HomeMy WebLinkAboutPermit Building 1987-3-19
CITY Uf SPRINGFIELD. INFOR/1ATION LWE ,I
cormlllATION APPLICATION/PERMIT 726-37531
ElIERGY SOURCES: I' Sq. Ftg. 1,Iain /7S0 C':f J7i'4:
7305 Main Strept. Snrinp'field Heat E'LeT ffEA-7" ,<1'....1 J ~q.. Ftg. oAccess.
Legal Description 7305 Main" Street llater Heater Sq. F~9 ber'" .3.::t:;l... M
<;:"- -~ J-'p ., PI ---:~~-d.-~'. New ddLAlter Rep. vu
~r:" .:.'.-.o...:.::...:.w......::. - ,i;,'IYtor-~Q.::' ............. -....... RanQe -Fence erno Change/Use
Upper Mausoleum /7-02.35- TL ::?7t?2 "j :J7",Q \ ValUE of H~~?~~O'~ C' Other- - I ~ij
Owner Springfield Memorial Garden, Cem & Mausol, . '-', '",_ ~/-,
BUlloinq Pernnt Info: Descnbe l~ork(1.e.. Build Single
Address 7305 Main St. Sorin~field. Phone 746-531Jamilv nesidence Ilith Pttached Garaoel ~
Ph.746-5311
011//,I~/I.y/. !J7'f'B? M;/V1M Fl/"7 Ii- e!rffJ"r) ''\J
t3A'vJ( 771ir' ~"'I-r~IkC".:J"'" W.J'f S'7;,t?/ZiD /..,/ /77:1
Blzl-.?oJ Phone 7:>'{.:q;n v./,ic>z L--jv€:, (OJ",,'); /'dI..v//lJ '3 fJ :7V;l..Y-.
"'d."'"".'~"~"'~o" .,we"", "",. M' '~,rel.. ." ':~.;:'"
1.r; t'n M';1....tr Mnn-rp or _
with Mack Moore and Robert R. Smifh. elect. Enp'ineer.
i-
'."
J' INSPECTlOU LIUE
726-3769
Job Address
.
Construction Lender C Ed- ~h; k/
Primary .Tame.c; Keefe. cl'p.seaserl
Structural Same
Electrical S::lmp
Mechanical c:.,rno
CONTRACTORS (name)
Address
Ut~I(jN ftN1
ev. I /0h trv'L
lnampl
"'tl- ..~,
u(addrpss"-"
Moore
(1 ic<;._ nn.
(pxoirl?<;')
(ohnnp nn_)
General M~H"k- Mn('l"T'1=> P"T'pc::; rlpn't_nwnpT" nper:\tn....
Plumbina M::l("k Mnnrp_ Prps; nFmt-nwnpr operator
Electrical Mack Moore, President-owner operator
'Iechanical Mack Moore, President-owner operator
PLUI,IBING
NO.1
6 Each single fixture
Relocated building
(new fix. additional)
S.F. Residence
(1 bathl
Duplex (1 bath) each
Additional bath
~)2/ ~Ia ter servi ce
!pC; Sewer
~ Storm Sewer
TOTAL CHARGES
HHEnE STATE LAW REQUIRES
shall not be vali1 until the
I HAVE CAREFULLY EXA~1INED the completed aprlication for permit. and do hereby certify that all information hereon is true
and correct. and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City
of Spri ngfi e 1 d and the Laws of the Sta te of Oregon perta i ni n9 to the work descri bed herei n. and that NO 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 OP.S 7~1.055 will'be,~sed on this project.
, Mack Moore, president/owner 11/.1 ~c?'~ ~/Yi~~
IWIE(please pnnt)._2f~~,nlZf; ,,1 r1 M"mnr;"1 r,"rrlpn~ SIGNATURE! f/{.= It-I //~ OATH,,}, <;
FOr. OFFICE USE OULY
Tyoe/Const.X_.! AIR. Units Sq. Ftg. rlain
Bedrooms Occy Load Sq. Ftg.
Stories / Occ,Y Group-4.:3~ Ftg.
,
Zone--L.PZ?
