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Home My WebLink AboutPermit Building 1985-01-08L COHBI APPL I IT 7?6 Job Address EIIERGY SOURCES: llater Heater Ftg n Sq. Ftg. Access.--- Sq. Ftg. 0ther__ J{ew_Add_A1 ter_Pep. _Fence_Demo_C ha n gel U se -other- H D N Legal Description za AL Val ue of l.lorkOary'-o-0wner addtessT.fglz /?e >?F> l;z- Phone Buildin Farni ly q Permit Info: DescriI llesidence I'li th Attacher [,lo Ga ra ..e., Bui ld Single ,4**o<.7 zak>at Constructi on Lender &cxa>* ,*acr?sz Addres s Phone DESIGN TEAM name address lics. no.exoi res phone no Pri mary Structura I El ectri cal l''lechani ca l CONTRACTORS name address I ics. no.exol res ohone no. Pl umbi no E I ectri ca I l''lec ha n i ca I PLUI4BI NG ELECTRICAL MECHAN I CAL FEE CHARGF NN FFF CHARGF NO FFF rHA PGF Each single fixture Residence of sQ FT furnace/burner to BTU' S Relocated building (new fix. additional ) New circuits alts or extensions Floor furnace and vent S. F. Residence ( l bath)SERV ICES Recessed wal I Snacp hpatpr and vpni Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seDa rate [.later servi ce C hange res i de i n exi sti ng nce Stationary evap cool er Sewer multifamily, comm or Indrrst-rial Vent fan with sinole duct Storm Sewer 0f .amps. Vent systern apart from heatino or A.C. COMI'I./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate di stri h- fppders l'lood stove/heater 0f amps ISSIJANCI OF PFRI,IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES l.lHERE STATE Ll\ll REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali'l unti'l the label has been signed by an Electrical Supervisor and returned to the Building Division t comp ap ca tion for oermit, and work oerformed shal do hereb.y cert 'I fy t ha t a I 'I 'I n fo rma t 1 0 n hereo n ,l S true a nd co rrec t an d I fu rther c ert I fy that any and alI State of 0reqon sion of the Buil I be done 'I accorda nc wi t h the 0rd 'I n an ces o f th c 'I ty of Spriof any Board i ng fi e I d and th e Laws of the DC rt a1 n 'I ng to the work descriI further cert if exempt the 701.055 wilI be bed herei n a nd th a t NC OCCUP ,ANCY wl 'I I be made s truct ure wl thou t. the permi nd effect ernpl oyees s d 1 ng Di VI s 'I on ti fy th a t m.y reg I tra t 'I n u/l th the B u1 I der s 'I ful I fo rce a s requ I red by ORS 701 055 th a ba s 'I s fo r ex emp ti on 1 s noted hereon and that on 1y s ubcontr ac to rs and who a re .I n comD I 'I an ce wl th 0t?s u sed 0 n th I nroj ec t nAilE(prease p"irtlf,l\Ao.\ P. B*tt i s S I GNATURE Zone 1.L Const,Uni ts Ftg. l'lain x Value FireZoneBedrooms0ccyLoadSq'Ftg.Accessxva.lue- Flood Plain Stories 0cc.y Group Sq. Ftg. othe"fE</)4?.7 ualue Fz*A,c-. TOTAL VALUATION BUILDING PERMIT Charges and Surcharges --/e.-z>PIan Ck. Conrn/lnd 65"1/81rlo Per Fpe Systerns Deve' Charqe (1.52'opment Plan Ck. Res 30%/Bldo Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERIIIT Charges and Surcha rges SldewaIk A/C Paving Total Comb. Permit I,IECHANICAL PERMIT Charges and Surcharges Curb Cut TOTAL /o.{o COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. examp)e- Lot 1. Block 3, Znd Addition to SIFffi-g'-fi el d EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATiON II 1. examp_le- heat/electricgl ceiling/or forced air gas2. example- waterhetter/elecu"lcal/or sofar-E. Square fbotage or valuation,E.- l. example- 1250 sq. foot house, 500 sq. foot garage?. example- 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 residence 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, Bui)dingDivision 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 only the No. Boxes adjaientto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be instal led are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor .ii not authorizedto sign the electrical labelApplicant to sign and date l,lhenever possibie, the initial appl.ication will be used asa.worksheet oniy. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actuai permit.is issued for hissignature. 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 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 i gnature da INSPECTION LINE 726-37 69 CTTY OF-SPRINGF'IELD COHBI iIATI ON APPLICATION/PERMIT INFOR'IATION LiNE 726-3753 >7Job Address / fAT UP Legal Description Hea Ranqe EIIERGY SOURCES: l,later Heater Value of llork:9a-* So . Ftg. I'la i n_ Sq. Ftg. Access._ Sq. Ftg. other_ _l.lew_AddJ1 ter_Rep. _Fence_Demo Change/Use 0ther Owner .e., Build SingleBuilciinq Permit lnfo: Describe Work(' Fanrily Residence llith Attached Garaqemarcss 14fR > /t/e, ?3??5a Phone ,4*xno<7 7ak?a' Construction Lender &cx<r€ t*actz > $ D N Addres s Phone cs- no-exDl res phone no.TEAII name addres s ( Pri mary Structura I El ectrical Hec han i ca I a ddrps s Iics- no.exDl res ohone no.