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Home My WebLink AboutPermit Building 1982-06-28ON LINE COMBI ERMIT 72 Job Address EIIERGY SOURCES Hea t lJater Heater Ran Ftq. tla Sq. c^ Ftg. Acce Ftg. I{ew Add TEEnep.-- Fenc -0the , Change/Use r )0DoJ B l-ega1 Description b vatue ottf,of'\D,cc Owner Address Phon ,Bui I ci in Farni I y q Permit Info: De Residence llith Att AC { ConstructionLender V,*<t-p fon oL Addres s Phone DES I GN TEAI.I name address exDl res rone no Pri mary Structura I E I ectri ca l l'lechanica l n ame address'(lics no exDt res 'ohone no- Genera l" Pl umbi n l'lechanical PLUIlB I NG EL ECTR I CAL MECHAN I CAL FFF CHARGF NN Residence of SQ. FT FFF CHARGF NO FFF .HAPGF Each single fixture furnace/burner to BTU' S Rel ocated bui I d.ing (new fix. additional) New ci rcui ts al tsor extensions FIoor furnace and vent S. F. Residence ( I har.h )SERV I C ES Recessed wal I Snacp hpatpr and vpnt Duplex (l bath) each Additional bath Temporary Construction Apol iance vent se Da ra te l,later servi ce Change in existing rp<i dpncc Stationarlu evap cool er Sewer multifamiIy, comm. or Industrial Vent fan with sinole duct Storm Sewer 0f amps.Vent system apart from heat-ino or A-C. COMI'!./IND. FEEDERS Mechanical exhaust hood and drrct Instal I /al terlrel ocate disfrih feedprc l'Jood stove/heater 0f amps. ISSUANCF OF PFRI,lIT TOTAL CHARGTS TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl,l REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this perriit shall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed apnlication for oermit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all r,/ork performed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0regron pertaining to the work described herein, and that l,l0 OCCUPAI{CY will be madeof any structure without the permission of the Bu'ilding Division. I further certil"y 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 heneon, and thatonly subcontractors and ernployees who are in comcliance with 0l?S 701.055 vill be used on this project. Jonn F*+h Jrno.KtlAl.lE(please print)S i GNATU RE FON OFFICE USE Oi/ Zo n e___________Typ e/ C o n s t Uni ts g Ftg Ftg Ftg . l'lain . Acce x Val ue Fire Zone Bed rooms Occy Load S q.Val Flood PIain 0 cc.y Group Sq X Val ue TOTAL VALUATION Stories 0ther BUILDING PERI{IT Charges and Su rcharges Plan Ck. Comm/Ind 65%/Bldo Per Fee Svsterns Deve Charqe ( 1. 5z opment Plan Ck. Res 30%/81dq Per Fee PLUI,IBING PERMIT Charges and Surcha rges Fence D6mo ELECTRICAL PERI1IT Charges and Surcha rges 5i dewa I k A/C Pavi ng Curb Cut Total Cornb. Permit 14ECHANICAL PERMIT Charges and Surc ha rges TOTAL i x I xJ N :€., I ie c n (n I ACTNRS . El ectrical 4W PERMIT VALIDATION Permit Clerk COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addition to Sliin-g-Fieid Estates C. Name, etc. of owner and construction lender D. Energy Sources r foryqd ldr Slqsolar E 1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new proiect, check new - if addition, check add, etc.F. Bujlding permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family res'idence into restaLrrant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Build'ing Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc.II. Abbreviated Plumbing, I'lechanical, & Electrical SchedulesA. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consu'lt the ful l schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to theelectrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical label.III. Appiicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staffwili prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnatu re.IV. Fees and Charges Plan 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 1. example- heat/electrical ceiling/o2. examp.le- waterheater/electrical/or Square footage or valuation, etc. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: ilrrt"^ \.)C{qQ- \n CCI--n0nLbD.,.