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Home My WebLink AboutPermit Building 1979-11-7 .. ,INSPECTION LINE t ;26-37 69 Job Address ~/~ .6 CITY Uf SPRINGFTELO COMBINATION APPLICATION/PERMIT EilERGY SOURCES: Hea t eJE~. l ~/,,~ \ l~ater Heater G/IOC. Range E/-ec. ...~ MluAl .st.. Legal Description L,..1' ,qll:A /7-oa-sS'-3, Owner '3"...; ltIC Cit'_U. Address ~ J:i~e "+:IIl-l-/"N -H 41 Construction lender Address OESIGN TEAM I name) Primary II...}. eM .11 1'~~ :r... R.T.Fi. Structural Electrical Mechanical CONTRACTORS (name) General J.l..T. 'fI."..~" w"" (1.."...1'. (0". Plumbino "P,nln.... 'VL"M l,,; u" -~ Electrical ~UAA"" ,+ Flee.. ~1echan; ca 1 PLUI.IBING NO, FFF l':HARGF 1~ Each single fixture 3~ 3"''1!! Relocated building (new fix, additional) S.F. Residence (1 bath) Duplex (1 bath) each Additional bath IWater service Sewer I I 13DD I .312-" Storm Sewer 1 ~klJ'.{ 9o",'bIl14.J/ll> ValuE of Work: $ ~:1SJ'f/"'7.... <;9 BuildinQ Pennit Info: Describe Work(i~e., Familv nesidence With Attached Garaoel Phone . I' \}J ~ .s I!~- i JNFOffi1ATION LJN" 726-3753 Sq. Ftg. l'lain:{S'1ll.77 ~q, Ftg. Access.~.v/'9K Sq. Ftg. Other1Qcqq~.~ itJlew__Add~lter-"qep, Fence Demo Change/Use Other -- -- I Build Single AJaw I="e ,e.,-t,...f.,." IoJ S IGIIATUR~ FOn OffICE.USE'OHL So. Ftg, Occy Load Sq, Ftg. Occy Group B-I-"- Sq. Ftg, Units Phone (address) (lies. no.) ~;l.O AI. SrP (exDi r@s) (ohane no.') \~t,> ~ "{. (address) (lir'!;;. nn.) (~xDirpc;. , (nhnnp nn , P.o. B... ,)..'ifntJ p'!Cj....u<? t'htP. ~ ELECTRICAL Nll.......1 I Re.s i dence of SQ. FT, I New circuits alts. 01'" extensions I SERVICES I Temporary Construction Change in existi~g rFl'ijqrJ1r'f3 [multifamily. comm. or Industrial 10f 4ln ICOMM./IND, FEEOERS I Install/alter/relocate dic;.trih. ff3f3nprc;. Q35'- //..,?,p, MECHANICAL <<< r>:IARG.E Nn <<< rLl~, I I .:J.~ I j I dSDD I I I I I I SSUANCf nf PFRlllT TOTAL CHARGES :!/t DO TOTAL CHARGES htJ ~81 TOTAL CHARGES WHERE STATE LAH REQUIRES that the Electrical work be done by an Electrical Contractor. the electrical portion of shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building ~ivision amps. / Of ::n.5" amps. furnace/burner to BTU's Floor furnace and vent Recessed wa 1 1 ~q~!p_hp~tp~ ~nrl vpnt ~ [Il/~'!fp [J Z 1M>. [ App 1 i ance vent s_eo<1rate I Stationary evap. coo h~r ., [ Vent fan with 0<.... sinale duct ., I Vent system apart from 0<. heatina or A.C. I 1 Mechanical exhaust hnod ...nd rluC't '/.rJrJ Irq? [ loW ~a1 3 DO 6<110 ~8 3"'0 I I I I .31flt.1 r2..'1QfJ Wood stove/heater this pel"'Tilit I HAVE CAREFULLY EXAMINED the completed aprlication for permit, and do hereby certify that all information hereon is true and correct. and r 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 OCCUPAr~CY will be made of any structure without the permission of the Building Division. r further certify that my registration with the Builder's Board is ;n full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon. and that on 1 y subcontractors and emp 1 oyees who are in como 1; ance w; th ORS 701. 055 wi 11 be used on th; s project. BUILD[NG PER/1JT Plan Ck. Comm/Jnd ..!)IJt,. (PO' IShsterns, Development Charges and _______':It2&OO 65%/Blda P.l'r Fee C aroe tJ.5~) Surcharges Plan Ck. Res I Itn.tJE/ 30%/Bldo Per fee PLUt1BING PERMIT ___u__39~ Fence I Charges and I Surcharges ISfe, 0_ ELECTRJCAL PERIHT n __ _ u /dJ,-f2l2 Sidewalk lit/. '13 '1d..J.Y Cha rges and Surcharges ,1.'/0 AIC Paving'1J07.~ s;':J .00 Total Comb. Permit MECHANICAL PERM[T _______~()fd Curb Cut 7D' /7.00 Charges and I TOTAf(y//9~.fe8) SurCharges ,9~ NAf1E(p!ease printjl J./I,/<))JJ2ted<<Ls Zone~:=p Fire Zone m Flood Plain ttLJ Tyoe/Canst, \I-AI Bedrooms Star; es DAT~/' ./,. / M~in ~<'t".77 x Access 2:J K I. '1~x Other~qZ. S' .x Value Val ue -t5lh5: 7.5't;: (){) Value CJ1tJ7.r7tJ ~ ~ VALUATIml~1~q :1.00 TOTAL mi."