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HomeMy WebLinkAboutPermit Building 1990-11-20 I INSPECTION LINE 726-3769 ! ~ Q <nTI \ '\ \(\ ~ f\ .st-). Legal Oescription \ i) U ~ '2)~\ ()"2JfJ(j owner\;(j "~\'Ill\(\ ~.~ tt\ Address ~ 1 ~~ 1)f) i N b g- Phone ce,~~tV~ \ ~~4~~1~~4 -/-/ - 1210 Z C( Q,~ (address) CITY UF SPRINGFIELO COMBIIlATION APPLICATION/PERMIT EIIERGY SOURCES: Heat Na ter Hea ter Range INFORlIATION LINt 726-3753 . Sq. Ftg. '.Iain r-. ~q. Ftg. Access. ~J Sq. Ftg. Other r ~ New Add Alter Pep.. ~ -Fence Derro Change/Use ___ V I f W an -Other-- aF!<r: . _ ,CD ~_Q BuilciinQ ~nnit Info: Descrlbe Work(i.e., Build Single r Fauiwi;j O:~tachU;MJ? ~ J}L u nlTht'\ "t ~ -I . .. a Job Address = Address Ut>J(iN IEAr~ (name) flies. no.l (exoiresl . (nh(lMp nn \ Primary -~ --y~ Structural Electrical Meehan; ca 1 I CONTRACTOR; i\ (~ame I General Qjl.0~ (address) l1ies.no.) (pxnirps) (ohonp nn. \ Plumbina ~. \v . . ' Electrical'- _ ~. ~Iechani~al .; \)Q i ^C\--?n\~ . PLUlIBI NG \J ELECTRICAL MECHANICAL NO. FEF CHARr,F Nn ~~~ r~AR~~ NO ~~I=' r~.lUU~~ IS Each single fixture Residence of 4a-e I~ SQ. FT. furnace/burner to BTU's Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (] bathl Duplex (1 bath) each SERVICES Recessed wall <:n;:lr'" hp;:lt.,... ;onrt ".,.nt Storm Sewer L~~UY/~~ Of amps., Appliance vent <;POfir;:ltp Stationary evap. cooli='r Vi='nt fan with sinoli=' duct Vent system apart from hi='atina or A.C. Mechanical exhaust hood and duct. Wood stove/heater Additional bath Sewer Temporary Construction Change in existing rp~irlJ'J1cP multifamily, corrm. or Tnnll"t.ri"l Water service /~- COI~1./IND. FEEOERS Install/alter/relocate rli"t,rih_ fpprlpr" Of amps. I ,:; & -",...../?.#C ;.-:;;;~ ~~ ~ ~~/~~..."..A7.~!Z ~~/7: I . M~ .9> 3'~~ .ar-~E,oy .~ 3.- .J./~ . -:>0 $S~ l/...cz.//.J/_AA . c;---o _ ':C.'_.o.c ISSUANCE OF PFRtllT /b.:".:)' TOTAL CHARGES . WHERE STATE L\IJ REQUIRES shall not be val;1 until the /90.- TOTAL CHARGES TOTAL CHARGES 22 S-= that the Electrical work be done by an.:Electrical Contractor, the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein, and that fW -OCCUPAUCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that ::III:(:~::::t:::::~S~d(~:; ~hO ar~in ~O:~~With :::II:::R::JZ ~hi;kr- omlr Od/{J FOr. orF! CE USE DIll Y -. . Units Sq. Ftg. t1ain x Value Occy load~.. ~~q. Ftg. Access x Value Occy Group "21-2 Sq. Ftg. Other~ x;>~"Value..8P~- :U- t63 ~ DcA Uc q_ _~~1:1MATIorl . Or I.I-l" /\.~ \ Sys te. ms Oeve I opment \ ~~.) CharQe (1,51) . zone~~~/'~TYOe/const. Fire Zon~ Bedrooms Flood Plain Stories ~-t:;>-/-Y -:2 BUILDING PERflIT Charges an~ Surcharges --:277- Plan Ck. .? 7- 65%/BI do ----/$~6? ~6~~Bi~~ ____i2.t;?.=.~ Fence "'7. S.c> D~o Conm/lnd Ppr ~~e Res Per Fee PLUf1BING PERMIT Charges and Surcharges ELECTR I CAL PERI~IT Char.ges and Surcha.rg~s. ." I1ECHANI CAL . PERMIT Charges and Surcharges 'Sidewal k AfC Pavi n9 ____::?Z.2~_ 'Curb Cut 1.58 . .T9t~J Gomb.. .rermit .... '_...,.,,\. . -- TOTAL 162e>. 05 . I I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. legal Description 1. example- Tax Lot 100. Lane County Map Reference II oj 4j 2.exam2le- Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources . 1. examDle- heat/electrical ceilinQ!or forced air oas 2. examPle- 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. checklruew - if addition, check add. etc. F. Building permit information: 1. examele - construct single family house with an attached garage 2. exam~le - 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 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 chock 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 . p~yable when the permit is issued. V. FOR OFFICE USE ONLY . . . . P~OJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: , ~ PERMI.T VALIDATION ~'\~\ ~\ C\y) ~~ ~..... ~D \ \/~~Y Permit Cl erk , Permit applicant exempt from registration with the Builder's Board because: ,l\dditi ona 1 Project. Informati.on.:. PLANS REVIEWED BY: name L...,RHcF 11:.. ~,g?\ Signatur~-,,_~ ~/ /' r date /O~9-9C> . ..