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Home My WebLink AboutPermit Building 1982-03-26INSPECTION L 726-37 69 NE CITY OF SPRINGFIELD COHBI NATI ON APPL I CATION/PERMTT rob Address 1f,6 t/. U !-r h 9t 4u,o tuct O Lesal Description l) 07 j 6 l?l,later Heater cf , !'z L6-LtRan EIIERGY SOURCES: Heat ,U+; (At o0>y00L.f Sq. Ftg. Access.-- Sq. Ftg. Other_ J'lew Add Allerfiflap. - _Fence_Demo_Cha nge/ U se -other- nSq. Ftq. Value of l,lork: 'TLo n&ner fy6,,,1A.Fr€tl CnrtPc"l dF r'ryA ?BeWfc,'it I Ga ra o: Des .€., Build SinglePhoneT{.ll)tAddr6ss 460 f/..?l{ 'r *, Rutrut FrA[ D*^'o-q"fel,rre €,erb C6 47721 Construction Lender Addres s Phone ohone no-I i cs. no.exD r resnameaddressDESIGN TEAII Primary Structura I El ectri cal Mechani ca l Genera l 't -3o'8?-u llechani cai MECHAN I CALELECTR I CALPLUIlBI NG FFF CHARGFFFFCHARGFNON0-FEE CHARGE NO furnace/burner to BTU' S Residence of FTsQEach si ngl e f .ixture Floor furnace and ventza lts. z S New circuits or extension )Relocated building (new fix. additional) Recessed wal I Soace heater and ventSERV I CESI Duplex (1 bath) each Apol iance vent spDa ra teTemporary Constructi onAdditional bath Stationary evap cco ! erCha i'p s nge in existing : f ^-^^l.later servi ce Vent fan with sinole duct multifamily, corm. or I ndustri a lSewer Vent systern apart from heatino or A.C.0fStorm Sewer Mechanical exhaust hood and duct-coMr.r./tND. FEEDERS llood stove/heaterInstai l /al ter/re l ocatedistrib. feeders 0f ISSI'ANCE OF PFRI{IT IOTAL CHARGESTOTAL CHARGESTOTAL CHARGES WHERE STATE LII.J REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Division mthecompIetedapp1icat.ionforpermit,anddohereb.ycert.ifythatallinformat.ionhereonistrue and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of 0regon oertaining to the work described herein, and that N0 0CCUPANCY will be made of any structure without the permission of the Building Division. I further certify that my registration vrith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in comoliance with 0l?S 701.055 r^rilI be used on this nroiect. .4ny',') /v,fl /aZA-z< ott,Acr t'n\.,1<lt enh,DA'lE hr< L(t6f\(nreca of'mo E*carc,tSrRw( Ftt&S I GNATUREt{Al.lE (pl ease pri nt) Val ueZone Val ue Val ue ToTAL VALUATIoN_. x x Load . 0ther Const Group Sq. Ftg ni ts So. Fire Zone Bedrooms Flood Plain Stories Ftg. t'lain Ftg. Acce Plan Ck. Corrn/Ind 65%/Bldo Per Fee e 1 VE opmen 5L Plan Ck. Res 30%/Bldq Per Fee BUILDING PERI'IIT Charges and Su rc harges Fence DBmo PLUI4BING PERMIT Charges and Surcha rges Sidewal k Tota'l Connb. Permi tA/C Paving ELECTRICAL PERI1IT Charges and Surcharges Curb Cut TOTAL HECHANICAL PERMIT Charges and Surc harges lrv, !ugv",r rp(q:T(}RS name i t i I l I I I t I I Ii i COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description 1. glample- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSEiJnlTielo EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION I ex amp I e- examp I e- re footag hea t/el ectri ca I Iin or forced air qas 2 wa te r e solarE. Squa e or valuat on, etc. l. exampje- 14!0 sq. foot house, 500 sq. foot garaget. exampte- .if new project, check new _ if add.ition, check add, etc.F. Building permit information:l. example - construct single family house with anattached garage ?. examp]e - remodei existing garage .into fam.iiy room3. example - convert single family-residence iniorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Speciaity CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, BuitdingDivision Staff must be able to contalt appropriitepers0ns-regarci.ing design information or job s.itecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except rirhere blank spaces occur in the descriptionportion of the Mechanjcal and Electrical Scheduies,the applicant need fill-in only the No. Boxes adjaient _ to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the-permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful l schedulesC. BUILDING DIVISION STAFF l.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 his electrr:cai - supervisor. The general coniractor .ii not authcrizedto sign the electrical Iabel Innl-'---,,PP I rlotrL LU 5l9lr drlu UdLe I'lhenever possible, the initial application wil.l be used asa.worksheet only. Where possible, Building Division Staifwill prepare a type written copy and returi it to theapp)icant at the time the actual perm.it is.issued for his s i gna tu re. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wiil be processed until thesetees are paid. AII other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY II IIT IV V Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Perm'it applicant exempt from registration w'ith the Builder's Board because Additional Project Informatjon: PLANS REVIEWED BY: (k'a l.