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HomeMy WebLinkAboutPermit Building 1983-4-14 t .' ., JrISPECTlOII LHlE CITY Uf SPRliIGflElD INfDRlIATlON lI,R ,I 1726-3769 ~.,~.n;;:' M.I/N 57:" C011BHlATlON APPlICATIONIPERMIT 726-3753 I EilERGY S,opRCES: I Sq, Ftg. l'lain-l~ Job Address Jl.I/J/2$fJJtJ l~kE /SPJ2.//JGF/EL-D Heat 1.;1,+ au ~/2("ElJI/I]t... ~q, Ftg. Access. - legal Oescription 17.AZ....~.LJJ. ""'dll- .J?~J !'Iater Heater eLeO)?JL Sq. Ftg. O~h r .... :;Iv'" - "" -., ~ Ilew Add Alter Pep. , Range-= -Fence erno Change/Use valu~o~ I~~I L ~. Other- - (V). Owner' €&:J1-r ,0<,4/ .:t fK<;O('/f1715 (;#/ 'I '7 , r .7-1/ BUllciin Permit Info: Describe Work(i-.e.t Build Single 00 Address C/3r;o WIL,9-IIIZC' P,LVO,5Tl'!"c9. Phone.:z7H17 J Fa~i1y nesidence ijith Attached GaraDel \0 Revau.Lf /-f1U..', M. C;n~/,;l. INF/Llv 1lJ J3.fJf)flj.J(O e.tJmrnl?J2..(!.lJ!rt.- M Construction Lender p}t25r P/lCIFIIG f!jAl.L SJ..l..F2L f::cJ(Z-- 1241J1tJ, ~ f>rl!.,JZ.6 ll~ /i = I II HIU. d-l~ V. V Address 'fC,7 fJ, C4/JOfIJ ,pe.. /Jfl;CA-t "A.! Phone .l1"~-IS2lq UI:.~Hm ItAft (name) ~ (addressl (lies. no.) (exo;res) (ohane no. /241)/0 6J.-14CK S1lJ!Z& pf/tTJNlrJG 4 J:Je5/6tJ , /JOtJ6" r;;rzeo W/"TJlC.OP f3J6INGCllIIJcE> .{)?j3 /l1OtJ!ZtJG ,elJa3Je '7Y.::J-1 Mechanical r;y::z(hfJ f),V/00 /'f1 C4(15P ('0. ,?81t' E /...qtJ:, Sr. . <5PIllN6P1~_(:)- CONTRACTORS ~amel (address) (lir:c;. nd. ~ (~xOirp.5l ) General 'iJd_:40 CO/'J517Z0qJo/v I ptJ. /3tJ~If(" -;;AJ~f?1Vff al7ff&fJ,.J (317t3, (' .J.IA5..F- (2(), 3k!Lt:;'" e .l..q.J.b. Sf. 5C!z./lJc;FtFlfl Of-. Electrical e/2E~ t?lZCflZ/C. QJf2/O ..Y;NOPll-rnA1V ro. ~.Of2- (l.UAf;F ('~ (" S~,:; .4Pft~ I . - '- I PLUIIBIIIG NO. FEE ...QjARGF NO S Each single fixture f.- IS. .. Relocated building (new fix. additional) S.F. Residence (] bath) Ouplex (1 bath) each Additional bath Wa ter servi ce Sewer Storm Sewer J Primary Structural Electrical , Plumbina "'~~hanical ELECTRICAL MECHANICAL I Ws-61d:J- 7rJ.b -Itf g I . (phone no.) 7:Jb --oO(,r:; "7;;.h -1iU.. ?<f1-(;87!o FFL .cHARliL / .. ... 6,<>e 3.'"" , I SSUANC, nF PFRillT / (). - TOTAL CHARGES /,7:00 TOTAL CHARGES <~ TOTAL CHARGES /9. """ WHERE STATE 1.,'14 REQUIRES that tile Electrical work be done by an. Electrical Contractor. the electrical 'portion 'of this permit sha~l not be ,vali~ until the label has been signed by an Electrical Supervisor and returned to the Building Division ':E.L J:IlABliE NO . Residence of furnace/burner to ~._ BTU's I HAVE CAREFULLY EXN11NED 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 NO OCCUPAI~CY will be made of any structure without the .penmission of the Building Division. I further certify that my registration with the Builder's 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 only subcontractors and employees who are in compliance with OP.S 701.055 \ ill be used on this project. A S,.,&:ill .1.U.j<fOCon~UURE ~4 . ~ FO~ OfFICE USE OHL 1 ~ . /:'. . \ i ~. -....... TVDe/Const. 11L~AI Units _ So, Ftg. rlain S~ x v~ue':i',,!-994(.- Bedrooms Occy load 5(/) Sq. Ftg. Access x value Stories I Occy Group g..<. Sq. Ftg. Other - -;:~ Value . TOTAL VAlUi\TIOIl21- 99Y.- SQ. FT. J New circuits alts. or extensions Floor furnace and vent SERVICES ~J~~ ~( JY .~ I Recessed wall SD~r:P hp~tpr ~n~ vpnt ~ Appl iance vent "ieoarate S'tationary evap. cooler Vent fan with ",inole duct Vent system apart from heating or A.C. Mechanical exhaust hnod And dur:t Temporary Construction Change in existing re'ijrlY.nce multifamily, co~. or Industria] Of 1St> amps, COI*I./INO. FEEDERS Install/alter/relocate di5trib. feed~r~ Wood stove/heater Of amps. IlAI-1E(please print)J~eU l-h Zone C G Fire Zone Flood Plain BUILDIIIG PERI.IIT Charges and Surcharges PLUt1BING PERMIT Cha rges and Surcharges ELECTRICAL PERlm Cha rges and Surcharges l\ MECHANICAL PERMIT Charges and Surcharges /.., 7. - Plan Ck. ConmlInd .., 65%/Bldo Per F~p ------------ Plan Ck, R'es S. ~8 30%/BI dD Per Fee __n.!.~~~__ Fence . ~~ ::<S. - I Sidewalk ------/-:-...--1 Ale Paving /~...c:. I Curb Cut ___n_ -.-76-1 ~ r~ 'Sys tems Deve 1 opment l?i'''' CharDe 0.5%) 'is:;l.,SS Demo I ITotal 1- -' IOTAL Comb. Permi t DATE t/-/LI-f3 YY9.9/ J'7'3..'1tJ. 6'1.3.3~ ~ . . ~ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. legal Description 1. examole- Tax Lot 100. lane County Map Reference II OJ 43 2. examole- lot 1. Block 3, 2nd Addition to Sprlngt,eld Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. exam~le. heat/electrical ceilinq/or forced air QdS 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. - I. example. 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check-new - if addition, check add. ete. F. Building permit information: 1. example - construct single family house with an a ttached gan~ge 2. exam~le - remodel existing garage into family room 3. examole - 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 TEM~ ANO 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 SCHEOULES 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 t ... I PERMIT VALIDATION lJ)'6\1l . / Permi t Clerk~~ ) . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ...{Pl>.ITA6.NA'<' 72.AN~ ff' ~R"""'/T.$ ~EQ(..)/RED 7&>~ M.a::HA'N/G4<" ---E~_.lJp~($Iy:r ~/~ .?; /.IY$7A~ LA7'/~. (5c:.~~ /77e;;D y- < ,)-B;:~ Permit applicant exempt from registration with the Builder's Board because: ." Additional Project Information: PLANS REVIEWED BY: name L~NG 7lE6e~ ~~ - , signature , --- 7~~....,.....,.. date ~-<6-8'3 .. ", ~