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Home My WebLink AboutPermit Building 1980-03-31INSPECTION LINE 726-37 69 TTTYTI-SPRIXG COI4BIi{ATION APPLICAT IT TMORI,IATION ITNE 726-3753 loA Y Job Address 38c" Lega1 Description EIIERGY SOURCES: ,ue* Ekcy't r C llater Heater Ranqe Sq. Fto . l'Iain //4O Sq. Ftg. Access._ Sq. Fto. Other J ,t Q _l'lew_Ad dJ I TEi____[eE. - _Fence_Demo Change/Use -other- 1r- flot flOzOl4L 'ut" ofuU,o'/rz, I Owne r 5 an!!:: t ?s- i; g;zl Phone Bui I cii FarniIy nq Pernrit Res i dence I nfo: 1,l i th Descri be l^lork ( Attached Garaoe 'e., Build Single 7J6"-oz7 f /6 r 30 A/&, Construction Lender 'oh e-. " epoc; *t E;Zrdch7 Addre s s Phone DES IGN TEAI.I name addres s l ics. no.exD l res ohone no. Pri mary Structura I E I ectri ca l Mechani cal CONTRACTORS name address )lics. no.exoi res (ohonc nn El ectrical t'lechanical PLUI{B I NG ELECTR I CAL I'4EC HAN I CAL N0.FEE CHARGE NN FFF .HARGF NO FFF CHAAGF Each single fixture Residence of 3*a sQ' FT' furnace/burner to BTLI' S Relocated building (new fix. additional) New ci rcui ts al ts or extensions /5*Fl oor furnace and vent S. F. Residence(i bath)SERV I C ES Recessed wal I Soacp heatpr and vent Duplex (l bath) each Additional bath Temporary Construct ion Apol iance vent seDa rate I,iater servi ce Cha res nge in existing i dence Stati onar.v evap. cool er Sewer multifamiiy, comm. or I ndu s tri a'l Vent fan with sinole duct Storm Sewer Vent systern apart from heatinq or A.C. COI4I.l ./IND. FEEDERS iilechan.ical exhaust hood and duct Instal I /al terlrel ocate di stri b. feeders liood stove/heaterEa s.* 0f S. ISSUANCE oF PFRI1IT /o.- o TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES I^JHERE ST A T E L,1r,r REQU ]RE c tha t the EI ec L rl ca I t^lork be done by an Electrical Contractor, the ele Electrical Supervisor and returned to the ctrical portjon of this Pernit Bui1ding Division s ha I I not be VA I i .)u nt I I th e l a be I h AS been s 1 I ned by an I E FULLY D the comp apni i cat on for oermit, an d do hereb.v certifY that all informat.ion hereon is true with the 0rdinances of the CitY that ll0 0CCUPAIICY will be madeand correct,and I further certifY tha t any and al1 wor k performed sha .ll be done in accordance of Soringfie ld and the Laws of the Sta te of 0regon oert aining to the wo rk described herein' and 'istration with the Builder's of any struc ture without the Permfull force and effect i ss ion of the Buildinq Division.Ifu rther certifY that m,Y reg tion is noted hereon' and that Board is in as required bY ORS 701.055, that i f exemPt basis for exemp only subcontr actors and ernployees who are in comc l'i ance wi th Oi?S 701.055 t1 used on thi s Pro,j 7/m a4 DAlE7 -r)-trU tlAl'lE ( pl ease Pri nt ) SI r C) e/const. T'tU. Units sQ Ftg t,1a 1 a 1 ue Zone E- I al ue Fire Zone-&--Pedrooms 0ccY Flood Plain Stories occ-Y Load Ftg. Access aroupkS sq. Fts 0ther x Val TOTAL VALUATlON 4< Svs cha terns Deve 1.5X 0pmen t 71 BUILDING PERI''IIT Charges and Surcharges oa>Pl an e a an Ck Res Per FBI Fence n OO PLUI4BING PERMIT Charges and Surcha rge s Dem0 Sidewal k@ ELECTRICP,L PERI1IT Charges and Surcharges 6;e A/C Paving LUTO LUL Total Comb. Permit gt.86 TOTALI4ECHANICAL PERMIT Charges and Surcharges t {OO ----LQ:----<? /9,u, tz 0f amPs .