\8el., , Permit applicant exempt from regjstration wjth the Builder's Board because: Additional Project Information : PLANS REVIEWED BY na date J .;IISPECTIOIT Li 726-37 69 COIIBI AP ICATI ERMIT 7?6-31 53 Job Address l-egal Description ,-/"/-J Descri r€., C: n F U ther- 'ild s ng e l,l i Sq. Ftg.eAcc s F tgSq II'lew Add ieLneE._ Chan /UsegeFence l.Jater Heater Ranqe Value of EIIERGY SOURCES Hea t Ftq. llain Address 0wner ( Construction Lender V et-p ti/n n n t$LL) J0 J) ? -2JJ# Addres s Phone IJLSI GN I LAI.I na nre address exDt res phone no. Pri mary ; Struc tura l El ectri cal l'4ec ha n i ca l I CONTRACTORS ^name address ( exoi res )ohone no. El ectri cal l.lechanical ELECTR I CAL MECHAN I CALPLUIlB I NG FFF CHARGF Ilo FFF I]HARGF NO FFFN0.CHARGT Residence of FTSQ furnace/burner to BTLI' sEach single fixture Floor furnace and vent Relocated building (new fix. additional) New circuits alts. or extensions SERVICES Recessed wal I Soace heater and vent S. F. Residence ( l bath) Duplex (1 bath) each Temporary Constructi on Apol iance vent seoa rateAdditional bath Stati onar.v evap cool erl.later service Change in existing res i dence Vent fan with sinole duct-I ndustri a I multifamily, comm. orSewer 0f amps.apart from .c. Vent system , heatinq or AStorm Sewer COI,IN./IND. FEEDERS i"lechanical exhaust hood and duct llood stove/heaterI n sta I I /a I ter/ re1 ocate di stri b. feeders 0f amps. ISSUANCI OF PERITIT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGIS WHERE STATE Lltl REQUIRES that tlre E'lectrical work shalI not be vali'l untiI the label has been signed by be done by an Electri ' an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division mthecomp1etedapplicationforoermit,anddohereb.ycertifythatallinformationhereonistrue and correct, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the City of Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that N0 0CCUPAHCY will be made of any structure without the permission of the Building Division. I further certify that my registration urith 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 her.eon, and that only subcontractors and employees who are in comcliance with 0l?S 701.055 vill be used on this proiect. l,lAl'!E ( pl ease pri nt )I GiIAT U Z D Flood Plain Stories Occ.y Group Sq u Ftg Ftg Ftg ToTAL VALUATI0N-- S q .0ccy Load Sq luee/Const. Uni ts al ue Val ue . l1ain Acce s s 0the r Zone Fire Zone Bedrooms Svstens Develocment Charqe (1.5q)Plan Ck. Comm/Ind 65%/B1do Per Fee P'l an Ck. Res 30"1/Bldo Per Fee BUILDING PERNIT Charges anC Su rc harges FencePLUI4BiNG PERMIT Charges and Su rc ha rges Demo SidewaIk Total Conrb. ['ermi t ELECTRICAL PERI,IIT Charges and Surc ha rges A/C Pavi ng Curb CutT1ECHANICAL PERMIT Charges and Surc ha rge s 5TOTAL LD I (cAP)COMBINATION APPLICATION/PERMIT L Applicant to furnishA. Job AddressB. Legal Oescription 'l^ CITY OF SPRINGFIELD Clty Hall Springlield, Oregon Department ol Public Works OFFICIAL RECEIPT No. B 53323 ( 1 ( l. example- Tax Lot 100, Lane County Map Refer, 17 03 432. example- Lot 1. Block 3, Znd Addition toSpringfield Estates Name, etc. of owner and construction lender Energy Sources l. examp_le- heat/glg!tr_lc+_!g_Llng/or forced ; i9:a. exam9te- wa[erheater/etectrlcal/or solar SqraiET6-orage or va i ua r i on;-EE- 8c. D. E. Bec'd Received For: l. examole- 1250 sq. foot house, 500 sq. foot r2. elample-.if new project, check-new - if add: !n,check add, etc. i F. Building permit information:l. example - construct single family house wiilattached garage 2_. examp]e - remodel existing garage into fami' t^.3. example - convert single family-residence ir _ restaurant (change of use)G. Value of work as defined in Section 303 (a) of tStructural Specialty Code ( H. DESIGN TEAI.| AND CONTRACTORS To avoid design or construct.ion delays, BuildincDivision Staff must be able to contatt appropriipersons regarding design information or job sit( I corrections, etc. Abbreviated Plumbing, Irlechanical, & E'tectrica'l SchecA. Except where blank spaces occur in the descripti .portion of the Hechanical and E'lectrical Schedu.l ( the applicant need fill-in only the No. Boxes ad _ to the appropriate item(s) to be installedB. FulI Plumbing, Mechanical, and Electrical Scheduare available at the Building Division ( l. To conserve space on the permit form the schhave been abbreviated2. If the item(s) to be installed are not coverthe abbreviated schedules you should consult Gful l schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered (t,electrical contractor for signature by his electsupervisor. The genera) coniractor i! not authoto sign the electrical labelApplicant to sign and date ( l'lhenever possibie, the initial app)ication wi.l I be u 'a.worksheet on)y. Where possible, Building 0ivision >rarrwil'l.prepare a type written copy and returi it to theapplicant at the time the actuai 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 thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY , I ( ( { I ( ( ( ( ( II III IV. Beceived al V intcos parlrrEns/LlrHocRApxEns. EUGENE oREGoN Permit Clerk ghall.rre da te PLANS REVIEWED BY: n ? PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: ,\ t applicant exempt from registration with the Builder's Board because:Permi Additional Project Information : II