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HomeMy WebLinkAboutPermit Miscellaneous 1990-1-26 I t ~ Y r~dtVp_J~GlO~k'S- Vl~J .1 - (lies. no. \ (~xDir~s\ (ohane no. ~"~S-\-\I1f1<;~'\ '{ 0 \)\~\-f'}> -C:A~-{)AA~L '\INSPECTION LINE ..... CITY OF SPRINGFIELD . INFO~~ATION LINE 726-3769 ~ COMBINATION APPLICATION/PERMIT 726-3753 Job Address 1C\ \ Ie-\: ~ ~ (\f)\(\. ~c1 ~~;~GY SOURCES: ;~: ~~~: ~~~~ss, I.egal Description liater Heater Sq. Ft9. Other New Add Alter Rep. Range Fence_Demo_Change/Use Val~{ l'EtxJ.ro _Other Suildin<:! \iennit Info: Describe Work(Le., Build Single Family nesidence With Attached Garace) Owner 'ili\\I.,NY\ 11\ Y'l\()\l~ :J\S3 Addrcssqm I\J _ \/'I~C'vtpJ~onc41\! Vnr-t\(). fY\ ~ C\Tc111 - J- Construction lender. Address DES t GNI EAr~ Phone (address\ (namel Primary * (exni rp.~'\ (nhonp no.' Structural Electrical I~echanical CDNTRACTllRS Genera 1 \ )''\ (name' {addressl ".e . (::l\\\(,~ \0 'i\ 'L.j_cArO ~ 0 I Il J ~~\I Plumbina Electrical ~lechanical PLUIIBING ELECTRICAL MECHANICAL NO. . I'~ Each single fixture Relocated building (new fix. additional) FEE '..QjARGF No FFF rH1RGF No. furnace/burner to BTU's Residence of I SQ. FT. 7--5 7):~ . I' New circuits alts. or extensions Floor furnace and vent S.F. Residence (I bothl Duplex (1 bath) each Recessed wall ~Dac~ hpatp~ ~~rl vpnt et~nt se03 ra te Sta'tionary evap. c:oolrr Vent fan with sinflle duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct Wood stove/heater SERVICES ( Additional bath Temporary Construction Change in existing resJ df'flce multifamily, conGo or Industrial / ~rater service Sewer Storm Sewer Of amps. CO~1./IND. FEEDERS Install/alter/relocate ~i~trib. feedprs I' Of 6~ 7-?7'J;v~ , .. amps. ISSUANCE of PFRIIIT TOTAL CHARGES WHERE STATE L'li REQUIRES shall not be valiJ until the "75."- TOTAl. CHARGES that tile Electrical work be done by an, label has been signed by an Electrical TOTAL CHARGES Electrical Contractor, the electrical portion of this per~it Supervisor and returned to the Building Division 2/.-50 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 Orel]on pertaining to the work described herein, and that UO 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 ORS 701.055, that if exempt the basi or exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 7nl.055 will be us n this project. HAr-tE(please print)X~~tdA/ .7'. 007.-4 SIGrlATUR~ FOP. orFICE USEIOllLY Zone L C- ~ Tyoe/const.-:5?'l-5~ Units Sq. Ftg. llain x Value Fire Zone Bedrooms Occy load Sq. Fta. Access x Value Flood Plain Stories I Occy Group.B--2 Sq. Ftg. OtherpQ;'.~i'iiC~ Value~'-'-~~ H~qo C::n<ld TOTAL VALUATION ' ~3, 5~~ha~~~s(~~moP~t '-?/'.?>. =s> F F ':...... .cHARfiE. 6'-- /- .:;Y 17~ Y'-:Y f-..€ I DATE 1<2(; -Pd Total Comb. Permit 2"%'~::0 TOTAL 5'c:6,26. BUILDING PERflIT Charges and Surcharges . / ~' Plan Ck. Comn/lnd _...._~~-::::'=:::__~/BldO Pj!r ree ~ Plan Ck. Res 6- 7 __ 30%/Bldo Per Fee ____7~,~ r_ :?75 Demo PLU'~BING PERMIT Charges and Surcharges Fence ELECTRICAL PERIIlT Charges and Surcharges 'Sidewalk A/C Paving ____'7?/QI2..~ Curb Cut / .Of-3 , . 11ECHANICAL PERMIT Charges and Surcharges . .. COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address . , B. Legal Description 1. example- Tax lot 100, Lane County Map Reference 1/ 03 43 2. exa~le- Lot I. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. exam~le~ heat/electrical ceiling/or forced air qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - 1. exam~le- 1250 sq. foot house, 500 sq. foot garage 2. exa~le- if new project. check new - if addition, chee Ie add. etc. F. Building permit information: 1. exam~le - construct single family house.~ith an attached garage 2. exam21e - remodel existing garage into family room 3. example - 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 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. II. Abbreviated Plumbing, Mechanical, & E~ectrical 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. BOILDING DIVISION STAFF WILL FILL OOT 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 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. /-c9b-Qb r b" '6' I ~ \? V;P V. FOR OFFICE USE ONLY Permi t C1 erk ~ . 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 &J'?;c~e?f signature aD ~~ date /-.26-7~ ,- "" """" ' l\).\,~S-t\[)~<:'~'l '\ Q. \j \ t'1Jl\> -' 2A -DBA';)., l'INSPECTlON LINE . TV SPR NGFIELO 726-3769 OMBINATlON APPLICATION/PERMIT \~ "(\11\0... \?<1 I ~~~~GY SOURCES: 1 N RHAT ON 726-3753 Sq, Ftg. t1ain Sq. Ftg. Access. Ilater Ileater Sq. Ftg. Other New Add Alter Pep. Range. ..'_~ -Fence Oemo Change/Use val~~ I'~k' '1 Other- - . - - ~ .6f:::) I \ ~ ' BUlldinQ 1>ermit Info: Descr1be Work(Le. f Build Single Familv Residence With Attached Garaae) i. i I i , . legal De~cription \C\ \ 'el '.Jab Address Owner ~\\\~ ~~<b9.1\ ~~3 Addrcss,Cl(X) I\j ."'" (\ I o!~onc411 ( V()\-t'~rY"\ ~ C{/c1lr / - p Construction Lender Address ODIGr~ II:..m1 Primary Structural Electrical Hechanical CONTRACP.'RS Genera 1 '\ )f'~ 'l ~ Plumbino Electrical~~~ ~1echanical NO. Each single fixture ~c\. V' 6(CC7~/~~~C~~ [lics. no. \ (exDiresl (ohane na. (name1 Phone (address' II. ..J~ ~ I',;. -:,. !r .\ name I addre~c;.l G\\\('~ \0)\ '\'1j\Uj ~ Q I Q ~y FCEz=7. (lir-s. "l' ffi~.\ (exnires) (ohon~ no. \ ) ::ZQ/~ L.(' "e?-/-~ ~-~- PLUlIBItlG ELECTRICAL ~ MECIlAN1CAL ..llL D!AIlGE .JiQ.... - furnace/burner to BTU's err .r,,'lRliL ...ilL CHARGE ..lIO...- Residence of SQ. FT. ~ New circuits alts. I' or extenslOns "'2 -dJIR ~R~ SERVICES 2?.J Floor furnace and vent Relocated building (new fix. additional) $.F. Residence (I bathl Duplex (1 bath) each Additional bath ~Iater service Sewer Storm Sewer Recessed wall SD~r~ hPAtpr And vpnt Temporary Construction Change in existing res i dence multifamily, conm. or Tndustr1al App\ lance vent seJarAte Stationary evap. coole" - - Vent fan with sln91e duct Vent system apart from heatinq or A.C. Mechanical exhaust hood and duct Wood stove/heater Of amps. COHl.t. II NO. FEEDERS Install/alter/relocate d~~trib. fppders I Of~ amps.. z<,.,-">'" ISSUANCE OF PERIIIT TOTAL CHARGES \. TOTAL CHARGES 71<;:- I TOTAL CIlARGES WHERE STATE LW REQUIRES that the Electrical work be dane by an Electrical Contractor, the electrical port Ian of this permit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building,Division 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 Spri ng f; e 1 d and the laws of the Sta te of Orel)on perta i ni ng to the work descri bed herei n, and tha t UO OCCUPAUCY 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 O~S 701.0~5, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project. EL.S:T. L"/Y7/? . II IWtE(please print) YV 1,\Ct. Zone Fire Zone Flood Plain BUILOING PERf tIT Charges an~ Surcharges PLU'~BING PERMIT Charges and Surcharges ELECTRICAL PERIHT Charges and Surcharges MECIlANICAL PERMIT Charges and Surcharges J. Go",-,\V\.