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Home My WebLink AboutPermit Building 1988-09-12INSPECTION LiNE 726-37 69 COMBI NATI OI'I APPLICATION/PERMIT 726-37 d2 l-ega1 Description Job Address Hea Ran qe EIIERGY SOURCES I,later Heater Owner Value of l,lork: /aoo. G Sq Sq Ftg Ftq Ftg n /Use p. Access 0ther Addres s Z/z-z- 57 . Phone Fami Desth At .e., Buiid Single construciion t"nE /o?lt*ao ?t+Zr a. d.z--S 7 Addres s €cPhone na N D 0o 0J Pri mary Structura I El ectri cal Mechanical Genera I rical PLUI{B I NG ELECTR I CAL MECHAN I CAL 7.*4/A Each single fixture 6-Residence of furna celburner to BTU, s (new fix I oca building additional )a/' 4or exten 0ns circuits aits. App I ance vent ti onarv EVAD Vient fan wit FI oor furnace Rec essed wal I systern apard and vent Duplex (1 bath) each Additional bath l,,ater servi ce F i dence Sewer Tempora ry Constructi on SERV I CES Chan nI Iex 1st n s Imu It I am II v c0mm or 0f TOTAL CHARGES s. 0f ca exhau s ttaIns'II a I t re re 'I oca te STA by ri, TOT.A L CHARGl^,HERE ESTELAI./IREQU RES thahas tII the 1Etno cte rbe .IVAl1I 'Icaun workIti beaI do ne anlbe EI echas tribeen ac 1stnedsbynajEectca1ISupe rv s0 r ISSUANCF OF PF RI{I T ATOT,L CHARG ES Con t ra ctor the e I ect cart I 1po rt 0nan)foret Sth.iurned rmipe ttotheBu1'I d 'I Di I Isng 0n l'Jood stove/heater COMI.I./IND. FEEDERS IGNATURE ?.YE7- ng fi stru Ci ty made theand ecompc0rrec t and cfurther ertof tha t af_vsprdeandtheLawsoftheaof s ta tenyuctrewlthoutthe truepermisBoard0nsnfuforceandefthefeconatsusvbconureqtracto rs a nd beernpoyeeswhoreader and tthaNAI,IE p ea se npri t an Ck. + Ftg Stor ies its Jue ue 0ccy Load, 0cc.y Grou Flood plai TOTAL VALUATION Fire Zone Zon ro0ms Cons t . 9. Fto. 146in s9. Ftg. Access ---?-z=.F__7-3 an I r Fence DBmo terils 0pmen ___3r_-u?__ a* Sidewal k Curb Cut A/C paving Tota'l Comb.Permi t TOTAL /82.o7 BUILDING PCharges an, Su rcha rges ERIIIT) P C S ETECTRICAL O'0,,,i,narges and iurcha rges :CHANI CAL PERl.tIT rarges and rc hdrges SQ' rr aa_> /4 I l I the ) a@ PERMIT VALIDATION *tr lalo 7 4-w Perm 'it Cl erk COMBINATION APPLICATION/PERMIT (CAP) L Applicant to furnishA. Job AddressB. Legal Descriptr'on1. example- Tax Lot 100, Lane County Map Reference 17 03 43 D. air gas E gara 9edition, F. Bui lding permit information:1. example - construct single family house with an attached garage2. 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 the Structural Specialty Cd(eH. DESIGN TEAM AND CONTRACTORS To avoid design or constr\rction delays, Building Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc.II. Abbreviated Piumbing, Mechanical , & Electrical SchedulesA. Except where blank spaces occur in tie description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be installedB. Ful l Plumbing, Mechanical, and Electnical 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 schedu'les you should consult the ful l schedulesC. BUILDING DIVISiON STAFF I.IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP' the label must be de'livered to the electrjcal contractor for signature by his e'lectrical, iupervisor. -ihe general contractor is not authorized to sign the electrical label' III. APP1icant to sign and date w[En.r.i potsiuie, ilre initial !PPlication will be' used as a worksheet onivl'r,rnete possiblb' Building Division Staff will prepare a type wr'itten copy and return it to the apptilant at the'ii*t tf.r" actuai permit is issued for his si gnature. IV. Fees and Charges Plan check fees are due and plyable at the time of the application, and-no piins *iit- be processed until these fees are paio' 'nii [intt ittt and charges are due and piviui.-*it.n the permit is issued' V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED B EFORE OCCUPAI{CY : 's Board because:erd11Buhethtw'ionitraS1tregfromextemptca1nIatpprmPe 'it 0nrmafnoIcetrojP1at1i0nAdd si gnatu name date PLANS REVIEI^IED BY: 2 Name,. of owner and construction Iender Energy i 2 or vai I 1250 sqif new2 , etc. - Legal Description l,later Heater EIIERGY SOURCES: Hea t Value of l,lork: /aoa. GOwner,*2 . Fto. l.lain_. Ftg. Acce;;- Sq Sq Sq Ftg . 0ther Address -,, ,z/z-.L 5.