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Home My WebLink AboutPermit Building 1991-02-25PECTION LIIIE -3769 COIiBI AP ICATIO ERMIT 7?6-3753 Job Address EI]ERGY SOURCES Ftq Hea t 5q. Ftg. Access._ l-ega1 Description l,Jater Heater Sq. Ftq. 0 ther Ranqe l{er.r Add A.l c[leF.-)+-Fen ce Demo Cha nge/ U se Val ue of l,lork -0ther- 0wner N $Addres s Phone t Info scr tache Gara .e., Build Single ?ogr>o. 5za..ry n''25*b**rzo=-/fi z*7y+v.bosro--- Construction Lender /bzce,D; ;:o-.; rA Addre s s pno""2L'22 DES I GN TEAI.I name addres s lics. no.exD r res ohone no Primary Structura l El ectri cal Hechan i cal CONTRACTORS n ame a ddres s (lics- no-exD l res ohone no- General lry.L .?aozE {.*29,2qa. , 422:4ym?*^sZ-<z q?4/")26.2ba P l umbi nq ElectricalL,.DD l'lechani cal PLUI.IB I NG ELECTRI CAL MECHAN I CAL N0.FFF CHARGF NN FFF NHA RGF NO FFF CHARGF Each single fixture Residence of SQ. FT furnace/burner to BTLI' s Relocated building (new fix. additional) New ci rcui ts a l ts or extensions FIoor furnace and vent S. F. P.es'idence(l uatn)SERV ICES Recessed wal l Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent cFna ra t F [^later serv ice Chan res i ge in existing dence Stationary evap. cool er Sewer multifamily, comm or Industrial Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatino or A.C. c0r,1H./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re1 ocate di stri b. feeders l'Jood stove/heater 0f amps, 4 %lrrG-4Ah 7/7,z# Ez WzzyEp Vf .4-- -4 =71.</24:E.raQ-*,ISSUANCE OF PFR!1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl,l REQUIRES that the E'lectrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division L E XAM I N ED the comp e ap r)c a t n fo r' oermi t, rformed s nq to the'ision. I ,5, that i h oRS 70i an d do he reb.v ce rt ,]fy t ha t a 'I t 'I 0n reon i s true the CityI be made ilder's and that and co rrec t and I f U rth e r ce rt I fy t ha t any a nd a I I wo r k pe ha I I be d on ,l n acc0r da nc w1 t h th e 0 rd 1 nan ces 0 f 0 f Sp r1 ngfi i stru s in bcon I d and the Laws o f the S ta te of 0reqon De rta 'I n1 work des c rl bed here i n a nd th a t N c 0cc UPAN CY wl I f a ny ctu re wl t ho ut the permi ss ,l 0 of the Bui I d I n g D I furt he r cer ti 'fy th a t my reg 'I s tra t 'I on v,l t h th e B u Boa rd I fu I I force a nd effect as recl u 'I red 0 DC 7 0 1 05 f exemp t t he ba s 1 s f o r exemr)t 'I on 'I s noted hereon n 'I v su trac tors an d s who comD e wi t u sed 0 n th 1 s pro.j I'lAt'lE(ptease print IGiIATURE DATE FOI-' ()FFICE USE Oi.II Zone Const. Un its So tg t0 tg l'la i n x al Fire Zone Bedrooms Loa d Access x Val uenrn""/@rau"Vg4- ToTAL VALUATI0N_ Flood Plain S 0c c.y Grou Ftories BUILDING PERMIT Charges anC Surcharges /y.E__Plan Ck. Comm/lnd 65%/Bldq Per Fee 28-?3 Svster,rs Devel ooment charqe (1.51)' Plan Ck. Res 30%/Bldq Per Fee PLUMBING PERMIT Charges and Surcha rges Fence Dgmo ELECTRICAL PERI1IT Charges and Surc ha rges Sidewalk A/C Pavi ng Total Comb. Permit I4ECHANICAL PERMIT Charges and Surc ha rges Curb Cut TOTAL 7u,66 7 7affi l.la i n--- Gry-a Z ffi. COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legai Description1' -CFIP.l-g-: Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition toSpringfield Estatesq. Nane, etc. of owner and construction lenderD. Energy Sources1. examp'l e-2. examol e-E. Square foota atr I example- 1250 sq example- if new check add, etc. foot house, 500 sq. foot ga- if addit rage 2 project, check new r on, II F. Building permit information:1. example - construct single family house with anattached garage ?. example - remode'l ex.isting garage into family room3. example - convert single family-residence inio - 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 construction delays, Build.ingDivision Staff must be able to contalt appropriitepersons-regarding design information or job iitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces ociur .in thd descriptionportion of the Mechanical and Electrical Schedulei,the applicant need fill-in only the No. Boxes iOjiient_ !o_!h9 appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Building Divis.ion1. To conserve space on the permit form the scheduleshave been abbreviated2. JI the item(s) to be installed are not covered onthe abbreviated schedules you shoutd consu.lt thefulI schedulesC. BUILDING DIVISION STAFF HILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to thee'lectrical contractor for signature by his "i"ii"iiui - supervisor. The general coniractor ii not authorizedto sign the electrical labetApplicant to sign and date I'lhenever possible, the initial application will be used asa.worksheet only. Where possible, Building Oivision-iiaiiwr il.prepare a type written copy and return it to theapplicant at the time the actuai permit is issued tor trissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wiil-be processed unti.l thesetees are paid. AII other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III. IV. V E rrFzove? PERMIT VALIDATION 6 -r)< r Permit Cler PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: icant exempt from registration with the Builder,s Board because:Permit appl Additional Project Information: PLANS REVIEWED BY: s i gnatuname date ?, OREGO'V 225 PIFTB SlTBBf, SPRINGEIBU), OREGON 97477 INSPBCf,ION RB0UBSI: 726-3769 OPEICE: 726-3759 1. LOCATION OT INS"TAIJATTONze*/,GADl-. I,BGAL DESCRITIIONF z,-?<vz,// AryrO JOB DBSCRIPTION Permlts are non-transferable and expirelf vork ls not started vlthln 180 days of lssuance or lf vork ls suspended for 180 days. 2. COIrnAGtOR INSTATIJTTION ONLI Electrlcal Contractor o Address ct Phone Supervlsor Llcense Number Exp lratlon Date Constr Contr. Number Explratlon Date of Supervlslng Blectrlclan rs Name Address. Ct ty Phone OSNBR INSTALI,ATION The lnstaLlatlon ls belng.made on property I orn vhlch ls not lntended for sale, Iease or.rent. 0mers Slgnature: DATE: RBCBIPI I: strrilN(;FtEL(, I BI,ECTRICAL PERHrt APPIJCATION Ctty Job Nuubet 91424_ 3. COHPIATB TBB SCIIEDT'I,B DETOII A. Nev Resldentlal-Single or Multl-Family per dvelllng unlt. service rncruded: rtems cost 1500 sq;ft. or less Each addltlonal 500 sQ. ft or portlon thereof Bach llanuf'd Home or Hodular Dve1llng Servlce or Feeder $ 85.00 $ 15.00 $ 35.00 Servlces or Feeders (10 Branch Clrcults included). Installatlon, Alteratlons or Relocatlon: Sum B 100 amps or less 101 amps to 400 amps _401 amps to 600 anps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only ST'BTOTAL OT ABOVB 5Z State Surcharge TOIAL $ 35.00 $ 60.00 $ go.oo $130.00 $300.00 $ 35.00 $ 35.00 $ 50.00 $ 15.00 C. Temporary Services or Feeders Installatlon, Alteratlon or Relocatlon 200 amps or less $ 35.00 0ver 600 amps or 1000 volts see rrBtr above D. Branch Clrcults Nev, Alteratlon o:'Extenslon Per Panel One Circuit Tvo to ten Clrcults' / Each Addt,I ten or portlon thereof E. Miscellaneous (Servlce/feeder not lncluded) -Each lnstallatlon Pump or lrrlgation $ 36.00 Slgnal Clrcult or Ilmlted energy panel $ 36.00 = RECBIVBD BY: 6-D^< /5 CsD