The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1988-05-12ONL COHBI NATI ON APPLI CATION/PERMIT 726 Job Address Js3 Legal Descripti 33 3a o Hea f EXERGY SOURCES l,later Heater Ra 0wne r Value of l,lork Sq. Ftg. Access Sq. Fto. Other _llew_Add Alte{[Ep. - _Fence Demo Change/Use -other- Ftq. I'la Addres s 3 s,/ € rlt vnone QZL I 1 dence t 'e., Build Single Qtqrl Construction Lender Address Phone vI I q \ \ \ DES I GN TEAI,I name address lics. no.exD l res Pri ma ry Structura I wEl ectri cal Mechan i ca I CONTRACTORS name addres s lics. no. ) (exoires ohone no- Genera I Plumbin PLUIlB I NG ELECTR I CAL MECHAN I CAL FEE CHARGE NN FFF . HA AAF NO FFF CHAPGF Each single fixture furnace/burner to BTU' s Relocated building (new fix. additional)New circuits alts or extensions Floor furnace and vent S. F. Residence(t 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 t-e hlater serv i ce Change in existing res i dence Stationary evap. cool er Sewer multifamily, comm. or I ndu stri a I Vent fan with sinole drrct Storm Sewer 0f amp s.Vent systern apart from heatino or A.C. c0r,1l'1./lND. FEEDERS Mechani ca l exhaust hood and duct Instal I /al ter/re1 ocatedistrib. feeders l'lood stove/heater 0f amps. -\A ISSUANCF OF PFRIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAIi REQUIRES that the Electrical work be doneshall not be vali'l until the label has been signed by an Elect by an E1 ri cal 5u ectrical Contractor, the electrical portion of this permit pervisor and returned to the Building Division DATES IZ-}t\ec e1l,lAt'lE( p1 ease pri nt)S I GNATURES"-,.th ngfi e strucof any Board e nca0ntifortanddoherertceIathatIIn'I rmatfo on'I s truecompappllerm r b.y fy nda rrecco t a Ind rthefu certr 'I t ha t a II work rmedfo has II donebe n'|acco th t 'I fandfyanyperrdanceWIhe0rdanocesn C 'Ithe ty 'Iof I ad ndSpr the ofLaws Sthe ta te of alrt 1n to het work crr nDE0regondesbedrehe'I and th at NC 0cc ,ANCYUP Iwt beI demang tu wlre tthou the 1ss o n of the Bu I'I di vlDi I 0n I furt r 'Ipermihecert tha t I trats on1 thtJ l Bthe Iu1 der sfymyreg 'I nI Ifu foI andrce as red 0Rseffect ng 707 tha 'It ba055requithe 'I5 fors e It 'I0n s hereonnoted th atandbyexemptxemp on ubco ntra rscto and I whos rea n'I I I wl1yempoyeeance th 701011s ti'l055 I'l us edbe no sthi ec tcompproj Ftg Ftg Ftg TOTAL VALUATION x x S q Fire Zone Bedrooms 0ccy Load Val Val Val itsZone Tyoe/Const. Un l'la i n Flood Plain Stories Occ.y Gro . Acces . Other Plan Ck. Cornm/Ind 65%/81do Per Fee Svstems Deve charqe (1.52 opmentBUILDING PERI.IIT Charges and Su rcharges Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges oo (q Demo Si dewa l kELECTRICA,L PERIlIT Charges and Surcharges A/C Pavi ng Tota'l Comb. Permit Curb Cut lq,-?5: I,IECHANICAL PERHIT Charges and Surc harges TOTAL escrl tacher )e Work ( I Garaop nhnnp nn ^ Residence of SQ. FT. --- COMBINATION APPLICATION/PERMIT (CAP) I. Appl icant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot l. Block 3, 2nd Addition to Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. example- heat/electrical ceil ing/or forced air gas2. ExamEl-e- waterfiEaterTETecTi]cilTor soTar - E. Square footage or valuation, etc.1. 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 single family house with an attached garage ?. example - remodel existing garage into family room3. example - convert single fam'ily residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI'I AND CONTRACTORS PERMIT VALIDATION To avo'id des Division Sta ign or construction delays, Bui)d'ingff must be able to contact appropriate II persons regarding design information or job site corrections, etc. Abbreviated Plumbing, Mechanical, & E)ectrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fil'l-in only the No. Boxes adjacentto the Ful I Pl appropriate item(s) to be instailed umbing, 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 abbrev'iated schedules you should consult the ful I 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 electricalsupervisor. The general contractor is not authorizedto sign the electrical label Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for h.is s i gna tu re. 