The URL can be used to link to this page

Home My WebLink AboutPermit Building 1980-11-17INE COMBI APPL I RMIT -37s3 FJob Address l-egal Description Owner t- Sq. Ftq. Other _l{ew_AddJl IEr-nep . - _Fence_Demo Change/Use 0theroo re., Buildd Gara Sq. Ftg. Access. nq Re Bu I ng e he Val ue l.lork: Ran l.later Heater I nfo s i dence !,li EIIERGY SOURCES Hea t q. l'lai DescrPhoneIAddressS6.l{ru- =--l+ (--f' Constructi on Lender Addres s Phone DES I GN TEAI.1 name address no exot res ohone no. Primary Structura I E.l e ctri ca'l llechan icaI ACI'O RS n ame add res s lics. no. ) (exoires (phone no. Pl umbinq Electricai tlechani cal PLUTlB i i]G EL ICTR I CAL MECHAN i CAL I !,-r -FEF CHARGF NO FFE C HARGF N0.FFF THARNF [acn single fixture Residence of FTSQ furnace/burner to BTU' s Relocated buildinc (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S . F. Res i dence(t bath)SERV I C ES Recessed wal I Space heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seDa rate l,Jater service Change in existinq res i dence Stationary evap cool er Sewer multifamily, comm Industrial or Vent fan with single duct Storm Sewer Vent systern apart from heatinq or A.C, COMI.I./IND. FEEDERS Mechanical exhaust hood and duct Instal I /a1 ter/re1 ocate di st-ri Fr. feeders l'Jood stove/heater 0f ISSUANCE OF PFRI{iT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAL,J REQUIRES that the Electrical work be doshall not be valil until the label has been signed by an E1 ne by an Electrical Contractor, the electrjcai portion of this perr,titectrical Supervisor and returned to the Building Division t,lAl.lE ( pl ease pri nt)7*S IGI,IATURE DATEe( and of of Boa onl f-v Ci ty made0reg the B E NXAI'1 tED (_he eted c ta onompap t dan hedo re rt ath at nl")Derm.r b.y t on rehe on truSfy a nd erfurthtco rrec cert hat t and a tior k fonyr srmed ha an c0c anrddonbeDE wl t 0rhe nadi snce of therfdandSongtheawsLtheofStaofn1onatohetdesc riwork hebed re n dan Lrtnq ha NCt CU0c PAI.ICDC wl bestrretutW1anyuthohetermlSsonf0udpnDsonftheurtCrrtehattsttirau/t0n theth Bu der sfym.y regfunsrdaforceeffindtCCsarequred7ORS0E05thatbasthebyfor L o ns heoted reon tha Landexemp bcu traconv rsto nd who be707eOPhempoyeesnaNCtvir oused thn ec tcomDnro,j Bedrooms Fl ood Pl ai n Stor.i es TOTAL VALUATION x Tyoe/ Cons t Occ.y Gro Ftg 0the r al 'i ts Load Value Val ue Fire Zone Zone Ftg. l,lain x Ftg. Access x Plan Ck. Comm/Ind 65%/B1dq Per Fee S vs tems Cha rqe DeVetl Rq opmentBUILDING PERMIT Charges and Su rcharges Plan Ck. Res 30%/81do Per Fee FencePLUI.4BING PERMIT Charges and Surcha rges Dgmo Sidewal kELECTRICAL PERI1IT Charges and Surcha rges Total Comb. PermitA/C Paving Curb CutI,IECHAN I CAL PERMIT Charges and Surc ha rges OO_L6_t5@TOTAL ),{ 0f amps f exempt .055 wi'l I I I th 1 I are 'l COMBINATION APPLICATION/PERMIT (CAP) T Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County l4ap Reference 17 03 43 ?. example- Lot 1. Block 3, Znd Addition to SprTngField Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examol e- Z. examp l e- E. Square footag hea t,/el rical cei I forced air gas wate le or r e or @- val uat oI1, 1. gI_UP-lS: 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check new - if addition, check add, etc. F. Building permit informat.ion: 1. example'- construct single family house with an atlached garage 2. example - remodel existing garage into