HomeMy WebLinkAboutPermit Miscellaneous 1989-12-22
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1 IrISPECTIOtI LItlE. ~- n r Y If) /I {1--.1 CITY UF SPRItI GFIElD
726-376g rXI /f I]Jl!lIrIATlOtl APPLICATlOtl/PERMfT
. ..-
Job Address 1"1 h "I- 1V/4 R Co L A Ref. I ~~~~GY SOURCES:
Legal Description 'DELGAfz>s tI+hlt.:~iC.f .INC. i I-later Heater
r'r7oh4wk. f'Wf1it:E?r PLAcE BW6- A r
"",5 l^"N::i ~Ns-he()df",1J
Address 9~O N. Wfll.A h/frAt vi S"J."+&
I'~-:
{name'
Phone ~~3-WI/
4-777:1'.:' ~70 ../;;..-v 0#-<;
I"'~F:L--;'6Z5 #~~pa/T
.~4~'c/'>-/ / ,/~. .1
(;;cs. no. f lexoiresl (ohane no.)
.-'b-...,
.~
~.
Range
ValUE of I-lark:
QQS,?'3.00
Builoir1f! Pennit Info: Describe Worl<(Le"
Familv Residence With Attached Garaae)
~~U--
..' . ItlFORlIATlON LINt "
726-3753
Sq. Ftg. Hain
:q. Ftg. Access.
Sq. Ftg. Other
Ilew Add Alter Pep.
-Fence Demo Change/Use
-Other - -
Build Single
~
~
~
~
N
Owner
Construction lender
Address
Ut~ llirl H.Ar1
Primary
Phone
(address)
Structura 1
Electrical
Mechanical
CONTRACTORS
(name)
(address)
(l ;t5. no.)
(pxnires)
(nhoop nn.
Genera 1
Plumbina
Mechanical
!-f7I:({ Jr;:.., '- /k~clE ld._
, . .
(0'aM'<:t k ~ )
t)olS" NV66irLAlM. EV6cwi tff!..
"77 /0-')1-9'0 7'ffo -I(P:JI
Electrical
, .
PlUllBltIG
ELECTRICAL
MECHAtlICAl
ND_
FEE CHARr.F NO
FFF r"~ NO
~~~ rl-lliB.G.(
Each single fixture
Residence of
SQ. FT.
furnace/burner to-
/ O~,~ BTU's
Floor fu rnace
and vent
7--S-
Relocated building
(new fix. additional)
New circuits alts.
or extensions
S.F. Residence
(] bath)
Duplex (1 bath) each
IAdditional bath
I ~Ia ter servi ce
Sewer
ISERVICES
1
Recessed wall
,n~rp hp~tpr ~nrl vpnt
TOTAL CHARGES
WHERE STATE L\l~ REQUIRES
shall not be vali~ until the
I
I
I
I ISSUANCE OF PFR!llT
TOTAL CHARGES I TOTAL CHARGES /-'0#. /,~-4
that the Electrical work be done by an.'Electrical Contractor, the electrical portion 'of this perlilit
label has been signed by an Electrical Supervisor and returned to the Building Division
ITemporary Construction
IChange in existing
rpc; i rlenr:~
Imultifamily, comm. or
Tnrlu<:trii'll
10f
ICOMM./IND. FEEDERS
I Install/alter/relocate
rlic;trih. fpprlprc;
Of amps.!
I
Appliance vent
seoarate
Stationary evap.
cooler
Vent fan with
sin9le duct
Vent system apart
heatinq or A.C.
Mechanical exhaust
hood ~nrl rlw:t
3'.-"
Storm Sewer
amps.
from
Wood stove/heater
I
I
1::<. ~..
1
I
~7},7;,-:'
I HAVE CAREFULLY EXNllNED the completed apf"llication 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 Oregon pertaining to the work described herein. and that NO OCCUPAIKY 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
only sUbcontr~t;;s and employees who are in comoliance wlth OP.S 7nl.055 will be used on this project.
NA!IE(Pl~~"'~5'"~...P~ FOP. OF~:~~^:~~EOlllY ~ U_ !AT~:;.J~
Zone cd Tyoe/Const..7-# L=,its SO.' Ft Ilain x Value
. ; ~~ g.
