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Home My WebLink AboutPermit Electrical 1980-11-26 'J INSPECTION LlIIE . CITY OF SPRINGFIELD 1726-3769 COMBIIIATIDN APPUCATION/PERMH Job Address 1(P-1-! Mil vhl- rSJ:;a:.f,j- ~~:~GY/I~:h'=(_ l'latef'-Heater RaD<je- ( ." Legal Oe5cription -r;, y I A">+ Owner IUnyj( Address / IP4/ Construction Lender Address Ut~llirl T~AH Primary Structural ElectriC:ll !lechan; ca 1 CONTR,t,CTORS Genera 1 Plumbina Electrical ~~echanical NO. Each single fixture "'yaluE of Horb' 'it' sro,O_ BuilGinQ Pennit Info: Describe I~ork{i..e.. Build Single Familv nesidence With AttaChed r.araQe) L.?hl/ rJIlVfr10!P_ hof -h-!h I . 11-h'3~2..t'::,-':),,'J. /4/DO ("Xflvd MY MIJ//h..i- 5,t-VILI- Phone 72;;'/ 589j (name) Phone (address) (1 ics. no.) (name I (address) (lies.. no,) (9 \t\J IILV,,-- ?LUIIB IIIG ~ .QlARli( -1lQ..1 I Relocatec building (new fix. additional) S.F. ?esidence (] bdth) Duplex (1 bath) each IAdditional bath ~}a ter servi ce Sewer Storm Sewer /6.0f; 1(') 0;: r I I ITempOrary Construction IChange in existing rp<; i d~ncc Imultifamily, COlIDl. or IndlJ<;trial 10f amps,l I COMI,\' liND, FEEDERS I Install/alter/relocate I di<;trih. feeders Of amps. " . , INFORl1ATION liNt _I 726-3753 Sq, Ftg, 1.lain ~q. Ftg. Access. Sq, Ftg, Other Ile" Add Alter Rep. -Fence Demo Change/Use Mlther-I-kf--=t Ir-> Ji 0, -. N o () * ; (ohone no.) (pxoirp<;) (ohonp nn. ) MECHANICAL furnace/burner to BTlI's 'I I I I I Floor furnace and vent Recessed wall So~~p hp~tpr nod vpnt Appl iance vent SPDarnte Stationary evap. cooler I Vent fan wi th sinale duct I'Vent system apart from heatina or A.C. I Mechanical exhaust hood i\nd duct I ~'Jood stove/heater I I I I TOTAL CHARGES HHERE STATE L~H REQUIRES shall not be vali1 until the ISSUANCE OF PFRIIlT o TOTAL CHARGES /0 ~ TOTAL CHARGES that tile Electrical work be done by an. Electrical Contractor, the electrical portion of this label has been signed by an Electrical Supervisor and returned to the Building Division CJ pemit I HAVE CAREFULLY EXN1INED 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 riC OCCUPAllCY will be made of any structure without the permission of the Building Division. I further certify that my re9istration with the Bui1der1s noard is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that :~::(:~::::t:::::~s ~e:~~s;o~~e~~::l~d:ce with :~:II::;;~n t~ect. om I/~;)!o-&J FO~ orF I CE U!IT miL yl " Sq. Ftg. rlain Sq. Fts!. Access Sq, Ft9. Other Zone 1<\ Fire Zone Flood Plain BUILDING' PERNIT Charges anc Surcharges PLU'1BING PERMIT Charges and Surcharges ELECTRICAL PERI:IT Charges and Surcharges t1ECHANICAL PERMIT Charges and Surcharges r ~ ~ Tyoe/Const. Bedrooms Stories \JM Units Occy Load Occy Group I Plan Ck, COll1l1IInd 65%/Bldo Ppr Fpp ------------ Plan Ck. Res 30%/Bldo Per Fee Fence O~mo . LO,a>- I'Sidewalk --- -,-"19----1 A/C Paving Curb Cut x Va 1 ue x Va 1 ue x Value. TOTAL VALUATIOffl2'>ot':> ."'E Isystems Development I Charoe (L5~) I I C.aJoe!F~ .~ Total Comb. rermit TOTAL I--IIIO,--;'~ - l~~ .O' I , ... . COMBINATION APPLICATION/PERMIT (CAP) ~ I. Applicant to furnish A. Job Address B. Legal Description 1. exa~le- Tax lot 100. Lane County Map Reference 17 U3 43 2, example- Lot I, Block 3, 2nd Addition to Sprlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. - I. examole- 1250 sq, foot house, 500 sq. foot garage 2. exa~le- if new project, check-new - if addition, check add, etc. F. Building pernit information: 1. examole -" constr:uct single family house with an a ttached garage 2.' exalTiole - remodel existing garage into family room 3. examole - convert single family re5idence into restaurant (change of