!, $11o.1.7.s- ~ AIo (!.i7J3l':J"'- . e.. ,o~ '-. '.-' 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 11 03 43 2, exa~le- Lot 1. Block 3, 2nd Addition to' Sprlngtield Estates C. Name. etc. of owner and construction lender 0, Energy Sources 1. examole- heat/electrical ceilin%r forced air Qas 2. examjile- waterheat~r~electrlcalior .?2.!.!!: E. Square rootage or valuatlon, etc. I, examole- 1250 sq, foot house, 500 sq, foot garage 2, examole- if new project, check-new - if addition, cneck add, etc. F. Building permit information: 1. example - construct single family house with an attacned 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 TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design infonmation 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. - , 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 ars 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 Pennit Clerk ~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Pennit applicant exempt from registration with the Builder's Board because: Additional Project Infonnation: PLANS REVIEWED BY: name signature bf!l~ date//-?-/-9 J . -=--. 11l'CPECTION LlIIE 726-3769 Job Address (o;,pJ! ~ CITY Of SPRINGFIELD COMBINATION APPLICATION/PERMIT - E!IERGY SOURCES: Heat e!c~. r5'IJI~) t~ater Heater .'-='~~r;c. Range /;/IlC. hlm.I.J .st.. Legal Description [,.,1' :11)~ (' Owner S, t:';..i 1'.;"" ',.>.Jl Address ~ Construction lender Address Do,IGN loAr1 17-~1-?-.t}-?-. Fi'",-" ~.L.~1-!-"~..V -if ~~ Phone Primary /Jy-.1A!J1.I,1') 1'~7- :rho R. r.rI. (name) Phone (address ) :nt.> ~1. S~ Structura 1 Electrical Mechanical CONTRACTORS General H..T. (namel (addrpss l ~ 1...., t ....,.... " '., '!~ ~"~/C.-t. I~... p'.~. ~r.\' ']_~'1(t Plumbino 'Rnh"'-.. rvl.!._.......l~\ '.1(/ ~'~l Electrical ~'J_~.~..t\'-+- F!C'.<=... ~1echan; ca 1 , INFORllATlON LJN" 726-3753 Sq. Ftq. 1.,ain<!S'l'tJ.?'L- ~q. Ftg. Access..::z.2Ylt98' Sq. Ftg. Other J.")tJri? .!:>~ llJlew Add Alter Rep. . _Fence_Oemo_Change/Use )a~~S~~\~~;~~ t. Other BUilciino Pennit Info: Describe Work. ( Le., Build Single Family Residence With Attached Garaoe' I ~ './':>'l.N .r:: ."~ .c....*. >>-+,' r, .V (1 ics. no.l r::.."".o~!Ip._ r'I:.~~ (1 irs. no.) PLUI.1BlNG ELECTRICAL NO, FEF CHARGE Nn 1_~F't' Each single fixture Residence of I !A.. 3 (-!? :21. CD SQ, FT, .:;)'.17-- I Relocated building New circuits alts. I (new fix. additional) or extensions Is.F. Residence ISERVICES 11 bath I IOuPlex '1 bath) each Additional bath Temporary Construction Water service Change in existi.ng rp~ i ttpnl'"p Sewer multifamily, COrm!. or lnrluc;tr;;d Storm Sewer Of 4t'n amps 3"0 0':) COMH,/INO, FEEDERS 1..111t_'" ::'~":J';N.!.._~~ .3 - I I I Of ':r:..5" I I I TOTAL CHARGES .,9 CiO I TOTAL CHARGES WHERE STATE L,;H REQUIRES that the Electrical work be done by an shall not be valii until the label has been signed by an Electrical Install/alter/relocate dic;trih_ fpprlprc; amps.. rlJAllll.E. Nn. .:t--79' I j I I ~srol I I I .06!<." I ,. (exoiresl (ahone no. (pxnirps) (nhnnp nn ) Cl",,--<;"- fI.3"" . MECHANICAL FF furnace/burner to BTU's Floor furnace and vent Recessed wa 11 ~p~r~ np~tp~ ~"rl upnt '7 I H.V,/I?-. . ^ 1-1/ P ,1- "'- fI,;>. I App 1 i ance vent ~~o~rtlt,=, Stationary evap. cool~r Vent fan with ~inole duct I Vent system apart from heatina or A.C. Mechanical exhaust hnod and dur::f. I ',-(Cd I ~C2 ZOd yeC 300 (;dO 30" 13(:10 I Wood stove/heater ISSUANCE nF PFRlm TOTAL CHARGES ~3 de..' Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division ~L.j'!f? 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 rlO 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 exemot the basis for exemption is noted hereon, and that only subcontractors and employees who are in comoliance with OP.S 7/')1.055 will be used on this project. ~~~~..