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Home My WebLink AboutPermit Building 1986-04-14I)tt EC 37 L INE COHBI APPLICATI ERMIT 375 Job Address ?OZO Noe--rrrA rn*h St.EIIERGY SOURCES Hea t_ I'later Heater Ranqe tg. Sq. Ftg. Access._ So. Fto. Other J{ew Add AII-er___.P€p-. - _Fence_Demo_Cha nge/ U se -other- "O\o R) [-q Legal Description Value of l,lork: /,, 2OOowner Fr<6t NsSennr uy OF GoO Address zoSo N). teTh'PhonelqUZ?l Buildinq Permit Info: Describe Work(FamiIy Residence t'lith Attached Garaqe .e., Build Single t\)5r-(- t+rO tr-,c Construction Lender FJ o rr E O De. Lasart-opY I F\ €x .s*r t) (z Addres s Phone hromr+oS Lo o*t G* DES GN TEAI4 name address I ics. no exoi res phone no. Prima ('4n -oG Structura I El ectri cal Mec han i ca I CONTRACTORS name add res s (licq nn exol res ohonc nn- ) Genera I Il/t Rrzr ortr Teo ? oC 5 ra$ rorhsl- Sppln 4o57 a/tglg b 742-qq t4 Pl umbi nq El ectrica l l.lechanical PLUIlB I NG ELECTRI CAL HECHANICAL FEE CHARGE NN FFF CHARG F NO FFF I CHARGF 3 Each single fixture Residence of SQ FT furnace/burner to 8TU' S Relocated bui ldinq (new fix. additional)New circuits altsor extensions _. 'drF 4 SERV I CES lsn Fioor furnace and vent S.F. P.esidence(l bath)Recessed wal I Soace heatpr and vent Duplex (I bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra te l.later servi ce Change in existing resi dence Stationary evap. cool er Sewer multifami'ly, conrn. or Industrial Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatinq or A.C. coMl.l./IND. FEEDERS Mechanical exhaust hood and duct v\ Z r^-:ciGt I nsta'l I /a I ter/ rel ocate dicfrih fecdpr<llood stove/heater 0f ampr l.so k'0-t\r51RL 8rtra I ,,t>Ei rstr r.:r(- 6UtLe r a ,?c ISSUANCE OF PFRIIIT TOTAL CHARGES Js,4c TOTAL CHARGES a TOTAL CHARGES HHERE STATE LAl.lshall not be vali.l REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernituntil the label has been signed by an Electrical Supervisor and returned to the Buildinb Division comp eted a pr)I I c at i on t hereb.y certify that ail information reon '|s t rueand correct, and I further cert 'i fy that any the State of and al I work rmed shall be done in accordance with the 0rdinances of the Cityofspr'I ngfi e I d and the Laws f 0regon pe rtai n 1 ng to the wo rk d e sc rl bed here 'I n and tha t r{c OC cuPAr'rc Y wt I I be madeofanystructurewlthoutthepermrIofthessBuiIding 701 Di vl s I on I fu rt her certi fy th at my re9 1 t ra ti 0n v/1 th the Bu I I der sBoardInfulIforceandeffectasrequIredbyORS055that1fexemptthebas'I s fo r t '|on '|n oted hereon and tha tonIsubcontractoandIwho'Ivrsempoyeesare n comD I I ance wl h 011s 7oL 055 wl '|I be u sed on th ,| I'lAl{E(please print)l"n ns Ora TURE FI Zone_-_____TyDe/Const. Un its Ftg . l'lain Val ue Fire Zone '- Bedrooms _Occy Load Sq. Ftg. Acces x Val ue Flood Plain Stories Gro Ftg.0ther-x Value_ ToTAL VALUATI0N_ BUILt)ING PERNIT Charges and Surcharges 20.5o.t2 PIan Ck. Corm/lnd 65%/Bldo Per Fee t7.==Svstems Deve Charqe (1.52 opment 44. Plan Ck. Res 30%/81dg Per Fee PLUT.IBING PERMIT Charges and Surcharges J .SC q Fence Demo ELECTRICAL PERI|IT Charges and Surcha rges ___/{_?_.a SldewaIk A/C Paving Curb Cut Tota'l Comb. Permit G;o,7? T,IECHANICAL PERMIT Charges and Surcharges TOTAL il23,6f tr* n*z-t lo' Qn (-.o,'t coMErNATr0N AppLICATT0N/PERI'IIT ( CAp) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition toS[ffi-gfield EstatesC. Name, etc. of owner and construction Iender0. Energy Sources !r gas E. l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, .check new.- if addition, check add, etc.F. Building permit information:l. exampie - construct single family house with an attached garage 2. example - remodel existing garage into family room3. examole - convert single family residence inloEffiFant (change of-use)G. Value of work as defined in Section 303 (a) of theStructurai Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedutesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need filt-in oniy the No. Boxes adjaientto the appropriate item(s) to be installed8. Full Plumbing, Mechanical, and Electrical Schedulesare avaiiable at the Building Division1, To conserve space on the permit form the schedtiles have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF I.IILL 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 eiectrical iabel.Applicant to sign and date lJhenever possible, the init'ial application will be used asa worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theappiicant at the time the actuai permit is issued for h.issignature. 