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Home My WebLink AboutPermit Demolition 1980-09-22NSPECTION LINE 26-37 697 CITY OF SPRINGFIELD COMBI tiATI ON APPL ICATI ON/PERMIT 726-3753 Job Address |:-Nt l-ega 1 pescription 1t =OO Hea Ranqe EIIERGY SOURCES l,later Heater l16Z3uzt Ownen naE l'1a i n_ Access.=---._- 0ther _l{ew__.Ad d_A I Iarlfle p . _Fence Demo Change/Use -other- Sq. Fto Sq. Ftg So. Ftg Builr Fami l Addres s Phone iinq Pernrit Info: Describe llork('y llesidence l,li th Attached Garaqd' ,e., Bui ld Single Construction Lender Addres s Phone c0 ooe $ DESIGN TEAI.,I name address lics. no.exDt res ohone no. Pri ma ry Structura I El ectri cal l'{ec han i ca I name addre-s s I i cs. no.exDt res ohone no.$no(I )o (-U Pl umbi nq n.(Q1Electrical Y Ilechan i cal PLUIlBI NG ELFCTR I CAL MECHAN I CAL NO FFF CHARGE NO FFF C HA AGF NO FFF .HAANF Each single fixture Residence of SQ FT furnace/burner to BTLI' s Relocated buiiding (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S. F. Residence(l bath)SE RV I CES Recessed wal I Soace heatpr and vpnt Duplex (1 bath) each Additional bath Temporary Construct ion Apol i ance vent seDa rate blater service e in existinq ence C hang resid Stationary evap. cool er Sewer T ndustri a I multifami1y, comm. or Vent fan with sinole duct Storm Sewer 0f s.Vent systern apart from heatinq or A.C. c0r4r.1./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re1 ocate di stri h fppdprq l'Jood stove/heater 0f amps. TOTAL CHARGES TOTAL CHARGES ISSUANCF OF PFRIIiT TOTAL CHARGES IiAl'tE (pl ease pri nt S I GiIATURE DATE{'}l'llul6Rer,. 6oer\e any rd n9 la H ULCARE F L XAME ED t an d do he re fIc'IdL n0 for ticomp ertC I tha at IIapp2erm n'I rmatfo on'I ereonh t,l sb.v v rue nda correct nda frI rth cer 'lertU t tha a nda la l^/O '1 kr rfo rme sd ha Iny be nedo n'I CCa nceorda thwl heL I0rd ncna ofespe het 'Ic ty,lr ff e dI tand Lawshe theofSong tSta oe on n'I n,i to eth k0regwor 5Cde 1r hbed 'Iere n nda atth OCCUPANC NC I IIoe rta g mad ebefcruretuIhoLutI5LtheermSs0n1thofBuiedI'|D I S1 I n fu thr cer Iert I ath t I tras 1t v/10n Lth 'Iu I rIvm.y he de s s,l ni Uf II a pr ffiBoaforceend 1u edr 0 I\J t ah f0551satCCreqt'I t ba ,] S fos r 0nti sI notheby ha ttandexemptexempedhereon no I SU 0nbc totrac rv S and I s who are 'I n 'lIempoyee w1ance 0r?sth 07 1 05 5 'I I be sed n 'Ith sc0mD tpro,j be done by an EI an Electrical Su I^IHERE STATE LAIll REQUIRES that the Electrical workshall not be vali:l until the label has been signed by ectrical Contractor, the electrical portion of this perm.it rpervisor and returned to the Building Division Fire Zone Bedrooms 0c Flood Plain Stories 0c TOTAL VALUATION Tyoe/Con s t Uni ts cy Load c.y Group X Val Ftg Zone alue Val ue Acces s 0ther So. Ftg. l,la in !q. Ftg Pl an Ck. Comm/Ind 65%/Bldo Per Fee Svsterns Deve Charqe (i.52 opmentBUILDING PERTIIT Charges anC Surc ha rge s l, Plan Ck. Res 30%/Bldq Per Fee FencePLUI,IBING PERMIT Charges and Su rcha rges D6mo SidewalkELECTRICAL PERIlIT Charges and Surcha rges A/C Pavi ng Total Comb. Permit Curb CutI,,IECHANiCAL PERl.,lIT Charges and Surc ha rges TOTAL Value of llork: CONT .oo COMBINATION APPLICATION/PERMIT (CAP) Applicant to furnish A. Job AddressB. Legal Description 1, example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources : 1. exarnple- heat,/electrical ceiling/2. example- waterheater/electr.ical/o Square footage or valuation, etc. or forced air gasr solar E 1 example- 1250 sq. foot house, 500 sq. foot g example- if new project, check new - if addi check add, etc. a rage tion,2 F. Building permit information:1. example - construct singie family house with an attached garage 2, example - remodel existing garage into family room 3. examole - convert singie family residence into restil-rant (change of-use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI,{ AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. Abbreviated Plumbing, illechanical, & Electrical SchedulesA. Except vrhere blank spaces occur in the description portion of the Mechan.ical and Electrical Schedules, the appl icant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedu'les have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedul esC. BUILDING DIVISION STAFF l,JILL FILL OUT A.LL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The generai contractor is not authorized to sign the electrical label. Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Bu.ilding Division Staffwill prepare a type written copy and return it to the appiicant at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans wi ll be processed until these fees are paid. AII other fees and charges are due and payable when the permit is issued. II III IV V. FOR OFFICE USE ONIY PERMIT VALIDATION Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s i gnature date PECT I ON -37 69 COI1BI IIATION APPL I CAIION/PERMIT 726-375 Job Address l Legal Description Ranqe l.later Heater EIIERGY SOURCES: Hea t Owner -{ lc t-tcl€, L ( Va l ue of l,lork . Ftg. Access.---- Sq. Ftq. Other_ J,lew_Add AItEr_R-ep._ _Fence_Demo Change/Use 0ther So Sq . Ftg. Addres s Phone e., Farni n i S ng e dence l,lith Attached Gara it Info: Describe l,Jork \ enrnoQJ Constructi on Lender Address Phone cccoa trJ+ DESIGN TEAII name addres s Iics. no.exoi res (p hone no. Pri ma ry Structura I El ectri cal l,lec ha n i ca l name add res s (lics, no.exDt res (phone no. EI r1 llechanical PLUIlB I NG ELECTRICAL MECHAN I CAL l\U.FIF CIJARGF lln FFF CHARGF N0.FFF CHARCF Each single fixture Residence of Sc]. FT furnace/burner to BTU' S I Relocated buildino (new fix. additional ) New ci rcui ts al ts or. extens i ons Floor furnace and vent 5. F. Pes i dence(l bath)SERV I C ES Recessed wal I Soacp heatpr and vpnt 0up1ex (l bath) each Additional bath Temporary Constructi on Apol iance vent sepa rate llater service ge in existing dencc C han res i Stati onar-v evap. cool er Sewe r^Industrial multifamily, comm. or Vent fan vrith s-inole duct Storm Sewer 0f "amPs. Vent systern apart from heatinq or A.C. c0r,1r1. / IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re1 ocate di st-ri h. fpeders lJood stove/heater amp s.0f ISSUANCF OF PFt?IlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I,JHERE STATE LAU REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernritshall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Division of any structure urithout the permission of the Buildinq Division. I further certify that my reqistration rrrith the BuildeBoard is in full force and effect as required by ORS 701.055, that if exempt the baiis for exemotion is noted hereon, andonly subcontractors and enn)oyees who are in comciiance with 0ll5 7n1.055 will be used on this nro,ject. I'lAt1E(please print 7*.t-O {.}i'8uS IGi,IATURE FON OFF r6Per* 6oar\€u fyICAREHAVEICOthDondcampdLfor'I t hedo reb rtce i t tha Ia I o Lrma oni IIhereonf,I i spo0erm,.y a nd t a ind u he cerr .lt t a nda Iatha tvo'I kr rfome0e sd ha I rdanco c ,l ht eth rd0 nI n 0 fn'Idonbe tf_v ny hefofirIedIndaLawtheofsLheSteLdofreSong0oonrtaDEn,l nI to th dest^iork bedcrl he re n'I an thad ilnt ilDOCC,ANCY Ii I(l be true Ci ty made r's tha t Fire Zone Bedrooms Occy Load Sq, Ftg. Access Flood Plain Stories 0cc.y Group Sq. Ftg. 0ther________x Value ToTAL VALUATI0N-- x So. F to. i4ain Value Val ue Zone Uni tsTyoe/Co n s t. Plan Ck. Comm/ind 65/,,/81do Ppr Fee Svsterns Deve Charqe (1.52 opmentBUILDING PERIIIT Charges anC Surcharges I"CC Plan Ck. Res 30-e;/Bl dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges Demo SidewalkELECTRICP,L PERIIIT Charges and Surcha rge s Total Cor,:b. Permi tA/C Pavi ng Curb Cut TOTAL IlECHANICAL PERt.liT Charges and Surc ha rge s m er. Q1 t i COMBINATION APPLICATION/PERMIT (CAP) Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map 17-03--43 Ie C ITY ( ( ( 2. example- Lot l. Block 3, 2nd Addition Springfieid Estates C. Name, etc. of owner and construction lend, ( D. Energy Sources i 