famiiy room 3. example - convert single family residence into resiaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, l"lechanical, & Electrical SchedulesA. Except r,rhere blank spaces occur in the description portion of the Mechanical and Electricaj Schedules, tne applicant need fill-in only the No. Boxes adjacent .to the appropriate'item(s) to be installedB. Full Pjumbing, Mechanical, and Electrical Schedules are available at the Buiiding Division 1. To ccnserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedul esC. BUILDING DIVISION STAFF l"lILL 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 authorr'zed to sign the eiectrical label.III. Applicant to sign and date Hhenever possibie, the 'in'itial application will be used as a worksheet only. I,Jhere 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 signature. IV. Fees and Charges PIan check fees are due and payable at the time of the application, and no plans will 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 PERMIT VALIDATION Permit Clerk PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPANCi Perm'it applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY name s i gnature da te IlENSPE ?5-3 Phone c0rlB I ,TI N v-C F Add A 'e., Build S n9nfo: ui th Descrr be t tached Pernri siden hlo rkntq lr.AIce l:d ICATI ERMIT Val ue l.lork:oo l,later Heater Range 726-3753 0the rLegal Description Job Address Owner Addre s Sc. Ftq. l.lain_ !q. Ftg. Access.------ Sq. Ftq l,lew EIIERGY SOURCES Heat a0 Constructi on Lender lo' )tAddres s Phone DESIGN TEAI!name address lics. no.exol res phone no Primary Structura I E i ectri ca i i'!echan i ca I address ( pxoi res )lics. no.)( nhnnp no Generai (!tte'rril 0 lf' PI umbi nc Eiectrical irecnanical EL ECTil i CAL i,IECHAN I CALPLUIlE I iIG CHARGE NO FFF ICI"{ARGF lr0.I FFF I CHARGFI FFi iacn s!n-ole fixture Residence of SQ. FT. furnace/burner to BTLI' s FIoor furnace and vent P.elocared bui ldir:: (neri fix. aCdiciona i ) New ci rcui ts ai ts or extensions S . F. Pes i cience(l brath)SERV I CES Recessed walI Soace heater and vent i OuOtex (l bath) eacrr Apoi iance vent seDa ratPTemporary Construct ionAdditional bath Change in existing res i cience Stati onar,v evap coo'lertlater service Indrrstrial multifamiiy, comrn. or Vent fan with sinole ductSewer Vent system apart from heatinq or A.C.0f amps.Storm Sevrer Mechanical exhaust hood and ductCOI4I!./IND. FEEDERS l'Jood stove/heaterInsta.l I /al ter/rel ocate di ctri h^ feeders amp s.0f ISSUANCF OF PFRI1IT TOTAL CHARGESTOTA,L CHARGESTOTAL CHARGES i,tltERE STATE 1.1'n REQUIRES that the Electrical urork be done by an Electrical Contractor, the electrical portion of this shail not be valil unti.l the label has been signed by an Electrical Supervisor and returned t.o the Building Division oerni t only subcontractors and emnloyees nho are in comoliance with 0l?S 701.055 vrill be used on this oroiect. 