The URL can be used to link to this page

Home My WebLink AboutPermit Building 1980-2-14 CITY Uf SPRINGFIELD CDllBHIATION APPLICATION/PERMIT ? R c/ f'/d EilERGY SOURCE~: Job Address ..3:7 t? $61rc",,/p-.. . S.f' . Heat E/eJ"- ['later Heater P /"'-1"'___. Range f"iv.+~Lid . U!!&l'aTION LINE 1726-3769 Legal Oe5cription ... .~-/l~/q~ " . INFORllATION UNt 726-3753 Sq. Ftg. 1.lain--,S nc- ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. - Fence_Oemo_Change/Use ValuE of Hork: _Other 11 1-1. t? L" c.? !J<!P'"P X. . o Phon """ BuilGino Permit Ihfo: Describe Hork( i.e., Build Single "r6~ e IVfrt<'1; ?Family nesidence I-lith Attached Garaqe) Owner JtJ.yn "" <: u/ ~ ~-e_/ I Address ::l~5?l:? 6 ffL> a 5p/,/./. C/N'... Construction lender Address UtSlliN TEAI.I Primary Structura 1 Electrical Hechan;cal CONTRACTORS Genera 1 Plumbina Electrical ~lechan; ca 1 NO. ~ \) N ~ d/"" ~..e.- ~~ ~:.-.-. .-h-------~J Zh ~;~ ELECTRICAL MECHANICAL ," nIAR~~ 1m. Residence of furnace/burner to SQ. FT. BTlI's New circuits alts. Floor fu rnace or extensions and vent SERVICES J Recessed wall Sn~~p hp~tpr rlnrl vpnt /Ju$. 'J:?c,- ?JhtJ (name) 5'-p' J,j:' S..... /.f' b___~'~ E/.et"_Tr/c.... ,t:<;..e.!-I (name) Phone (address) (l ics. no.) -;'" Ir- (address) (lit':~. nn.) PLUllBING FEE (HARGF Nn Each single fixture "--It), "' ,. ::z. Relocated building (new fix. additional) S. F. Res i dence (l bath) Duplex (1 bath) each Additional bath ~Iater service Sewer Storm Sewer ITemporary Constructi~n I'Change in existing rp~_i dpnce Imultifamily, comm. or Tndu<;tri<ll IOf amps.1 ICO~j./IND. FEEDERS IInstall/alter/relocate distrih. feerlers I 10f f.J"O amps. I I I I f5.-= (exoi res) (ohone no.) '* (~xoi rE's) (ohnnp no ) ~n' r~.Il.Q~~ ~~ I Appliance vent SflDaratp Stationary evap. cooler Vent fan with ~inole duct Vent system apart from heatina or A.C. Mechanical exhaust hood and dut':t "3. oe. Wood stove/heater ISSUANCE OF PFR'HT It::), "'.. 19.""'1> thi s permit TDTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the 1""- I.... TOTAL CHARGES that the Electrical work be done by an label has been signed by an Electrical /..1"'"". e;><> '"J. TOTAL CHARGES Electrical Contractor, the electrical porticn of Supervisor and returned to the Building Division I HAVE CAREFULLY EXArHNED the completed aprl ication 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 Ore~on pertaining to the work described herein, and that rw OCCUPArKY 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 subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I~AHE(please print) .Jam...< 4~ ;:;:, ,_v<?_/ / Zone_M- J Fi re Zone rzt: Flood Plain BUILDING PERI.IIT Charges anc Surcharges PLU'1BING PERMIT Charges and Surcharges ELECTRICAL PERI~IT Charges and Surcharges /IECHANICAL PERMIT Charges and Surcharges . ?v/~R~./ Dm:::2-Ih"- '70 Tyoe/Const. ~.i\f . Bedrooms Stories I s IGrl.~TURF /'7", FO~ OFF I CE USE filLY Sq. Ftg. riain Sq. Ft9. Access 'R.~ Sq. Ftg. Other "3'1 S- Units Occy Load Occ'y Group "'1.00 Plan Ck. 7 65%/Rl no ...-----------""Pian Ck. /. 76 30%/Bldo ...___/~'-~::':._ Fence '-{O ...___.1;5": .. e> . 6C:> AIC Paving /.,. dU I Curb Cut ...------.-7~-1 Corrm/lnd Ppr Fpp Res Per Fee '2.8, "0 Demo Sidewalk x:z.I.~dValue 79/'1,..... x Value x Va 1 ue TOTAL VALUATlO/l<ll'7 '31"1. CJ'C' Systems Development Cha rQe (1. S%) 109.71 Total Comb. Permit I :to. 17l" rq 4 <"'j. 6.$ ~ TOTAL "..