1. exampte- heat,/elqc!ri5qL_!e'!t'!nglor fr2. exErpTe- waterheater,/ElectlJcllTor so-E. SquareE-otage or valuation;etc. {i. example- 1250 sq. foot house, 500 sq.2. example- if new project, check new - check add, etc.F. Building permit informationr ( 1, exanple - construct single family hou: ;TTachA qardge 2. example - remodel existing garaqe intc3. examtle - convert single iaiity-resioe fiFE!taurant (change of-use)G. Value of work as defined in Section 303 (a Structural Specialty CodeH. DISIGN TEAI.I AND CONTRACTORS ( To avoid design or construction delays, Bu Division Staff must be able to contact app persons regard ing design information or jo corrections, etc.II. Abbreviated Plurnbing, i4echanical, & ElectricalA. Except r-rhere blank spaces occur in the des porrion of the l'lechanical and Electrical S the applicant need fill-in only the llo. Bo aito the appropriate item(s) to be installedB. Full Plurnbin_0, Ilechanical, and Electricai are available at the Bujlding Division1. To conserve space on the permit form t $c,. have been abbreviated 1' 2. If ihe item(s) to be installed are not the abbreviated schedules you should crful] schedules .,- C. BUILDIIiG OIVISION STAFF I^IILL FILL OUT ALL I \ CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be del'electrical contractor for signature by his JCtsupervisor. The genera) contractor is not r$' to sign the electrical label. Ciry Holl Springfield, Oregon Deportmenl of Public Works OFFICIAL RECEIPT il B 54654r} Dote -l -l9 F ( ( ( Received Amounl Received cc ( III Applicant to sign and date Hhenever possible, the initial application will a worksheet only. rrJhere possible, Building DilwiII prepare a type rvnitten copy and ret,urn it applicant at the time the actuai permit is issu signature. Fees and ChargesIV AUTHORIZEO SIGNATURE SHELION TURNBULL PRINTERS . EUGENE OR 97'OI Plan check fees are due and payable at the timel_application, and no plans r.ri1 I be processed unti I tnese fees are paid. All other fees and charges are due and payable vrhen. the permit is issued. FOR OFFICE USE ONbY Permi t- Cl erk PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPANCY Permit appijcant exempt from reg'istration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s i gnature da te PERMIT VALIDATION OF SPRINGFIETD ECTION L IIIE 37 69 " COHBIiIATION APPLICATION/PERMIT e/Const. a-,J its Bedrooms Load Sq croupT'7- |_sq 726-3753 lue Val ue Iue TOTAL VALUATION N?/ ) . ZO Ftq. l'lain Fire Zone Flood Plain - Sto BUIL0ING PERi'lIT Charges and Surcharges PLUI,4BING PERMIT )harges and iurcha rges LECTRICP.L PERI:IT harges and rrcha rges CHANICAL PIRMIT arges and rc harges Ftg. Access Ftg.0ther x ries / AtbJob Address 145 Legal Description Ir\-1AV -qti'"Owner ,\\J Sq. Ftg . l.lai n_ Sq. Ftg. Access._ Sq. Ftg- 0ther_jew_AddJl ter_Rep. _Fence_Demo Change/Use 0ther tlater Heater Ranqe EIIERGY SOURCES Hea t Value of uort:3 6l I k6honu/Addrdss -.1^ tr.f Bui I rii n Farni 1y g Permit Info: Describe llork( Residence liith Attached Garaqd .e., Build Single X ,- . 1' ) i t; f ii r [i]l"t I1i1 1. ?,:(l-'lrr! .r Construction Lender Addres s Phone e>0 q o+ DESIGN TEAI{name addre s s Iics. no.res ohone no- Primary Structura I El ectri cal l{echanical name addres s I i cs. no.(expires)ohone no- );/General' .I Plumbinq Electrical l.lechanical PLUIlB I iIG ELECTR I CAL MECHAN I CAL NO FEE CHARGF NN FFF CHARGF NO FFF CHARGF 4 t\Each single fixture lO, or-; Residence of FTSQ furnace/burner to BTU' S Relocated building (new fix. additional ) ^ New ci rcui ts al ts or extensions /$-,q Fioor furnace and vent S . F, Res i dence(l oatn)SERV I C ES Recessed wal l Soace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seoa ra te [,later servi ce res i dence Change i n ex isti n-q Stati onar_v evap cool er Sewer lndustrial multifamily, comm. or Vent fan with sinole duct Storm Sewer Vent systern apart from heatino or A-C. c0r.il',!./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re1 ocate distrib- feeders ['Jood stove/heater 0f s. TOTAL CHARGES TOTAL CHARGES /fia ISSUANCE OF PFRI1IT TOTAL CHARGES I'JHERE srATE L.