use) G, Value of work as defined in Section 303 (aJ of the Structural Specialty Code H, DESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or jab site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electr'ical Schedules A. ~xcept where blank spaces occur in the description portion of the Mechanical and Electrical.Schedules, tne 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 Oil 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 work.sheet 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION j J I I , I I 1 j j , j .Permi t Clerk d Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: .' PLANS REVIEWED BY: name signature ., " date , -, .\ 'i' ! . "'. , .I I I I Ran.q<>- I ;..)'alu< of Hort,: f+.P 8ro,o_ Phon . I Builr:inQ Permit Info: Describe \'/ork(;-.e., Build Single e 721)-- Familv nes;dencc Hi th .^.ttached Garaoc) 6MQ_IL.da/ / j?/JvfrJ hlL . I f I I I I I I I I I I I I o I TOTAL CHARGES I(), ,,~ TOTAL CHARGES that tIle Electrical work be done by an 'Electrical Contractor, the electrical portion of this label has been signed by an Electrical Sunervisor and returned to the Building Division 1 HAVE CAREFULLY EXM1WEO the completed apfllicat;on for ~ermit. and do hereby certify that all information hereon is true and correct. and [ further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Orec:ron pertaining to the \~od: described herein. and that IlO DCCUPAHCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Guilder's Goard is in full force and effect as required by ons 701.055. that if exemot the basis for exemption is noted hereon. and that only subcontractors and emflloyees '.'/ho are in comoliance with ORS 7(')1.055 will be' used on this iject. IJAlIE(please print) M()...r-/t- f' (.,,,,-r-d},jf.r SlGIIA4~ ...ytn . FOr! OFF i CE U5'E' DilL yl / Sq. Ftg. 11ain . ~. C', " 1 HISPECTI01I LlIIE 726-3769 Job Address /(,p-1-f . . CITY Of SPRINGFIELD C011BI IIAT! OH APPLl CA T!0I1! PERMn M/Jv/:j,j ,,')..J-vr'f' I' t ~ EIIERGY SOURCES: , Heat pl.:),.-hrIC t'lat~eater , . legal DescriPtion / '1-n-=<- _ ~C; -:::l.'1. ---- /1'\, y (,,..,1- 1411)0 Owner NflV/( (T(Jvd )'l".v Address /IP-<f/ Mill/b) ,St-f/f'.fJ_! Construction lender I\ddress Ut~H.iij jtArl Phone {address 1 (name) (l ics. no.) Primary Struct~:",~i Electr~c:!1 ~lec~Jl'lica: CGilTR':'CiGRS {namel (addrpss) (1 its. no.l Generi'll Plu:':Ibinc E'iectric,~1 C9 \Allr1i.Y "'!:cr.:!nic! 1 ::'LUi:13i!lG EL~CT:EC';L rEf" i (J1.I\RGE "0 I I Residence of Fe"::' ; n.:/l.or..~ FT. I I I It) ,o~l('J ~ I r I . I I I I I I i "en 12eloca:e~ c~lldinq I (ne'"" fix. ecaition.:l) IS.F. ;:esldence I f1 bdth) ~ir:;ie fixture SO. INew circu!ts aits. I or extenSlOns SERVICES jDuolex (1 bath) each IAddltional bath ! ~!ater service I Sewer I .Storr.1 Sewer Temporary Construction Change in existing rP'iidl?nrr:- multifamily. COfll!l. or Inrlustri,1l Of amps.j I I I COI1i'1.lIIiO, FEEDERS Install/alter/relocate di<;trih_ fpodpr";. IOf amos.! TOTI,L CHARGES WHERE STATE L~H REQUIRES shall not be valiJ until 'the Zone 'Kl Un; ts \1M Type/Canst. Bedrooms Fi re Zone Flood Plain Oeey Load Occy Group Sq. FtlJ, Access Sq, Ftg, Other Stories BUILDING' PERI.JIT Charges anG Su rcha rges I Pl an Ck. CorrmlInd 65%/8ldo Ppr Fpp ------------ Plan Ck. Res 30t/Bldo Per Fee Fence PLUI1BING PERmT Charges and Surcharges Demo ELECTRICAL PERil IT Charges and Surcharges /1ECHArI I CAL PERMIT Charges and Surcharges __~LQ!.~_____ ,"'fu - .Sidewalk I Ale Paving Curb Cut '. '"I. ,~- ~ , IIIFORIIATION Uik 726-3753 Sq, Ftg, 1.lain ~q. Ftg. Access. So, Ftg. Other Hew Add Alter P.ep. Fence_Demo _ Changel Use ~ther i-kfl-i Iv-. I)) () -. N o I\)- I h 0 f -Job (exn; res) (ohone no. I fexnirp<;) (ohane nn_l MECHANICAL ':0 I I furnace/burner to BTlI's I I Floor furnace dnd vent I Recessea wa i i So~cP nenter nnn vent I I='.