~ SIGNATURE Pl~ FOr. OEF t CE USE OItL Y S~. Ftg, liain Sq, Ft9. Access S~. Ftg. Other H~qO 15:.<64 TOTAL VALUATION U';.l.. c=......, ~ ws~lte. ms oevelopment ('Ju. LJ~ Charae O,5~ '" ,- pATE /-~ '1-'90 Type/Cons t. Bedrooms Stories Units Occy load Occy Group Va.lue Value , x x Value . Plan Ck. ____________ ~/Blda Plan Ck. 30%IBlda Fence ConrnlI nd p.pr Fee Res Per Fee D~mo 4'S- -n_-..LZ~ 'Sidewalk A/C Paving Total Comb. Permit Curb Cut '/725:' I J ------------ TOTAL . / i I COMBINATION APPLICATION/PERMIT (CAP) .' 1. Appl icant to furnish A. Job Address ' , B, Legal Description I. exam~le- Tax Lot 100, Lane County Map Reference 11 U3 43 2. exam~le- Lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources' .';' I . : ' 1. example- heat/electrical ceilinq/or forced air Qas 2. examele- waterheater/electrlcal!or solar E.... Square footage or valuation. etc. . 1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- T1Inew project. check new - if addition. cneCk add. etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family ~oom 3. exam~le - 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 TEAM AND CONTRACTORS To avoid design or construction delays. Building Division Staff must be able to contact app.ropriate persons regarding design infonmation or job site corrections, etc. II. Abbreviated Plumbing, Mechanical, & E)ectrical 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 instal,led 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 b~ 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 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . ~ I., ';, -1.) ..,... . '[' i PERMIT VALIDATION Permit Cl erk . Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: ,.' PLANS REVIEWED BY: name signature date ~., - - ....... :jdtV p ,\~G1.off' \S- VI Xvn.o.:J Bcc77?/-4:f"-C 04 C. Y -() ~ L' {lies. no. \ l@x~ir@sl (ohone no. j , ~\\~S+\\)fI<-~'l '( 'L \) \~\j)\> ...344-oA0)~, I~SP[CTION LitlE TV SPR NGFIELD N R/1AT ON 7/.6-3769 DINATlON APPLlCATlON/PERIHT 726-3753 J;)b Address \ G\ \ tel % h (\ fl\ C\. \? ~ ~~~~GY SOURCES: ~~: ~~~: ~~~~ss, Legal Description Nater Ileater Sq. Ftg. Other 1 Ilew Add Alter Pep, Ranqe_ .~_. Fence_Demo_Change/Use Val,\(.of '?t:.k' ro _Other i\ O\~..l'X). . Dul tdino 'Penlllt Info: Describe Work\ he.. Build Single Family Residence Nith Attached Garaoe' Owner m\\It0(\ l!\ ~\()\lQ~ ~~3 Addrcss_qm /\J. \tl~C'9tQ)~one4-1\( V()\-t\~sY\ ~ CHcO-ll I '" , Construction lender Address Ul~tuN IlN1 Phone (address' (namel Primary Structural Electrical 11echanical CONTRAl',' i<~ Genera 1 . ~ j ~ ; . i I , Ii ~.3 (~hnnp nn~ Plumbino E1eetricalA1.E~ ~S';?:C?z;7. 2Q/~ L., ~./-~ ( ./~./_~_r .- ....~'::.oc;.._~ ~lechan1ccl \ PLUIIB I NG ELECTRICAL MECHANICAL NO. FfE CIl1BliL ..JI(l ~FF r.H~ _NO. furnace/burner to DTU's Residence of Each single fixture SQ. FT. Relocated building (new fix. additional) New circuits alts. or extensions "'LL3JQ~R~ SERVICES Floor furnace and vent / Z28 Recessed wall S~ace heater ~nrl vpnt S.F. Residence 11 botbl Ouplex (1 both) each Additional bath Temporary Construction Change in existing rl!si4f!J1ce multifamily, conm. or Industrial Appliance vent ~eoarat@ Stationary evap. cooler Vent fan with sinale duct Vent system apart from heatinq or A"~. Mechanical exhaust hood and duct Wood stove/heater Water service Sewer Storm Sewer Of amps. COMlt.IINO. FEEDERS