\CTORS name (/^tcqrrls*v Z-e+nzet= - k)t*€ Bun*n >Y>/a/S-Genera I Pl umbi nq El ectri ca I Itlechani cal MECHAN I CALELECTRI CALPLUI.IBI NG FFF .HAACF llo FFF CHARGFFEECHARGENO Residence of FTSQ furnace/burner to BTLI' 5Each single fixture Relocated building (new fix. addit'ional) New circuits alts. or extensions Floor furnace and vent SERV I CES Snacp heatpr and vcnt Recessed wal lS . F. Res i dence(l bath) Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seDa rate Change in existing rps i dencp Stati onar.v evap cool ertlater service multifami1y, cornm. or Tndrrstria l Vent fan with sinole ductSewer 0f Vent systenn apart from heatino or A-C.Storm Sewer cot'f.t./IND. FEEDERS Mechani cal exhaust hood and drrct Instal I /al ter/rel ocate di stri h- feeders l'lood stove/heater 0f amps ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES HHERE STATE LAll REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernit shall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division I'lAl'tE( p1 ease pri nt)tl\iA^"\ P. B*(r i 3 s 0regon the Buiof any Board exempt t55 wi I the e ted II tca on'I rfo I t doand rehe ce Irt tha at 1I nI tfo rma 0nI ihereon scompapr)Derm b.y truefy and coffect Iand rthefu r 'Icert haL t a nd a II rkwo rfo rmed has I'I donebe n1 ac wtrdance th .I0rdfyanythe ofnances cthe 1pe efi dI andof the ofLaws Sthe teta of nlI to workthe beddescri rehe n1 and thangSpri ty deoertatNCwlOCCUPANCYIImabeng ruL ctu wlsre thout the ISS n of dI I D 'I s1 I n I hefu rt cer Irt t tha '|permi tstra on tt/ l theh IBui der sfyregim.y I I Ifu Is force and ng 701 ba Is for t no 'Ithe055tthatfefasfecturedORSI s tedno hereon and th atreqexemptby 1on su bcon dtractorsan I who '|are n I WIance ht 0tls 0 I us onedel,'!p oyees 701v be Ith ectcomDrojp Ftg Ftg Ftg Access x Valuenrn"r@u.tr.----EE l'la i n Val ue Flood Plain Stori es x 0c c.y Group Sq. TOTAL VALUATI nt! cy I oa r'l nits SoTone __1_1__I yp e/ Co n s t Fire Zone Bedrooms Plan Ck. Conrn/Ind 65%/B1do Per Fee tems Deverqe t1.5i Svs Cha opmentBUILDING PERIIIT Charges and Surcharges --/2.4V> Fee Plan Ck. Res 30%/Bldq Per FencePLUT,IBING PERMIT Charges and Surcha rges D6mo SldewaIkELECTRICAL PERIlIT Charges and Surcha rges Total Cornb. lermitA/C Paving Curb CutI,IECHANICAL PERHIT Charges and Surc harges TOTAL /o.{o ti For: rY OF SPRINGFIELD Clty Hell Sprlngfrcld, OrcAon Oeplrtm.nl ol Publlc Workr OFFIC!AL RECETPT No. BCOMEINATION APPLICATION/PERHIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. glalplg: Tax Lot 100, Lane County Map Reference17 03 432. gxaTplq: Lot l. Block 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction .lender D. Energy Sources (64090 (Rec'd From ^dd,ess ri;g;S 6y'.Q. ?U*? +. ( hea t/e I ectri wa te eaE. Squa e or valuation, examol e- examp I e- re-T6otag example- 1250 sq example- if new check add, etc. I ceili or' forced air o SOlar O. *-oa nu"rn- if addition e 2. foot house, 500 sproject, check-new & oFBui Iding permit information1. .I?rp.t. - construct single family house with an ^ attached garage :. +lgglC - remodet existing garage into family ro,r. exampte - convert single family residence iniorestaurant (change of-use)G. Value of work as defined in Section 303 (a) of the.. lllggtural Specialty Code - -- H. DESIGN TEAM AND CON1RACTORS ig..::?lt 9:tis-n or construction detays, Build.insulvtston Staff must be able to contait appropriitepersons.regard.ing design information or jbU iitecorrections, etc. lbb.:yil!:a Plumbins, Mechanica.l, & E.lectr.ical SchedutesA. ExcepE where blank. spaces occur in the descript.ion - portion of the Mecha-nical and E.lectriiat Scneliutei,the applicant need fiil_in onii ine llo. ao*., iajii.,_ !o lhg appropriate item(s) to -Ue institteaB. Full Plumbing, Mechanicit, ira-if".iiicat Schedulesare available at the Building Division1. To conserve space on the-permii iorm ttre schedulehave been abbreviated2. II tl'g item(s) to be installed are not covered onthe abbrev.iated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ANDCHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be de.livered to theeiectricaj contractor for signatur" Ui ni, electriiai'-supervisor. The general coniractor is not author.ized Appiicant to sign and date Whenever possible, the initial app)ication will be used asa.worksheet oniy. Where possibtb, Sullding 0ivision Staiiwlil.prepare a type written copy and return it to theapplicant at the time the actuai perm.it is issueJ io" f,is s i g nature. Fees and Charqes Plan.check feis are due and payable at the time of theapplicatjon, and no plans wiil-be procesiea unti.l theserees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY o (, II. III. )- ( ( ( {.\ Amount Received /E.FO hEr o,,","rsc EoeMc rtu. rtnrru2.rt.q I IV V Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: t applicant exempt from registration with the Builder's Board because:Permi Additional Project Information: PLANS REVIEWED BY: name dates't gnature