~ . . "''''"l. COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATIDN ~ I. Applicant to furnish A. Job Address B. legal Description 1. example- Tax lot 100, Lane County Map Reference II oj 43 2. exa~le- Lot 1. Block 3, 2nd Addition to Sprlngfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceil;~q/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. example- if new project. check:ruew ~ if addition, check add. etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. examele - 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 (aJ 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 O. 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 Permit Cl erk ~ I ,. ~/~./h"7" 7b MAf&fG:>u PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: :>..4# hPfft;YeMC'r;/ ~h'cS'~M~"'.r ~k ~ ?:l..... / -,.., ,,",P. r-#/<f>}q 70 /S.s~~^" <:er &:>~ /' ~~"r ~ Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: i PLANS REVIEWED BY: name LCP?N€ ~~ Signature4_J , ?~~ . .; ~ date .?'..y/-~ 1\6;;' ti d .~i"iOII LIIIE 1726-3769 Job Addres s J:i"? 0 Leg31 Oeser; pt; on IIIFORIIATION Ll"t 726-3753 So. Ftg. 1.lain .:; ".... :q. Ftg. Access. - Sq. Ftg. Other rle\-l Add Alter Rep, Ranoe --- _____ -Fence Demo Change/Use Va 1 UE of Hark: -Other - - It ~/ ". t"' e J2 r'N.)( . - Ph /l., Builc((no Permit I~o: Describe I'Jork(Le.. Build Single R,;-<;~ one nl/,tc4 ~Far.1i1v nesidence \-Ii th J'l.ttached (;araae) .. "\ "'-I}~/q~O . . CITY OF SPRIilGFIELD COIIBIilATIOII APPLICATION/PERMIT ;.:> I f Id EilERr,y 50U'!f,EJS: R'l,a,. c"" /..-.c ^ c!. 5p' . Heat /.~ r> '"_ Hater Heater P /4/".r..... Owner .j tL )'~' ... .; t,,/ ;:), <c. .;..t.~ / I Address ::I ~ ~'..~ ("'J ff~ a Sp//j. 0/'<" Construction Lender Address Ut,lolI TEAl.' Primary Structural Electrical t1echan; Cd 1 COtITRACTORS Genera 1 Plumbina Electrical tlechanical 110. ""? .... Each Single fixture .~ Co (). ~ N ...... \) /!/ "" .r.> -e.- /'" ,,' L. /.'T. L/ _Uc.-.~_~;' a/:u:e:<..~.b'1.-\.. r-' . -L_, "~7 .& -4-.-".,-tZZ:.7 , .7 !J1.{5. /~::~> ;:"fttj S.P )-1-' <;'... /f' b/_~'~ E/ecfr/c- ~';'4'j .t IRelocated building (ne..., fix. additional)_ Is.F. Residence 11 bath) IOuPlex (1 bath) each IAdditional bath I ~!ater service jsewcr I Storm Sewer (name) Phone I address) flies. no.) C.'." I/-'" {name} (address) fl ics. no.) PLUI1BING ELECTRICAL FEf rH^Rr,f Nn ~~~ r~AP~~ NO. ___<X"; , ..0 .) - '-'. Residence of SQ. FT. New circuits alts. or extensions I SERVICES I ITemporary Construct;~n Change in existing res i d_enr:~ multifamily, camm. or Indll<;trial I / I I I I ! I I I ~:). =1 I 1 10f ICOI'II-I./lIIO. FEEDERS I Install/alter/relocate rli<;tdn. fppdprc; Of 1.;0 amps.1 amps. I I I TOTAL CHARGES /6. -- I TOTAL CHARGES WHERE STATE L,'I~ REQUIRES that the Electrical ",ork be done by an shall not be valii until the label has been signed by an Electrical (exniresl (ohane no. I (exoiresl (ohone no.) MECHANICAL furnace/burner to BTU's I ~TI=" nHl.pr.~ I I I C;~O I I I I Floor furnace and vent Recessed wall ~On~P hPntpr ~nrl vpnt Appliance vent <;~oarnte Stationarv evao. cooler ~ . Vent fan wi th sinole duct I Vent systeM apart heatino or A.C. l'lechanical exhaust h('lOr! nnd du~t Wood stove/heater --. .....'\:: " r'. from I ISSUANCF OF PFRIIIT 1.)-: ""'1 TOTAL CHARGES Electrical Contractor, the electrical porticn of Supervisor and returned to the Building Division ;...... c=ta ,""" fa ~D , . thi s permit I HAVE CAREFULLY EXN1INED the completed application for ~ermit, 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 Soringfield and the Laws of the State of Orel]on pertaining to the \oJork described herein, and that r10 OCCUPArlCY will be made of any structure without the permission of the Building Division. I further certify that my registration It/ith 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 subcontractors and employees who are in compliance with O~S 701.055 will be used on this project. r~AHE{please print) "/d'/If""<:' k) ;::;., u';"(;;: 1/ 5 Ir,iIATURE a~__--:"_....