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Home My WebLink AboutPermit Building 1986-07-21L CITY OF SPRINGFIELO COHBII{ATION APPLI CATIONIPERMIT 7 -37 Job Address 7 Legal Description .o z Hea Ranqe EIIERGY SOURCES l,later Heater Owner Va I ue,.of l.lork : ^fl /q, (bc) !q. Ftq. Access. r Ftq. tla i Address 3S Phonea Pdrnit Info'idence lii t : Describe lloik(h Attached Garaoe .€., Build Single 2gKog44ld Constructinn y'"nJ..U Addres s Phone I loA eo Uto --0 DESIGN TEAI,I name address (cs. no.exni res ohone no.*uoor Jt lltO ./,*2. ?9R ,l/r--o 18-a>a-'-€c-.rcrz*Pri mary St ructura I 7I E I ectri ca I l'lechan i ca I CONTRACTORS name a ddres s 'I CS. nO.( exn i rp<ohone no. Genera I ///t El ectri cal l,lechani ca I PLUI1B I NG ELECTRICAL MECHAN ICAL FFF CHARGE NO FFF CHARGF Ir0 FFF CHA RGF Each single fixture Residence of SQ. FT furnace/burner to BTLI' S Relocated bui ldino (new fix. additioial ) New circuits alts. or extensions Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wal i Soacp hprtpr and vont Oupiex (l bath) each Additional bath Temporary Construct i on Apol iance vent seDa rate l,la ter serv i ce Change in existing res i dence Stati onar.v evap. cool er Sewer multifamily, conrn I ndu stri a I or Vent fan with sinole duct Storm Sewer 0f imps.Vent systern apart from heatinq or A.C. 16 s.c COI,lI.!. /IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/re1 ocate dicfrih fpedprs l'lood stove/heater amps.0f /r*&ttov kvz lrs 'tf? Exmz ac h/a ?z # kt< Beyrss,tsreJz>H; 5et*,h l*7t7 l lxq.w Za,t 6 ISSUANCF OF PFRI1IT TOTAL CHARGES /s*TOTAL CHARGES TOTAL CHARGES fu-* WHERE STATE LAt,l REQUIRES that the Electrical work be doneshalI not be vali.l until the label has been signed by an Elec by an Electricai Contractor, the eiectrical portion of this pernittrical Supervisor and returned to the Build.ing Division SIIlAl.lE(please pri nt)'NDilst)^)1-zr -8/,lnRt n of any Boa rd Y t +ca on rfoeapr)comp he re rtce hat a+doandt rma t hereonon s tnb.y ruefy and correct a nd fu certrther hat t a workaandfyny sha donebe n cordancac wt theth nances0rdi ofe the c tytefdoftheofLawsthendaSorioSta te f rtang0regonoe to worthe descrk bed rehe ng and atth OCCUPANCYHC wt be maderutctusrethouI,/l tht fpermson t he Bu d Di sv1 onng furth c ert f tha s Ltra 0n thvr'l Bthe u r,fy regm.y de ssfuforceandeffecastred701ORS055frequbytthaethebasforxemptexemDt0nsnotedandhereon tthaonubcontracandtors'ly s awho Ire anceempoyeecomo w1 0r?sth 7o 505 1., I be used 0n hiL 5 ectProj Fire Zone Bedrooms 0c Flood Plain Stories ,/ 0c cy Load Sq. Ftg. Access_ x Value ,y e"oupfr7ir*3 sq. Fts. nrn""@r--r. u"@- 1-Zl-8u TOTAL VALUATION Zon"_4C__tyoelConst. Uni ts Ftg. l,lain x Val Plan Ck. Conm/Ind 65%/81dq Per Fee Bn,4=Rll"1gfl Svsteris Deve charqe (1.51 opment /Y"4 " BUILDING PERI.IIT Charges and Surcharges /.ro Plan Ck. Res 3l%/Bldo Per Fee FencePLUI,IEING PERMIT Charges and Surcha rges ___/f._?2_.66 Demo Sldewal kELECTRICAL PERIIIT Charges and Surcharges Total Cornb. PermitA/C Paving Curb CutI.IECHANICAL PERMIT Charges and Surc harges 6 zo TOTAL /%.69 0ther. Ftg. ul _fu,. coMBrNATr0N AppLrCATroN/pERMrT (CAp) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot .100, Lane County Map Reference 17 03 43 ?. exampie- Lot l. Block 3, Znd Addition to SEFirrlfiet d EstatesC. Name, etc. of owner and construction lender0. Energy Sources PERMIT