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Home My WebLink AboutPermit Building 1980-11-21 ,\ , .~ . 'j INSPECTION LIIIE CITY Uf SPRINGFIELD 726-3769 COIIBIIIATION APPLICATION/PERMIT Job Address JS-.3 6 !J1"rJ. fi ~~ Jiilii 1 ~~;~GY SOURC~o... Legal De<cr;ption 17- O~;c; -?_~~-=S =<,'( Hater Heater-N~~ .-r-' ' / I- 0 Range 'i\ 1/\ '/0.'1 en J~.:sO JlaluE of Hork. Ow;er C..,L /'Vl ~>-L;f~ .... -360. 0.9' Address It..r fJJ i n I Buildino Pennit Info: Descr be I;ork( Le.. tj{) M ~ K.:l Phon~_24'4< Fa~i1v Residence l'lith Mtached Garaael -6 I .... .".-"" INFORlIATION LINt 726-3753 Sq. Ftg. 1.la;n ~q. Ftg. Access. Sq. Ftg. Other 1.!20 If:1 Ilel< Add A Her P.ep. --Fence Demo Change/Use .0lther - 010" V., ~. - Build Single 1-0 A Construction lender n.. 10rll';'1l rt a r.k>. Address DESIGN TEAH (name) Phone (address) (lies. no.l (exoiresl {ohone no. I Primary ~ Str1lctura 1 Electrical !1echanical CONTRACTORS (name) I.J. J. trrdL 6-1 dr ' (address) 90)~r in~R.I (lie!'>. no. (~l(o;rp" ) (ohnnp no,) Genera 1 ;109)....j> 2-;>/ 7;/6 -:>-'0 Plumbino Electrical t~~chani Cd 1 ?LUIIBlIIG ELECTRICAL MECHANICAL 1;0. ! lEaCh single fixture Relocatea building (new fix. additional) FFF cHARGE Nn FFF rHARhF NO. FFF rHARr,F Residence of So. FT. furnace/burner to STU's New circuits alts. or extensions Floor furnace and vent S.t. Residence (1 bathl Ouplex (1 bath) each SERVICES Recessed wall Snacp hpatpr anrl vpnt Storm Sewer Of I COI1l.1. /I NO. FEEDERS I Install/alter/relocate rli<:t.rih. fpprlpr<: IOf amps.1 I Appliance vent ~PDa ra tf! Stationary evap. cooler Vent fan with sinale duct Vent system apart from I heatina or A.C. Mechanical exhaust hoarl and duct Additional bath I ~Iater servi ce Sewer Temporary Construction Change in existing r~s.i d~-"c~ multifamily, comm. or Inrlll~triil.l Wood stove/heater amps. ISSUANCF nF PFRIIIT TOTAL CHARGES TOTAL CHARGES WHERE STATE L'14 REQUIRES that tile Electr;cal I<ork be done by an shall not be valii until the label has been signed by an Electrical TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFULLY EXM1INED the completed application for permit, and do hereby 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 Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that UO OCCUPAIlCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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 ORS 7nl.055 will be used on this project. Zone_T? \ Fire Zone Flood Plain Tyoe/Const.\1 ~ Bedrooms Stories Uni ts Occy Load Occy Group SIGIIATUR~). ,:;t - 'hIt:;.1L FOR OFFICE USE miL Y I Sq. Ftg. riain Sq. Ft!J. Access U_ \ Sq. Ftg. Other_/n DmLf::2'/-'?O HAI.1E(please printlt1j.L'. m~7.L ~~.:$4...r - x Va 1 ue x Value x I;::) Value TOTAL VALUATION~OO.~ BUILOING PWlIT Charges and Surcharges ~ c,D _ Plan Ck. _'>-..L,-~-:'______~/Blda :9..0 Pl an Ck. , _ 30%/BI do Conm/lnd P"r Fpp Res Per Fee ISystems Development I Charqe 0.5%) PLUI~BING PERMIT Charges and Surcha rges Fence ELECTRICAL PERI~IT Charges and Surcharges 11ECHAN I CAL PERMIT Charges and SurCharges D~mo . 