Fire Zone
Flood Plain
BUILDING PERIIIT
Charges and
Surcharges
PLUI1BING PERMIT
Charges and
Surcharges
ELECTRICAL PERfHT
Cha rges and
Surcharges
rlECHANICAL PERMIT
Charges and
Surcharges
7.46..:5..'" ,
~ril
,
ELECTRICAL
MECHANICAL
I FEF I r.HARr,F f.Jn I
Residence of
. ~~~ I n-l4IU~~ NO I
I ~n. I n-l4Qr.~
furnace/burner to
SQ. FT. BTU's
.
7$0 rso",
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wa 11
~n~rp hp~tpr ~nrl vpnt
/;0) ?~~
Appliance vent
seoarat~
Stationary evap.
cooler
Vent fan with
",;nale duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hnnrl and r1urt
~-"Ib
I
I
A
fS'-
7'61. -
125:- ' /
Temporary Construction
Change in existing
rp<;..; denc-p
mUltifamily. comm. or
Tndllc;tr;al
:z..
"j"'?9- ,
Of ;;2 ere::> amps,
COMM./IND. FEEDERS
Install/alter/relocate
rlic::.trih. fpprlprc;
Wood stove/heater
/ Of <' /=
amps.
(.!J:-
ISSUANCf OF PFRPllT
255 ~ TOTAL CHARGES :5"2-50 TOTAL CHARGES
that tile Electrical work be done by an Electrical Contractor. the electrical portion of
label has been signed by an E1~ctrical Supervisor and returned to the Building Division
/8.--
thi s permit
1 Q.8,
Access
Other~/""'4.
x Value /7:f>,-,. 0
x Value
x Value:"'p_~
TOTAL VALUATION /6"'l 0.:>0. ..
/ 7.'C- Plan Ck. ConmlInd
~<?I../ 65%)Rlrlo Ppr Fpp
------------ Plan Ck. Res
7'1. 07 30%)81 do Ppr Fep
~<"<" <=-eo> Fence
----&.,/~:...._---
/61.2:?
_ __2?:f2::.__Sidewalk
:::< -/t::J
____!tl;.=__ Curb Cut
,72
1'1>-::>0 '<:'-<;>..,
'I?7. 7.::>
JI'~7 ~'?
Systems Development
Charqe (1.51,) ,
2~O~ <So;.
Df:j:ffio
~,,?.-r ..L.;,r..... c; i:;:;--'"':":C..~!?r,.y7
k-H/ ~</~04''='"'' -:::v.:;-. ~c:.
I -, -- ---
ITotal
I
I TOTAL
Comb. Permi t
/0':>6'. gr;
-:;&25: <'8
92-:S'D
AIC Paving
~
o .
.
.
11- 'H~'~
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Oescription
I. example- Tax Lot 100, Lane County Map Reference
II U3 43 .
2. exa~le- Lot I. Block 3, 2nd Addition to
Sprlngfield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. exam~le- heat/electri~al ceilinq/or forced air cas
2. examyle- waterheaterjelectrlcal/or solar.
E. Square footage or valuation, etc. ------
I. examole- 1250 sq. foot house, 500 sq, foot garage
2. example- if new project. check-nfw - if addition,
chec"k. add. ete.
F. Building permit information:
1. example - construct single family house with an
attached garage
2." examl?le - 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. OESIGN TEAM 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.
PERMIT VALIDATION
. ~ l\\t\
'b\Q(\~f\
Ol~\
V. FOR OFFICE USE ONLY
Permit Clerk ()~
,PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
~At .4'~,.;-,v?n M,./O'-< 5<.J~ '7-' C ....."?/'?3LG' ~~ ->0 PZ>.c: Y/JVG. T#~
?i-c:P'-'/7?~ h,?i'E h-,I,.,- hA /'-/7;>".,,- ~&>T'==?>=/1, .s.-r_~ ,1?~
~6V/ nlZ='?::?
, ,-
,..
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information: .c;~.Jr#lA~_M -:<G':};-' /A'__<>>r b'~
",li'CVL.T //"c.?T/~ #P;P./-?&:>V~.o fie,,:. p/S~::Z:?~?/~~/"{",2?y ~-=:;~
-1 ~/~ ??~v/cge~ ~=-c"-=<::'=-;
,PLANS REVIEWED BY:
name
I ::'~A/&
~=..---,
rc.~-r~ ~
signature a.~~ '?
// lr_~~
.
date "';:3-/9-&-;
- .
""
.
CITY Uf SPRINGfIElD
COMBlIlATlON APPlICATION/PERMIT
EIIERGY SOURCES:
Heat
l~ater Heater
Range
ValuE of Work:
.
