EIIERGY SOURCES: Heat fuiE^dw-P # 'I ue of l,lork:6,0/v , oo Sq. Ftg. Access.-- Sq. Ftg. 0ther-_ I'lew Add_Al ter u{6. nce_Demo Change/Use her n &_0t Owner duE/,7v/ax12rp/141 /Y/tu.az 'e., Build SingleArrdress llVV N /+7. jlUWnAn vno"u/($-@., BuiTciinq/Family Re Permit Info: Describe Work(' sidence llith Attached Garaqe Wqraz€ Z /a4tLr, r0 Fxtrrtr',to Construction Lender (0il0/no LJ. EE+:pEZ- ,-E/1tCt s U ^-G R.\ Addre s s Phone addre s s 'lcs. no.exD l res ohone no.DES I GN TEAI.I name Pri ma ry St ructura I EI ectri cal +'LiZto 4-s-0+l"lechanica l IACTORS n ame addres s Iics. no.exDt res ohone no. Generar E^ i/r-t r 4)ttr*r /orusrru"nolJ fl?. EoxZtlZT- Euae*e 0z Qz4at- 7c1<i'ob0z L(a Foa .Z'Z MECHAN I CALPLUIlB I NG ELECTR I CAL FFF CHA PG FFEECHARGENOFFFCHARGFNO Each single fixture Residence of FTSQ furnace/burner to BTU' s Relocated buildinq (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S. F. Residence(l bath)SERV ICES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDa rat e l"later servi ce Change in existing rpsi dpnnp Stati onar.v evap. coo l er Sewer I ndu stri a i multifamily, comrn. or Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatino or A.C. COI.lI.l. /IND. FEEDERS Mechanical exhaust hood and duct I nsta I I /a I terl rel ocatedistrib. feeders [,Jood stove/heater 0f amp s. ISSIJANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE Lll.J REQUIRES that tlte Electrical work be done by an Electrical Contractor, the e'lectrical portion of this permitshall not be vali:l until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAHINED the completed application for permit, , and correct, and I further certif,v that any and all work oerformed sof Soringfield and the Laws of the State of Oreoon oertaining to theof any structure without the permission of the Building Division. I Board is in full force and effect as required by ORS 701.055, that i only subcontractors and employe6 who are in comcliance with 0l1S 701 and do hereb.y certify that all information hereon is true ha'll be done in accordance with the 0rdinances of the City work described herein, and that NC OCCUPANCY will be made further certify that my registration r,rith the Builder's q IGNAl.lAl{E(please print)?an f st)ect.0n DA t the ba 'I '.r be L. s for exemption is noted hereon, and that I ,l Fire Zone Bedrooms Occy Load Sq. Ftg. Access. FtU. t'lain I I UC Ftg 0ther I x xZone____Tyoe/Const. Uni ts TOTAL VALUATION Flood Plain Stories 0cc.y Group Plan Ck. Conm/lnd 65%/8ldq Per Fee Svstems Deve Charqe (1.57 0pmefltBUILDING PERNIT Charges anC Surc ha rges r@ Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges D5lrno Sidewal kELECTRICAL PERI1IT Charges and Surcha rges A/C Pavi ng Total Cornb. Permit Curb CutI,IECHANICAL PERMIT Ch6iges and Surcha rges TOTAL t +t bcr lrpchanica t I l,tn ll P\ COMBINATION APPLICATION/PERMIT (CAP) I. Appiicant to furnishA. Job AddressB. Legal Oescriptionl, glample- Tax Lot 100, Lane County Map Reference 17 03 432. ellrnlle- Lot I. Block 3, 2nd Addition toSFijlibTield EstatesC. Name, etc. of owner and construction IenderD, Energy Sources1. example- heat/electricai ceilinq/or forced air oas.. exampte- waterheater/etectrical/or solarE. Squaie-footage or valuat.ion-tc. l. example- ]4q sq. foot house, 500 sq. foot garage?. elample- if new project, check-new - if