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HomeMy WebLinkAboutPermit Building 1983-8-22 . . I IrISPECTIOII LIrlE CITY OF SPRINGFIELD INFDRlIATIDN LINe ,I 726-3769 COtlBIilATION APPLICATION/PERMIT 726-3753 --- E!lERGY SOURCES: Sq. Ftg. r.lain--L8~' Job Address' "S6/<:' M-9/N... !; T.RSe7 Heat ~g, Ftg, Access. I.ega I De<<ri ption /".,,;Z_"2 3- (,JI . ~ <!lOe) .I -:>00:11 Hater Heater Sg, Ftg, Other F .. ".. oJ '7 ..... Ilew Add Alter Rep. , Ranqe -Fence Demo Change/Use Valu, of I'/ork: x.Q.t.her~"""_rE' Owner Ctf.v~ fit! (krr~ . <# ':!lZ . n()O.OO ,,' cr~'83~#~1f: Address ,--;) I //",,-n'. Ph ,gf' Bui~I'oino Pel'mit i"fo: Describe Work(;.,e.. Build Single ,i j C; <l lIJ,'IIf1~1 t"?{J) on ,,</b// Familv nesidence Ilith Attached Garaae) I:;("~/) 9'/'7/5.5 C~k..~r~..i..J:;d.s....dP~~PJ~5Lr~ Construction Le<n'der I VI1><S"O-:~,ft:,4P'~L: ' .' ..~~it-..... ~, Address Pho"e I _.... - ,_-.:LT- -c "...,. ...--........, IJ Ut~HjN 11:.Ar-' (name) (address) (1"les. no.) (exo;res) ~Ohone no.') 1/1"A.:h.r) .. _r> 11.../ f;r:- e-(l~~t/-b0tix J to&.:> I 11-1<::/'""-' ~ t \. / ~ 1- ..D o ~ Primary 4("/1~ A/II Ph (ltll? If f~, l~ /'I? (J I' /1n 1'l2A Structural ~ Electrical Mechan;cal CONTRACTORS (name) {addrflssl Oi!"- nn 1_ fexniresl (ohnnp no 1 , I .. '~:r"-'O W/l;lM'.Ihe l:Tc.lIP./:5."'T~S.Y3 ( :'\ General ,M~AII.1''''#~.sC< '/ e$JI~~ AR..~!S, <::..4.. "'d-::ZF~ ";;.r3.J::Z7/~/'?'71 Pl.mbipo It\ ,J..L0r\ V (' f). '\\ () ~ "'-- *' Electrical (\ l\ ~'echanical -- PLUlIBIIIG ELECTRICAL MECHANICAL --.till.,,' 5 Each single fixture . FFF . CHARGE 'J(1 TOTAL CHARGES WHERE STATE L~1l REQUIRES shall not be vaIil until the ;: - ~S'O " I INew circu~ts alts. I Floor furnace ,K. 0.;:~';l!i~...)9~ /S:-~' and vent I I I I I I Recessed wall I SERVICES SOiH".p.....P~tpl" i'lnrl vpnt I I I I I I II~A7' -;::t..,.,."", I~. ... I I I ITemporary Construction I I Appliance vent I spoaratp Water service I I I~~:j~:_n~~ e~.isting I I I ~~~r~~nary evap. I I I I Sewer ~:tct'JD.ha.u:I~.- I~~~~~r~~~~y.conm,or I I <I~~~~l:a~u~~th ~~"I".- I I I 10f J 3JF amps,1 I-..-- I Vent system apart from I I Storm Sewer J,..(.."). . -' , heatino or A.C. ' . I I I IC0I1H,/INO. FEEDERS I I Mechanical exhaust I hood and duct I I I I Install/alter/relocate I I I ~lood stove/heater I rl;~tr;h fpprlpr~ I I I 10f amps.1 I I I I I I I I I I I I I I I I I I I I I ISSUANC, OF PFRIIlT AlA . ;s:-/ TOTAL CHARGES o/'G>.uoj TOTAL CHARGES 1-:<. _A 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 Residence of ITL'..cJJAIlliE.JlQ..... ... rlJARliE I , " I " SQ, FT. furnace/burner to BTU's IRelocated building (new fix, additional) IS.F. Residence 11 bath] IDuPlex (1 bath) each Additional bath I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and 1 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 NO OCCUPAHCY will be made of any structure without the permission of the BUilding Division. 