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HomeMy WebLinkAboutPermit Building 1990-06-147 NSPECTION L 26-37 69 CITY OF SPRINGFIELD COMBI NATI ON APPL ICATION/PERI4 IT 7 Job Address 4Zg rV. tO . SP?ltfiFt€O. otz ,l-esa1 Description 6cocK fotnuren- Foue of }wner $fpl M AF1€LD S€Ho c L Dt-rfRl c T .Pao SPP Sq. Ftq. Oth/r _t{ew_Add y'Al ter-Tep. - _Fe n c e_Demo_C ha n g e/ U s e 0ther- /-GsEGrfr EIIERGY SOURCES Hea t .e., Bu Fami I ,t\ 'I nf l,ln2,#i Res i ng e at Val ttc liater Heater Range Access I rmi At o:' Descri Sq. Ftg . Ftq . l'la i Address e zr- Htl,L sr Phone ? q.? -3r3 |€?oru6reL[2 2 cl,A99rz.as ADPtrruD C one*+ue{,io.o-[-e.nde r Addres s Phone 'tr J\O $ *.{\ \ DESIGN TEAI.I name ( addre s s tcs- no-exo'i resr phone lo. Primary lUA4o frctptc RAneq B?q e/s"/qr dst-86aa i'lechan i ca I Struc tura I E I ectri ca I phone no.r(1 AAr J) L itlec ha n i ca I El :ctri c PLUT{B I }IG l, MECHAN I CALELECTR I CAL FEE CHARGE NO FFF CHARGF NO FFF C HA RGF 2 [ach single fixture ?fl 5.*Res i dence of FTSQ furnace/burner to BTLI ' S Relocated building (new fix. additional)I t"tew c i rcui ts al ts . , or extensions ! I Fl oor furnace and vent S. F. Residence(l bath)SERV ICES Ret++ed-*+l.l Cf44 Soace heater and vent Duplex (l bath) each Additional bath Temporary Construction Apol i ance vent seDa rate lnlater servi ce e in existing ence C hang resid Stati onary evap. cool er multifami)y, comm or Tndrrstrial Vent fan with sinole ductSewer 0f -amps. Vent system apart from heatino or A.C^Storm Sewer c0Mt1./IND. FEEDERS Mechanical exhaust hood and duct I nstal I /al ter/rel ocate di stri h. feeders ['lood stove/heater 0f amp s. ??2r'-,4,**,a-7>2 4z {412 ,23724-7r,4 42 >/,r?h4rg-7a7,ISSUANCE OF PFRt.lIT /5. -oTOTAL CHARGESTOTAL CHARGES /{"TOTAL CHARGES I^IHERE STATE LAI,I REQUIRES that tlre Electrical work be done shall not be valil until the label has been signed by an Elect byri ' an Electrical Contractor, the electrical portion of this pernit ca1 Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed application for oermit, and do hereb.y certify that all information hereon is true and correct, and I further certif_v that any and all r^rork performed shall be done in accordance with the 0rdinances of the Ci of Springfield and the Laws of the State of 0regon oertaining to the work described herein, and that NC 0CCUPANCY will be ma of any structure without the permission of the Building Division. I Board is in full force and effect as required by ORS 701.055, that if only subcontractors and employees who are in comcliance with 0115 70i.055 I,,lAl,1E ( p l ease pri nt )S I GIIATU DATE tration vrith the Builder's on is noted hereon, and that further certify that m.y regist the basis for exemJrti I I be used on thi ty de {EI\/A/ETH /UA6/4o I E al ue Val ue Val ue t t\ocio-\4-qD \13{q'VALUAT I ON Ro 0c c.y Gro Ftq. l'!ain E- Ftg. Access ,x rts. otnerf/ZVz#%7x z";_PD Fire Zone Flood Plain Stori Plan Ck. Comm/Ind 65"1/B1d,o Per Fee Svsterns Deve charqe ( 1.51 opment tPlan Ck. Res 30%/B1dq Per Fee Fence BUILDING PERMIT Charges and Su rcha rges PLUI4BiNG PERI4IT Charges and Su rc ha rges cc) D6mo Aq.o5Si dewa I k A/C Paving Total Comb. Permit ELECTRICAL PE Charges and Surcha rges T Curb Cut ,dAll.a3 I,IECHAITICAL PERMIT Charges and Surc ha rge s TOTAL s COMBINATION APPLICATION/PERMIT (CAP) I . Appl i cant to furn'ishA. Job AddressB. Legai Description- l. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot 1. Block 3, ?nd Addition to SFTlnsTield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. exampl e-2. exampl e-E. Square footag hea t/e trica l tn or forced air gas wa e or soTar e or valuat on, etc. II. l. example- 1250 sq. foot house, 500 sq. foot garage2. rxqmplq- if new project, check new - if addition,ifetl--add, etc.F. Building permit information:1. example - construct single family house with an attached garage2. glamLl_g_ - remodel existing garage into family room3.- example - convert single family residence into restaurant (change of use)G. Va'lue of work as defined in Section 303 (a) of theStructural Special ty Code'H. DESIGN TEAI.I AND CONTRACTORS To avoid design or construction de)ays, Building Division Staff must be able to contact appropriate persons 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 installedB. Full Pr'umbing, Mechanical, and Electrical Schedulesare available at the Building Div.ision1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbrev'iated schedules you should consult theful I 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 theeiectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical labelApplicant to sign and date llhenever possibie, the initial application will be used asa 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 his s i gna ture. 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. \ III.#rn1 IV V. FOR OFFICE USE ONLY Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIiCY: Permit applicant exempt from registration wjth the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s1 gnatu re date 7- S-=a I 7 N rt014B I nN IT rl RMIT I tb- Job Address s EIIEI.GY SOUP.CES . Ftg . liai n Legal Description l,iater Heater Sq. Ftg. Access._ Sq. Ftq. Other__ -l'l er^r-Ad dJ I te r-Re P . _Fe n ce_Demo_Chan gel U s e -other- S-Ra Val ue o i' llork: 0wner L\..\ Address /),cc S.r Phone /2 ? n tI Descr 'e., BU ng e S t ?) Cons tio Lender ieu Addre s s Phone DESIGN TEAM name address tcs. no.exDl res ohone no. Pri ma Structura l EI ectri cal l''lec han i ca I name address 'I i cs. no.exDl res I (^-)Tr*J O.,-q t cy; E I'lechani PLUi..IBI NG ELECTR I CAL MECHANICAL N0.FEE CHARGE NN FFF THAPGF NO FFF .HA AGF Each single fixture Residence of sQ. FT. furnace/burner to BTLI' s Relocated building (new fix. additional) New circuits alts or extensions Floor furnace and vent S. F. Residence ( l bath)SERV I CES Recessed wal I Snace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent cFnarate flater service Change in existing res i dence Stati onar,v evap cool er Sewer multifamjly, comm. or T ndrrstri a I Vent fan with sinole duct Storm Sewer 0f amPs. Vent system apart from heatino or A.C. COI,lI.l. / IND. FEEDERS Mechan ical exhaust hood and duct I nstal I /a I ter/ rel ocate dist-rib. feeders l'Jood stove/heater t of ,OC amp$I iSSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl,l REQUIRES that the Electrical work be shall not be valid until the label has been signed by an done by an Electrical Contractor, the electrigal portion.of this permit Electrical Supervisor and returned to the Building Division I comp'le ap r-)ca on for oe Perfo rm'it,do hereb.y certify that a nformation hereon is true and correct, and i further certify that any and all work of Soringfield and the Laws of the State of Oreqon oerta of any structure without the permission of the Building Board is in full force and effect as required by ORS 701 rmed shall be done in