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Home My WebLink AboutPermit Building 1988-5-31 llNSPECT ION LI liE 726-3769 Job Address \-\.re.. '\~0-,- <\: (;"\) , ,~ CITY Uf SPRINGfiELD COMBIIIATION APPLICATION/PERMIT EilERGY SOURCES: Heat I-Sater Heater . INFDRlIATION liNe 726-3753 Sq. Ftq. 1.lain ~q. ~tg. Access. Sq. Ftg. Other Xllew Add Alter ~ep. -Fence Demo Change/Use -Other- - I I Do CA) D I~ I~ legal Description 5344 MAIN. SPRINGFIELD OR Phone Range Valu€ of Hark: 72,000, BuildinQ Permit Info: Describe Work(i~e., Familv nesidence With Attached Garaae) Build Single 'PAY T.n'1'-17023331 650fi/fi507 Owner VETERAN' SOF FOREIGN WARS Address 5344 MAIN SPRINGFIELD, OR Construction Lender Address DESIGN TEAl1 (name) 97477 NEW 1ST AND 2ND FLOOR ADDITION, 2.440 SQ, FT, Phone (address) (l ics. no.) (exlJires) (ohane no.l Primary mut:' ~Tl~mcON A~SQCIJ\TF~ Structural Electrical ?Q{1 c:: C::.E.RTr.N"PTRT.n 746-8?11 -It . ~ (lire:. no.) (":')(I)irp~' ~ (ohonp nn l 11I.L!, c:: '1' nRC::Tr.", RJlTT.n RV nWlllRR 11echanical DESIGN BUILD BY OWNER CONTRACTORS Iname) (addro,,) General ~.k'#?/~ .lk-~_";r ~~. Plumbino M/~r~- ElectricaIL/7'V'0~~ ~1echan;cal PLUIIBING rHARGF Ln -1J!.h FEE Each single fixture IRelocated building (new fix. additional) IS.F.--R-esidence (1 bath) [Duplex (1 bath) each IAdditional bath I [ [ I A1:v/7/..,:s-"y,A>-C b.h~ .1 r;r P/9l?/7,>/T- I 'I""'Z>I"..H Re7-=> ~Iater service Sewer Storm Sewer : , ELECTRICAL MECHANICAL ... C"1\R!iE. _llil..--' furnace/burner to BTU's C"1\R!iE. ... Residence of SQ. FT. New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wall So~rp hp~tpr ~nn ~pnt Temporary Construction Change in existing rp$ j qp'nrp Imultifamily, comm. or Inrlll"tri;'l1 I Of amps, [COffi1./INO. FEEDERS [ Insta.11/alter/relocate [ [ di"trih. fppopr" I Of amps.[ I k/R-p.h'd'C 7$#~ ~Jy.~ ~~#/ 71- I ~/i'~ I [ Appliance vent seOi'lr~t~ Stationary evap. cooler I Vent fan wi th sinole duct I Vent system apart from heatinq or A.C. I Mechanical exhaust hood and r1ud. I Hood stove/heater I ~77D' .m>..-?'/9 ~,~ ~ ~/7/?t [ '$@-p~~ I I ISSUANcr nF PFRllIT TOTAL CHARGES TOTAL CMARGES TOTAL CHARGES WHERE STATE l;\\~ REQUIRES that the Electrical work be done by an. Electrical Contractor, the electrical portion of this permit shall not be valiJ until the label has been signed by an Electrical Supervisor and re~urned to the Building Division I HAVE CAREFULLY EXAtlINED the completed application for permit, and do hereby certify that all information hereon ;s 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 NO OCCUPAUCY will be made of .any structure without the permission of the Building Division. I further certify that my registration rlith the Builder's Board is ;n full force and effect as required by ons 70~, that; exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in COmaliancrwith OP.S 70 .0 1 be US~d is project. rW.IE(please print) John M, Amundson ",-. DATE 5/31/88 FO~ or Zone c::::: r". Type/Canst. .<"-N Fire Zone Bedrooms Flood Plain Stories~ 7bfJ/h7 r~-;;' ~C.c ~L~ ~~~~~~~Ga~~R~1IT ___;1X2_~ - m~B~~~ ~~~~~~d S h /7 4/"'- Pl an Ck. Res urc arges .,r;> 30%/Bldo Per Fee PlU!1BING PERMIT Charges and Surcha rges ElECTR I C~,l PERIIIT Charges and Surcha rges 11ECHANICAl PERMIT Charges and Surcharges ICE USE mil Y Sq. Ftg. Sq. Ft9. Sq. Ftg. Units Occy Load 2'7'>2 Occy Group .~ "'::f ' r1ain Acc'ess Othe"r ~ x Value Value Value x , -:<-~40P 7=9....-~ 'S-7S/-&'Y ---z.Zfp -.85 TOTAL VALUATION I \ I -l~ Sys tems Deve 1 opment uov Charqe tl.5~) . / t:::/@:5, <:>-eo Fence Demo [Sidewalk I A/C Paving I Curb Cut I Total Comb. Permit I 3"66. 7' S- Ifj'l~. '15 [ I TOTAL ~ .. , .1 COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Appl icant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. lane County Map Reference 17 oj 43 2. examp]e- lot 1. Block 3, 2nd Addition to Springtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilin%r forced air Qas 2. exa~le- waterheater/electrical/or solar E. Square footage or valuation, etc. ------ 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. examyle- if new project, check new - if addition. check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. example - 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 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. 11. 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 fu 11 schedu 1 es C. BUILDING OIVISION 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. --- 111. 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. (. '15~ I . ' l-~f &~)- V. FOR OFFICE USE ONLY Permit Clerk Cv ,I PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . \ \ Permit applican~.exempt from registration with the Builder's Board because: .. .., \ ~.. . Additional Project Information: .' . , PLANS REVIEWED BY: name~r/C H...C?~ . v signature ~..-.4______~_- .." date C-/'T~8B //', /' I