VALIDATION t ti forced air gas e or solar E valuat on, etc. II 1. example- 1250_ sq. foot house, 500 sq. foot garage2. Exampte-: lF-new project, check-iEw - if additio;, check add, etc.F. Building permit information:1. example - construct singie family house with anet$cIa garage 2. example - remodel existing garage into family room3. e:xample - convert singie famjly residence intoiElTiuiant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. OESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in oniy the No. Boxes adjacentt0 the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Building D.ivision1. To conserve space on the perm.it form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you shouid consult theful I schedul esC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the iabel must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label Applicant to sign and date l,Jhenever possibie, the initial application will be used asa.worksheet only. Where possible, Bu.ilding Div.ision Staffwill prepare a type written copy and return it to theappl'icant at the time the actuai permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY ry III. IV V Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s'l g nature aate 7-Zb*C ,$\g r^ ON LINE conBI ICATI 726- 3 r 7//Job lddress Legal Oescription .O 3-z l tHea EIIERGY SOURCES: [,later Heater Ranqe Value,of llork: ^'8 /'7, ccaOwner : q. .. tg. Acces s . sq. Ft;.ll ew_Ad d-A I Ie r-___[EE:- _Fence_Demo_C ha n ge/ U se 0ther Sg. Ftq Flain Address Phonec-- l-_/.)Builciinq Pernrit Info: Describe llork(i.e., Bui ld SingleFarnilv llesidence l,li th rtttached Garaoe) .Q-,:.( Cr{TsKo /,') -.t a-D-l- Constructinn tiender CAJ D(f \-lo Address Phone name address lics. no.i ohone no. Struc tura I Pri Electrical l'lec ha n i ca I name address'(exn'lics- no-)res )onone no. ? .rir,/f, 2ll.lPlumbino El ectri ca l tlechani ca l ELECTR I CAL MECHAN I CALPLUIIB I NG FFF CHARGF uo FFF C HA RGF t.t0 _i FFF I CHARGF Each single fixture Residence of FTSQ furnace/burner to BTLI' S New ci rcui ts a l ts. or extensions Floor furnace and vent Relocated building (new fix. additional) SERV I CES S . F. P,es i dence(1 bath) Recessed wal I Soace heater and vent Ouplex (l bath) each Temporary Construction Apol iance vent seDa ra teAdditional bath Change i n exi sti ng rpci dpncp Stationary evao cool prl,la ter servi ce Tndrrstria l multifamily, conrn. or Vent fan with si nol p drrctSewer Storm Sewer 0f Vent systenn apart from heatinq or A.C. t75 /q,n c0r4r.!./rND. FEEDERSl/arEx6*sp Mechanical exhaust hood and duct Instal i /a I terlrel ocate di stri b. feeders l'lood stove/heater amp s"0f &rYtrtsr BgVt /r* ls 'tF? Exmz ar h/c PK # k4< ReY,.st,trS ls* lr€Jz br-r; is>*ntu?mtr llx:rc.Zaz f5 ISSUANCE OF PFRllIT TOTAL CHARGES /s*TOTAL CHARGES TOTAL CHARGES 30-* WHERE ST shall not be ATE LIN REQUIRES that tlre Electrical work be done byvali'l until the Iabel has been signed by an Electric an Elal Su ectrical Contractor, the electrical portion of this permit rpervisor and returned to the Building 0ivision and correct, and I further certify that any and all work performed shall be done in accordance with the Qrd'inances of the Cityof Soringfield and the Laws of the State of 0reoon oertaining to the work described herein, and that NC OCCUPANCY will be madeof any structure without the permission of the