HomeMy WebLinkAboutPermit Building 1989-6-5
I INSPECTION llJll
726,3769
Job Address
CITY OF SPRINGFIELD
COIIBIIIATlON A"PLlCATlON/PERMIT
EIIERGY SOURCES:
I Heat ~,;~,~,None
Hater l1eaterJnnp
Range' None
70 "r,,:e..., Valu, of Hork:
Ml1rr"" (:, Mrnrl1J<>l 1 rl\6i.p-2531 fu~~r.~';~fO: Oeser be Work{Le..
Rnv 1 A 1 "l Family Residence IHth Attached GaraQe)
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INFORIIATlON UNt
726-3753
Sq. Ftq. ',lain:27.8<:>
~q. Ftg. Access.
Sq. F~9' Other
..Jle~dd~lter'-p'ep.
Fence Demo Change/Use
Other- ' -
.
Legal De,cription 17-02-19,
3950 Marco1a Rd. . SpJ:ingfi.e1'
.G.;J..J d'-l.1::;:'
Tax Lot 1I03500
Owner
~ 17-0~-1qL-Tax Jot 1I0330l
Address
Construction
Address
DES I GN TENI
Pri ma ry
Structural
Electrical
Hechanical
CONTRACTORS
Genera 1
Plumbino
Electricill
~1echanical
..J!Q.,.
o n
Build Single
Euqene, Oreqon 97440
Lender Centennial Bank
P.O. Box W.
PROPOSED ADDITION TO RXrS~TN(:
l\ HC'lMRl
BllILDIIJG (N()~
M'I LV'/'j'773'G?'1
ilies. no.).
,.._._~ _ _.L:! _., ..,
'1/I:I11le'1.'''~-~-~-'
r~~6-8',ll
-I~,;r
0:::-,,---
~, ~ 1-;>
{exniresl
.....---.-
.:....""j......
{nhone no. j
Rn'2..e.noc:~h::loll~t. 388 J.:Ij'Jl-t (~-t:'
~~JQnQ Or~ !??7! !~ 31 gO
4B5 BJe]
C:,..h.=r.ll~r. c:.....o.mrn r-: r.l; 1...:1 T......,..
1\1"'+ R:~d.horton 8-?
1I1'f111
C~~Rgfio1d ~" n~
SL ~;prinafi,,1 n -fill PS
(addressl (lies. no.)
~'} :'.. ~~
1.0-1-1\9
(exnir@s1
,26 027~
7?6-()?7"l
(ohonp nn. \
Ar,t' Eatherton 83
(name)
IITII
Owner
A
No addition to the present pIumbina sv~r<>m, ~A
Art Eatherton, licensed Plant Electrician, also Supervisor ~~
,:.i--M-echa-n-i-c-a-l F&.vj'C'c~,;:), dl\~ J..J.~. nl.dOnam, J.nc. td.eCt.rlcal ~ '\Aft
Contractor, wil. inRtnll t-hp. p,lp,..t-l"'i("'O:lIl t:lov~""'ncd,......~ ~~
PLUIIBItIG
ELECTRICAL
MECHANICAL
FEE [I'^RGF .1'0
~n: rHf;IillE..1ill.....
H F rIHiRGL
Residence qf
furnace/burnerto
STlIl s
Each Single fixture
sq. FT.
Relocated building
(new fix. addition~l)
.......- .._-
S.F. Residence
11 bath)
Ouplex (I bath) each
Additional bath
~Ia ter servi ce
Sewer
Storm Sewer
~ New circui~s a1t5.
or extensions
oJ? 4'!>/.( ~/'?cE
:z.;?,2 ,
Floor furnace
and vent
SERVICES
Recessed wa 11
Sn~~p hp~tpr ~n~ vpnt
Temporary Construction
Change in existing
r~s.i dcnce
multifamily, conrn. or
Jpoustrial
-~ ....--
Of amps,
COI~I./lND. FEEDERS
Install/al~er/relocate
distrib. fr.erlers
Appliance vent
s.@oarat@
Stationary evap.
cooler
Vent fan with
singl@ dvct
Vent system apart from
heatinq or A.C.
Mechanical exhaust
hood and duct
Wood stove/heater
/ Of _L:::?=r::>
amps.