Install/alter/relocate d~~tr1h. fppdpr~ I Of ~..;> amps. Z<.,-""9' :.EL LllAllG.E. t I SSUANCf OF PfRlIIT TOTAL CHARGES . TOTAL CHARGES lJt::;:---1 TOTAL CHARGES WHERE STATE L\1I REQUtRES that the Electrical work be done by an. [leetrical Contractor, the electrical portion of this pemlt shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Duilding.Oivision om J-;;;2 '1-'10 I "^VE C^REFUlLY EXNllNEO the completed appl ication for permit, and do hereby certify that all infonnation hereon is true and correct, and I further certify that any and all work oerfonmed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Ore~lOn pertaining to the work described herein, and that UO OCCUPAUCY will be made of any structure without the permission of the Ouilding Division. I further certify that my registration with the Guilder'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 compliance with OPS 7"1.055 will be used on this project, ELB:T-L'//7?'? ..f) IlN.tE(please print) rv 11\4. Go'-.J\V\.~ .SIf,rIATURf f11 ~ FOP. OfFtCE USE DilLY Sq. Ftg. liain Sq. Ftg. Access Sq. Ftg. Other H~qO /5'"1<64- TOT^L VALUATlmt (!..:( ';..l.. c=.. -=\~sAtems DeveloPll1ent (-,0. ;: .J." IChorqe t1.5~ . Zone Fire Zone Flood Plain Type/Cons t. Dedrooms Stories Units Occy Load Occy Group Value Value Value . x . DUILOING PERHtT Charges and Surcharges ptan Ck. Comm/lnd 65%/Bldo ~pr Fpp PlanCk. Res 30%/Dldo Per Fee ------------ PLUI1BING PERMIT Charges and Surcharges Fence D~ 'Sidewalk A/C Paving ELECTRICAL PERIHT Cha rges and Surcharges ~,5:- ------;LZ~ Total Comb. Permit 11ECIlANICAL PERMIT Charges and Surcharges 7'72> Curb Cut TOTAL ------------ . I COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A. Job Address B. Legal Oescription 1. examQle- T~x Lot 100, Lane County Map Reference II uJ 4J 2. examole- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name. etc. of owner and construction lender O. Energy Sources' :. , 1. exam~le- heat/electrical ceilinq/or forced air aas 2. examole- waterheater/electrlcal/or solar E . Square footage or valuation, etc. - i. example- 1250 sq. foot house, 500 sq. foot garage 2. example- rr-new.project. check new - if addition. check add, etc. F. Building permit information: i. examole - construct single family house with an attaChed garage 2. exam~le - remodel existing garage into family room 3. exa"Ple - convert single famlly residence into' restaurant (change of use) G. Value of work as defined in. Section 303 (aJ of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building ~ivision Staff must be able to contact appropriate persons regarding design infonmation or job site corrections, etc. II. Abbreviated Plumbing, Mechanical, & E)ectrlcal 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 pcnmit fonm 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. - 111. 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 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: [: CITY OF SPRINGFIELD . City Holt Sprlngftotd, Oregon Development Services OFFtCIAL RECEtPT I . 15861 , - · Date r~ -:2'1;.. 19~ ... . , . Rec'd From..(l/'~ V~ "c-~7 ~~c:n-..s Address . ~ Received For:nh?'~:~' '-Q"~ y~: i - . . q. · :f-~ 9.S:~ .?~ h7r-Y ~?C/ / C~"7: E_~ /~-~ · r-~ <;>~:;c> . '?';/'?k' 97"- 5C> ~ . . 4~Y6'>V <0 Y.c;-o Amount Received . ~~ , , AUTHORIZED ~~hE" / I - !!L . ... Permit Clerk .. Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature i, ] date ,.