1 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 701.055 will be used on this project. Ahrs :/66 ~~""""N tiS 7?'/~~ e-<Ho,D ...../V~.M',.. T#SSD<.. /. IIAf.lE(please print) --r:e-e e. V\ (;y ~ (iAJ SIGII^TURE1/A~ (";,LA,,/k.. . "FOP. OfFICE u~mlL Y Tyoe/Const. :tzr-N Units so,)tg, 11ai,,_J~"" . Bedrooms Occy Load /~ Sq, Ft9. Access Stories J Occy Group 4-3 Sq, Ftg. Other n~ 2 '2-13 I Zone C;~ x 2Ze>QD. .... Fire Zone x Value Value Value Flood Plain x TOTAL V ALUA TI ON BUILDING PER/lIT ____I.!/!!.._~--- PIa" Ck, Comm/Ind 76.7(;) Shstems Development '!II< +'~s: "'0 Charges ant: 65%/Blda p~~ F~~ C arge tl,5~) , Surcharges 'I.7Z Plan Ck, Res lol4lo~ 7\' Q.. ?In R:~' 30%/Blda Per Fee PLur1BING PERMIT ____Js: eo Fence I ( I () I I Cha rges and Surcharges /. YC::>> I Demo I I I ELECTRICAL PERr:IT ~c:>. c::o.C> I Sidewa I k I I I Charges and -------i~-.;-I A/C Paving I ITotal I '=< 13'. ~ .,. Surcharges Comb. rermit 11ECHANICAL PERMIT 1<. -. I Curb Cut I I .# ~/8.<o Charges and Surcharges __n_=__.~~1 J I TOTAL ._~------_._- --- . . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A, Job Address B. legal Description I, examp.le- Tax Lot 100. Lane County Map Reference II 03 4J 2, example- Lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D~ Energy Sources 1. example- heat/electrical ceilinqlor forced air Qas 2. examole- waterheaterlelectrical/or SOlar E. Square footage or valuation, etc. ------ I. examole- 1250 SQ. foot house, 500 sQ. foot garage 2. example- if new project. check new - if addition, Check add, etc. F. Building permit information: 1. examole - construct single family house with an a ttached garage 2. exam21e - remodel existing garage into family room 3. examDle - 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 TEM4 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 OIVISION 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 wi 11 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 . .. . PERMIT VALIDATION Z" ';}.;) -83 Co i5 7 f..p 'cY oJ. & / Pennit Clerk ('.A /zrb. u PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: '." 1)4"PJ7',U>hAL ~~. ~M.....~ ~ ~~~eA_J" ..R€tPoh~EZ::> , . - i F~ ~c~""".N~<"""< ,C('~C7.H/Gil-L ~W',p 5V-':::;N. - ~. - , ~ St..>7r'u/r ~ c::::.~~ ~ (;""'~'.4~ ~rJ~=~~~ AiL...,,,,,,,' 'OP~FS S.Ae........,...c;.: ~ '7 s?....~~ ?Rc::ot--....&>Ep M./.S ;Z:~.......... _ Permit applicant exempt from registration with the Builder's Board because: ~ Additional Project Information: S"..D c:::... /-S I.:?(:.I".~....-c.; ~~.z:>/.......~ ;::E~ F~~ ~~'c.. ~,A, ~;z:. (~7Ft!::> PLANS REVIEWED BY: ~~h"E...P';t'l5't::.<i:~ signatur4:a name .,' .4P;:><../<~h~~ $h'~~ W~~ N'~~ ;;>~~cC'"'..z:, V.+~~tF . , a ; ? date ,0