addition,check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. examp-le - remodel existing garage into fam.ily roomJ. example - convert single family res.idence intorestaurant (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, BuildingDivision Staff must be able to contatt appropr.iitepersons regarding design information or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces ociur in the descripiion--portion of the Mechanical and Electrical Schedules,the app)icant need fill-in only the No. Boxes adjaient - to the appropriate item(s) to be installedB. Full PIumbing, Mechanicil, and Electrical Schedu.lesare available at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF t.lILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by h.is electricalsupervisor. The general contractor ii not authorizedto sign the electrical labelIII. Applicant to sign and date l'lhenever possible, the initial application wilI be, used asa-worksheet only. Where poss.ible, Building Division Staffwill prepare a type written copy and return it to theapplicant 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 theapplication, and no plans will be processed until thesefees are paid. Al l other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s'l gnature date INSPECTIOII LiIIE 7?6-37 69 -____TTTTOTST R I NGF I EL D cOtlBI NATI 0N APPLIcATI0N/PERI'IIT Job Address ,r3 l-egaI Oescription EIIERGY SOURCES: Hear fuEFdl&-Q Ilater Heater A/0/vF Ftq. I'lain_ Sq. Ftg. Access._ Sq. Ftg. Other_ _l,lew_AddJlter r*q. y,funce_Demo Change/Use 0therVal ue of l.lork:# b, CIl7 ,oa7//itt(40wner Itl'Lr*z .€., Build Single,.Builciinq Permit Info: Describe t,,lork(/Fanily Residence tlith Attached GaraqeAddress llVg N /+7. furAUnAtO enone/(g-Ary EZ4?"EE Z tt//+1L6, r0 FXtrrwA7(oAlDlno N. EE+W(-E- ;ErvCEConstruction Lender s or ^-o R \ Address Phone I ics. no.exot res phone no.DESIGI{ TEAI.I name address Primary Structura l E'l ectri ca'l + Li3 to 4 - i-A+Hechan i ca I pYnl rFs ohonp no- )addres s lics. no.CONTRACTORS name (<-oF0.?t4z Ga .ZZ MECHANICALELECTR I CALPLUtlBI NG FFF .HAAGF flo FFF CHARGFFEECHARGENO furnace/burner to BTU' S / Each single fixture Residence of FTSQ New circuits alts. or extensions Floor furnace and vent Relocated building (new fix. additional) SERV I CES Recessed wal 1 Snacp hpatpr and vent S.F. Residence(l bath) Duplex (l bath) each Temporary Construction Apol iance vent seDarateAdditional bath e in existing pnae Chang rpcid Stationary evap cool erllater service multifamily, comm. or Tndrretria l Vent fan with sinole ductSewer Vent systern apart from heatino or A-C.Storm Sewer 0f Mechanical exhaust hood and ductc0Mr.1./IND. FEEDERS Insta l l /al ter/rel ocatedistrih- faeders llood stove/heater 0f ISSUANCE OF PFRIIIT TOTAL CHARGES TOTAL CHARGESTOTAL CHARGES IIHERE STATE Lltl REQUIRES that the Electrical wo shall not be valiJ until the label has been signed rk be done by an Elect by an Electrical Contractor, the electrical portion of this permit rical Supervisor and returned to the Building Division only subcontractors and employe6 r.rho are in compliance with 0l?S 7n1.0 S IGIIAl.lAtlE(please print)?a,nL- Ll,t+r,iz reb,y cert fy t al'l information hereon is truec0mr)oneapr)cat any,ofngfie struc 0reqon the Bui ng 70 nda rrecc0 t nd I fu rrthe tcer ,l hat t a II kl.JOf I1 n h 1andpesrmedhadonbeIeacwlcordancet0rditheonancestheCf"v ty Iof d1 and ofLaws tatheS nsprtheteal I to workthe beddescri relhe nrt thaand ilc+WIOCCUPAI'ICY II madebengoe wl houtt the 'I n ofretu di'|vt 'I rofpsrmissDisonhe cert 'I ttha ts tra on'!thwl Buthe '|I der sfurtIfyreg imyany I fun II a nd a5IrdBoa 05 51 tha t f the ba1 I s'I hereonnoted a thatndforsforceeffectSred0RsexemptexemptrequibyI'l be 0n S t, an on ect I Zone___-___Tyoe4onst. Units____--___Sq. Ftg. llain x Va'lue_ Fire Zone Eedrooms Occy Load Ftg Access Flood Plain S tori es Group Sq. Ftg . 