'Sidewalk ....,...... ~-- A/C Pav;ng I Curb Cut I Total Comb. rermit -5.~ '- S, a!; Y'Ut..lf'i' Ss-2."7 I I I TOTAL '. ~~/, ., . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. examole- Tax Lot 100. Lane County Map Reference 1/ 03 43 2. examole- Lot 1. Block 3. 2nd Add;tion to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical cei1;nqfor forced air QdS 2. examole- waterheaterjelectrlcal/or solar E. Square footage or valuation, etc. ------ 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. examole- if new project, check-new - if addition, check add. etc. C Building permit information: 1. example - construct single family house with an attached garage 2. .examole - remodel existing garage into family room 3. examole - convert 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 TE~~ ANO 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. II. Abbreviated P1Ulr.bing. l-lechanical. & Electrical Schedules A. ~xc~Pt where blank spaces occur in the description . ~~rtion of ~he 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, l'-lechanical, 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 SCHEOULES O. As noted an tho 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 far his signature. 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 ~, .". . . 't' .~~ . PERMIT VALIDATION , ! ~ j 1 , . " Permit Clerk ~ , PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: -';'~N_A.f OO'i~1O~ f'I nO l \), h 0.0\ CD __:t~~" (~,,-::fAo._JIY1.L,Yl'a ~/./K~ () ~" f' ~L{ Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name 10M $J.t.a.1 vholl\ Signatur~f7YV..._"~-' 0 J ~ '"-' u date 1/-2Z~/q&t , -....t.. . ":-' \.......... 't. 1 INSPECTION LINE . CITY UF SPRHIGFIELO 726-3769 CDMBHIATION APPLICATION/PERMIT Job Address ,___? ^, .0 II -A,' J,~ E!IERGY SOURCES: / ,<) '_:> U -rn",(U, V- ~J}I"""_,, Heat vvo... l.egalOe<cription 17- 6~<; -?,~-;;.-=s=<, r, liater Heater ~/('~ .-r-' / I D I Range I'\, &-. 10.1 en.,- 'J~.::sO JlaluE of I-Iork' Ow~er c.-.I-/1\ ~>-L;f~ .... -36('), 0.9' Address ' It..r fJJ i n I Pha ""-_ Bui1dina Permit Info: Descr be 14ork{ Le., cj{) (~ 1\,.)....tM.R k:d ntt/r.....2LiQ:.. Far.Jilv nesidence l'lith Attached llaraoe) . ../.... A INFORlIATION UrlE 726-3753 Sq, Ftg, f1ain ~q. Hg. Access. Sq. Ftg. Other 1.!20 If:1 ~lew_Add_Alter -,~ep, Fence Oemo Change/Use .0lther 01 or v _ ' f ~' i ~ Bu;ld Single -0 A Construction Lender ~~ 10rll M1, .--to r.k>, I I I I I I I 5 I ' : Wood stove/heater I I I I. I I '. . ;..' I ,.', "'I- I ISSUANCE OF PFRIlIT TOTAL CHARGES ~ I TOTAL CHARGES . that the Electrical \'lark be done by an Electrical Contractor. the electrical portion af this label ha~ bee~ signed by an Electrical Supervisor and returned to ,the Building Division I HAVE CAREFULlV EXAMINED the completed application for permit. and do 'hereby 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. Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAllCY 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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that ~nl:y subcontractors an~ em~loy~es who are in campI lance w.ith OP.S ](}l.055 \.Jil ~ be used on this project. . .:. IjAJ:;E(~l~a~~;:~;;~~)jj.1 )n~;;_ ~4 ~r" . .'~, , SIGi~;~UR~;' ,j ~- .-h, ifL c', ";;,::.: OAT~~(S;~;p~. FO~ OfFICE USE Qj{l Y Sq. Ftg. Hain . Sq. Ft9. Access Sq, ,Ft~, Other Address Ut,lurl ItAll Phone I address I flies. no.) {nameJ Primary ~/ Str1lctura 1 Electrical ~echanical CONiRACiiJ~S {name) I.J.). trr;./.L. 6-1 dr_ (addresc:; ) 90)~r in~~R.I (lice:.. no.) ;109)....j> Genera 1 . Plumbinc Electrical ~~~chi!,.,icel ?LUIIB !riG ELECTRICAL :.0_ ! . FFF CHARGE NO ~~~ r~AQr.~ NO lEac~ ,ingle fixture 1~~lOcatea CUlidinq . (ne~ i~x. additional) Is.F. Residence (j bath) , I Duplex (1 bath) each Additional bath Residence of' SQ, FT. New circuits alts. or extensions SERVICES I'TempOrary Construction IChange in existing re':i.i ftepee ' multifamily, comm. or Industrial ~!ater service Sewer " Of amps. Stann Sewer COI~1./INO. FEEDERS .'~ : . I Install/alter/relocate ,dic:;trih. fpjld~rc:; , IOf .... . '.i1~,::1':<'5':,;""",:, amps. .. .:;t :-;o-:,'.~~."'-.~~~-."" ''';; ". ;::'. .,' _I. ._~,i'.'_""~ ". .pi! -" .~ ; .~.~,;(..~.;~:;.. ...:-, ~ ~ - .,.-' " TOTAL CHARGES' ' WHERE STATE L~H REOUIRES shall not be vali1 until the Zone ~I Units Occy Load Occy Group :I() .. Type/Const:~~ Bedrooms Fire Zone Flood Plain - u\ Stories :. -.~. ~i;-;~,tt'- ~'-.~ .;; ......,~ ~~:~ \...... . . . ~:. . ~.\ ~'.: ,.,'. H~,_, .- .,,'::.~ ...., '. BUILDING PERHIT Charges and Surcharges e'." ,5,00 . . , - --------- f;lC> , - Plan Ck. Corrm/lnd 65%/Bldo Ppr Fpp Plan Ck. Res 3D%/Bldo Per Fee Fence ...... .... _ . "._J .~ '0' 'J Systems Development Charq. (J.5~) '" .....~ ~-, PLUI1BING PERMIT Charges and Surcha rges r~i.T>-i. ..... :"1. " D~mo. -: "..~ I.Sidewa 1 k ----------:~-I A/C Paving __._.__~~:...~,::,:.~.I Curb Cut ", ELECTRICAL PERr~1T Charaes and Surcharges (exo;res) (ohone no. I (e'CoirF's) (ohnnp no_ ,2-:;>/ 7;/6 -:>-'0 '. >:1 ., MECHANICAL F='~ ~ 1.Cl:iARGE. furnace/burner to BTU's / Floor furnace and vent Recessed wall ~na~p hp~tpr ~nri vpnt Appl iance vent. c:;p.oarate Stationary evao. cnnler J , Vent fan with sinole duct Vent system apart from I heatino or A.C. Mechanical exhaust hnod and duct . '" . l" -; 'I I pen:tit ..'"1" x .!alue 'x Y- "'Value '~" ".~'M x I;::). Value TOT^L VALUATION '-.300, o~ ~ .' -........ ", '''-'1' ,. - , '/ ' . : . .... ~r". I, 11ECHANICAL PERMIT Charges and ; ;-:n::.. Surcharges . .~ , ./rota1 Comb." Permit. ; I' -5. ~ . '.' _',' IITO;;~...,.~:../.::>.i>J1.~ a3. :;.;\::j . . .' ~:~.. ~'~I'--'" .'. I' ~ '.~ , V'c..c<.\Ft Ss';a..q . ~.. . :7 ~......~ - I , , ,.' . I -., 1." . ~':.' 'f'..t~~~f' t'':::. ~ ; . "-.- .:~::. :;~ :. .' .. .. .to. . \.':C.~...~- '"... '. ' '. ~ -C"<t," .".--' ,,). ' -~ ...... ..~-..... -1', . .