7-TEllAl.'lE(pl ease pri nt) , d-d FI gon Bui truejicertthaatI1dofotrma0n'I re0heLIaetedthejitcao'1 IU r L acornppl')Derm hereb.v fy c itheIIdoineanordaccwlncetthhena0rdinc tyofScorrectdanrUIrrtheticerthatandIatJ0Irkesnaberformedndaanyfy ma deiberijnthanddLNCPAI,ICOCCU Y ItnnItothkwordescbedhere'Iofhetta5of0refrtSofeIdIoanthLawse soe rtang 'i dI rIsItratiththeue'ID I Is on fu errth ertC 'l dLth on vllIdIIfi'I o'I of v re{lmythescttruuretht0usstheanyperm an tha td1reonhehat'I I t ba 1s for t on si otednhe055auiORS ng 701 exempt exempfuIItoerceandtffecsreQrednI.1Boa by IGi,IATURE Ftg Ftg Ftg Zone 0cc.y Group Sq x Val ueBedrooms StoriesFlood Plain Fire Zone Value 0ccy Load Acce s s 0the r l,lain x - Value TOTAL VALUATIOTI---- e/Const. Uni ts So rqe ( 1.51 Svs cha tems Deve opmentPlan Ck. Comm/Ind 65"1./Bldq Per Fee Plan Ck. Res 30%/Bldq Per Fee BUILDING PERI'IIT Charges and Su rcha rges Fence D6mo PLUI4BING PERMIT Charges and Surcha rges 5idewal k Total Comb. Permit ELICTRICP,L PERI1IT Charges and Surcha rges A/C Paving Curb Cut t5 6eTOTAL I1ECHANICAL PERT4IT Charges and Surcha rges @6_t_ I J-tr ./_lrn-.,na ) 9-),)twa A ACt il?s =- t COHBINATION APPLICATION/PERHIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. examole- Tax Lot 100, Lane County Map ferI7-ITTI?. example- Lot 1. Block 3, Znd Addition SpilngTield Estatesq. Name, etc. of owner and construction lend( ('D. Energy Sources examole- heat/electricai ceilin PERMIT VALIDATION CITY O F SPRINGFIEi.D CirY Holl SPringfield, Oregon Deoortmeit of Public works OFFICIAT RECEIPT r Sjgmol3: 1250 sg examole- if new cnEcr add. etc foot house, 500 proj ect, chec k ner.r 19 Perm'it Cl erk E 55i91r D 5IGNATURE ' EUGETE OR ITIO' wa te rfo soT sq. - j' B2. Exanple-E. Square T6o-ota ea Ier ec ca or ge or valuati on,{ F- Buildinq cerrnit .information: 1. exanc'ie - construct single family house ;tEaahed garage2. e.xamcle - remodel existing garage into3. exarolE - convert sing'le iamity residenresraurant (change of use)G. Value of work as defined in Section 303 (a)Structural Specialty CodeH. DESIGi'i TEAIi AND COIITRACTORS To avoid design or construction deiays, BuilDivision Staff must be able to contact appro _persons regarding design information or job correc!ions, etc.II. Abbreviated Plumbing, i.iechanicai, & Electrical S,A. Except, t.;here blank spaces occur in the descr. Dortion oi- the l,:echan.ical and Electricai Schtrhe appiican! need fill-in only the No. Boxesto the aopropriare item(s) to be installedB. Fuli Plur-nbing, i'iechanical, and Electrical Schare available at the Building Divisiorr1. To conserve space on the permit form the have been abbreviated2. If the item(s) to be .installed are not corthe abbreviated schedules you should constfull scneduiesC. BUILDIiIG DIVISIO|,I STAFF l^JILL FILL OUT ALL FEES CHARGES Oi{ THE SCHEDULES0. As noted on the CAP, the label must be deliver : ,(fl dF ress ved For: ' A.no,nt Rec eived a j- t uil ( (r (l () t B ( f a III. IV electricai contractor for signature by his elesugervisor. The general contractor is not aut. {zto sign the electr ical labej.Applicant to sion anci date Whenever pcssibie, the initial application wil l be ta worksheeE oni_v. !.Jhere possible, Build.i ng Divisic ftwill orecare a type writren copy and return it to tapplicant at the time the actual permit is issueci f s i gnature. Fees anrj Charoes iPlan check iees are due and payable at the time of rappiication. and no plans will be processed until td-_.fees are paici. All other fees and charges are due andpayable when the permit is issued. -1E AUTHORIZE SHELTOtr'TURNBUL! PRIiTERS V. FOR OFFICE USE ,JiILY PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPAI,IC\ : Permit applicant exempt from registration with the Bu i I der ' s Board because : Additional Project Information : PLANS REVIEhJED BY: name s i gnature date