€e COMBINATION APPLI CATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. ' example- Lot 1. Block 3, Znd Addition to SErlngfieid EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check new - if additjon, check add, etc. i Iding pernlit information : example - construct single family house w'ith an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into restauiant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Speciaity CodeH. DESIGN TEAM 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. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except r.rhere blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the appl icant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1, To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF l^llLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by h.is electricalsupervisor. The genera) contractor is not authorizedto sign the electrical labelApplicant to sign and date [,Jhenever possible, the init.ial application will be used asa.worksheet on1y. Where possible, Bu.ild.ing 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 theie ' tees are paid. All other fees and charges are due andpayable vrhen the permit is issued. FOR OFFICE USE CNLY II III IV V 1. exampl e-2. examcl e- Squa re -i6otag heat/el ectrical cei I i forced a'i r gas wa te eor or sol areec tr etcE eater ca va I uati on , F. Bu 1. PERMIT VALIDATION Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: P e 'trm at 'l ac tn epp x +L romf re s.I ratemp 'lt Won t hg ht e 1Bu dI re S B oa dr cbe a u eS Additional project Information: PLANS REVIEWED BY: name Lansar gna tu r date 7 '7/- i ae< si a I I 7 LIIIE ICATION RMIT 7?6-3c011BITIATlON AP 't.3t t l-egal Description Job Address Hea Ranqe llater Heater EIIERGY S -ft- AO 4.Val ue of..|lork:,l4, vclc) Sq. Ftq. I'tain l/4d Sq. Ftg. Access. Sq. Fto. Other ?.J () rlerv Add AII#46:- Jen-e_OEfr.o C ha-nge/ Use 0theru5a.n Phon e Owner Address Single Fani I Des Ga nq Re S dence lli th t In (-o77 f Phone C,)7 e-Construction Lender Address D, e, ,( -3o ca : DES IGiI TEAII n ame addre s s lics. no.exr|l res ohone no. Pri ma ry Structura I El ectrical llechan i ca l name address I i cs. no. ) (exoi res ohone no- ) PI ,AI Electrical l.'tec ha n i ca I PLUIlB I IIG ELECTR I CAL MECHAN I CAL FEF CHARCF NO FFF al-.14 pc F N0.FEE CHARGF Each single fixture Residence of 3?ct sQ. FT s furnace/burner to BTLI Relocated building (new fix. additiona l ) New ci rcui ts al tsor extensions /t.Flqor furnace and vent S . F. Res i dence(l bath)SERVICES Recessed wal.l Soace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent sepa ra te l,later service ge in existing dencp Chan res i Stationary evap. cool er Sewer multifami1y, comrn. or Industrial Vent fan with sinole duct Storm Ser.rer 0f .amps. part from c. Vent system a heatinq or A. COI4I.1./IND. FEEDERS Mechanical exhaust hood and duct Instal I /a l terlrel ocate d'i stri b. feeders ['lood stove/heater s.* amp s.0f ISSUANCE oF pFRtltT /o.n TOTAL CHARGES TOTAL CHARGES l<--t.!r TOTAL CHARGES /5:* WHERE STATE LlN REQUIRES that the Electrical rvork be done by an Electrical Contractor, the electrical portion ofshall not be valil until the label has been signed by an Electrical Supervisor and returned to the Building Division of soringfield and the Laws of the State of 0reoon Dertaining to the woof any structure without the permission of the Building Diviiion. I fuBoard is in full force and effect as required by oRS 701.055, that.if eonly subcontractors and emnloyees who are in comcliance with ops 701.05 const. "F-l2. Units sq. Ftg. nain..Lap a?c> x_Zc.i*_ua'tu"_#E&:-_ DAIE) -, ),- fctllAl,lE(please print)SI Zone R- I Flood Plain Stories Val ue F x TOTAL VALUATIOI (o't ilp 0cc.y Gro 0cc y Load Sq. Ftg x Val t basis for exemption is noted hereon, and that E 'n L E NI tED he eI ote L n rIcompfo LI an dapDerm!