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Home My WebLink AboutPermit Building 1986-09-29E 1 COMBI APPL I 726-3753 Job Address ggg N. 47nd Street Legal Description See AttaChed EIIERGY SOURCES: Hea t Ran $70 000.00 l,later Heater Value of l,lork Access._ Sq. Ftg. 0ther_ -|{ew Add AIIEEIAp.- _Fence_Demo_Change/ U s e -other-- lnFtg Sq. Ftg OWNCT 50g1H}JEST FOREST I NDUSTR I ES &aa :€., Farni Nit ng ePhoneAddressP.o. Box l54B Ttun*, fuzzr< / V.ormzrUPHoENIx, AR B50ll (OO2) 954-8751 Fa,q .bzz e- Fb.-7ra7*,9-*r-Construction Lender N s 0\ m m Address Phone DESIGN TEAI.,I name address I ics . no. Primary EVERGREEN ENGINEERING 860 C0NGER ST. EUGENE' 0R 484-4771 Structural PAUL BROOKS '13216 tlll Electrical LARRY EBERT 9735 ltll Hechanical RICHARD BARNHARDT 10263 lt CONTRACTORS name addres s (phone no. )(lics. no. ) (expires) I.ITI| CONSTRUCTION. INC. P.O. BOX 06453 PORTLAND 777-3788Genera I Pl umbi nq El ectr i ca I l.lechani cal ELECTRI CAL MECHAN I CALPLUI{B I NG FFF CHARGF NN FFF CHA PGF NO FFE CHARGF Each single fixture Residence of SQ. FT furnace/burner to BTU, s Relocated bui lding (new fix. additional) New circuits alts. or extensions Floor furnace and vent S . F. P,es i dence ( I bath)SERV I CES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Construct.i on Apol iance vent seDa ra tF tnJater servi ce ge i n exi sti ng dpncprpq 1 C han Stati onar.v evap. cool er Sewer I ndu stri a l multifamily, comm. or Vent fan with sinole duct Storm Sewer 0f amps,part from C. Vent systern a heatinq or A. COMI.1./IND. FEEDERS Mechanical exhaust hnod and drrrf Instal i /al ter/re1 ocate di stri b. feeders [,Jood stove/heater -amp s.0f ISSUANCE OF PFRIlIT TOTAL CHARGES TOTAL CHARGES WHERE STATE LAN REQUIRES that the Electrical work be done by an Electricalshall not be valiC until the Iabel has been signed by an Electrical Supervisor Contractor, the electrical portion of this perr,rit and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed apnlication for oermit, and do hereb.y certify that all information hereonand correct, and I further certify that any and all work performed shall be done in accoidance with the 0rdinances ofof Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that t,l0 OCCUPAIICY wilof any structure without the permission of the Building Division. I further certify that m.y reqistration vrith the Bu Board is in full force and effect as required by ORS 701.055, that if exempt the baiis for exemption is noted hereon,only subcontractors and ernployees who are in compliance with Ol?S 70i.055 will be used on this pro,ject. t'lAt'1E ( pl ease pri nt )S I GNATURE DATE i s true the CityI be made ilder's and that Ftg Ftg Ftg 4o Fire Zone Bedrooms 0ccy Load I UF5q lueGroup Sq.0the r Tone _.kZ_____t yoel Co n s t .i ts Scr. Flood Plain Stories TOTAL VALUATION . l'lain x Val ue . Access x Plan Ck. Comm/Ind 65%/81do Per Fep ///Rc 2a.-Systerxs Deve Charqe (1.52 opmentBUILDING PERMIT Charges and ____9,::_ Su Plan Ck. Res 30%/B1dq Per Fee FencePLUI'4BING PERMIT Charges and Surcharges Demo Sidewal kELECTRICAL PERI,IIT Charges and Surcha rges A/C Paving Total Comb. Permit Curb CutHECHANICAL PERMIT Charges and Surcharges TOTAL 4zo.* PYnr rpc (n rnnp nn TOTAL CHARGES COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. glample- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot l. B'lock 3, 2nd Addition toSpringfie)d EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. exampl e-2. exampTA-E. Square footag heat/electrical or forced air" gas WA e ec or soTar e or valuat on, II. 1. examp-le- 1?50 sq. foot house, 5O0 sq. foot garageZ, example- if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. examp_le - remodel existing garage into family room3. example - convert single family res.idence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specia)ty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bu.ildingD'ivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. 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 instal'ledB. 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 consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectricai contractor for signature by h.is electr.icalsupervisor. The general contractor is not authorizedto sign the electrical label Applicant to sign and date Whenever possible, the initial appl.ication will be used asa worksheet on1y. l^Jhere 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 PIan check fees are due and payable at the time of theapplication, and no p)ans will be processed until thesefees 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: Perm'it appf icant exempt from registration with the BuiIder's Board because: Additional Project Information: PLANS REVIEWED BY: name SI g nature date ? -Z lv- I J 1 fL INSPECTION LINE 726-37 69 COHBI IIATI ON APPL I CAT I ON/ PERMIT INFoRflATI0N LlNr 726-3753 | Job Address ggg N. 4?nd Street Lesal Oescription See AttaChed Ra EIIERGY SOURCES: Hea t l,later Heater Value of l'lork: $70,000.00 Sq l'la i n Acces s Sq. Fto. Sq. Ftg. OwneT 5gglHwEST FOREST I NDUSTR I ES &d-aIdo7 ild Single Fami I nPhoneAddress p. g. B0X l54B Tuua fu7724 y' P.