Loading...
HomeMy WebLinkAboutPermit Building 1984-1-18 II INSPECTION LINE 1I726-3769 Job Address 1485 Market legal Oescription\~ a~ 2.6 41_ Lease' CITY Of SPRINGFlElO COMBHIATION APPLlCATION/PERMlT E!IERGY SOURCES: Heat Hater Heater Range_ ValuE of Hork: $4,200.00 Phone 746- 50 3lf~~~~~n~e~~~~~e Inf~h A~i~~h~~e G~~~~~ 1-.e. I Build 51 ogle ~w.ACzf) ~~ no.) (exnires) 1.t - .' ~~ \0605 " Gene Bartlett Address 90366 Shadows Drive Springfield, Oregon Construction lender Address UI:.:'ll:iN Tf.Af~ Primary Structural Electrical {namel Phone (address) , ~'" !1echanical IfONTRACTORS Inamel General Fredrick Christiansen Plumbina Electrical ~lechanical NO, (addrpsc;) Construction 658 (lir:<:;. no.) Fairview Spfd. 39287 (nhflnp flQ- \ 747-1381 Dave 0 sElectric 401:5: '. Main Spfd. PlUI1BING \).I~ I FFit rHARr,F Nn ELECTRICAL Residence of Each single fixture SQ. FT. Relocated building (new fix. additional) 1\ 5.c::t \5 cD I I I I I I I I I I I I I I I I I I I I \~.OJ I TOTAL CHARGES WHERE STATE L'H REQUIRES that the Electrical work be done by an,'Electrical Contractor, 'the electrical portion of this permit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the BUilding ~ivision S.F. Residence 11 bath) Ouplex (1 bath) Additional bath Water service I Sewer IStorm Sewer TOTAL CHARGES \ New circuits alts. or extensions each I SERVICES I 13240 ~~~ r~4Qr.~ Nn INFDRllATlON LINt 726-3753 Sq. Ftg. I-tain ~q. Ftg. Access. Sq. Ftg. Other flew Add Al ter Rep. Fence_Demo _ Change/U se _Other CX) ~ C) Q ~ ~ ITemporary Construction IChange in existing rps.i d_e.nce. . Imultifamily, comm. or Inrlu<;triil.l IOf ICOMI-t./INO. FEEDERS I Install/alter/relocate r1i~trih fpprlpr~ I Of amp~1 C1TCUJ."'C I liS amp. to uu lb.Lc..s .b.Lgu I 8 nllHl'-inR I I amps.! I I TOTAL CHARGES (Dhone no.) (pxoirpc;.) 3-19-84 5-10-84 746-5640 MECHANICAL\" \\ ~ ~~~ r~4l)r.~ furnace/burner to BTU.s Floor furnace and vent Recessed wall ~n~rp hp~tpr ~nrl vpnt Appliance vent seoaratp Stationary evap. cooler Vent fan wi th sinole duct I Vent system apart from I heatina or A.C. I Mechanical exhaust ' hood and rllJ~t I Hood stove/heater ISSUANCE OF PFRIIIT I HAVE CAREFULLY EXM1INEO the completed aprlication for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Orec,:lOn pertaining to the work described herein, and that rw OCCUPAHCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder.s Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 7Ql.055 will be used on this project. SIGrlATURE 'rr-tWo~ ~,Q,~"",,0.6JU-o./' Foii"'o'r'FICE USE OIll Y ~ Sq. Ftg. t1ain x Sq. Ftn. Access x Sq. Ftg. other.3.R?--.~ x IIAHE(please print) M A<>CE:fJ€ 20ne CJ Fire Zone - Flood Plain - BUILDING PERflIT Charges and Surcharges PLU'1BING PERMIT Charges and Surcha rges ELECTRICAL PERI~IT Cha rges and Surcharges ~ I1ECHANICAl PERMIT Charges and Surcharges CHRISr/AN5.erJ Type/Const5-U Bedrooms Stories Units \ Occy load Occy Group~-~ --::2 (') C:C::> P I an C k , ___~,,~_____ 65%/Bldo 2. 0 Plan Ck. \ ~ ~ 30%/BldQ ___~~~___I Fence OfIRIO CO COIll11/1 nd Pj'r FpE' Res Per Fee ;-:/!; i'l rAJi_ -!J.{) ~o "4oZZLLJ \5, --------~-- AIC Paving _ --.k). \ ~ __ -' Curb Cut ~ I ' ' 'Sidewalk DATE 1- le-84 Value Val ue Value ,-/, 'l_()/') TOTAL VALUATION \01~ ~--\\-- ': I~ Syste~s Development Charqe (1.5%) , Total Comb. Permit k\ ~. 8B f TOTAL , l COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Oescription 1. example- Tax Lot 100. Lane County Map Reference II uj q3 2. exa~le- Lot 1. Block 3. 2nd Addition..to Sprlngtield Estates ..' C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. ----- 1. example- 1250 sq. foot house, 500 sq, foot garage 2. 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. exam~le - remodel existing garage into family room 3. examele - conver~ single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code. " H. DESIGN TEM~ AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate perSOilS rega'rd1ng :design in'formafion or jOb site .. ~ <. corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve. space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is ,not authorized to sign the electrical label. --- III. Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signa ture. IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY (,l .t.. - ~ PERMIT VALIDATION I/)f/Y( , d ~.,. . ,.. ,~.L LI~7~.1 :'..... ./' ~~l J'Penni t C1 erk ~~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ~ ~\~\ \\')'b'->F.C'"'t\C"\\\,q.. "Tl"'\ ~F: ~QQQ~("') \AC=.~~_E: D('{\.\~~"\('~ Permit app1 icant exempt from regi strati on with the Buil der' s Board because': Additional Project Infonnation: PLANS REVIEWED BY: name\'"")~'\C"\ ~"9\.}.,~~ Signat~....A~:'P"" \r dt~e\':"'\~-~"-\ J