Fire Zone Bedrooms Occy load Sq. Ft9. Access x Value
Flood Plain Stories / Occy Group B-2 Sq. Ftg. Other~"""~/" Value '7:.,,:--, -,,>_=-
r- TOTAL VALUATION
BUILDING PER~IIT Plan Ck. ConmlI nd ~~ Shste~s Development
Charges and J.". . 65%/Bldo Ppr Fee C aroe (1.5%)
------------ Plan Ck. Res
Surcharges 3D%/Bldo Per Fee
PLU'1BING PERMIT Fence \C\~, ~ \~,W
Charges and ------------ ~~~ ~. 1- 0 ffi:1~
Surcharges D/llllo
ELECTRICAL PERI:IT I'Sidewalk
Charges and ------------ [ Ale Paving --------._-
Surcha rges Irotal Comb. Permit /5". .?S"
11ECHANICAL PERMIT n/~~___ Curb Cut 1 84.~i
Charges and
Surcharges 7S- I TOTAL
.
lm~~mOtllINE f~ 'ifI-f:l4:2. .
I q '2.0 m fr~COLfJ f<DftD
I.egal DescriptionDIE!.bAro'S - fYInhf/t..IJ!< l1111t2kt.fdf1:1E
I
Job Address
CITY UF ~PRINGFIElD
COMBItlATION APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
l~a ter Hea ter
.-
INFORllATlON LINt
726-3753
Sq. Ftg. I.lain
~q. Ftg. Access.
Sq. Ftg. Other
Ilew Add Alter Rep.
--Fence Demo Change/Use
-Other - -
I
OJ
I-D
l-
IS))
~
Owner HtLLmfTlI! t'~()f)EJfTlE5 NW
Address rfOf)j(. Tom/fhirwk lj/l!-#bPhonojgYI/I/
(/O((-rW#P I Ole Qn./7
Ran!1e
ValuE of l'lark:
BuildinQ Permit Info: Describe Work{;..e.. Build Single
Familv nesidence 1-1; th ~q.ach~~ (;~rao~.)
Construction Lender.
Address
DESIGN IEAr1
(name)
Phone
{address 1
(1 ics. no. \
(exnires\
(ohone "0. I
Primary
Meehan; ca 1
CONTRACTORS
(namel
(address'
(1 ics. no.)
,.."~ '"~""""'
Structura 1
Electrical
General
Plumbincl
Electrical L.!? l?(Ut~ft~. 1"..m)f'rDIAl."0"sr., 5,*w, tJ~1'f11
2J)-l(7c... /O/;/9{)
I ,
717.U3J
~lechanical
PlUllB I NG
ELECTRICAL
MECHANICAL
NO.
FEE CHARGF Np
FFF I J:IlARliE. ~
F F F I DJARG.E..
SQ. FT.
furnace/burner to
BTlI's
Each single fixture
Residence of
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(] bathl
Duplex (1 bath) each
Additional bath
SERV I CE:b<a?/I - 'Kf)~
. )),q,O I
Recessed wall
Snacp hpatpf nnd vpnt
I
Storm Sewer
Of
amps,
Appliance vent
seoa ra te
Stationary evap.
cooler
Vent fan wi th
sinole duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hood il.od duct
I
~Ja ter servi ce
Temporary Construction
Change in existing
res j de.nce
multifamily, conm. or
Industrial
Sewer
COMfI./IND. FEEOERS
Install/alter/relocate
r1idrih_ fppdpr<;,
Wood stove/heater
Of
amps.
I
;{ 0 Un tJ1u.CJzf-j , ;{:?, 50
5 % .lJfJ.,ilth 7/lJ1J.- 3,75
7g.75
ISSUANCF OF PFR!llT
I HAVE CAREFULLY 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 nerformed 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 rlO OCCUPAUCY will be made
of any structure without the permission of the Building Division. I further certify th~t 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 7111.055 1'1111 be used on this project.
1lAf.IE(please print) L,q~It~ fL bf2Fte>HA-W\ SIr.!IATURE- ~ J~ DATE I2./ZI/%1
FOP. OfFICE USE OIlLY /7
Zone Type/Con,t. Units Sq. Ftg. f1ain x Value
Fire Zone Bedrooms Occy load Sq. FtlJ. Access x Value
Flood Plain Stories Occy Group Sq. Ftg. Other x Value
TOT ^l V AlUA TI ON
PlU!1BING PERMIT
Charges and
Surcha rges
Plan Ck. Comm/lnd
65%/Blda P~r F..