- - NAME(please printj! Zone_P- P Fi re Zone rIT Flood Plain 11"l BUILDING PERNIT Charges anc Surcharges PLU'~B ING PERHlT Charges and Surcharges ElECTRICA.L PERI~lT eha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges SIG;I^TUR~ OFFICE USE o;~L.v /' Sq. Ftg. r~~~n ~S.ql'). /7 Sq. Ftg. Access .7:1 g J, 'If} Sq, Ftg. Other If)l.jq2, t,- ,~//. )<))..}l?ttd'~{/...5 FO!"! Tyoe/Const. Bedrooms Stories V-II Units Occy Load Occy Group 13-) -;J. _ I Plan Ck, ConmlInd _______~/.:20C~ 65%/~lda PI:''" ~pp .'/ Pl~n Ck. Res ! (,/J- 30./B1 do Per Fee 33: ')Q Fence __n_n /_5(:1 ~e~o _______!dJ:...Ql1 Sidewalk 1/2.1. '/3 :1.. if() AIC Paving<.'1j,??~ _ _ _ _ _ _ _cJ!.-!.:Cr:;' Curb Cut 7.) i ,~~1; OAT~/:;/ < x Value Value ~;;"'-S~_7z.0::'J:.) Value Q7(J7.r:.'J VALUATI or(:-:1 f.c;, l.J~:;..':? x , TOTAL Systems Development -7/21:. ,:,.5' Charoe (j,5?') IIp,!.-?:!. 1/:;, 1</ 5'1.!XJ Total Comb. Permit 17,00 " _L'OTAl(:'i1N.r.,s ) ~~~.7S- liI;ClW':Je... I - . COMBINATION APPLICATION/PERMIT (CAP) J [. Applicant to furnish A. Job Address B. Legal Description I, examole- Tax Lot 100, Lane County Map Reference II 03 43 2. examole- Lot I. Block 3, 2nd Additio~ t.n- ,pr,ngtield Estates C. Name. etc. of owner and construction len ~ D. Energy Sources I. examole- heat/electrical ceilinq/or 2. examole- waterheater/electrical/or 51 E. Square footage or valuation, etc. - ( I. examole- 1250 sq. foot house, 500 sq. 2. example- if new project. check-new - check add, etc. F. Building pennit information: C. 1. example - construct single family hau: attached garage 2. examole - remodel existing garage fntc 3. examyle - convert single family residE (i restaurant (change of use) G. Value of work as defined in Section 303 (a Structural Specialty Code H_ DESIGN TEAM AND CONTRACTORS C To avoid design or construction delays, au: Division Staff must be able to contact appr persons regarding design information or jot corrections. etc. ( II. Abbreviated Plumbing, Mechanical, & Electrical A. Except where blank spaces occur in the desc: portion of the Mechanical and Electrical Scl the applicant need fill-in only the No. Box. to the appropriate item(s) to be installed B, Full Plumbing, Mechanical, and Electrical Sc are available at the Building Division 1. To conserve space on the permit form the have been abbreviated 2, If the item(s) to be installed are not C( the abbreviated schedules you should con~ fu 11 schedu 1 es C. BUILOING OIVISION STAFF WILL FILL OUT ALL FEE CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must electrical contractor for signature supervisor. The general contractor to sign the electrical label, Applicant to sign and date Whenever possible, the initial application will be 'd a worksheet only_ Where possible, Building Oivisi, will prepare a type written copy and return it to . applicant at the time the actual permit is issued 1 signature. IV. Fees and Charges Plan check fees ar2 due and payable at the time of application, and no plans will be processed until t fees are paid, All other fees and charges are due. ( payable when the permit is issued. ~ be del ive, by his el. is ~aut , ; Ill. V, FOR OFFICE USE ONLY ..~, '.... '~_.!>J-_~.~ ." ..........1 - PERMIT VALIDATION SPRINGFIELD City Hall Springfield. Oregan t of Public Works Departmen OFFICIAL :tt;T B 52009, Date II-'! 1~ f1~ ( tJY}.~. Rec'd From6 J..rrPrf - iL\. Addres.e~~:(i _ ,~~ ""'-'u(') Fgi< -~ ~ ~.i' W [linr}]f. ~'e' ~(0Uf\ a ' . .~g.~ ~~ ' u__- :,~)(~ ~;g~ -( J~Bf1----= ( CITY OF (' ( ---~ ( ( ( c ( Amount ~ R::eive~lJr ) ~-' ('p \I\UTHORIZIED SIGHI\TURIE ~,,'''TI''S . IUGINI 010 .140' SNI~TON.TUION.UU ...".. c (' "'. I ( o \.,-. ' Pennit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Infonnation: PLANS REVIEWED BY: name signature . .r t2 ed~_~7L da te /./ -?-/4 "