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. All other fees and charges are due andpayable when the permit is issued. t(+?s r2 -F{ III IV V. FOR OFFICE USE ONLY Perm'it Cl erk 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 s'r I nature date (- q We, the undersigned property owners, request permis described property to the sanitary sewer owned and maint We therefore agree to pay a charge of .fiA per square fothe first 150 feet of depth as a deposit against future Tax Lot No. /-oJ36fZ- 7/ot Receipt feet, south 557.01 feet, 5.0 feet from the Northwe in Townshtp 77 South, Ran Smit| sion to connect the following ained by the City of Springfield. of of the benefiting property for assessments for sanitary sewer.I t.No. t(1tr> 882609? crry oF spRTNGFTELD _ T'--7 IMPROVEMEIII AGREEMENT AND APPLICATION FOR siWER HOOKUP Property Description:Address : 2,f3 3o. /56 S/r.rt Beginning at a point on the north line of South B Street whjch is East 2472.2 B9 89 be 10 o14'30" East 164.36 feeo14'30" West 164.36 fee Soutstc ge3t; tt; t 0re h 0'34' W 283.31 feet and South 89"14'30" East orner of the Issac Briggs Donat'ion Land Claim No. 83 West of the Willamette Meridjan; thence South hence North 00'34' East 65.00 feet; thence North hence South 00'34' West 65.00 to the pojnt of gon.ginning in Lane County, 683.4 sq. ft. ?484A007 fi&/30/88 REC **0 0 0 1** 5.A0 This agreement does not'include the cost of a house connection to said City sewer, sewer user charges, connection fees, p'lumbing permits or other such costs to be assumed by the property owner. The appiicant agrees to waive al'l right to remonstrate against an improvement project for sant'iary sewer to be duly initiated by the C'ity Council, but not the right to protest the amount or manner of spreading the assessment thereof, if the same shall appear to Applicant to bear inequitably or unfairly upon said property of Applicant; NOl,l THEREFORE, the City agrees that if Applicant complies with the terms o ment and with all other applicable laws of the State of 0regon, Lane County, an the said Applicant shall be entitled to connect the existing residence to the p systems. The covenants herein contained shall run with the'land herein described, and shall be binding upon the heirs, executors, assigns, administrators, and successors of the parties hereto, and shall be construed to be a benefit and a burden upon the property herein described This agreement shall be recorded in the Lane County Deed Records. WHEREF0RE, the parties have set the'ir hand and seal this 2z%ay of CITY OF SPRINGFIELD APPLICANT JuNtS , l9OA. By tor o u 'lc S ftdt ubl his agree- he City,ic sewer r STATE OF OREGON ss. COUNTY OF LANE 0n thi t 729day of above document. My commission Expires: For Finance Department Trunk Sewer c/s ED 120 REV 2/81 Lateral Sewer ) ) )3f 'I (.].99A, there personally appe ared before :rrre ,drd si gned the -9 ormati on t/- *tz n /r/5-{ S, A /a,/8 ,/-4s-7 s[.0]I 882609? State of Oregon' CountY of Lane--ss' I the County Clerk' in.'rnd for the said i,l"i,i, i"'i'"rehv ''ertifv that the witlrin :.';;ilii";i'*as recei'e'l r()r rec()rd at o"", 1 5;,21 R Latrt' ( trutrtr ()l;Fl(lAl Ilt'(trt'tls l-.rtrt' Ctruntv ( lcrk t \ an TJoo(3 { ( By, (