HomeMy WebLinkAboutPermit Building 1986-11-25r'
CITY OF SPRIN6FIELD
COHBI I{ATION APPLICAIION/PERMIT
ST\-Job Address 2O?A Aloyfu
Lesal Description / 7- O7-,3O
EIIERGY S0URCES: " /\ rHeat e ,/ rr *.i - //a
w^t"" n"it."Vbifi2s--
aanqe q /p aA.l iTar Lo+ /ffi\
Hain nal-Q
9q. Ftg. Rccess-.----r-
Sq. Fta. 0ther__
J,lew-q66 Alter_Pep.
Fence Demo Chanqe/Use7t h. "-.gott-.!tri*ao^-
So. Ftq
e of l,lork:
4ffi,o9Val u
0wner -<,1 $ Co
'€., Build SingleBuilc,inq Pernrit Info: Describe tlork('
Farnily Residence liith Attached GaraqeAddress 2072 Nov*tr 39 vnone ///-
AO
I5e-tt'Iu D -€ tnnlt w'tAL*"irlorr-Sos7
Constructi on Lender
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Addres s Phone
ohone no-lics. no.( exo i resaddre s snameDES I GN TEAI4
Pri ma ry
Structura I
El ecrri ca.l
llechanical
i
Genera l
hani ca I
al ectri
MECHAN I CALEL ECTR I CALPLUIJB I IIG
FFF CHARGFFFFCHARGFti0CHARGENO
furnace/burner to
BTL|' sEach single fixture Residence of
FTSQ
Floor furnace
and vent
New circuits alts
or extensions
I Relocateo bui iding
(ner fix. additional)
SERV I CES
Recessed wal I
Soace heater and vent
5.F. Residence
( l bath)
Dupiex (l bath) each
Apol iance vent
qeDa ra teTemporary Constructi onAddi tional bath
Change in existing
rp< i dpnrp
Stationary evap
cool er[,later servi ce
Vent fan with
sinole ductI ndus tri a I
muitifamily, comm. orSewer
0f s.
Vent systern apart from
heatinq or A.C.Storm Sewer
Mechanical exhaust
hood and ductCOI4I.I. ,/ I ND . FEEDERSM "bi b +ioww /59 /5,ryI
llood stove/heaterInstal I /al ter/rel ocatedistrib. feeders
0f s.
/0,o9 /0,"9Il)abt b Hovru
ISSTJANCF 0F pFRtlIT o
-o-TOTAL CHARGESTOTAL CHARGES /o,o9/< ooLa':'TOTAL CHARGES
WHERE ST.
shall not be
ATE LAtl REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit
vali'J until the iabel has been signed by an Electrical Supervisor and returned to the Building Division
pnlication for oermit, and do hereb.y certify that all information hereon is true
and correct, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the City
of Soringfield and the Laws of the State of 0regon oertaining to the work described herein, and that NC 0CCUPAI,ICY will be made
of any structure without the permission of the Building Division. I further certi,'y that my registration vrith the Builder's
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemf;tion is noted hereon, and that
only subcontractors and employees who are in comcliance with 0l1S 701.055 will be used on this nro.ject
t-2<8llAt'lE(please print)ryATURE R,
I HAVE CAREFULLY EXAIIINED the completed a
Zone M3 Tvoe/Const.tr.H Units 1 So Ftg
Ftg
Ftg
Val ue
|\+ sq
x
0c c-y Group
0c cy Load Val ue
]-
liain
Flood Plain t/\Cr Stories
TOTAL VALUAT TON I 9,. b1^r. 09
Fire Zone
Val
Acces s
0the r
Bedrooms 2-
Svstems Deve
Charqe (1.57"
opmentPlan Ck. Conrn/Ind
65%/8ldq Per Fee
BUILDING PERI'IIT
Charges and
Surcharges Plan Ck. Res
30%/81dq Per Fee
FencePLUI4BING PERMIT
Charqes and
Surcha rges Demo Labc-l Fee "RO
SidewalkELECTRICAL PERI|IT
Charges and
Surcha rges A/C Pavi ng Total Comb. Permit 5/,ry
Curb CutI4ECHANICAL PERMIT
Charges and
Surc ha rges Mobib {hrvu-a< oo4-)te
TOTAL #51 ,n
;$t
ty\r^ a{
nhonp nnn ame
ue
i
COMBINATION APPLICATION/PERMIT (CAP)
Applicant to furnishA. Job AddressB. Legal Description1, example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, 2nd Addition to
5p7-ingField EstatesC. Name, etc. of owner and construction lenderD, Energy Sources
PERMIT VALIDATION
I
1)
E. Squa
exa:'nole- heat,/electrical ceil ino/
exanp I e- waterheater/el ectri ca I /ore footage or vaiuationlltc.
or forced airrso s
II.
l. examole- 1250_ sq. foot house, 500 sq. foot garage2. !ilirnplEJFnew project, in"irf,* - if additio;,
check add, etc.F. Building pe-mit information:1. examole, - construct single family house with an. attacheC garage2. e4qmole - remodel existing garage into family room3. qqlStr - convert single iarii ly-resiaence intoiEiTifFant (change of-use)G. Value of work as defined in Section 303 (a) of theStructural Specia lty CodeH. DESIGN TEAI.I AND CONTRACTORS
To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design infornration or job sitecorrections, etc.
