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Home My WebLink AboutPermit Mechanical 1980-09-25L CITY OF SPRINGFIELD COMBI iIATI ON APPLICATION/PERMIT 726 Job,': lress l-ega1 Description q Ran l.later Heater EIIERGY Hea t AP L tg. l'lain_ Sq. Ftg. Access._ Sq. Ftg. 0ther_ J{ewJddrAl ter_ReP. _Fence_Demo_C hange/ U se 0ther""i:u8b.ooOwner-fi:,c k€-1.'Rott scr Att tI ng e Addres s Phone lt )A')SnAU6 i Chtmn4tttLb)H3_-l Constructi on Lender so O -D \ O Addres s Phone dre s ll-/ El ectri cal Structura l Pri ma r l''lec ha n i ca I ohone no-'l i cs. no.'exoi res )addres sname Genera l Pl umbi nq El ectri cal I,lec ha n i ca I MECHAN I CALELECTRICALPLUIIB I NG FFF CHARCFFFFrHA RGF NOFFFCHARGFNOilo. furnace/burner to BTLI' s Residence of FTSQEach single fixture Fl oor furnace and vent New ci rcui ts al ts or extensions Relocated bui1ding (new fix. addjtional ) Recessed wal I Soace heater and vent-SERV I CESS.F. Residence(l bath) Duplex (1 bath) each Apol iance vent seDa rateTemporary ConstructionAddi ti onal bath Stationary evap. cool er Change in existing resi dence[.iater servi ce Vent fan with sinole duct-Tndrrstrial multifamily, comm. orSewer Vent system apart from heatinq or A.C.amps.0fStorm Sewer Mechanical exhaust hood and ductCOMT.I,/IND. FEEDERS Insta l I /al terlre1 ocate di stri h- feedprs l'Jood stove/heater amp s.0f ISSUANCF OF PFRI1IT TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES WHERE STATE LAt,l REQUIRES that the Electrical work be done shall not be valiI until the label has been signed by an Elec bytri an Electrical Contractor, the electrical portion of this permit cal Supervisor and returned to the Building Division I HAVE CAREFULLY EXAIIINED the completed application for oermit, and do hereb.y certify that all infonnation 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 Cityof Springfield and the Laws of the State of Oregon 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 certify that my registration urith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in comcliance with 0l?S 701.055 wi'll be used on this nroject. oor?25-fuI'lAl'lE( pl ease pri nt )S I GIIATURE a Flood Plain _ Stories Occ.y Group Sq al ue TOTAL VALUATION x Uni ts/Const Bedrooms 0c cy Load Val !q S o,. rtg.qlal Val ueFire Zone Zone Ftg Fts Acces s 0ther Plan Ck. Comm/Ind 65%/B1C'o Pcr Fee Svs Lna terns Deve rqe (1.52 opmentBUILDING PERMIT Charges and Surcharges _5 Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surc ha rges Demo SidewaIkELECTRICP,L PERIlIT Charges and Surcha rges A/C -Paving Total Comb. Permit Curb Cut TlECHANICAL PERMIT Charges and Surcha rge s _t TOTAL e0.re )e Work ( I Garaoe rnnp nopYnt reqIFAtl :TORS 0r COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. gf{p]g- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot I. Block 3, Znd Addition toSpringfieid Estatesq. Name, etc. of owner and construction lenderD. Energy Sources l 2 atr as E. Squ ga dit rage i on, II. F. Bui lding permit information:1, example - construct single family house w.ith anattached garage ?. examp]e - remodel existing garage into fami.ly roomr. exampte - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Speciaity