Plan Ck. Res
30%/Blda Per Fee
Fence
Systems Development
Charqe (1.5~) .
BUilDING PWlIT
Charges and
Surcharges
ELECTRICAL PERr~IT
Cha rges and
Surcharges
IIECHANICAl PERMIT
Charges and
Surcharges
Demo
__Q~.:.~__ Sidewalk
(~. 'IS A/C Pavi ng
Total Comb. Permit
,
TOTAL
1Z,1~
.
Curb Cut
.
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. legal Description
1. example- Tax Lot 100. Lane County Map Reference
11 03 43
2. example- lot 1. Block 3. 2nd Addition to
Springtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceilin,!/or forced air qas
2. examyle- waterheatertelectrical/or solar
E. Square footage or valuation, etc.
I. example- 1250 sq. foot house. 500 sq. foot garage
2. example- if new project. check-new - if addition,
check. add, etc.
F. Building pennit information:
1. examole - construct single family house with an
attached gClfdge
2. examole ~ remodel existing garage into family room
3. examyle - 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 TEM1 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, & 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
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:
.
PERMIT VALIDATION
~,!fi-'61
\ \Sb ~1
Permit Clerk8([)rl)
.
~
Permit applicant exempt from registration with the Builder's Board because:
Additi ona 1 Project Informati on:
PLANS REVIEWED BY:
name
signature
. date
.
e
~
COMBINATION APPLICATION/PERMIT (CAP)
,
,..:
PERMIT\VALID~TIDN
III .
I. Applicant to furnish
A. Job Address
B. legal Description . t '
1. example- Tax Lot 100. Lane County ~ap'Reference
11 03 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. eXal1!Ple- water'heater/electricai'tor solar
E. Square footage or valuation, etc. -
I. example- 1250 sq. foot house, 500 sq. foot garage
2. exa~le- 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. examole - remodel existing garage into family room
3. exa~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 TEAH ANO CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information qr jab site
corrections, etc. . .
Abbrevi a ted P 1 umbi ilg'. Meehan i ca 1. 8., E 1 ectri caLSchedul es
A. Except where biank 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. fonn 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. ---
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.
f ~
"
.h'..
. .. .;. ,<i
~mbl1R- \~/~q
~ ~\ CO~
. - IL
V. FOR OFFICE USE ONLY
Permi t Clerk (i fD~
.
.
.PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
.
PLANS REVIEWED BY:
4;1" ~ ~~--?1a~e
- R'.:....~ .~./ .
/2-//-a7..
name ~~HE i-7~ 6-"f signature
"
Address
DESIGN lEAf1 (namel
Primary ~V4'?#.v~h?~/.
. //
Structura 1
\ Q<6y)-~~
TY F SPR NGF I ElD - I NFORlIATiON LI NE .
COMBINATION APPLICATION/PERMIT 726-3753 ~
EIIERr,y SOURCES: Sq. Ftg. 1'lain2~O \J~
Heat ~q. Ftg. Access. ,~
Water Heater Sq. Ftg. Other 'U
Ran", e . _ ,KIlew_Add_Alter -Yep. .......
" Fence Demo Change/Use ~ ,
~&,~ *=~'Y~ I ~1\J
Bu;(GinQ Permit Info: Describe Work.(i.e.. Build Single l
Family Il.esidence I-lith Attached GaraQe~
'2~~/// ,... /'
c.-~/'7?,;;q:E7iE ~~0::5 ""'>i5:>.A'T. L ~.
-5'"~.F ~ !/r-C':;;A:.72;::/..s .4THL~~
Phonc m.c. - ~L'ln-.....-.L ~C~
{address1 (lies. no. l (exnires) (ohone no.
"2f!'O /Y-.#?~ /S'~L':::-~ ~C>
,,t/~~N7J~' 9?::z/? " '7~~~::?'2-~-
*,
I INSPECTION LINE
726-3769
Job Address /92C> /$o:::7,,4..q'4::;:> (,4 ;P2>.
legal Description 17--&:>2-2 ;:>-'2. "2) /co /C//. /&:>.2
, .
~.o<;' ~c:>
Owner', .~/L.L/77.#-.1f7 ~,v"",,, /~-::r ~ W'.
Addrcss ., -r / 7>- Phonc
?~ ft/. /AA1'1AA'rA,..".K /.oS. ~.
~~z;. C>?? <97:z/7
Const~uction lender.