< 4 ft.P tf name I si g na tu re da te L4 ,l7FZ E -COMBI NATI ON APPLICATION/PERMIT Job Address o EIIERGY SOURCES Hea llater Heater Ran0e So. Ftq. l'1a in_ _ Sq. Ftg. Access._ S_0. Ftg 0ther _l,lew_Ad d_A1 te r_Rep . _Fence_Demo Change/Use 0ther $l -PrJ+ l-egal Description o l-t ots 3b13 Val ue of l,lork Z.ZOOC-h-ur.nrc-h cr+ Clne- IOwner l.aA o ren Address Llbo u. zl s+Phone n In 0 l,^lork .e., Build Single SpP13 rq€, Constructi on Lender Addre s s Phone DES I GN TEAII name addre s s ICS. nO-exDt res ohone no. Primary Structura I El ectri cal l''lec ha n i ca I CONTRACTORS name a ddrps s lics. no.exDl res ohone no. Genera I Pl umbi no El ectri cal Itlechanical U' PLUtlB I NG EL ECTR I CAL 14ECHAN I CAL N0.FFF CHARGF NN FFF CHARG F NO FFF CHARGF Each si ng1 e fi xture Res idence of SQ FT furnace/burner to BTLI' s Relocated buiIdi (new fix. additi ng 0n a I ) New c i rcui ts al ts or extens i ons Fl oor furnace and vent S. F. Res i dence ( l bath)SERV I C ES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Construction Apol i ance vent seDa rate l^later service Chan ge i n exi sti ng dcncprFq l Stat ionar-v evap cool er Sewer multifamily, comm. or Tndusfria l Vent fan with sinole drrct Storm Sewer 0f Vent systern apart from heat'inq or A. C. COI,lI.l. /IND. FEEDERS Mechanical exhaust hood and duct Instal I /a1 ter/re1 ocate di ctri h fcpdprc l'Jood stove/heater 0f /Boiler BZ, ooo 7.4 's ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAll REQUIRES that the Electricai work be done by an Electrical Contractor, the electrical portion of this perr,rit shall not be valil until the label has been signed by an Electrical Supervisor and returned to the Buiiding Division I HAVE CAREFULLY EXAMINED the completed apolication for Dermit, and do hereb,v certify that all information hereon is true and correct, and I further certify that any and all r^rork per.formed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0reoon oertaining to the work described herein, and that NC OCCUPAI'ICY will be madeof any structure without the permission of the Building Divisjon. I further certify that m.y registration vrith the Bui)der's, Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption.is noted hereon, and thhtonly subcontractors and ernployees who are in comcliance with 0l?S 701.055 r.rilI be used on this oro,ject. tlAl'lE(please print)7 /rrrrl S IGIIATURE oArE,o,/l-f T? Zone Cons t.Units Ftg . l,la i al ue Fi re Zone Bed rooms Load.5q. Ftg. Access x Val ue Flood Plain Group Sq.FtS.0ther____________x Value TOTAL VALUATI Stori es NN BUILDING PERMIT Charges and Su rcharges Plan Ck. Comm/Ind 65%/Bldo Per Fee Systems Deve Charqe (1.51 opment Plan Ck. Res 30%/Bldq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence Dgmo ELECTRICAL PERIlIT Charges and Su rcha rges Sidewalk A/C Paving Total Comb. Permit 14ECHANICAL PERMIT Charges and S urc ha rges 1 *_Curb Cut TOTAL 'l to COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legai Descriptionl. gCTg]C- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, ?nd Additisn toSpringfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources PERMIT VALIDATION 1. exampie- heat,/electrical cei I ino/ot. exampte- waterheater/ejectrical/ort. 5quare f0otage or valuation, etc.1. example- 1250 sq. foot house, 5002. exampTe- if new project, cirect< newEIeck-add, etc. r forced air gas solar sq. foot garage - if addition, II F. Building permit information:1. example - construct single fam.ily house with anattached garage2-. examp-l e - remodel exi sti ng garage .into fami Iy room3. example - convert sing)e fami)y-residence iniorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contatt appropriitepersons regarding design information or job sitecorrecti ons , etc. Abbreviated Plurnbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechan.ical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjaientto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated?. if the item(s) to be instalied are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF WILL 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 his electricalsupervisor. The general contractor is not authorizedto sign the electricaj label.III Applicant to sign and date i,Jhenever possible, the initiai application w.ill be used asa.worksheet oniy. Where poss.ible, Building Division Staffwili prepare a type written copy and return .i t to theapplicant at the time the actual permit is issued for hissignature. Fees and Charges PIan check fees are due and payable at the time of theapplication, and no plans wil l be processed unti.l thesefees are paid" All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY IV. Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: ' Permit appl icant exempt from reg'istrat'ion with the Builder's Board because: Additional Project Informatjon PLANS REVIEWED BY: name s i gnature date 13f'cd tr (rup 6 Lst 7/y"c D x ly*orO cutft 1?q CIc.H DovgLt Zx6 Rnrreu v{ " o.c. lxY t1v€t-wALL L-" ( ty wo ob Douots Ttc Tof Prrrr Lxe tlubt t("0''' Cuafe-t &oor firrrL'r uRc Sf n,, Ft€t ! 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