-_COMBINATION APPLICATION/PERl1IT (CAP) C. , O. , .. PERMIT VAl r.nHTI'I" ".', CITY' 'OF 'SPRI NGFI ElD City Hall ' Springfield, ' Oregon :, t of Public Work. Oepa rtmen , OFFICIAL RECEIPT No. B 552 47 ( L /:.p f 19 8 CJ ' .. Dale . ';."J fl1 ::z:J1. \fl'filM.u/J~( Rec'd From ( ....., ~ _ t ~1iJJ fU , - d " -:::4t~~ .J;M;!J ~ Address 1;Ji'~)'//_~ " (rJ. C '1' ::/fBD Jtq-4 d For'. P. .0 . , Receive i '[ _' '. 1.. Appl icant to furnish A. Job Address 'B. Legal Description ( "='1..'''' 1. examole- Tax Lot 100. Lane County Ma~ .,.",.., 1/0343 , ..' 2. example' Lot I. Block 3, 2nd Addition Springfield Estates ( Name. etc. of owner and construction lend Energy Sources 'i. examole- heat/electrical ceiling/or n 2. exarnole- waterneater/electrlcal/or Sel, (:- E. Square footage or valuation, etc. --- 1. examole. 1250 sq. foot house, 500 sq. 2. examole- if new project. check-n€w - i c/'leCK ,add. etc. ...., ( '..J -~.,~.'u Building pemit' information: .'.- .,' . . -;...... '~.l. exar.iOle - construct single. family. houst ......'.:!....'. attached garage '.~'~~ ~.,."., ::.2:"'"':examole - remodel existing garage into (~-l . -. ", '3: examole - convert single .family residen .t:::.:,...~~~:.:~ . ,.'. restaurant (change of use) - G." Value of work as. defined in Section 303 (a) .....~.;-:: _ ~<, : Structural Specialty Code (' P 'H. OESIG:I TEAl,! ANO COIlTRACTORS .- .To avoid design or construction delays, Buil ~ivision Staff must be able to contact apore persons regarding design information or job . (f~ corrections ~ etc. ... '.~-tJI.--, Abbreviated Ph.m:bing, i-techanical. & Electrical 51: ., ': .':~. A. . S'xcept I.tnere blank spaces occur. in the descr' ".. ,"'. - '..::::rtion of :ne'Mechanical and E,lectrical SChE ~s '. ~ ".'.: '\.~~ ~ tne appl icant need fill-in only the No. Boxes :.. :..- ~~~..~-:.',.. ~.!,'t:) tne appropriate item(s) to be installed ",':~B. : Full Plu:;;bing.. :-1echanical, and Electrical Sch_ ,- . ....t.<./,:., are available at the Building Division (~. ~~' -..........;y. 1.' To conserve, space. on the permit form the '! .:;-' '. have been abbreviated , 2.' If the item(s) to be installed are not cov' -fj 'J.. ;.'. the abbreviated 'schedules you should consu .l't,h, .;. .,; . full schedules ".... ,''', ,',;:.',",,~,C:.. BUILOn;G OIVISION STAFF WILL FILL OUT ALL FEES ;~'.. ~,.. , (l \ , . "CHARGES ON'TriE 'SCHEOULES ;;;L CI ~ '\ ': ",..:,0.. As noted on the CAP, the label must be'deliverl fO . ';;;f 51 ,/ C. ''--"' } .: .'electrical contractor for signature by his elec ......:..: Amount Rec~_ ~--- .'~. .. ',,' ... superv.isor. The general contractor is .not autt. -~.~ ,:.------., .~-: <D '. to sign the. electrical label. - ~ I -ilL. Applicant to sign and date _ ,_ ..":' :.:;".-, ( (~ - ",-~ ' Whenever possible. the initial application will be l '. IlY " AUTH~RI'ZED 5IGNATU""E ....... '---;'1' "'MT~Il' . ~u'u,,~, all .TAO' ~ j\>' a worksheet only.....Where possible~ Building Divisiol .t._:~' r. ,MIlLTO...TUIl..IlU\.L" ~ . ~.,.' .... d, ' :;;~, . will prepare a type written copy and return it to tt \. : ::" ,,:-. ! j,-:..;.',,~~~~:~~~~.at ;h.e: tim~ th-.~,~~tu~l:permi.t is i~s~ed ,f~ CS ~l~"".'.. " ~.,,~,,~,':""~':;_:;:.~'_. ~~___~. .:1- ....;.