INfORllATlDN l1"t
726-3753
Sq. Ftg. 1,Iain
~q. Ftg. Access.
Sq, Ftg. Other
Ilew Add Alter Rep.
--Fence Demo Change/Use
Other - -
I INSPECTION lINE
726-3769
Job Address
1305
!'11. ~
Address
Phone
BUildina Pennit Info: Describe Work(Le. f
Familv nesidence With Attached Garaoel
..0,/1'10") ;;;A~
/0/1 , j). J?A
Bui! d Sing I e
~
....:]
~
~
<><:;l
-----:r
l
Legal Description
Owner
Construction lender
Address
Ut>! uN TEAl1
(name)
Phone
(address)
(lies. no.)
(exo;res)
(ohane nn.
Primary
Structura 1
Electrical
Mechanical
CONTRACTORS
Genera 1
(namel
hlli//
(address)
flies.nn.)
(exoirp<:.)
(ohonp nn )
Plumbina
Electrical
v
~'echani ca 1
PlUIIBI NG
ElECTRICAl
MECHANICAl
NO.
FEF I CHARGE NO,
ITL J:IJARliE. NO,
H'~ r~@.G(
Each single fixture
Residence of
SQ, F1.
furnace/burner to
BTU's
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 hp~tpr ~nrl vpnt
Storm Sewer
Of
amps
Appliance vent
seoaratp
Stationary evap.
cooler
Vent fan wi th
sinale duct
Vent system apart from I
heatinq or A.C.
Mechanical exhaust
hoorl rind duct
~Iater service
Tempor~ry Construction
Change in existing
rp') i rl.pprp
multifamily, camm. or
TnrllJc;.tr;i'll
Sewer
COMI,I./lND, FEEDERS
Install/alter/relocate
rlhtrih. fPPrlprc;.
Wood stove/heater
Df
amps.
ISSUANCE OF PFRIIIT
TOTAl CHARGES TOTAl CHARGES TOTAL CHARGES
WHERE STATE L\I; REQUIRES that the Electrical work be done by an,'Electrica1 Contractor. the electrical portion of this permit
shall not be vali1 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 UO 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 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.
Zone
Fire Zone
Flood Plain
Tvpe/Const.
Bedrooms
Stories
Units
Occy load
Occy Group
SIGNATURE ,lJ/1bt'e1 ~
.. Far. OFF I CE USE DillY
Sq. Ftg. 'lain
Sq. Ftg. Access
Sq. Ftg. Other
DATF'7/W~.
NAI,IE(please print)
x
Value
Value
Value
x
x
TOTAl VAlUATION
BUIlDING PERMIT
Charges an~ ""'\
Surcharges Cf'-
______~f',e~.~r
15- Oll
_____L2_~?P.. Fence
(., .3 go 00.0
_____.:.~jp,;;l.5" 'S1dewalk
/, .3 ( A/C Pavin9
tt, 01L) I Curb Cut
--------~95-1
Plan Ck.
65%/Bldo
Plan Ck.
30%/B1dQ
Conm/Ind
Ppr Fpp
ROes
Per Fee
Systems Development
CharQe tl.5~1 '
PlUl1B ING PERMIT
Charges andc'.'''c;
Surcha rges
I
I
I
ElECTRICAl PERI~IT
Cha rges and I j
Surcharges ...,
MECHANICAl PERMIT
Charges and f_
Surcharges \p
fj
qb,~
ITotal Comb. Permit
I
I TOTAL
53? oft, I
.
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B, Legal Description
1. example- Tax lot 100, Lane County Map Reference
11 oj 43
2. examole- Lot 1. Block 3. 2nd Addition to
~prlngtield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceilinq/or forced air Qas
2. examele- waterheater/electrical/or solar
E. Square footage or valuation, etc.
1. example- 1250 sq. foot house, 500 sq, foot garage
2. examole- if new project. check new - if addition,
enee k. add. etc.
F. Building pemit information:
1. exam~le - construct single family house with an
a ttached garage
2. examele - remodel existing garage into family room
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
H. DESIGN TEAM 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:
I
.
PERMIT VALIDATION
l t q 1 ~~ i
1~}lt-
Pennit Clerk
(b'
.
. Permit applicant exempt from registration with the Builder's Board because:
Additional Project Infonnation:
" ,
PLANS REVIEWED BY:
name
signature
date
""
"""'..
.