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Home My WebLink AboutPermit Building 1986-9-11 . 0' . ItISPECTION L1IIE /1726-3769 ' , Job Address Lega 1 De~cri pt i on ,. ~@) c.\ ~\~1.:)\ S~ CITY OF SPRItIGFIELO COtlBIIIATION APPLICATION/PERMIT E!IERGY SOURCES: Heat I~ater Heater NFOIllIATION l"" 726-3753 Sq. Ftq. /-lain ~Q. !'tg. Access. Sq, Ftg, Other Uew Add Al ter ~ep. Fence_Demo _Change/Use _Other i ~ ~ ...() C;Ll/5" ~J <..+- /7-6'7- 3-=?- '1<., ~~-=<---= , RanQe ,~~"""~ S':2< Tlf/r. Va JJ€ of Hark: cJO 11 ~~ 7'2.'). ~ Buildin Permit Info: Describe \~ork( Le., Far.1ilv l1esidence l"Ii th fl.ttached r.araael Sui ld Single Owner . ,~.. Address .~ f),r1 ~I?X Phone r lA<:, 1111 tt1 A ~ Construct1on Lender Address Ut.~ltiU lEAr'. Primary Structural Electrical f1echanical CONTRACTORS mP~. Ph,.{l""A'1 /. Flrwf'{) 1'11'.j(f.....,.." IAI~74U fn~m~l Phone (address) {exoiresl " (ohane no.' \ (lies. no.) " If\ ~ ~\ (pxnirp~) ; '(ohonp no.) (name I faddrec;s) (1 ir:<;_ nn. General M /:l-Dll",-t ConjH.Ade'R~ Q1:11'2 1,,&/. P.t) P'"V l'lll/.t, Po~T1M...I ",I/J., Plumbino , Electrical ,,::-L<2,-I~J Plechan; ca 1 tlO. t)~...u ('.'bOe :rill/' ~nt.11AAdJ aJl,o 0"7'7/'> p, n ~... ~ ," ,1Jt, PLUlIBIIIG I (" sq, FT, ELECTRICAL MECHANICAL FFF ! rHARr,F ITLI~" furnace/burner to BTlI's I FFF I rHAPr.F Residence of Each single fixture /Relocated building (new fix. additional) Is.F. P.esidence (] bath) IOuplex (1 bath) each Additional bath ~!a ter servi ce Sewer Storm Sewer I I -I I I ~ New circu~ts alts. or extenSlons "2 e.;t? ~csRt€ SERVICES d I I kG, <>0 I Floor furnace. and vent Recessed wall ~n~~p hp~tp~ ~nrl vpnt V l~rR/"", u"" //, I App 1 i ance vent ~,pn;lr':lt/) Stationary evap. cooler Vent fan with sinole duct Vent system apart from heatino or A.C. Mechanical exhaust hood <lnd durt Temporary Construction Change in existing rp) j rlJ'nrp multifamily, COITrn. or Tnrluc;trii'll Of amps. [ '"I I , I I I I I I I j COMH,/INO, FEEDERS Install/alter/relocate rli~trih fpprlpr~ Wood stove/heater Of amps. TOTAL CHARGES J TOTAL CHARGES WHEnE STATE UI~ REQUIRES that tile Electrical work bo done by an shall not be vali1 until the label has been signed by an Electrical rSSUANCF OF PFmIlT :<2,50 TOTAL CHARGES /0,,-'11" /:>: .-. Electrical Contractor. the electrical portion of this pe~it Supervisor and returned to the Building Division 1 HAVE CAREFUllY EXAt1INED the completed aprlication for rJermit. and do hereby certify that all information hereon is true and correct. and I further certifv that any and all work oerformed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Oregon !Jertaining to the work described herein, and that UC OCCLJPAUCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Goard is in full force and effect as required by ORS 701.055. that if exempt the basis for exemotion is noted hereon. and that only subcontractors and employees who are in compliance with OP.S 7~1.055 will be used on this project. rlA/,IE(please print) .,t:t\ / A ) AtQ~11'''12 -j.;1J J.{Q,J DATE cr- I{- 5f' ~ Zone r..C". Fire Zone Flood Plain BUILOItIG PERNIT Charges anC: Surcharges PLUtiBING PERMIT Charges and Surcharges ELECTRIC~,L PER'~IT Charges and Surcharges I1ECHANrCAL PERMIT Charges and Surcharges S Ir,IIATURE FO~ orFICE USE DillY Sq. Ftg. riain x Value Sq. Ft!]. Access x Value R-? Sq, Ftg. Other.wnsr?~. "1, ~_.-,ayalue TOTAL VALUATION Tyoe/Const. ;;':-1" Bedrooms Stories fP.K>,Uni ts Occy Load Occy Group qo.?. 72<:;: '"'" , -?7~ """ 'Plan Ck, COl!lll/lnd ___~__L:"'____ 65%!Bldo Ppr Fpp Plan Ck. Res 10, '76 30%lBldo Per Fee ~R~<fE.:~"_-_ J Fence /;>:;'O€p I Oemo , 22-:>= Sidewalk -n----~--7.;-1 AIC P?ving -____.I~~J Curb Cut . G-:> I Systems Development Charoe (1.5~) /78. // /Lfl. /) / . ~c..=-=r --/r~6C. #;- ? "'>'? ':? c... I I I ,?e> I I ?,Z"3.96 tf5oZ:g7 ITotal Comb, I TOTAL, :., rermit .1 J I .,<.- - COMBINATION APPLICATION/PERMIT (CAP) I. Appl ieant to furnish A. Job Address B. legal Description 1. examole- Tax Lot '100, lane County Map Reference 11 03 43 2, examole- Lot I, Block 3, 2nd Addition to Sprlngrield Estates C. Name. etc. of owner and construction lender C. Energy Sources 1. examole- heat/electrical ceilinQ/or forced air oas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. - I. examole- 12S0 sq. foot house. SOO sq, foot garage 2. examDle- 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. examole - remodel existing garage into family room 3. examole - convert single famlly 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. 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. FullP.lumbing. 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 OIVISION STAFF WILL FILL OOT ALL FEES AND CHARGES 011 THE SCHEOULES O. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical suoervisor. 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 OFF! CE OSE OilL Y PROJECT CONOITIONS TO BE SATISFIEO BEFORE OCCUPANCY: . " , , PERMIT'VALIDATION :P67Clgs, 13(5;;/oS7 1?6.70 ;7C> f(~. 0.7 :<:50. 60 /.)-: 6{c> ,-- ;&r4C- -,. J"c:>z ~Z? Permi t Cl'~rk 4. . ~ ........ , ''/ 7-/,("i -- --- Permit appl icant exempt from registration with the Bui,lder's Board because: Additional Project Information: ,PLANS REVIEWED BY:, name L&>R~ ./7~GZ? Signature~~_~ // ',p' date 9-/5-.gr;; , , _.