CodeH. OESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Bu.ildingDivision Staff must be able to contalt appropriitepersons.regarding design information or job sitecorrect'ions , etc, Abbreviated Plumbing, Mechanical, & Electrica.l Schedu.lesA. Lxcept where b)ank spaces occur in the descriptionportion of the Mechan.ical and Electrical Schedu.les,the applicant need fill-in only the No. Boxes adjacent - to the appropriate item(s) to be .insta'lled B. Full Plumbing, Mechanicai, and Electrical Schedu.lesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF I^JILL 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 his electr.icaisupervisor. The general coniractor ii not authorizedto sign the electrical labelApplicant to sign and date Hhenever possible, the initial application will be used asa.worksheet oniy. !,lhere possib)e, Building Division Staffwill.prepare a type written copy and returi it to theapplicant at the time the actua) perm.it 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. Al l other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONIY III. IV. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: PERMIT VALIDATION Permi t Cl erk Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: datenameSigna tu re PECTION -37 69 I,IECHANiCAL PERIlIT Charges and Su nc na r^ges COIIBIiIATI ON APPL ICATION/PERMIT 726-31s3 )JFt ql-ega l Descri pti on Job /- -rs5 5 Ran Hea l.later Heater EIIERGY Owner C Vai of rilork eo Sq. Fto. l4ain.-- Sq. Ftg. Access.--_-- Sq. Ftq. 0ther_ _l{ew ,Add--_rAl ter TEp. _Fence_Demo_Chan ge/ Use _other-_=--- F il nq Pernit Info: Descr Resi dence t'li th Attach i1d SingleeAddres s Phone L1 Construction Lender Addres s Phone \Jc -c N\) \)U' a s Pri ma n0 Structura I lJ Electrica.l i'lec han i ca I Genera I Pl um n r hani I PLUIlB I I]G ELECTR I CAL MECHAN I CAL F Each single fixture Residence of SQ. FT furnace/burner to BTLI' 5 Relocated bui ldinq (new fi x. addi ti onal ) New ci rcui ts al ts or extens'ions Fl oor furnace and vent S . F. Res i dence SERVICES Recessed wal I Duplex (l bath) each Additional bath Temporary Construct'i on Apol iance vent l,later service Change in existing Stati onar,v evap Sewer multifamily, comm. or I I ent fan with Storm S r 0f .amp s orA Vent system apart from COI4I.,!. /IND. FEEDERS exhaustnca Insta I I /al terlre1 ocate llood stove/heater amp s.0f ISSUANCE OF PFRI,iIT TOTAL CHARGTS TOTAL CHARGES TOTAL CHARGIS hIHERE STATE L1I,Ishall not be valil REQUIRES that the Slectrical work be doneuntil the label has been signed by an Elect by an Electrical Contractor, thericai Supervisor and returned to electrical portion of this permit the Building Divis.ion I HAVE and correctof Soringfiof any stru Board is in onl,y subcon I.lAl'lE( pl ease pri nt)I GiiAT o Derm i fo rme Y EXLL t CO tede a c ap t o fornpp t an d do he rt hat atreb.y tfo rna nfy0 he nreo rt uefundahertcerrtf+tha a nd-V ny t^/o r roe d has AC rdc0 ceanndonbe ht he 0rd nan ce 0S f rh C tyadndtheofLawsStheteta0OTre00nrta0enntothkilo rq |^des c b heed re n dan hat ilct OC CUP AI w1CY b dematu!