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Home My WebLink AboutPermit Building 1988-5-25 ~ -\ l" ~t J " Jo:6 Address / /~ ~ / ,...,., .." ~ ~ ///H//V y, ,Legal Description /7.cT2.'87r?2 ~L?.r ~/'SI:?&r " -- /' , CITY OF SPRINGFIELD COMBIIIATION APPLICATION/PERMIT I EIIERGY SOURCES: Heat l~ater Heater Ranqe ValuE of Wor~: Owner 7J?'?'G Ve V/g~~77'6.M4L l/;n~o /.oa? =i!> dd /;) Pho BJi'lciinq Permit Info: Describe Work(Le.. Build Single A ress ~ /2'" ....:;'7~.........A<d'VE""A-" ~ :/!2i-..... __.... Familv nesidence Uith JI..ttached (laraae) ,~~-J" ~ Fc...e:.-r.:',;"_ ~A. ~~~h'T ~-'7"T~/~ .}.n:s-R~ Construction Lender po OC::::::::::-. _ _ /..~ J/ ....."r,,/'r1~,& _~s: /Nn~ V/.n....e;:> Phone 1~~"'~~7 ~_,--? (address) . (lics. no.) (exoires) (ohone no. ~ -- ~ -,~ - . I NFOR/1ATION LINt 726-3753 Sq. Ftg, 1,Iain ~q. Ftg. Access. Sq, Ftg, Other Uew Add Alter ~ep. --Fence Demo Change/Use Other- - l~ . 00 o ~ ~ '1INSPElCTION LINE I 726-;S769 ' Address DESIGN TEAM (name) Primary Structura 1 Cl""\" S~OO \,IV Electrical Mechanical CONTRACTORS (name' Genera I )II ~ /';.,~"'T Plumbina r (addre~o;.\ (lir:c; no.1 (PlUlirpc; , ('lnnnp I'In \ Electrical c~c; FrEe? Y/'; ~.tYS.7. .., ~' ~1echanical 1'tm!llllG ELECTRICAL MECHANICAL NO, FFF r"~ ~n 'CEL..I:.liARG.E. 'In t't't' rl-lAllliE. Each simgle fixture Residence of SQ, FT, furnace/burner to BTU's Relocated buil~in9 (new fix. additional) S. F, P.esidence (1 bath) Duplex (1 bath) each Additiooal bath ~ New circu~ts alts. or extenSlons ~ '2. c>?f ~.o~.,. SERVICES ;('2.'50 Floor furnace and vent Recessed wall Soace heater ~nn vpnt Sewer ITempOrary Construction I'Change in existing rp-s- i d~nt"P Imultifamily, comm. or Innu<:.tr;i'll 10f amps,l ICO~1,/INO, FEEDERS I IInstall/alter/relocate I rl;~tr;h_ fpprlpr~ 10f amp~1 I I I Appliance vent ~eoaratp Stationary evap. cooler I Vent fan with sinale duct I Vent system .~p'art from I heatino or A.C. I Mechanical exhaust hood and dut"t I Hood stove/heater I ~ ,4.,~ZJLIo=,>,tr~ ,16- I I I I I I Water service Storm Sewe,- I I TOTAL CHARGES TOTAL CHARGES ;r:?.,s-o TOTAL CHARGES d?/~ /5:.-t::> WHERE STATE UlI REQUIRES that tile Electrical wor~ be done by an Electrical Contractor, the electrical portion of this pemit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division ISSUANC, OF PFR!lIT I HAVE CAREfUllY EXM1lNED the completed aprlication 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 UO OCCUPArlCY will be made of any structure ~ithout the permission of the Building Division. I 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. 'l'-/l.,-(",ee 1W.IE(please print) "Ka.,J." lcu..~.,... S IGrl^TURE ~o.;nJ., T "'"=\~ FOr. OFFICE USE OIlL Y \ ' Sq. Ftg. r1ain ,x Sq. Ft~. Access x Sq, Ftg, Other5~~&<:: , DATE ..f:J~/8'O Zone./" ..r:- Fi re Zone Flood Plain Tyoe/Cons t, Bedrooms ~)f/ Units Occy Load Occy Group Value Value Value /.i.-i-t...-l...~ Stories ~-.2 , m I'') Plan C~, Comm/lnd-' ____f.:.!?!:?.___ 65%/Bldo Per Fee //. ~~ Plan C~, Res 30%/Blda Per Fee TOT ^L V ALUA TI orl BUILOIrlG PERJ.lIT Charges an~ ""\ Surcharges q... Syster.ls Development I Cha rqe (1. 5~) ##~ ,5:'& PLU'~B ING PERMIT Charges and Surcharges Fence ELECTRICAL PERmT Charges and \, Surcharges ~ Demo 27<-fiiP ISldewal~ ------------ / ./3 I AIC Paving, L:i::: ...... I Curb Cut nn ~;,~__I " ITotal Comb. rermi.t I I TOTAL 5"7. ?6 MECHANICAL PERMIT Charges and S Surcharges ~9. ILf , . . I I, I; COMBINATION APPLICATION/PERMIT (CAP) ~ ~'- '\.":'~. -~ / "\' ,IJ " I. Applicant to furnish A, Job Address 8. legal Description .) 7';> _ __ " ...."',.., " I. example- Tax Lot 100, Lane County' Map Reference', ; .) 11 uj 4j 2, exainple- Lot 1. Block 3, 2nd Addition to '-." ~', Springtield Estates ,. .'C..... Name. etc'; of -owner~and '~onstruciion'-.l'ender D. EnerQY_ ~ou:ces . _ , ... '- ...1'. .example- heat/el'ectrical ceilinq/or .forced air qas 2. example- waterheater/electrlcal/or solar E."-'Square-rootage or'valuat1on. etc. ----;--;:- 1, example- 1250 sq, foot house, 500 sq, foot garage 2. example- j,f new project. check:ruew - if addition, check. add. etc. F. Building pennit information: 1. example - construct singl~ family house with an attached garage 2. example. 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 TEN4 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 portioni: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,labbreviated schedules you should consult the" ' full schedules -" ~ . \-'......, ,\- C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGESliON 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 signll 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 . ~,.p_ay~ble ~he~ ,the. p.ermi,t is' issued. V, FOR OFFICE USE ONLY " II PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . . ,. "", .,...-. \ Permit appl,iican~ ~,XP!lPlt froml,regi strati on }' , , I with the Buil der).s,'.Board because: J I" _Ad,diti ona 1 Project ~nforma,tjon: " II , I, ~, \.~I '4., ).~ .~..: "',' '" . ,. ..-::-, '.EERM.I.'1:.~~L.r~A,TION .\ .' , ~..'.. ' Y",' ...t~ I, ......,., - .:-.,: \ .......... .".'......", ," . ~....... " .-........... -, -'-- (( ~c;9', "";. e~f)J~r( , , ' Permit Clerk C0 '.'A' , ,_ ;..J., I ". , , " PLANS REVIEWED BY: 'name~L~("'~ ~~E?r Signature~__~.. date_~-:::7~-~ .