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Home My WebLink AboutPermit Building 1986-02-26-3753LILICATICOMBIINSP I 16- IT Job Address l-egal DescriPtionT 3taw Hea EIIERGY SOURCES Ranqe l.later Heater Sq. Ftg. Access.-=-- Sq. Ftg. Other---New -'Aaa -rnl teF--F-eP. -Fence Demo Change/Use _0ther Sq.l'1a l,lorkVal ue .tr edSDescr Aarni I nn denAddress .Phonen Construction Lender oa )t) S Addres s Phone sname Pri ma r Structura I El ectri cal Mechan i ca l l,tec MECHAN I CALELECTRICALPLUIIB I NG furnace/burner to BTU' sResidence of FTSQEach single fixture Floor furnace and ventNew circuits alts. or extensionsGlocated building (new fix. additional ) Recessed wall Snace heater and ventSERV I CESRes i dence Duplex (1 bath) each Apol iance vent seoa rateTempora ry Constructi onAdditional bath Stationary evaP. cool eri n exi sti ngge den ce C han res i|later service Vent fan with sinole ductmultifamilY, comm. or IndustrialSewer Tent system aPart from heatinq or A.C.0f S rm SewerS Mechani cal exhaust hood and ductCOMI.I./IND. FEEDERS l'lood stove/heaterInstal I /a'l ter/re1 ocate distrib. feeders- 0f ISSUANCF OF PFRIlIT ica'l Contractor, the electrical portion of this permit isor and returned to the Building Division TOTAL CHARGESTOTAL CHARGES LAl,l REQUIRES that the Electrica li'l until the label has been sig I work be done bY an Electr ned by an Electrical SuPerv TOTAL CHARGES WHERE STATE shall not be va S IGNATUREtlAl'lE (pl ease pri nt)DAT E2.:L. YL perm ffect any of Boa 4zr-a) t all information hereon is truer oermit, and do hereb.y certify thaapnlication foNED the completedi HAVE CAREFULLY EXAI'II with the Ordinances of the CitYdone in accordancerformed shall beand al I work peand correct, and I further certify that and that NC 0CCUPANCY will be madeto the work described herein,Oregon oertaining the Bui1ding Divisfield and the Laws of the State registration vlith the Builder's emition is noted hereon, and that of Spring ion. I further certifY that mYucture without the ission ofofany str rd is i that if exempt the basis for exas required by ORS 701.055'n ful l force and e Droj ectORS 701.055 wilI be used on thisonly subcontractors and ernployees who are in comcliance with Uni ts x ValS Val Cons tZone Val ue Flood Plain Stories TOTAL VALUATI Fire Zone Bedrooms o. Ftg. l'lai Load Sq. Ftg. Access Group Sq. Ftg' 0ther o pmen tteris 5q. Plan Ck. Comm/lnd 65%lB1dq Per Fee Plan Ck. Res 30%/B1dq Per Fee BUILDING PERI'lIT Charges and Su rcha rges 14w- Fence Demo PLUMBING PERMIT Charges and Surc ha rges Sidewal k A/C Paving Total Comb. Permit ELECTRICAL PERIlIT Charges and Surcha rges Curb CutI,IECHAIIICAL PERMIT Charges and Surc harge s TOTAL I Fyy, rr n- COMBINATION APPLI CATiON/PERMIT (CAP) L Appl icant to furnishA. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County t"tap Referencel7-03-?'s2. SIggLJg- Lot 1. Btock 3, Znd Addition to5prtngfield Estates I, Name, etc. of owner and construction IenderD. Energy Sources 1 exampl e- examp I e- re footag heat/el ectrical cei I i or forced air qasr solarZ.wa ter ter e e ca 0E. Squa e or vaiuati on, etc.I example- 1250 sq example- if new EIETI-Edd, etc. . foot house, 500 sq. f,project, check-new - if oot garage 2 addi ti on, E Building permit information :l. gx?Tp]e,- construct single family house w.ith anattached qaraqe i. =Tg]S - 19roae1 existins sarase into family roomr. exampte - convert single family-residence into .. - restaurant (change of-use)Value of work as defined in Section 303 (a) of theStructural Specialtv Code DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuiidingDivision Staff must be abie to .;;i;;;'uii"op"iatepersons.regard.ing design information or jbO iitecorrections, etc. G H II Abbreviated Plumbing,. Mechanicar, & Erectricar scheduresA. Except where urinr ipacts;;;r; in'ir,l o.r."iptionportion of the Mechanical anO ffeCtricat ScfreAuiel,the applicant need fill_in onfv tfre Ni. So*., uajii.nt_ to_the appropriate item(s) to 6e insiarteUB. Fuil pty1bing, Mechanicji, i.a-if.iri.ical Schedutesare available at the Building Division1. To conserve space on the"perm.ii iorm tne scheduleshave been abbreviated2. II tt':. item(s) to be instal.led are not covered onthe abbreviated schedule, yo, ,horld coniuit-tn.ful i schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ANDCHARGES ON THE SCHEDULESD. As noted on the CAp, the labej must be delivered to theelectrical contractor for signaiur. ly f,i, "f"iiriiai - supervisor. The general conlractor ii not authorized- to sign the electrical labejApplicant to sign and date bJhenever possible, the initial application will be used asa.worksheet only. l,there possibtb, euilaing oiviiion-iiaiiwiil.prepare a type written.opy ina-""tr.i it to theapplicant at the time the actuiri perm.ii-ii irru"A io. ni,s i gna ture. Fees and Charges Plan.check fees are due and payable at the time of theappiication, .and-no plans wiil-be processed until theserees are pard. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III IV V PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name aate 7-2>-x>s'l gnatu re IIISPTCTIOII LIIIE, 7?6-37 69 TITY OF SPRINGFIELD COI1BI IIATI ON APPLICATION/PERMII INFORIIATION LlNI 7 26-37 s3 I $al ).J CJ \ ,( t?aJob Address ,QOKO EIIERGY SOURCES: Heat liater Heater Ranqe Sq. Ftq. l.lain_ Sq. Ftg. Access.----- Sq. Ftg. 0ther-__ I'lew Add Al ter 9ep. -Fe-0t nce_Demo_Change/Use her Lesal Descriot;on1tJ-g3-e.S-AO TL, /3b@ Val ue of l,lork: )</'?eo@ownerfr p3r Ass*^ Bt-r' O4uect' Address aaKo /r/, l?m Phone Builrlinq Pernlit Info: Describe t'lork(' Farnily Residence llith Attached Garaqe .e., Build Single Fseoop O-HuD-cH Construction Lender Addres s Phone DES I GN TEAIJ name l ics. no exDr res phone no. Pri ma ry Structura I Electrical Hechan i ca I n ame lics. no- )I PXnt req nhone no- ) General Ollcgr-e S Q.oL e Coru sr Pl umb i nq El ectri ca i l'lechani ca l PLUI1B I NG ELECTRICAL MECHAN I CAL N0.FFF C HARGF NN FFF THARGF NO FFF CHARGF Each single fixture Residence of SQ FT furnace/burner to BTU' S Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S. F. Res idence(l bath)SERV I C ES Recessed wal I Snace heatpr and vent Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seoa rate l,later service Chang resid e in existing ence Stationary evap cool er Sewer multifamily, comrn. or Indrrstrial Vent fan with sinole duct Storm Sewer Vent systern apart from heatino or A.C. c0r.rH./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al terlre1 ocate dist-rih. feeders l'Jood stove/heater 0f amp s. ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L1N REQUIRES that the Electrical work be doneshall not be vali.l until the label has been signed by an Elec by an Electrical Contractor, the electrical portion of this permittrical Supervisor and returned to the Building Division CARE FUL L comp ap l-)ca ti on fo r Derm l L a nd do re ce rt I fy t ha t a I I 'I n forma t 1 n he reo n s tr ueand of of Boa onl c0 rrec t an d I further certify that the Laws of the State thout the permission rce and effect as req a ny an d a I I work perfo rmed sha I I be don e 'I n ac cordance w1 t h the 0rd I nance s o f the City be madeSpr1ng fi e I d an d of 