Electrical
f1echanical
CONTRACTORS
(name)
{address1
{l ie5. nQ. \
(exn; res \
(ohone no. \
Genera 1
Plumbino
Electrical
~lechani ca 1
PlUIlBING
ELECTRICAL
MECHANICAL
NO. .
FFE . CII~Rr,E '10..
FFF rH1RG[ NO.
FFF . rH1RG[
7.5'0 -Z:?.S&
SQ. FT.
furnace/burner to
BTlI's
'7
Each single fixture
Residence of
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(1 bath)
Duplex (1 bath) each
Additional bath
SERVICES
Recessed wall
Sn~~p he~tpr ~nrl vent
Storm Sewer
Of
amps.
Appliance vent
seoa ra te
Sta-tionary evap.
cooler
Vent fan with
sinale duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hoorl ~nd duct
Uood stove/heater
Sewer
Temporary Construction
Change in existing
resj~eJ1cP
multifamily, comm. or
Industrial
Water service
COMN. II ND. FEEOERS
Install/alter/relocate
rlic:.tl"itL fpprlprc:
Of amps. ~ =-~_ ~_ -'_, ....--\ ~
~"'~/~~ Ece.?::7.,~ 4~..-v~.-<.E
5M<<c~~ ~~~ 'I
~"..",..r7:'
.-<; /.>;;:>
A~"'''''7
ISSUANCE OF PeRllIT
TOTAL CHARGES
WHERE STATE lAW REQUIRES
shall not be vali1 until the
-;:;?'7.-S,c:> _ TOTAL CHARGES TOTAL CHARGES
that the Electrical work be done by an.-Electrical Contractor, the electrical portion of this permit
label has been signed by an Electrical Supervisor and returned to the Building Division
jlWIE(please prin;{;p"u;;;,!4-S
/ '
I HAVE CAREFULLY 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 oerformed 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 HO OCCUPAIlCY will be made
of any structure without the nermission of the Building Division. I 'further certify that my registration \'lith 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 701.055 will be used on this project.
/' &//j' SIGIIATURE- ~j)(tf<..<;V [~
FOP. OFF I CE USE OIll Y
S~. Ftg.
Sq. Ft9,
8- 2 Sq. Ftg.
DATE/.2 ./~ f3 7'.
Flood Plain
Type/Const. "'5'-M.~nits
Bedrooms Occy load
Stories I Occy Group
PlU!1BING PERMIT
Charges and
Surcha rges
/ <!!?u #z=' Plan Ck. ConrnlInd
___Lt!?_.f..;____~/Bldo P,.er Fee
Plan Ck. Res
<J. 20 30%/Bldo Per Fee
____:?_"?-..;2.CZ_ Fence
1./"3 0111110
_~l?'#..I€ _S1dewal k
~/""/ y-
~~_ Curb Cut
76/;-,//7'.
, .
Hain x Value
Access x Value
~____A!O"
Othc_~_.... ~~...2~alue
TOTAL VALUATION
;e. ....,# / -5Y:::z-:-
. Systems Development
//9.";'01>0./1-'27 Charoe (1.5%)
.
..-'~~'
,.;
20ne L. C.
Fire Zone
BUILDING PERflIT
Charges and
Surcharges
'-I :::? c::?,
"",",,.
ELECTRICAL PERIIIT
Cha rges and
Surcharges
MECHANICAL PERMIT'
Charges and
Surcharges
A/C Paving
Total Comb. Permit
-:2/6. &'3
I
,.
TOTAL
1&'760.83
.
.
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
C
(\ ,\A..-~ n~
~o- Sv
\S
I. Applicant to furnish
A. Job Address
B. legal Description
1. examp.le- Tax Lot 100, lane County Map Reference
17 03 43
2. example- lot I. 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 Q~
2. exa~le- waterheater/eJectrlcal/or solar
E. Square footage or valuation, etc.
1. example- 125D sq. foot house. 500 sq. foot garage
2. example- if new project. check new - if addition,
cneck. add, etc.
F. Building pennit information:
1. exam~le - construct single family house with an
attached garage
2. examele - 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 TEM~ 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, & 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 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 i?sued.
'.
"
V. FOR OFFICE USE ONLY
Permit Clerk
d(D~
.
i
.I
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Infbnnation:
.
PLANS REVIEWED BY:
name -.L...offf/~ ;q p-Z;: ~
signature ~~~- date
. / " .
/7~//'.!!?9