~~. .FeesandCharges','."~':" .,.:' ','::' '..~'l,"'-.'F"'..:,,;,:~.i -l- J'" ~':::::.__.~.-:-;-.---,_..-..;-.:.~.-.-.--. ,. ".~ .J.- I~.. .~ '. <..P.lan check fees are due and payable at the time of'tl1e;--.~"~~:-:~ . ,;":'''':'':-'.>'' .... '.._'._ -:'~"" "'~:.. -_" _~~...... app 1 ica ti on. and no plans will be processed until these . .'< : .._'1~... \" . .: . ~_'> _ :. :<_, ~.\<:~' fees are paid. All other fees and charges are due and t ,'.:......~.::.. L .;.;" ,:~., :. ~-;:-..payablewhen the pennit is. issued. ...",';.....!,''!;:--:-~--:..~--:..,..; :~;";.:- ~...,..'::!.:.<- ........... .....'-..~..T'..:. '_~.' .'-~~ ';OR OF~~~E USE}NLY . ":';',~;,;::"'.:~~::+}~l;l~"< ::::,: .... Per~i t. Cl erk'" ::., - -~''" ,: -p..- "'.. -'-~''''':'' /\<:.., . I. - .'__. -. -..' - Co ( .'-\ c '}. Re5- {)p r 1(, c -' , " A fcl;- ./ <.c;. O~ ( '-1,%-' ;;. ,:;).() - c' ,,' " n '.. ....J,. ..."..._IIIL'. '''' ~ .:. .... .- .. .' . .. _' '. . " " . ~~', ~'< . .-.. l' . " :PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY :.::.i>,';:'--:' '., ,;,.:,', ,'" .~~:~~2~~:.<{.~-8~~,6~;~.~,::.'::;:~,::~~;~;~.~'~'~~-d'(}j-=~~;~;;~~, y I- "," ' 0 ~-( ,. "'.-:'.~- I' ~.~ - ....,..... ..._ - ..~\..' '--.">;>."-: ,.\~',;.'~, , ~......::::;"'::-.'=--"::"... -~',~.-. --. '--:':--50:: -. . ..... '. " . :.: -.. '. ',' ". ,. '" ":;~:~:.~::(0J~1A~(:iA1tL-it;J. ~;)/.jy , ----- " K ' . . --..,c' ~._, >';:;0..,0.:,;:-= V ~ "~" .. - ..... '-.- . .._'....,...: ,,:" -e.:::' \~~~,,~' , . .!~. .! . . . ..," : ~.':....l..,,-;~"\......,:~. :--!h'r-_'O;.:....:.. ~'~..~ - . -...., ...' ' ., , ~'. . .: .:: - -~-. ~, .. -' ..: :; ..~...,~, .-' i._ ~ '. . :,\ '. . ~ '. .~:",.P.ermit...appl icant exempt from registration with,,,.~.he Builder' sBoard because: ~.', ..... '-i~::''''7'~' './~.". . -.. . ,~...:~~' ':~'~.;.. .: ,:' ":.,t-":<' 1..-'_"!'_ .. =~,.':';:,.. ~~' ...,' . :,;-.'. " , "',l. .::'.r:.....;,. , ........ ;. ;--t~>..._; ..~":-........... ,,,.,', ,. . ..'.' . :..,~~" ..,-"'...,., ., Additional Project Information: ,,'::;' ,..~. , . ':;:"~ "":(Z. ,> , ,,:,., ,':" ',. ,'" ,.......,...;.",,~~,;.t.,... _,~...,,~ .'. ~ " ..,~ '." . <'r' ... .,. ."-'" . . - .'. .- .~ ..~.'-t.. '..'-.....Tr. .-<' . .:. . r ....':t.:__~-:. ..: . "",' ~ ,., ,-,,-,~; '",::." ~....' . '..~;.. :...... .. '., ., ..'..-. ~ .... ,,: '.' - .--~.',--; ~ " ..- '- .:...,! .-. " ..,:::'_J~,:.,~~,~_r~:.::~_.,;: _;" ;. ~ '..~ , . .','.. - -... ..!-- '. - . ~).: ~ .- . r~ .~..., -.;. ">~' ".'. :". . '. ._ . '_..;~ >.C~~~' .""'1. :. ," . ~' ~ . .'-,.. . , '. ~ '.'".~1.',:,__~'; Q , -':'~!, "~' . . .: ; ~,' ,~ ....~ .... '.. ;F':~...:~-~~ ,.~....;..:....-"1- ,:. '., p~~~~., ~EVI ~~E~. .~~:. ,>C >~~." '.: >~, r \.:,:,~,; '.. ,:.,~'." ,,':..,.:..~:.:;.~j;.~.. ';"_'. : . ,'. ':- '" :~~'],':.,.,. ':,' , n~~~':'} ;);,}:~~);;{l~?k';:~' : .~. s fg~:~~~~~~~:: ,,'&,}/ll;;J ~."d;~e 1/:'22 ~lqjcr . . . '.; ". ~-.. " ~ l.t' : .. .";'; . ... . " ""f'.,' , , . .. -1" '-". . }Tr.,__,-~.~, 1"-:- , ' .....~~ '--,' . .... :. ~'~"'-"... '-~,_.-