Building Division. I further certify that m.y registration vrith the Builder,s Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemotion is noted hereon, and thatonly subcontractors and ernployees who are in comcliance with 0l?S 701.055 vlill be used on this oroject. : llAl{E(please print)S IGiIAEfqoil -\LfiP?r- flrtlO ap!')r oermit, anca0n hereb-y certify that a I infornnation hereon is truethe comf) Fire Zone Bedrooms Occy Load Sq. Ftg. Access x Value_ Flood plain-gtories ,/ 0ccy croupft/f1fr3sq. Fts. otn""EeZ.aF-^-------vatue/2asa ' 'l -L\Av TorAL VALUATI0N- its Val uextFtgl'la i nZone CC Plan Ck. Conrn/lnd 65"/"/B1do Per Fee Systens Cha roe Deve(1.52 opment /</.,4 .BUILDING PERMIT Clrarges and Surcha rges _121. { fo PIan Ck. Res 30%/B1dq Per Fee FencePLU4BING PERMIT Charges and Surcha rges t{ ao ---Ld-'----.€o Dgmo Sldewa l kELECTRICP.L PERI:IT Charqes and Surcha rges Total Comb. FermitA/C Paving Curb CutI1ECHANICAL PERHIT Charges and Surc ha rges zo TOTAL /8a.e a ( I F AI.I \CTORS 91.47t'. __fu==_ COMBINATION APPLICATION/PERMIT (CAP) I. APPIicant to furnish A. Job Address B. Legal DescriPtion1- example- ii*"r-ot'100' Lane County Map Reference 17-T3-T3 2. example- Lot 1. Block 3, 2nd Addition to Sprlngfield Estates C. Name, etc. of owner and construction lenderD. Energy Sources1. examoie- heat2. EIamE-l e- wate SquaiEEot-tage or / el ectri ca l eili forced air qas rhea er,e ec tri ca or solar E va I uati on, etcl. example- 1250. sq. foot house, 500 sq. foot garage2. @ iFnew project, ctreir-iEw - if additio;,check add, etc.F. Building permit information:t. example - construct singie family house with an;tGcIa garase 2. ' example - remodel existing garage into family room3. exarn;'te - convert singie iuiliiy'..iiaence into ^ relta-urant (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, BuildingDivision Staff must be able to contatt'appropriitepersons.regarding design informat.ion or job sitecorrections, etc.II Abbreviated Plumbinq. I'lechanA. Except where bl5nk spaceporti on of the l,lechan i cathe appiicant need fill- _ to-the appropr.iate item(B. FulI Plumbing, Mechanica cal, & Electrical Schedulesi occur in the description and Electrical Schedules,n only the No. Boxes adjacent) to be installed , and Electrical Schedulesding Division the permit form the schedules are available at the Buil1. To conserve space on have been abbreviated III. ?. If the item(s) to be installed are not covered onthe abbreviated schedules you shouid consu.lt thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAp, the Iabel must be delivered to theelectrical contractor for signature by his electricai - supervisor. The genera) contractor is not authorizedto sign the eiectrical labelApplicant to sign and date l,lhenever possible, the initial app)ication wil.l be used asa.worksheet only. Where possibie, Building 0ivision Staiiwill.prepare a type written copy and returi it to theapplicant at the time the actuai permit is issued for his s i gnature. Fees and Charges Plan check fees are due and payable at the t.ime of theapplication, and no plans wi)l be processed until thesetees are paid. All other fees and charges are due andpayable wnen the permit is issued. FOR OFFICE USE ONLY IV. V PERMIT VALIDATION Permit Clerk 0i PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEI^JED BY: name /oz*€*s i gnature da te 7'Z>;8G ,$\0f