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. FOR OFFICE USE ONLY II. III IV V PERI'IIT VALI DATION b u\o q .q a 't /\\, trth \,, Permit Clerk r!, PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s't gnatur date'6-VE€ {, CTION LINE 769 726-37s3COMBIICATI Job Address ?-o zo Noe-trA rR+h st Legal Description Ilater Heater Ranqe EIIERGY SOURCES: Heat owner Pt*6-1i- NES€n^iOLy oF Goo Value of l,lork /.,2oo I'lai n_Access._ 0ther _l{ew_AddJl teFlREE. _Fence_Demo_C hange/ U se 0ther Sq Sq Sq Ftg Ftg Ftg Lqf h'PhoneTtlbtZ?lAddress zoao N)n F De scrAtt .e., Build Single a,L(- t-.rO (l)Fsre.1..)c Construction Lender N) o Ff, t O De Larrart-oe-Y I l.l €x ro*r l) (z Addre s s Phone t-r"lo mr+r-JS t-o"iE "a\o BJ $-q DES I GN TEAI.I name address exDI res Dhone no. Primary Bob Jo[nson ttSot S\ s*'s.rctrLrc -747 - ocTd Structura I El ectri cal Hechani ca l name addres s 'licc- nn exDI res ohone no. ail sl- s osl rr il o,q,)Lstt b 74zqn t4Genera I IhA n rzr o*J Te.s e.5ro t.J Pl umbi nq El ectri ca 1 l,lecha ni PLUHBING ELECTRICAL MECHANICAL FFF CHARGE NO FFF CHARGF NO FFF CHARGF 3 Each single fixture Residence of SQ. FT furnace/burner to BTLr s Relocated bui ldinq (new fix. additional)E*Floor furnace and vent 5. F. Residence(l bath) .drE € SERV ICES New circuits aitsor ext-ensions Recessed wal I Soace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seoarate Change i n exi sti ng res i dence Stationary evap. cool er Sewer multifamiiy, conm I ndu stri a I or Vent fan with sinole duct Storm Sewer 0f s.Vent systern apart from heatinq or A.C. l/^,o:lall^tnj-COMI1./IND. FEEDERS Mechanical exhaust hood and ductv\ f D;frl Insta l I /aI ter/rel ocate d.i stri b. f eeders l,Jood stove/heater 0f .ampi lso ZZs0-1u91AL 6 trtY r (-l-r r\ /-L I ,,r)6U+t-€r o ,?D ISSUANCF OF PFRIIIT TOTAL CHARGES Js,rlo TOTAL CHARGES a IOTAL CHARGES s DATE llAt'tE(please p rint)6h ns Onu{_- r Ci ty made0regon the Bui fythe perm d effect xempt 5 wiI t e ted 'II ca roncomp fI and heredo 'Iapppermcert tha t la 1I tn fo rmab,y fy hereon0n s'I etruandcorrectndaIfucertrther'I that an d IIfyany work Isha Iperformed be 'Idone acc0n anrd wlce th the 0rd snance theofrtof'If I ad ndSp the ofLaws the Sta ote f Irta 1n n theto kwor r 1pesdesc bed rehe n'I an td tha OCCUPANCYNC Iwl beIng stofa ructu wlnyre thou L 'I s 'Is oon f I di V1Di ts 0n fuIng crther '!ert that s ttra on'I thI{t Buthe 1I derm.y regi s'IBoard Is fun '|'I anforce redIasrequ 0Rs 7At 055 tha t t f e ba Is forshetby It n I s henoted reon tha tnd0nubconS1yantractorsdISwhoare'I n 1Iempoyee ncea thw1 7ORS 0 I1 05comD I be sedu n 1th cal Contractor, the electrical portion of this perm.it sor and returned to the Building Division an Electri a1 Supervi IIHERE STATE Lll,l REQUIRES that the Electrical work be done byshalI not be valiC until the label has been signed by an Eleitric Ftg Ftg Ftg Val ueZone sxVal l4ain Fire Zo Bedrooms Value TOTAL VALUATION Acces 0ther Const. Uni ts_ So Load Sq. Group Sq.Fl ood Pl ai n Stori es "0cc.y Plan Ck. Conrn/lnd 65%/Bldq Per Fee t7.==Svstems Deve' Charqe ('1.57'opment u4.BUILDING PERI'IIT Charges and Surcharges 20,5o "t2 Plan Ck. Res 3l%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges J .SC DOmo Sldewa l kELECTRICAL PERI1IT Charges and Surcha rges -a-e> A/C Paving Tota'l Comb. Permit 60,7? Curb Cut I4ECHANICAL PERHIT Charges and Surcha rges TOTAL ry.6; ,I' . tt)R5 l,later servi ce COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot I. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources ical or forced qir gas e or soJarE. Squa valuat on, etc1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check new.- if addition, check add, etc.F. Building permit information:1. example - construct singie family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructurai Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical Schedu'lesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be instailedB. Fuli Piumbing, Mechanical, and Electrical Schedules are avai'lable at the Building Division1. To conserve space on the permit form the scheddles have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labe'l must be delivered to theelectricai contractor for signature by his electricalsupervisor, The generai contractor is not authorizedto sign the electrical label. Applicant to sign and date I'lhenever possible, the initial app'lication will be. used as a worksheet only. Where possibie, 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 gna ture . Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wil) be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. II. III IV. V. FOR OFFICE USE ONLY PER}4IT VALIDATION b ta\B a '{ /\\n' 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 /-d<tyeft#sienatu da t" 6-VE€