-) an d fu rthertrrecc0nda a 'Il rkt{oandceIrtttha shaoerfo rmed If5rany do hereb.y certify that a I inforrnation hereon is true used on this oro,j Acces s this perrilit --////,////744 --6l r re Zone 1;; Bedrooms uP:{.-. . Sq. Ftg. 0ther I be done in accordance with the 0rd'inances of the Cityrk described herein, and that NC OCCUPANCY will be madLrther certify that m.y registration vrith the Builder,s Pl an Ck. Comm/ Ind 65"1/Bldo Per Fee Svs Cha VC 51 tems Deroe ( i.opment 3aBUILDING PERI,lIT Charges anC S u rcha rges .1!"> aa> Plan Ck. Res 30r1lBldq Per Fee i.ra>/2 Fen cePLUI4BING PERMIT Charges and Su rcha rges Demo 5i dewa I kELECTRICAL PERIIIT Charges and Su rcha rges iL* C o'd2 Total Conb. lermit 8?.A/C Pavi ng Curb CutI,IECHANICAL PERMIT Charges and Surc ha rqe s co___ _L> {e I(.TAL /3t rz RA(: it)RS I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job Address8. Legal Descriptionl. iie;l}, Tax Lot 100, Lane county ,u, 0".; iT.,2. examole- Lot 1. Block 3, 2nd Ad Ao, U I r ' - Sflffi[field Estates tu-, C. Name, etc. of owner and constructior PERMIT VALIDATION OF SPRINGFIELD CitY Holl "'rlli;ili'-'t,"#-; E 3 1 u n'. 17 l) D. Energy Sources1. exar"nol e- he?. ExanElE rvaE. squaiE-EoG9e at,/electrical ceilin e ectri ca at or va I uati on, etcl. example- 1250_ sq. foot house, 50(2. examoie- JT-new project, cheik.:rx tr1check add, etc. \ F. Eui lding perr,rit information:l. exanple - construct single family attached garage i2. exarnole - remodel existing garage \^ 3. exarCIIE - convert singie iaiily"re iEsti-uFant (change of-use)G. Value of work as defined in Section 30.Structural Specialty Code .H. DESIGN TiAi.,I AIID CONTRACTORS To avoid design or construction delays,Division Staff must be able to contatt , ..u,persons recarding design informat.ion or 5 . corrections, etc. Abbreviated Plun:bing, i'lechanical, & ElectricA. Except r.rhere blank sDaces occur in the d ,,portion of the Mecnanical and Electr.ical Lo the applicant need fill-in only the No. t _ to the appropr.iate item(s) to be.i nstalleB. Full Plumbing, l'iechanical, and Electrical rrtare available at the Build.ing Division ( l. To conserve space on the-permit form have been abbreviated2. If the item(s) to be installed are not oLthe abbreviated schedules you should c (rr ful l schedulesC. BUILDING DIVISION STAFF WiLL FILL OUT ALL I CHARGES ON THE SCHEDULESD. As noted on the CAp, the iabei must be delielectrical contractor for signature by hissupervisor. The generai contractor il not ,to sign the electrical label Appl icant to sign and date lJhenever possible, the initial application wilIa.r.rorksheet only. .l.lhere possible, Buitding D.iviwill prepare a type rvritten copy and returi it t,applicant at the time the actual permit is issuersignature. Fees and Charges PJan check fees are due and payable at the time oapplication, and no plans r.rii l be processed untiltees are pajd. All other fees and charges are durpayable r.ihen the permit is .issued. FOR CFFICE USE CXLY dF Rece ived For: A mou nt sr |- ( ( II III IV. c ( (oc ?( ( (,I Ga ( ( (BY ( 9I6NA'TURE 97aol ga!rl'6 V Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Bujlder's Board because: Additional Project Information: PLANS REVI EIdED BY name I2.+"e dat e 7'P.Bos't gna tu reLavu* (