~ I rUADr.~ I I Appl iance vent seoarate Stationary evao. cooler Vent fan wi th c;innle duct Vent system apart heatina or A.C. Nechan i ca 1 exhaus t hood ,'lnd duct I Hood stove/heater i I I from ISSIJANCF OF PFRfllT Q permit DftTE-LL';;>/'-Bo I x Value x Va 1 ue x Value. TOTAL V ALUA T lOif/9'>on .of! ISystems Development I Charoe (1.51,) C-aJcxd ~<!-- I . ;u!J j j --/I/O. 0~ , _J" , , Total Comb.-Permit -- -- ----- --... I TOTAL , '" . COMBINATION APPLICATION/PERMIT (CAP) I. f~ Applicant to furnish A. Job Address B. legal Description 1. e~amole- Tax Lot 100. Lane County Map Reference 17 OJ OJ 2, examoie- Lot I. Block 3, 2nd Addition to Sorlngrield Estates C. :lame. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinQ/or forced 2. exa~Dle- waterheater/electrical/or solar E. Square footage or valuation. etc. - 1. examole- 1250 sq. foot house. 500 sq. foot 2. examole- if new project. check-new - if adc cnecy. a.dd. etc. F. SuildinQ perr.l'it information: 1. eXdmJle -' construct single family hOl:se \.lit dr:acned garage 2." exar.:ole - rer.:odel existing garage into fa:ni (." 3. e~a~~le - convert single family residence i res:aur3nt (change of use) G. Value of work as defined in Section 303 {a} of Structural Soecialtv Code H. DES I G:-~ TEAH Aim COi.TRACTORS To avoid design or construction delays. Buildin Division Staff must ge able to contact appropri persons re9arding design information or job s~t ('. corrections, etc. Abbreviate.J ?lw::oing. Nechanical. & Electrical Sene k. ~xceot \.:nere nlank SDoices occur in the descriot ~=r:ion of the Mechanical and Electrical Schedu . :ne aD~liccnt need fill-in only the No. Boxes a ~p' to tne ~DDrO?riate item(s) to be installed 3. Full Plur.:::ling, ;'iecn3nical. and Electrical Sched are available at the Building Division I 1. To conserve space on the permit form the sc \Jl' have been abbreviated 2. ! f the item(s} to be installed are not cove the abb,'eviated schedules you should consui ..n;;. full schedules {~ C. BUILDIr:G DIVISIOij STAFF WILL FILL OUT ALL FEES CHARGES 0,1 THE SCHEDULES O. As noted on the CAP, the label must electrical contractor for signature supervisor. The general contractor to sign the electrical label. Applicant to sign dnd date Whenever oossible. the initial application will be I ~'. a worksheet only. Where possible. Building Divisio will preoare do tyoe'written copy and return it to t. aoplicant at the time the actual permit is issuea f, siQnature. ( Fees ana Charaes Plan check fees are due and payable at the time or application. and no plans will be processed until tl fees are paid. All other fees and charges are due i ( payable when the penmit is issued. I- ., II. be delivere by his elec is not auth. IlL IV. 'I. FOR OFF! CE USE miL Y ~ I . PERMIT VALIDATION ". : . C I T Y 0 F S P R I N G FIE l 0 (I. City Hall Springfield, Oregon Deportment of Public Work. OFFICIAL RECEIPT ( 9 55282.8 Dote if - 2& No. B 1950 (-'IaYd~ MtJ'rkPJ Sf, $;('.4 Rec'd From I-f IlvJL Address 1~4/ / ! , ( C/e.rJ'/i /1'7 r l~e.c.;; rlMJ.-d/ Received For: iliirwY:- Ef.ec- /"1). oq- (J i/?) R --<j'Cf1 4b J ._ L.o.iJp , ~( ;;lC i . ca Amount $J() biJr^/J. Received ( , __ ~ ~1(}?o/'-.J!~~ B' (I AUTHO"'ZEO SIGNATUIIlI! ,.,,,.. c. S"(~To...r"....",~~ .",,,,(,,s . ~,,<a"~ 0" 8HO' I Permit Cl erk "._..',,, ....._....,,--=~.,. ....'-'.. ..... ..~."...... . .. .........,....",..............1.. ._. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature ,. , f .. date '-" iij -15 1m In ,n '6 1m ill 10 '1 h / 1 "