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