-. ~~c-",,/,~ e...-e/' FO~ OfFICE USE Q7IL y OPTE;C2-/;.t/- :}O Zone ,111-) TYDe/Const. n,z-"N Units Sf!. Ftg. rlain "3'15- x ~l. ;:00 Value 73/<,'. "e. - Fi re Zone -ro= Bed ro oms Occy Load Sq. Ft~. Access x Value Flood Plain Stories f Occy Group i? . 7- Sq. Ftg. Other x Value TOTAL VALUATION ,.P' 7 3/'1. <.P5 BUILDING PERI.IIT Charges an~ Surcharges PLUl1BING PERMIT Charges and Surcharges ELECTRIU.L PERI~IT Charges and Surcharges IIECHArHCAL PERmT Cha rges and Surcharges '! ';'. 0,"" ------------ /.76 ____B-?'--:_=-_ <../0 . , Plan Ck. 65';/Bldo Plan Ck. 30%lBl do I Fence Demo COIMl/l nd Per F'pe Res Per Fee 28.6~ 'Systems Development ' Charoe (1.5%) /0</,7( /.c....-. o.S c> Sidewalk -----~----- . 66 I AIC Paving _n_j_~:'~n Curb Cut .7~ I TOTAL Total Comb. rermit ,I / :;;'0 . 1"2. 17~<~~~~J ?'. .... . . \ -., ""' '..' COMB INATI 0:1 APPLICATION/PERMiT (CAP) ( CITy OF - "., T nATION SPRING s . City Hall FIE L 0 o Pflnglield epart"'ent " OregOn OFF' C, A ~ Public Work. RECEIPT No. B (8 I I 1. I. Applicant to furnish A. Job Address B. legal Description 1. examole- Tax lot 100. lane County Hap Ref. 17 U3 43 2. examole- lot 1. Block 3. 2nd Addition .to (" sprlngtield Estates C. Name, etc. of owner and construction lender O. Energy Sources 1. eX3lilole- heat/electrical ceil inQ/or for' ~l 2. examole- waterheater/electrlcal/or sOla E. Square rootage or valuation, etc. - 1. examole. 1250 sq. foot house, 500 sq.' , Address ZZz I 2. examole- if new proJect, check new - i (?d-- check add, etc. _ . ) ,'" ( F. Building permit information: Rec . ---- - ~ 2. examole - remodel existing garage in ( ffoo -.~( 3. examole - convert single family res; ')" . restaurant {change of use} I G. Value of work as def,ned in Section 303 ( l Structural Specialty Code H. DES I GN TEAI.I Aim CONTRACTORS To avoid design or construction delays Division Staff must be able to contact pr\ persons regarding design information c " corrections. etc. II. Abbreviated Plumbing, Mechanical, & Elect A. Except where blank spaces occur in tr le; portion of the Mechanical and Electr" the applicant need fill-in only the to the appropriate item{s) to be ins B. Full Plumbing. Mechanical, and Elee' are available at the Building.Divis 1. To conserve space on the permit have been abbreviated 2. If the item(s) to be installed the abbreviated schedules you full schedules C. BU'lDING DIVISION STAFF WIll FIll CHARGES ON THE SCHEDULES (~' D. As noted on the CAP, the label mt electrical contractor for signat! supervisor. The general contrac to s;9n the electrical label. Applicant to si9n and date Whenever possible. the initial appl~_ a worksheet only. Where possible, Building Ulv,.. will p',epare 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. ( , Date (. '. I I / I ,... 03018. ( ( (" ( (1,- - -. ., ~"'OUnt ;-~ ece'ved ., ~le \auth -.-. . ( 2 /9~~}5; C!..P, ----= ( --:: ( S"t~'O".'lJ" "'UTIolOlltlZC "lJ(l ....,..tt..$ ~ !!i/CN"'Tl1I1tC t!.JCt"t.O".'40, -.s".. ( --\.. ( I... V. FOR OfFICE USE ONLY' Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: /- tf.PP<"/':'/l-r/T /-;.., S~.N hPd(,)Y6:M__-",,7 A:;'/?e=~"4<S"':7-.r- ~~ /-::: / ---::-., ~ .5"5~,"","/Y <~ d'>~ r c:r7"~/.r ~ 1~.4.i"i'C""~ KP, kc/"":? Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name /OKN'-."'- ~ @:;:c.e:--;t.e Signature~~ , fl:<(? ~_r.:=> date "?-//-S'o . ... .. -,~.