0reg on pe rt 'I 'I n g to the WO r k descri bed he re 1 n and tha t NC OCCUPANCY wl I Ianytructurewloftheuilding Divi oRS 701.055 l i ance wi th s I 0n I further certf exempt the .055 wilI be r ,l fy t ha t my re s 'I s tra t 1 on vri th the Bu I srd'I 'I n ful I fo u 'I red by th a t t ba s 'I s for exempt I 0 n 'I s n0 te d hereo n a nd th a tbcontractondwho ,v su rs a ernp oye e s are 'I n comD OP.S 7 0 used on t hi s p roj ect I.lAtlE(please print)S I GiIATURE Wo ir-t o=1.' oA,E 2 -JL- Y2- FOII OFF Zone Const. Units So. Ftq. l4ain Fire Zone Bedrooms 0ccy Load Sg. Ftg Flood Plain Stories _0cc.y Group Sq. Ftg Access 0the r Val ue Value TOTAL VALUAT roN--/z/.7:wm----_-fJ-_ BUILDING PERNIT Charges anC Surcha rges 1&w_Plan Ck. Comm/Ind 65%/81dq Per Fee S v s '"erxs Cha rop Deve(t. sq 0pment Plan Ck. Res -30?j/Bldq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence Dgmo ELECTRICAL PERI1IT Charges and Surcha rqes Sidewal k A/C Paving Total Comb. Permit I,IECHANICAL PERMIT Charges and Surc ha rge s Curb Cut FyxuTOTAL 0f amps 'I der' COMBINATI ON APPLI CATI ON/PERI,IIT (CAP ) I. Applicant to furnish A. Job AddressB. Legal DescriPtion l. example- Tax Lot 100, Lane County Map Refer T7-f3 43 2. example- Lot 1. Block 3, ?nd Addition to SEffigTield Estates C. Name, etc. of owner and construction lender D. Energy Sources l. example- heat/electrii?l ceili!g/or fgrced 2. exarirple- waterheater/electrical/or solar E. Square footage or valuation, etc' 1. example- 1250 sq. foot house, 500 sq. foot 2. exampls- ii hew proiect, check new - if add -ctreck add, etc.F. 8ui)ding permit information:1. example - construct single family house wit aTTaEIEa garage 2. example - remodel existing garage into fami 3. example - convert single fam'i1y residence i restaurant (change of use) G. Value of work as defined in Section 303 (a) of Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Buildin Division Staff must be able to contact appropri persons regarding design information or iob sit corrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical Sche A. Except vrhere blank spaces occur in the descript portion of the Mechanical and Electrical Schedu the applicant need fill-in only the No. Boxes a to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Sched are available at the Building Division 1. To conserve space on the permit form the sc have been abbreviated2. If the item(s) to be installed are not cove the abbreviated schedules you should consul ful I schedul es C, BUILDING DIVISION STAFF HILL FILL OUT ALL FEES CHARGES ON THE SCHEDULES D. As noted on the CAP, the labei must be delivere e'lectricai contractor for signature by his elec supervisor. The general contractor is.lgjl auth to sign the electrical label. III. Appl icant to sign and date name --r- CITY OF SPRINGFIELD City Hall Springlield, Oregon Deparlmenl ol Public Works OFFICIAL RECEIPT No. B 53473 't9 ( ( I I I I il C ( 't f, ,T I (t C ( '4n (' 6 ( Bec'd Address ,"""*.;,JR6 lmq (. or Amount Beceived a,"! Whenever possibie, the initial application will be a worksheet only. Where possibje, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his' signature. IV. Fees and Charges PIan check fees are due and payable at the time of the application, 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 PLANS REVIEI^IED BY: sig nature intccs natnreas/LtrHoGRAFHERs' EUcENE oREGoN Permit Clerk aate V2 >_Y)- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI'ICY: Permi t appl i cant exempt f rom reg i strat'ion wi th the Bu'i l der' s Board because : Additionai Proiect Information : i I i i ii