accordance w'i th the 0rdinances of the CitY ining to the work described herein, and that NC 0CCUPAI'ICY will be made Divis ion, I further certify that mY regi stration vri th the Bui I der's 0s5,that if exempt the basis for exemPt ion is noted hereon, and that only subcontractors and enrployees who are in compjiance with 0P.S 701.055 r.r'i I I be used on thi s rrroiect BSsI,AQ G.3e DA.TE R-s -fo IiAtlE (pl ease pri nt)r*21r4 g S IGNATURE Zone Uni ts Ftq. l4ain x Value Fi re Zone-pedrooms 0ccy Load- Sq. Ftg. Access x Val u Flood Plain Stories 0cc.v Group Sq. Ftg x Value TOTAL VALUATION- 0ther BUILDING PERNIT Charges and Surcharges Pl an Ck. Cornm/ Ind 65"/"/Bldo Per Fee terns VC 51,rqe 1 Plan Ck. Res 30?l/81 dq Per eFe PLUi4BING PERMIT Charges and Surcha rges Fence D6mo ELECTRICP,L PER}IIT Charges and Surcha rges Sidewalk A/C Pavi ng Tota'l Comb, Permit HECHAI{ICAL PERM Charges and Surc harges iT Curb Cut TOTAL != /"3 A,^., \r\ut f?L..* opment PERI4IT VALIDATION Permi t Cl erk \7,\ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot L Block 3, Znd Addition to Spfingfield Estates L D Name, etc. of owner and construction lender E 1 2 s 1 2 air qas E ga ra9 'i ti on e F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert singie family residence into restaurant (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, Building Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occurin 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 installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. 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 theful'l schedulesC. BUILDING DIVISION STAFF l,IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label.III. 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 the applicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans wi)1 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registratron with the Builder's Board because Additional Project Information : PLANS REVIEWED BY dates i gnaturename 'p NEW WAY ELECTRIC ELECTRICAL CONTBACTORS SPECIALIZING IN INDUSTRIAL CONTROL SYSTEMS (5O3) 686-236s P,O Box 21503 Eugene, Oregon 97402 E . . -r'r A \r\ € /, *', ---'. \oou - L-\-hs-\\'\'\\\(\r\; Po ' 't '/Jc. f ,tis 9 (1n1\t )\^rc l.3OO A.". P E.x\s\ \(1 I-\a rN Swtrcr\ Pa*Eu \)sc txrs'r r^1 JoOr'-e *^'{4$lo JgoA [Scc^vt{ trO.A nu,-) . -Qn*rL R- olcfka) P^,.:C-[fr R gvlArN tsOs s rJnOerl,"oosu\ Fg i\ OT'L'r'i cs*1^^y ,* I q:30 Y'v\cv\ C.oPPu Q-'\-tr\ t' h\'qs( I P^*.L R Lar+tts I ^ f,1.rrrn1 MucronT gY Yv!') C\qss rtov^ As\\i'\ov\s - 6OO n- ? &** Bu.,L"e Roo^ 2oo^*.g B'** El.r-rc... R,oo"^'' Ex,sl '"'1 \Vr "*uss -[or JCOa ?^.-S Y B ?O.*e -S*< outsl 'Da^p Sr*x Boctrg* $pr. Lr-)*rtr P^seu R .Q6Qn r^LO rro/.,.rou I / trlrun m'rn!. INSPECTION L 726-37 69 CTTY OF S COMBINATION APP FI ELD I ON/ PERM I TLICAT 726-375 O Cv \) Val ue te. 'scrInPhone o-t/o n il rE n At'I ,| 5 Phone oU .€( ng e tg Ftg Ftg u'o . Acces s ha U esCe/n9 EI1ERGY SOURCES: t'later Hea Legal Description Address &M Addres s Constructi on Lender Mechani cal El ectri cal Struc tura I Pri mar I ter-TAp. Job Address f e Sq. Sq. Sq. 0wner B f t\^ S# ical MECHAN I CALELECTR I CALPLUIlB I NG furnace/burner to BTU' S Residence of FTSQEach single fixture Floor furnace and ventNew ci rcui ts al ts or extensionsRel ocate, (new fix building additiona'l ) Recessed wa'l I qoace heater and venlSERV ICESRes'idence I Duplex (l bath) each Appf iance vent seDa rateTemporary Constructi onAdditional bath Stationary evaP cool erge in er.isting denceres il,later servi ce Ven t 'an wi th sinqle ductmultifamiy, comm. or I ndu stri a lSewer r apart from A. C. Vent system heatinq or-0f Storm Mechan ical exhaust hood and ductc0Mr.1./IND. FEEDERSl,.dDJ'l,lood stove/heaterInstal I /al ter/re1 ocate distrib. feeders-t4.b1b {S40fs.