> . Phone Quilqiino Permit Info: Describe Work(Family Residence l,lith Attached Garaqe .e., Buiid Single l2s7-^t). ,-57 Vs*e.a@5Pz.o construciion- t"n6, /,/Z< <oPtsy-,,b2 r;6-z,s f€crq::r.,*. lr/znr*Addres s Phone iN TEAI.IDESII name address lics. no.exD I res ohone no- Primary {zt Structura I El ectri cal Mechani ca l name a ddres s 'lics- no- )pYnr rpq ohonp no- ) E\eelrical fu>6 ^Ay tt'lechani cal I PLUI,lBI NG ELECTR I CAL MECHAN ICAL N0.FFI.CHARGE NO FFF CHARGF N(t_FFF CHARGF 7-?ffaZEach single fixture Res idence of FTSQ furnace/burner to BTU' s 3-9 Relocated building (new fix. additional)t/-New circuits alts. or extensions -) afr,lY2zZe Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra te l,later servi ce Change in existing rp< i dpnre Stationary evap. cool er Sewer I ndus tri a I multifamily, cornm. or Vent fan with sinole duct Storm Sewer 0f amps,Vent systern apart from heatino or A.C. COMII./IND. FEEDERS Mechan ical exhaust hood and duct Instal I /al ter/rel ocate di stri b. feeders l'lood stove/heater 0f amps. ISSUANCF OF PFRtlIT TOTAL CHARGES /q.G TOTAL CHARGES ??-to TOTAL CHARGES I.JHERE STATE shall not be vai LAN REQUiJ until IRES that the Electrical work the label has been signed by be do an El ne by an Electrical Contractor, the electrical portion of this permitectrical Supervisor and returned to the Building Division "^oFFl il l.lAt'lE ( pl ease pri nt )DA.TE 7-/z -/sIGNATUREt Ci ty made fyof any Board t at foron t an doc0mpDermr)ap re cert th at rmatfo on nhereob.y ,fy s true nda rrecco t an d certrther ttha afu a kwor rformed hasndafype be done an 0cc anrd wlce tth he naOrd i ofnces theofd ny ofandthLaofwssthetang fiSpri te nl to eth workoe rta beddescri here n tha tand OCCUPAI,ICYNC wl0regronng betrucw1turetthoutheerm l ofonsp Buithe d Ing cefurther rt that t tira v,lon tth Bhe ulm.y r sdereg n fffec aandrcesfulfo tha tred7ORS055t bathe s fors +0nrequbyexemptexemp henoted reon thaand t on ntracsubco to rS and who 'I1yare wlance ORSth 7olnempoyeescomD 055 wt be oused thin s +proj Fire Zone Bedrooms 0ccy Load Sq. Ftg. Access _. x valF]oodPlainStories-0cc.yGroupSq.Fts.otn",@,-------ual TOTAL VALUATI Value. Uni ts Sq . Ftg . l,la inst ue ?ea.oo0N-.__-- PIan Ck. Conm/Ind 65%/Bldq Per Fee 28.2i Svsterns Deve Charqe (1.57 opmentBUILDING PERNIT Charges and Surcharges ___yz-_P_ Plan Ck. Res 30%/81dg Per Fee /4arva*//F.,v Fence fg€,/n a@b/. PLUI,IBING PERHIT Charges and . Surcha rges aa (-D6mo Lrloa5 2>* Sl dewa I k W.-Zzat f fu Vh7/,ELECTRICAL PERI1IT Charges and Surcha rges 2z-s> A/C Paving Tota'l Comb. Permi t 36.,/ / Curb Cut I{ECHANICAL PERHIT Charges and Surc harges TOTAL /82-o? CITY OF SPRINGFIELD COHBI NATION APPLI CATION/PERMIT w D DO 0J Ranqe \CTORS a) fL COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. SIgIEI_C- Tax Lot 100, Lane County Map Reference 17 03 432. gxample- Lot l' Block 3, 2nd Addition toSpringfield Estatesq. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION lalo ? l. exartple-?. exarhp I e- Square footaq1. exampl e-2. exampi e- alecf add heat/eIectrica l iti &tqed air sas 1-t*strwatesoJar E e or valuation, 1250 sqif new foot house, 500 s q. foot I i ara9eproject, check-nEw if add tion,, etc II F. Building permit informat.ion:1. example - construct single family house with anattached garage ?. example - remodel existing garage into family roomJ. exampte - convert single family residence into - restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or constr\ct.ion delays, BuildingDivision Staff must be able to contalt appropr.iitepersons.regarding design information or job iitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedulei,the applicant need fill-in only the No. Boxes iAjii.nt_ to the appropriate item(s) to be instal.ledB. Full PIumbing, Mechanical, and Electrical Schedulesare available at the Build.ing 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 thefull schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labet must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor ti.not authorizedto sign the electrical labelApplicant to sign and date Whenever possibie, the initial application wil.l be used asa.worksheet oniy. Where possibie, Building Division Staiiwill.prepare a type written copy and returi it to theappiicant 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 wiii-be processed until thesetees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III IV V Permit Clerk 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 si gnatu date V 7sB