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Home My WebLink AboutPermit Building 1990-10-12COMBI TI APPL I ERMIT 7 Job Address l-egal Description rq( EIIERGY SOURCES: Hea Range. l.later Heater.: 0wner "'\4P*.,, 5q. Ftg. Access._ _Fence_Demo_C ha nge/ U se 0ther I'lew Add A I ter Pep Sq. Fto. 0ther Address Phone Builriinq/Pernrit-lnfo: DescilSe l,lork-tFamily Residence l,l'ith Attached-Ciraqe :e., Build Single t QHII ( d\l G0 Y. *t),{ t },frr,iYl gltrru I,constructi\ LlnJJ.'-\ \ Addres s Phone 5 b DESIGN TEAI,{name address exDl res no-1r)ne Pri ma Structura I El ectri ca I l''lec ha n i ca l name addres s PXnt rpq ohone no- E I ectri ca l PLUI{B I NG ELECTR I CAL MECHANICAL N0.FEF CHARGF NO FFF CHARGF NO FFF CHAPGF 3 Each single fixture /o T Residence of FTSQ furnace/burner to BTU' s Relocated building (new fix. additional ) New circuits alts or extensions Fl oor furnace and vent S, F. Residence ( I uattr )SERV ICES Recessed wal I Space heater and vent Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent sepa rate [,later serv ice Change in existing resi dence Stationary evap. cool er Sewer multifamiiy, comm or Industrial Vent fan with sinole duct Storm Sewer 0f S.apart from .c. Vent systern heat'inq or A c0Mr.1./IND. FEEDERS z-Mechanical exhaust hood and duct /.tu 74Instal I /al ter/re1 ocate di stri b. feeders [,lood stove/heater 0f A Z *?rr,,bzZ * W41,7%9€fr v7 /d.*ISSUANCF OF PFRI,lIT TOTAL CHARGES Va^u TOTAL CHARGES TOTAL CHARGES 17.*I REQUIRES that the Electrical work be doneunti'l the label has been signed by an Eiec bytri an Electrical Contractor, the electrical Supervisor and returned to the Bui ca1 portion of this permit lding Division tiHERE STATE L,1I,JshalI not be val il t'lAl.lE ( pl ease pri nt) S I GNATURE TEt fy Ci ty made0reqon he Buiany rd the permi nd effect L the e rtcaoncomp t a nd doapr)Derml here certb.y th aat fofy rmat hereon0nnda truestcorrecandurrthefcerthattaandanyworkrmedahperfodobeneanwlccordancethhe0rdna nces f0 tfrlfedSpngandLtheawsf0theState,ro rta n n toDEg the rw0 desck r bed here n and atth NC 0cc ,ANCYUPf w1 bewts tructure hot ut ss n of t di Di s onng fu certrthe r atth sfy tra t vlr0n thBoaregmy the uB rde qsnfuforceasaredORS055701requtthafbyLbaheexemptfosr0ntiexempsnotedhereonand0nha ttbconutracvtorsndawhoernpnreWIancethcomD0t?s 7ol 055 be sedu n th s tProj __28-s_q_ qD n ter,rs I ve 5X? 4tD Loa x u l4a i Gro Val Value Re Pe n x Value PI an % un;tsi,tns opment Bedrooms Acce s s 0t her Pl anBUILDING PERI'IIT Charqes and Surcha rges SrF Ftu Ftg Ftg Fire Zone I Flood Plain Stories 2* TOTAL VALUATION FencePLUI4BING PERMIT Charges and Surcha rges --Za=__ Dcmo Sidewal k ELECTRICAL PERI1IT Charges and S urcha rges Total Comb. permitA,/C Paving Curb Cut I,IECHAN I CAL PERH IT Charges and Surcha rges "{ 4A TOTAL /5?-sa t ln.a.n&n- (n to4 D3 ff,ii I ___/_z-_ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. glaTple- Tax Lot 100, Lane County Map Reference 17 03 432. grqlnple- Lot I. Block 3, Znd Add.ition toSFiJngTietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. examo l e-2. exampl e-E, Square footag hea t/e I ectri ca I or forced air gas WA ea e sol ar e or valuation, e 1. example- 1250 sq. foot house, 500 sq. foot garage2. exampie- if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2, example - remodel existing garage into family room3. example - convert single family res.idence intorestaurant (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, Building Division Staff must be able to contact appropriate persons regarding design informatjon 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 Plumbing, Mechanical, and E)ectrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated?. If the item(s) to be installed are not covered on the abbreviated schedules you should consult theful i schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be deljvered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label Applicant to sign and date Hhenever 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 theapplicant at the time the actual permit is issued for his s i gnature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until these fees are paid. Ail other fees and charges are due and payable when the permit is issued. FOR OFFICE USE ONLY II. III. V PERMIT VALIDATION / \AL\x a \L D u L\,l"U\r I Permi t Cl erk tDfu- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAITCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : L PLANS REVIEWED BY: name sign ature da te /P-/aGD IV OREGONCITY OF SPF IJGAL oiil I?O 3r+ oo3oo JOB Permits are non-transferable and expire if-vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electr ical Contractor Address iration Date SPFINGFIELO EI,BCTRICAL PERHIT APPLICATION City Job Nunber 4 ts ) 2ot- COHPI,BTB FEE SCEEDTIIJ BELOV Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost 1500 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf'd Home or Hodular DveIIing Service or Feeder $ 8s.00 $ 1s.00 3 A Sutn $ 3s.00 B. Services or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: 100 amps or less 101 amps to 400 amps -401 amps to 600 amps - 601 amps to 1000 amPs Over 1000 amps/volts Reconnect Oniy .00 .00 .00 .00 .00 .00 $3s $60 $80 $130 $300 $3s -z-.'O444-4- city il.,<.lzz*r? Pno"" d#Z-d%' ,/ Supervisor License Number l5/*S Exp Constr Contr. Number .?tL,r-C Expiration Date, Signa f Supe rvrsl ng Blectrician OIINER INSTALT,ATION Name Address Ci Phone The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. Ovners Signature: DATE: Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 35.00 Over 401 to 500 amps - $ 80.00 0ver 600 amps or 1000 volts see uBil above Branch Circuits Nev, Alteration or Extension Per Pane} c D $ 1s.00 B. Miseellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/0utline LightinS_ Signal Circuit or limited energy panel s 36.00 3€4L $ s 00 00 35. 50 36.00 0036 $ $ 5 SUBTOTAL OF ABOVE 5Z State Surcharge TOTAL -7-Fe-E; RECEIVED *: c 225 FIFTH SIBEET SPRINGPIEID, OREGON INSPEGTION REOTIEST: OFFICE: 726'1759 1. LOCATION OF 477 726-3769 one iircuit Tvo to ten Circuits Each Addt'I ten or portion thereof @wtrticute ut @ccupnllt? CITY OF SPRINGFIELD BUILDING DEPARTMENT ,,his certi/icate issued pursuati to tlrc recluirentertts of section 306 of the unifonn Building code certiff irry that oi ttrc tine of issutilrce this stntcture Le)As irt compliartce with the "tariotts ordinances of tlte City regulgtitry buiLlittg cottstrrtction or ute' For the following: V.N II R-3 w c. u. Occ. Grou P--&,-TYPe Constructio ire Zon Louis Bel I 6557 E Street Owner of Buildin 1505 North l8th Street ldg. Permit N00574 Building Add By Do Buildins Officiol POSI IN A CONSPICUOUS PI.ACE