/tre hot tU th rmlpe s o ofn Buthe d ng s on fu r rthe rte ttha rat tfym.y v/t0n theth Bu der SIuforcendaeeffLLasudrereclORS070t55bythaexetbahemptfosrtonexempnsheoted0nreathand ttrtoracndemDawhoreoyeesnanc0mDcethtliT.J0 07 05 5 be sedu n th ec tDTo.j A-z cr-er-, DATE / C' -t Lt'-' Ftg Ftg Ftg llni ts So c.7 Group TOTAL VALUATION X X Ine/Const. Loa dBed roomsF i re Zone Zone al ue Flccd Plain_stories : Val ue Val ue Acces s 0ther an Ck omm/ Jnd 6 o roe 1.5q Svs Cha S opmen tBUILDING PERI.IIT Charges anC Su rcha rges an C Btd Res Per FencePLUI4BING PERi4IT Charges and Su rcha rges D6mo SidewalkELECTRICAL PERI,IIT Charges and Surcha rges fotal Conb. permitA/C Pavi ng Curb Cut ec.8cTOTAL ul arn re l,lork Garao lt)ffiD1Tfit )F; | ( j 1t ]Ttj RS n amP taq nn C HA PGF iin FFF r.HAPT:F T]FFF Snacp hpatan:nd vanf sPDa ra tp s -=-ruilce44 COMBINATIOI'I APPLI CATION/PERMIT ( CAP) Applicant to furnish A. Job Address B. Legal Description 1. examole- Tax Lot 100, Lane County Map Referr l7-T:-?3 2. examole- Lot 1. Block 3, 2nd Addition to Spifngfield Estates C. llame, etc. of owner and constructjon Iender D. Energy Sources i 1. exancl e- heat/el ec trical ceiIi /or forced e- r^ra te ea er, CITY OF SPRI${GFIEtD Ciry Ho[ Springfield, Oregon Deportment of pubtic WorksOFFICIAT RECEIPT c PERI4IT VALIDATION No. B l9 54700 { E 6 0r so ar t. Square-Tootag e or valuation, e 1250 sq. foot house, 500 sq. foot if new project, check new - if add , etc. L. e e 1 2 e a,qol e- ex an e- ec k aCdF. Bui lding permi t informat'ion : ( l. exaiple - construct sing'le famiiy house wit a -ttei"€d garage ?. era::le - remodel existing garage into fami 3. axar'.51E - convert single family residence ' r r'"-s tl,.lrant (change of use) 5. Talue of r.rork as defined in Section 303 (a) of 5:ruc:'..;r-al Specia I ty CodeiJ. ::5;G:. T:ii.'i AIID COIITRACTORS l::vc;c cesign or construction deiays, Buildir :i.,i::.r 5taff must be able to contact appropr :,.1r:cns ra;:rding design information or job si :crri:'-ions, etc.-'.'1.i.r.:'-:: ili,--cine, i'lechanical, & Electrical Sch t^ :.:'r:r:.."ii.e Dldnk spaces occur in the descrip':.::.n :i:r:e llecn..rn'i cal and E'l ectlical Sched '":.? ii) i:c:ni need fill-in only the No. Boxes" "'r jilr'c:r'jate jtern(s) to be installed .' : . :. : r'r1, :''rch.tni ca l , and El ectri ca i Sche :r,. ri.r:l rtle :t the 3uilding Division 'ti.rr-ve soace on Lhe permi t form the s :-.'rn rcbr?v'i aied,.::.:r{si to be installed are not cor. ..vr,rtec scnedules you should consr :re4,lleS::.'::IC:i STIFF ilILL FILL OUT ALL FEE: r ,.L jLr:iL"JLt) ::r'.:r. CiP. the label must be deliver _.:r.lctcr for signature by his el .,r:n5.1 I ggpg;actor is not au:.: .:i l:bei. :i rl ,rpplicatjon will b,.:rlie. Euiiding Divis' '.r:; .rnd return it tc'-' ..r i lerr:it is issuec ::lr, ,ri. ihe time,. ; rnlg<5e{ g;1lj :r tr:8s are due and d rom For: Amounl Received HORIZED SIGNATURE H E t E hE ,F ;^rdL :dt 'rn r"lr 6i. ) (, \s (i_ I inese BY ro(-TURNAUL! pRrilrERS - EUGENE OR 974Ot 56!fi.a : it tl1+ : . tttt +.g r ilrrt. jr --r- () Perm'it Cl erk l-) Li'\ r'r(UJLLi L-'r.,r .. - rr ; : .: ]!;:OF.E OCCUPAI{CY : permi t appl icant exempt from regi strat.i cn it i;h the 3ui I der's Board because Additional Proiect Informatjon: PLANS REV I EI^IED BY : date name Si gna tu re (l ( l