AbbreviateC Plurnbing, Mechanical, & Electrical SchedulesA. !.rcept r.rhere biank spaces occur in the Cescription:ertion of tne i'lechanical and Electrical Schedules,tne applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be .installed
B. Full Plumbing, Mechanical, and Electrical Schedulesare avaiiable at the Building Division1. To conserve space on the pernr.it form the schedules
have been abbreviated?- If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISIOII STAFF I,JILL FiLL OUT ALL FEES AND
CHARGES ON THE SCHIDULESD. As noted on the CAp, the label mustelectrical contractor for signaturesupervisor. The general contractorto sign the eiectricai label.Applicant to sign and date
Hhenever possible, the initial application will be used asa worksheet only. Where possibje, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual 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
be delivered to the
by his electrical.is.not authorized
iII
IV
Permi t Cl erk
PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit app'licant exempt from registration with the Builder's Board because
Additional Project Information :
PLANS REVIEWED BY:
datenamena tu reSig
?+vz
IilSPECII0ll L il/E
726-37 69
MECHANICAL PERMIT
Charges and
Surcha rges
CiTY L)F SPRIiJGFiELL]
COI1BI iIATI ON APPL ICATI ON/PERI'IIT 726-3753
Job Address STO/\/)a/1L) /\ r\
r-esal oescription / 7- CA- ,7C Ranoe
EiIERGY SOURCES:
l,Jater Heater
Hea t 5q. Ftg. Access
S_0. Ftq. Other_-_
_l{ew-Add_A1 te r_!iep .
Fence Demo Change/Use
-i.dtfrer-I,,| trir, t o t-t ...r^ -
ntq
Value of ljork:i?1ec*!9Ovrneri ..e., Bui1d Singletsuilc.inq Pernrit info: Describe l^lork(
Famil y Res idence ili th ilttached GaraqeAddress 2072 Norlu S,fq vhone 7Z/-
A-n-*viio,^r-Setr rlo \J D -< tnnll-YiL,<,\< -"y_trztJ I
{fi(A)hConstruction Lender
No
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t-,
o
$f
\-l
Addres s Phone
exn.i res )ohone no.lics. noacidre s snameDESiGN TEAIi
P ri rna ry
3truciura i
El :cr ri ca i
fiechani c: i
exctres onone no.!C;iiS na-e ( acidres s )----.\
Ovnr v\-cv:Cenera i
Pl unbi nc
!-l ec:r: ca I
"acl':ni c: l
II
i
}liCHAii l CALiLiCTR I CiLiLUi ,j^ilU
I FEI i Ci]AFGiN0_i Fr5- , qiAgli:a: rt.iiitRGE
furnace,,burner to
BTU. s
Resioence cf
CN
i
I
I
!
I
i:tn s:ncle fixture ''
I
I
I
Floor furnace
anci vent
Nerv circuits aits
or extensionsi
i
I
Iieiccetec rut idinq
(ner fix. additionai)
Recessed l.ra lI
Sna.p heatpr and vent!
ISERV i CESI
I
I
l
- a< ! don.d
{l tath)
lOuoiex (l bath) each i
Apoi iance vent
seDa ra teTemporary Construct.i onAdditional bath
Stati onar-v evap.
cool erres i dence
Chanqe in existingI,later servi ce I
I
t Vent fan with
si nol e ductI ncius tri a I
mu i t.i fani iy, conrn. or
Seurer
Vent system apart from
heatinq or A.C.0f S.Storm SewerI
i.'lechanical exhaust
hood and ductCOI,1I',!. ,i I ND . FEEDERSi.<(*/5,o9M obi [a *owr"-
|/lood stove/heaterInsta i I /a1 terlrel ocate
distrib- feeders
0f s.
1CI,a9Mnlrft {o l-brt tz /0,0J'I!
I
:
issrJANCF 0F PFP.|IIT o I
-oTOTAL CHARGESTOTAL CHARGES
o!/< ooTOIAL CHARGES
i'lHEP.E STATE L1U REQUiRES that tlre Electricai work be done by an
shall not be vaii'l until the label has been siqned by an Electrical
Electrical Contractor, the electrical portion of this pernit
Supervisor and returned to the Buiiding Division
roermit'anddohereb]1certifythatallinformationhereonistrue
and correct, and I further certif_v that any and all work.lerformed shall be done jn accordance with the 0rdinances of the City
of Soringfield and the Laws of th; State of 0regon oertaining to the work described herein, and that. ilO 0CCUPAI'ICY will be made
of any slructur-e without 1;i1g ps!'mission of the Building Diviiion, i further certify that m.y registration vrith the Builder's
Board is in full force and effect as required by oRS 741.055, that if exemot the basis for exemption is noted hereon, and that
only subcontractors and eninloyees who are in comcliance,rrith 0l?S 7n1.055 will be used on this pro,ject.