{l,J REQUIRES that tlre Electrical r^rork be done by an Electrishall not be valil until the label has been signed by an Electrical supervi cal Contractor, the electrical portion of this pernit sor and returned to the Building Division l,lAl'lE (pl ease pri nt )Ic(- IGIIATURET and of of Boa onl INEEXAM theD eLL ca 0nti rfo t and do herc0mpoermi cert tha aL n rma t onapr)eb.v fy hereon s true dan fucorrec t rrthe ticer tha t nd a oe rfowork rmed ahafy donebe n daacc0r nc t theh rd0 nwl ofances het Ci tyr't f e d and any ofSpthLawsetheoftaSn9te n art to .wothe d0regoDCr e crt hebed tlrel a thand NCtg UPAI'ICYOCC wl be maderutctw'laure thou tht s5 n ofnypermr the Bu di Di vl on fu rnghert cert t tha re ts tra o n ht eth ul d refymygtrlrdsfulnfoarceeffendaLLsutred700R50515tthafreqbytthbaSforSnoexemptednohereon thand taexempt bcou trn whoCS aandrsvtoac 0r?shrenancetwl l,I usbe oned ht s055701ernpoyec0mc tecro.jp FI Plan Ck. Conm/Ind 65%/81do Per Fep Svstems Deve Charqe (1.51 opment'{ro-Q /,q2 P'l an Ck. Res 30%/Bldq Per Fee 4l+ qo f >q -23-8() Fence A4-(nf ,QJltao- iqo Dgmo SidewaIkLLoe_ ,bO Tota'l Comb. PermitA/C Paving Curb Cut r{ 5,? ?-#TOTAL RACTTIR S I 0f amps. examol e- heat/el ectrica l cei l i or forr (ar d ( ctTY OF SPRINGFIEIDCOMBINAIION APPLICATION/PERI'IIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. examole- Tax Lot 100, Lane County Map Re17tT-432. example- Lot l. Block 3, Znd Addition tc SETIngTield EstaresC. Name, etc. of owner and construction lenderD. Energy Sources i &\ Ciry Holl ^ Springfield, OregonuePorlmenl of public WorksOFFICIAI RECEIPT C Do 4 No oRrzEo s IGNATURE EUGtTE Oi craot !a5I.6 B 547 43 9 t n2. ExarTrDl e-E. SquarE-T6oTa water ter e ec or5 oIil ge or valuati on, etcq. foot house,500 sq. f proj ect, check new - if ,ni ,0 (' L examole- 1250 s, exanole- if new EI.eEFi-dd, etcF. Building perr,rit information:1. exampie - construct single family house attat,iEO garage2. ey.amole - remodel existing garage jnto 3. AGmtIE - convert single iafrily"resider - FesTi--urant (change of"uie)G. Value of work as defineci in Section 303 (a r IStructurai Specialtv CodeH. DESIGN TIAII AI,ID COIITRACTORS R ecei verJ For: A mount Rece ived BY To avoid Cesign or construct.ion delays, BuDivision Staff must be abie to contait aop ,r.ipersons regardin_c design informaiion or jc corrections, etc, Abbreviateo Plumi:ing, i.lechanical, & ElectricalA. Except vrhere blank spaces occur in the des rplportion of the t'lechanical and Electrical Ithe appl icant neeo f i ll-in oniy the l,lo. Br - to the appropriare item(s) to be instaije,B. Fuil Piu;rbing, Mechanical, and ilectrical ne(are avai iable at the Building Divisionl. To conserve space on the permit form have been abbreviated2. If the item(s) to be installed are nc .ovthe abbreviatecj schedules you Shouldful I schedulesC- BUiLDItic DI'/lSI0i,l STAFF'$tILL FILL OUT ALt CHARGES ON THE SCHEDULES ,!D. As noted on the CAP, the label must be d, \^. electrical contractor for signature by hSupervfsor. The general contractor i! nto sign the electricaI labelApplicant to sign and date Whenever possible, the initial application nl_a-worksheet only. Hhere poss.ible, Building Divisiwill prepare a type written copy and returi it toapp)icant at the time the actual perm.it is issuedsignature. C II --61 \ed SHfltoi.TUirauL! IiI IV Permit Clerk $ Permit app'licant exempt from registrat'ion with the Builder's Board because: Additional Projecr Information: PLANS REV I EI,^/ED BY : on Starr thefor his Fees and Charges P'lan check fees are due and payabJe at the time of theapplication, and no plans rviil be processed until thesetees are paid. AII other fees and charqes are due andpayable when the permit is issued. FoR oFFICE USE oilt Y ( ,( E c. Sr I -.!1!--ta ttE ch Su PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: name Si gnature .-i da te :-l'_ c I I --.{