'i::?-so
This buiIdin ~ pe ~mi t u;w] icatioll ,is for. "n ;,<'ini r,; nQ..t.o "n <>y; ",,; n.o
building to 10US ~ mac line ry. AU uti Ii' ,ies inc1 ~dii 19 Plumbing, '
::l~_.;"...':"_':";".t' 3"1;:;..,:;.... 3y H..l;;;:1I I QUU ~..Ll,..y t'4dl,..I1L. H(',"~ O~~I1 ~n se.r;Vl.ce
a this Iocat ion Fnr m,n~ ~<>"r" ISSUANCF OF PFRrHT
TOTAL CH~,RGFS TOTAL CI1^RGES CP5': cSl::> TOTAL CI1ARGES
WI1Er~E STATE l.\H REQUIRES that tile Electrical work be done by an Electrical Contractor. the electrical portion of this pernit
shall not be valiJ until the label has been signed by an ElI~ctrical Supervisor and returned to the Building Division
I IlAVE CAREfUllY EXAtlltlED the completed appllcation for [lermit. and do hereby certif.v that all information hereon is true
and correct. (lnd I further certHv that any and all work nel'formed shall be done' in accordance with the Ordinances of "the City
of Springfield and the liHo/S of the State of Ore<<:lon rertainil1f) to the work described herein. and that 110 OCCUPAI{CY will be made
of any structure without the nermission of the Buildinfl Division. I further certify that my registration \-lith the Builder's
Board is in full force and effect as required by Or.S 701.05~. that if exempt the basis for exemption is noted hereon. and that
only subcontractors and employees '....ho are in comoliance with Or.S 701.055 \"1111 be used on this project.
OREGON INDUSTRIAL PRODUCTS, INC.
1lAr-IE(p1ease printl.~Y' DOU2LAS VI. ORl-lE
Zone~
Fi re Zone
Flood Plain
BUILDING PERI,IIT
Charges an~
Surcha rges
PLU'1BING PERMIT
Charges and
Surcharges
ELECTRIU,L rERI~IT
Charges and
Surcha rges
IIECHANICAL PERHIT
Charges and
Surcharges
TYDe/(ons t.
Bedrooms
Stories
5'N
_SIr.II^TURE . ,f)~ om 6/')/89
FOr. I.HICE USE IIIIL Y /
_Units Sf!. 'nf}. t1ai~ x Value. .
Occy load Sq. Ftl]. Access x Va 1 ue'
Occy Group-E':::7 Sq, Ftg, Other_~ ,<,z.~~ V;lue
7?C?T--P' /7".?-;;:> /' TOTAL VALUATlOrl~,6''i!/. "'"'"'"
Con.'/Ind '€>/::?= /"j....." Systems Development
P,pr Fp,> //. :;/;;.'. 6>T--"'-/ Char~e (I.5~) '2,$57 62-
Res
Per Fee
/
Plan Ck.
_ _ __ {!/{?j,~?2 _ 65%181 do
Plan Ck.
7..:::>"3 30UBldQ
Fence
Oemo
_____7"~- Sidewalk
::<.~ A/C Paving
Total Comb. Permit /'1"1.78
I,
TOTAL ' 57/. 7::3
Curb Cut
, I.
,/
r.
;'
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A.. Job Address
B; legal Description "d.", -', .
1. example- Tax Lot 100, Lane County Map Reference
17 03 43 '
2.' examele- Lot I. Block 3, 2nd Addition to
>prlngtield Estates
C. -,'Name. etc. of owner and construction lender
'0. "Energy. Sources
_ "1.' example- heat/electrical ceilinq/or forced air Qa~
"..2. example." waterheater/electncal/or solar .
E. Square footage or valuation, etc. -----.
.J.....examole- 1250 sq. foot Iiouse, , 500 sq. foot garage
..,~; examp.le- if new project, checknew - if addition,
cheCK add, ete. .
f.,. ' Building pennit information:
'I. example - construct single family house with an
a ttached garage
.2. exam~le - remod~l existing garage into family roar.:
3. examJPle-~ convert. single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
~. DESIGN TEAM AND CONTRACTORS
To pyoid 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 installea
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. JO 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. ---
Applicant to sign and date
Whenever possible, the initial application will be used a5
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. I
IV, Fees and Charges
Plan check fees a~e 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
payab 1 e when the permi tis i'ssued. .
III.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
.
PERMIT VALIDATION
llc.ff;;e I c.; 6' D 7
b-c.-?57
Permit Clerk ~p ~_~ ~
/' /' / '----t' --e.::.; _
Permit applicant exempt from registration with the Builder's Board because:
Additi ona 1 Project:'-Info'rmati on,:
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C~.:'-J.< .::.
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PLANS REVIEWED BY:
~~nie J-,R~ li~~
Signatur~~A-?'~"'-/ date 6-Z6>-~
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