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Home My WebLink AboutPermit Building 1990-4-17 a I INSPECTION LINE 726- l7 69 Job Address /9:<g M/'J'8Ce::'>4f' ~ ~ legal De~cription T'JI\_I". J "I"\-k...: /'7,..:<..:75-t:t\/_;i"(-/'z. ~ .,,:>'~. Owner . e.,)".\:;~ ~1;[J.(..;,5 U:d (.t....... '~aJ-~ Addres~ N 1~lt~1 ~. 'Dr: ~-chone.1lM-'(tlt '?i'J'b-(l Construction lender . tNFORl1ATlON UNt 726-3753 Sq. Ftg. 1,Iain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Demo Change/Use -Other - - I ~ I~ IvJ \lJ ...z ctTY OF SPRINGFIELD C0I1BIIIATlON APPLICATION/PERMIT E!IERGY SOURCES: Heat Hater Heater Range ValuE of Hark: /~.~ Builri4nQ Permit Info: Describe Work(i.e.. Build Single Familv ~es;dence Hith Jl..ttached Garaae) /~~~~ 7;;:...... ?"""',,!';e-...,::....~--=- ?~~,E A~ 6.....~r,<S,~f"?w'/s --) .7Z:Sn'"€ b tL 9r.;;>/? Address Ut~ J liN I E.Al1 (namel LMl'j tLU~ Phone (address) Primary Structura 1 Electrical Mechanical CONTRACTORS (name) General n^.:~( s.\\A.-c.::t~",,- Plumbino ~d PIV\.vb,,^,,\ , , ~~~\\b\d" "echanical :~..e./~"""'- t.f Rd~^?J \j (address) flies. no.1 (1 ic~. no.' 9-C..,,>,o ?:,,,-=-~ 35',<;'0 Electrical PLUlIBING ~ ELECTRICAL NO. Fer j;JJARGF Nn '2 Each single fixture Residence of 7-~ /;5'- 13 t:JO \ ~S <-{qCot Of ~~~ rijARG[ NO SQ. FT. " N~cuits alts. ( '9f\extenslons r7 ' SERVICES /DD Cu>tf wllG P,4h<tft bruUlt> / I S) ('~, I c:::j.. a .l, ..J Relocated building (new fix. additional) S.F. Residence (1 hath 1 Ouplex (1 bath) each Additional bath ~Iater service '. ' Temporary Construction Change in existing rp~ j rle..n~p multifamily, COI1111. or Industrhl Sewer Storm Sewer Of amps. CO~1./INO. FEEOERS Install/alter/relocate distrib. feeders Of amps. (e:miresl (ohone no. ') ~ .~ l (pynirpc:;l ~ (r"lhnl'lp !'In. 1 51".... 7/"10 I\IO.(J <= <; 7-::JSl{,( 3c..{S--.3<:lS'.5f ./ Lj ~t/ -';;>3D<l 17J ZlJ /.,-() MECHANICAL furnace/burner to L' /~~.ee.:>BTU's FFF I CHARGF b'=" Floor furnace and vent Recessed wa 11 Sn~rp hp~tpr ~nrl vpnt / Appliance. vent c;poariltp S'tationary evap. cooler Vent fan wi th s;nale duct Vent system apart from heatina or A.C. Mechanical exhaust hood <Ind duct 3- 6&> Wood stove/heater 6A--; 7/TJ..;:;~ <-~ , /6 '~r;;:or/c:A'-t:. /"', S'>.#Y? /f". ~ ~/ ~7A?'/..-y.-# ~.?~~ f~'/';;?/- T: .) ISSUANCr nF PFRlIIT TOTAL CHARGES '/,'5.. e;sP TOTAL CHARGES 4.... '"'\ ~ TOTAL CHARGES M/# /.s: C>iii> WHERE STATE LAW REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be va1i1 until the label has been signed by an Electrical Supervisor and returned to the Building Division 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 rm 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 ons 701.055. that if exempt the bas's for exemption is noted hereon, ap~}hat only subcontractors and !j1ployees whg.are i? compliance with OP.S 7()1.05~Wi11 be~d 0 . r. ct. ~t/7/~O W,alll#;.~ ]'AC-X""'1........ -, p.5UJ- 5 fn. Iblqo IlAI-lE(please print) JAc../:::. .1!~Ybf9 'I.ds SIGilATURE .'. ~ _ OATE ~-17-'j) FO~- OFF t CE USE/Oill Y S0t9. riain Sq. Ftg. Access Sq. Ftg. Other~~ Zone-"':::::;;:/'. Fi re Zone TYOe/const.;S"'~ ~lJnits Bedrooms Occy load Stories / Occy Group ,?-::2. Flood Plain x Value x ~lue x.<:: 7;>;;7alue /~~ ? TOTAL VALUATION -;P>-~/~-:fJe'. /h~1 ,/ ..&>-,. . Systems Development 7,._ ~ Charqe (J.5~) BUILOING PERmT __.J~Se__ Plan Ck. Comm/lnd Charges and 65%/B1d~ Ppr Fpp Surcharges 5-S:! Plan Ck. Res lOX/Blda Per Fee PLuP1B tNG PERMIT ___/;5:~ Fence Charges and Surcharges -7:;:- Demo ELECTRICAL PERlm --~~~~ Sidewalk Charges and Surcharges A/C Paving /1ECHAN I CAL PERMIT ---~-~-- Curb Cut Charges and Surcharges -75"" --:22 ~ C$O Total Comb. Permit /f/7S3 A \C\ JB TOTAL . - COMBINATION APPLtCATION/PERMIT (CAP) PERMIT VALIDATION , - I. Applicant to furnish A. Job Address B. legal Description 1. example~ Tax Lot 100. Lane County Map Reference II U3 43 2. exam~le- Lot 1. Block 3, 2nd Addition to sprlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources '1. examyle- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrical/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. examole - construct single family house with an attached garage 2. exam~le - remodel existing garage into family room 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. OESIGN TEM1 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 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. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEOULES 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. --- Ill. 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. II J (qC{) ~ lro ll2- V. FOR OFFICE USE ONLY Permit Cl erk tjlmJ . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board. because: Additional Project Information: PLANS REVIEWED BY: namek/'"7#tF aCZ;~ signatur4~~--..-.:> date ~-/h-~ .:- ' ' .,. " . . . - ,- .\ '"