*rrcnuPHOENIX, AR B50ll (002) 954-8751 Construction Lender Fart .hzz. Ebz>rtuEa7 N C* N N CI Addres s Phone DES I GN TEAI{name address cs no exn i res )( ohone no Primary EVERGREEN ENGINEERING 860 CONGER ST. EUGENE, 0R 484-4771 CONTRACTORS name EXD'I TES ohone no. I I 9 ',3216Structura l Mechani ca I El ectri cal WT}I CONSTRUCTION. INC. P.O. BOX 06453 PORTLAND 777-3t88Genera I P l umbi nq El ectrica l l'lec ha n i ca I PLUI{B I NG ELECTR I CAL MECHAN ICAL FEE CHARGE NO FFF l'u a pli F NO FFF Each single fixture Residence of FTSQ furnace/burner to BTU' s Relocated bui lding (new fix. additional) New circuits alts or extensions Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal I Snaap htratpr and vpnf Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra tF [,later servi ce e in existing ence Chang resid Stationary evap. cool er Sewer multifamily, comm. or Tndrrstrial Vent fan with sinole duct Storm Sewer amps.0f Vent systern apart from heatino or A.C. COMI.I./IND. FEEDERS Mechanical exhaust hood and duct- Instal I /al ter/re1 ocate di stri b. feeders l.lood stove/heater 0f amps. ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE Llt( REQUIRES that tlte Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Buildinb Division I'lAl.lE ( p1 ease pri nt ),TEsI Gi,JATURE fy fyany rd perm ffect t ndaetedtcaonrfotc0mpapl-)perm rehe c rte t tha a tn fo rma on nhe reob.y true nda dan I cerfu rther fti trreccottha a and a workvny shanerfo rmed be done an rdancecco ht 0the rd ancesn f t he c tyofsedandthLaofwshetStapringfitofertannthetokDCOregonrt^JO descr bed rehe n and tha t wlUPANCYs0cc madbe eofsttrucurewltht0uhetSSontheofBudvtDiS0nngfuthrrecerttthats tra n ht eth u d rou/l ereq im.y s n fu fo rc dan eBoa red 0Rs 0s5701 ath t tasrequby e the ba S forS s hereon na dxemptexempttedno ha tt 0n ntracsubco +^rs nda1y 'I n wlan ce 0t?sth 07areoswhernp0yeecomD 505 tJr be sedu Lon sh'i ctProj Flood Plain Stories 0cc.y Group Sq. FtS Access x Val ue nrnur@urr" G fc C>4 Ft9. l4a i FtgFire Zone Bedrooms Occy Load TOTAL VALUATION.-.-=.--- Val ueZone/ Con st. .7F y'{.72, Pl an a(. Comnr/ Ina /l?c 2a.n S y s terns Cha rop Deve(t.st opmentBUILOING PERMIT Charges and ____5e,::__ Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges Dgmo Sidewal kELECTRICAL PERIlIT Charges and Surcha rges A/C Pavi ng Total Cornb. Permit 14ECHANICAL PERMIT Charges and Surc harges TOTAL d7r, -' 0ther. Ftg ll I Curb Cut I coMBINATT0N AppLICATI0N/PERMIT (CAp) I. Applicant to furnishA. Job AddressB. Legai 'Qescription 1. gSlElC: Tax Lot 100, Lane County Map Reference17 03 43?. example- Lot l. Block 3, Znd Add.ition toSpringfield Estatesq. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. 2.E. Squa example- he example- wa re footage a t/e I ectri ca ceilin or forced air gas r solartere0or valuat O['cIexamp]e- 1?50 sq. foot house, 500 sq. foot garageexample-.if new project, check-new - if addition,check add, etc. ? II. F. Building permit information:1. example - construct s.ingle family house with anattached garage ?. examp_le - remodel existing garage into family roomJ. exampte - convert single family residence into ^ restaurant (change of use)G. Value of work as defined in Sect.ion 303 (a) of theStructural Specia)ty CodeH. DESIGN TEAI,| AND CONTRACTORS To avoid design or construction delays, Bu.ildingDivision Staff must be able to contait appropr.iitepersons.regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur .in the descriptionportion of the I'lechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjaientt0 the appropriate item(s) to be.instailedB. Full Plumbing, Mechanical, and Electr.ical Schedulesare available at the Building Division1. To conserve space on the perm.it form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefui I schedul esC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label mustelectrical contractor for signaturesupervisor. The general contractorto sign the electrical label.Applicant to sign and date be delivered to the by his electrical is .not authorized III. IV. Hhenever possible, the init.ial appl.ication will be used asa.worksheet only. Where possible, Building D.ivision Staffwill prepare a type written copy and return it to theapplicant 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 theappl ication, and no plans wil l be processed unt.iI thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLYV Permi t 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 /*h#e 77ce-f er?Si gnature date ? -?z -* e ,-\