I,lAllE(please orint)ry\TURE
Ftg
Ftg
Ftg IIE
TOTAL VALUAT rcN i ?D . O Cb nQ
Const. L^ H Uni t s t so.
Fl ood Pl ai n rAC) Stori es I 0cc.y Group I
T'yoe/lue
lue
r.{ Y+ sq
/one
Fire Zone - Bedrooms 2 0ccY Load
l,la i n
Acces s
0ther
Svstems Develocment
Charqe (1.52) 'Plan Ck. Comm/1nd
6591/Bldq Per Fee
Plan Ck. Res
309ilBldq Per Fee
BUILDING PERNIT
Charges anc
Su rcharqes
Fence
.2,CLr,bLl FeeDemo
PLUI4BING PERMIT
Charges and
Surcha rges
Sidewa I k
Total Cottrb. lermi t 5/,?e
ELECTRICAL PERIlIT
Charges and
Surcharges A/C Pavinq
Cut^b Cut #51,UTOTAL
Mobib Lbmt-4/{ OOArJ,-
SirrlliZ
!i
COMBINATION APPL{CATION/PERI.IIT (CAP)
Applicant to furnlshA. ,iob Add res sB. Lega I Descriotion
1. examDle- Tax Lot I00, Lane County llao Reference
1f 11 .:a
oF sPRINGFIELD (
\
CitY Holl
Sorinqtieid, Oregon
""Jllt';l '-H:,XT*'
Ho. B 55?75,
2. examole- Lot 1. Block 3, 2nd Additio" -
sI7lllii eta EstatesC. llame, etc. of owner and construction lenr {D. Energy Sources1. exanole- heat/electrical ce.ilino/or Iz. p-."":-l e- waternEareEETEETIlEf/oi siE. Squaie i66tage or va.l uation-Ec. -1. exai-.cle- iZ50 sq. foot house.500 sq.?. !ri:lole-. itlew project, check-new -
cnecx aocj, etc-F. 3uilcing pe-r.lit inrornation:i. exancle - construct single tamily ncus. atzrcnec,larage2. exar:ie - relnodei existing garage into3. qljEtr' - convert singie iaiily-resiOe i ir
- r-eC;urant (change of-use)G. .,'al ue of r.Jork as def ineC in Section 303 (a,Strucrural S,,:eciai ty Codei{- OEsiGt,i TE.4.i Ai{D c0t{TRACT0RS
To avorrj design or ccnstruction deiays, Builiviston Staff nust be able to contect apprrersons ragarding ciesign infornation or job
ccrrecEi cns , :tc.
Abbrevracec Flunoinq, i.lechanical , & Elecir.ica l 5i- i.rce:i :;nere Dlank spaces occur in the iescr::r'iion of ::e:.:ecnanical ani ilectrical Sch:ne appiic:nr need f.ill-in onjy the No. Boxe:c !ne acorocriate item(s) to be instal'led8. Ful l Plunlin_o, ilechanical, anci Electrical Sciare ayaj iable ai the Bui lding Division1. fo conserye space on the pernrit form thehave been abbreviatede. If the rtemisi to be installed are not co!he aobre.riated scheciuies you shoulri consful i :cneiulesC. suiLlIiic Oi'/iSIOi,I STAFF lllILL FILL OUT ALL F'E:
CHARGES Oii iHE SCHEDULES0- As ncced on the CAp, the label must be delivereleccrical contractor for signature by his elesuDervisor- The general contracaor ii not autto siqn the eiectrical label
App licant to s i._rn and date
Hhenever pcssible, the.initial aoplication will bea.worksneet only. ,,lhere possible, tsuilding Divis.icwill.prepare a type written cqpy and return it to tapplicanE aE ihe cirne the actLial permit is .i ssued f
s i gna ture.
CITY
PERMIT VALIDATION
19 c
:
ctd
Dote
,ll v-
d e
{t
()
4
l\
Add
Receiv For:
iI
IiI.
IV.
U 09!
U,
ojl
69
{.
rt
?a
4 ?n ;P4 (i
L
e
(.r'€
i
{d\ Amou-nt R.ec eived
Fees and Charges
Plan cneck ;ees are due and oayable at the time of tapplication. ano no plans wiil-be processed until tlfees are paic. All other fees and charges are due apayabie wnen the permit is issued.
FOR OFFICE IJSE OIILY
BY AUTHORIZEO
SHELloH'luRtau!! PFrxtEls
Permi t Cl erk
EUGENE ot 97'or
v f-
4
PROJECT CONDITiONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit app'licant exempt from registration with the Builder's Board because
Additional Project Information :
PLANS REVIEiiIIED BY:
name signature date
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