0ther I ue- lue ToTAL VALUATIoN_ Plan Ck. Conrn/Ind 65%lB1do Per Fee 7.51, terisBUILOING PERI'IIT Charges anC Surcha rges Plan Ck. Res 30%/B1do Per Fee FencePLUI4BING PERMIT Charges and Surcha rges D6mo SidewalkELECTRICAL PERI1IT Charges and Surcharges A/C Paving Tota'l Cornb. Permi t Curb Cut bc)4\ IIE'HANICAL PERMIT Chirges and Surcharges TOTAL r*rcchanlcll (ltnil f\ COI{BI NATIOI{ APPL I CATI ON/PERMIT I. Applicant to furnishA. Job AddressB. Legal Oescription (cAP) l. example- Tax Lot 100, Lane County Map RefeIfT: q-43 2. example- Lot l. Block 3, Znd Addition toSEffi!'Field Estaies l{ame, etc. of owner and construction IenderEnergy Sources PLANS REVIEWED BY: PERMIT VALIDATION CITY OF SPRINGFIELD Clty Hall Springfleld, Oregon Deparlmanl ol Public Works OFFICIAL RECEIPT No. B 60922 19 l. example- heat/electrical ceilinq/or forced_ 2_. Eilffie- water;EaE tffiffi; ,oT.r-L. Square footage or valuatioilE-l. example- tZ50 sq. foot house, 500 sq. foot2. exafile- Tr n-,r""'p.oj"it,-.h"it *, - if ad,Ef'EEFE-dd, etc.F. Building permit informat.ion:l. elamp.le - construct single family house wi. ^ attached garage !. examp_le - remodel existing garage into fam.J. example - convert single family residencerestaurant (change of use)G. Value of work as defined in Section 303 (a) of.. Structural Specialty CodeH. OESIGN TEAM AND CON1RACTORS To avoid design or construction delays, BuildirDivision Staff must be able to contait appropripersons.regarding design information or jbO sitcorrections, etc. Abbreviated Plumbing, Mechanical, & Electrica.t ScheA. Except where blank spaces occur in the descriptportion of the Hechanical and Electrical Scheduthe applicant need fill-in only the No. Boxes a_ !o_lhq appropriate item(s) to Le installed8. Full Plumbing, Hechanicil, and Eleiirical Schedare available at the guilding Division1. To conserve space on the permit form the schave been abbreviated2. If the item(s) to be instal'led are not covethe abbreviated schedules you shou.ld consu.lfulI schedulesC. BUILDING DMSI0N STAFF l,tILL FILL OUT ALL FEES , CHARGES ON THE SCHEOULESD. As noted on the CAp, the label must be delivererelectrical contractor for signature by his e.lectsupervisor. The general coniractor ii not authrto sign the electiical label: ----' Applicant to sign and date llhenever possible, the initial application wil.l be, ra.worksheet only. lJhere possible, Building 0ivisior wr il.prepare a type written copy and return it to ttapplicant at the time the actual permit is issued fcsi gnature. (' ( (,, (; c D o {) (l I il ,l ( ( I q { ( ( Date Rec'd Received For: ( 6sII III. IV. ( ( (o (t Amount al SIGNATURE BATO(ra PiltttERt/L|THoonaPHERt. EUOENE' OiECOI{ Permit Clerkv Fees and Charges Plan check fees are due and payable at the time of tapplication, and no plans wiil-be procesied until thtees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: name S1 gnature date