\6.6D1-5a2tlL ISSUANCF OF PFRI,IIT SItiAltlE(please print) TOTAL VALUAT s u terilsnd lE 7';,7-70 tZoir Load Fts . 0ther its an Electrical Contractor, the elec ca1 Supervisor and returned to the tri c Bu i'lREQU I unti l dobe1Erectca1workItlretha+sREEATLAI.IST,I"lH ERE an E1sbeenIIIabesgnedbyhaa1I,l theIshanotIbe City madeany,of Oregon the Buiof any Board exempt t55 vri l rueonreonhet.I s11formant'|t t tha adocerandfyhereb.yrmlt1Iac'It onItINEpapcomp o thehttheIrdnancesencw111dobe1neaccordanshrmedaaIIworkandIhattfucrthe r ertIand fyndtcorreca w'l I1 beNOOCCUPAI,ICYatn'|thandkderscbed1heret'I n theto wor'Irta gpeStateofthed'I theand Laws1efngfi 1 der sBu'lSpronIthvrlthesItra tc1rtthatregfu rther fy m.yI,l Is nd'I 'I IDngrmlsoIofnIhou tt theure pest ruct tthaandIShereonnotedfor1t0nba'IS s exemptheha'It ft701055ORSas'Iu redaforceeffendctreq bys1n'|Ifu I s ectusbe0nedthiIproj07ot'|1 ncea twl 0t?sharewho1ndancomp'Ion s bconu to rstracv an Ck. Fi re Zon Bedrooms TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES an Ck. Res 1d al portion of this Permit ding Division BUILDING PERI1IT Charges and Su rc ha rges Flood Plain Stories Occ'Y GrouP Ftg. t'lai n Ftg. Access x Va ne by ec tri Fence DEmo PLUI4BING PERMIT Charges and Surc ha rges -^E";1\-r Si dewa l k Total Comb. PermitA/C Pav i ng ELECTRICAL PERI1IT Charges and Surcha rges Curb Cut 6= -o.)TOTAL I,IECHANICAL PERMIT Charges and Surc ha rge s t-l3 "1.^s tN l(s Mnnn ?o&'ok empl oyees COMBINATION APPLICATION/PERMIT (CAP) L Appf icant to furnishA. Job AddressB. Legal Description 1. exampie- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition to S[rTig'Fie)d EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION l. example- heat2. 'example- wateE. Square footage or ,/electrical ceili or fo ed a ir a ea er e ec tr ca ors ar val uation,e l. example- 1250 sq. foot house, 500 sq. foot garage2. 'exampib- JT new project, check-new - if additio;, check add, etc.F. Building permit information: i examp I e attached - construct singie family house with an ga ra ge2. example - remodel existing garage into family room3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Sect.ion 303 (a) of theStructural Specialty CodeH. DESIGN TEA|\,I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriatepersons regarding design information or job sitecorrections, etc.IL Abbreviated Plumbing, Mechanical, & Eiectrical Schedules' A. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrica'l Schedules,the applicant nqed fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedulesare avai lable at the Bu.ilding Division1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF I.JILL 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 labelIII. Applicant to sign and date Whenever possible, the initiai application wilt be used asa worksheet only. l^lhere possibie, Building Division 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.IV, 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. Ail other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY 8/CA 'b\y )r? 84 t ,) _3/ ?o Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name SI gnature date