Loading...
HomeMy WebLinkAboutPermit Building 1988-4-4 ..-..- -....--..-. .,'~-.. ---" 'i\""!I Z1:i1 E..~~Tl QWtJ'; {"~o71 7~ 3<ls-- 3J/L Q ) ,I\. ~t;? y~ (pxoirpc;.) fY i~ I I INSPECTION LINE 726-3769 . . CITY Uf SPRINGFIELD COMBIIIATION APPLICATION/PERMIT EIIERGY SOURCES: Heat p~ Ha ter Hea ter t INfOR/IATJON llNL 726-3753 Sq. Ftq. 1,Iain 'f/'t> ~q. Ftg. Access, Sq. Ftg. O~h r Ilew Add lter Pep, Range__._=_.___ . -Fence D mo Change/Use ValuE ef Werk: I Other- - OwnerL.~ss.t:..:/J.".J_t:".I1u AiZN.../I"..Q"~UP':"M ,~n.r '1t!>~_- Address "'.0.' A / I I I Phene7 Buildino Pennit Infe: Describe Werk(i.e., Build Single 5,;,#" "~Pt...,~~, ,J 11....".,~,.. .;bt.-iti' Jt,.:,'; Family Residence Hith Atta.ched Garaeel 2./). &x C-?7,?,?;"' ,f4./J:. &A.!lFj2q.JZ~'>. ~",.t.j ,4/'/"/tt:,h,u.! /J1".k,Nf:J;; 1Je,.,.'; Jeb Address '7".2.2 7 A MAl/.! S7 Legal Description /10 d..., 5' ::;,),;2 o (t:{ 0 0 Construction lender >hu/l~J"'; .' I C'N.kJt, Address Ut~ 1 tiN TI::.Ar~ Phone (address) lnameJ ~"./""A!. flies. no.) (exn;res) (ohone no. /'....,<k......'/';"; C", P.6. f2,~ >f Primary Structura 1 Electrical Mechanical CONTRACTORS Inamel General 4vt!:Jt...t',,""J~"c/';" (address) (1 ics. no.) fnhnnp on ^ ?j<;""-ll.L..1- c /) D. /Jox 73'11 E'-)L#f!! 012 q.1!:&1 ~ <{ 117_7 ) Plumbina .. DCV -i).- eO&:: 7'17-0.&'1/ Electrical L.II. I'Y/0.4.JUS "I fJ..s ~LjJu 1 .:{M;....t:';~ i1n.. I ~lechanical PLUI.IBING ELECTRICAL MECHANICAL NO.1 Each single fixture FEE rHARr,F Nn ~FF rH~ Nn Residence of furnace/burner to STU's SQ. FT. Relocated building (new fix. additienal) ~ New circu!ts alts. or extenslons ":2~J#l/~~ SERVICES ?2-~ Floor furnace and vent S.F. Residence {] bath\ Duplex (1 bath) each Additienal bath Recessed wa 11 ~n~rp hp~tpr ~nrl vpnt Temporary Construction Change in existing rp" i Qr.nr.p multifamily, COITl!l. or Industri;d Appliance vent goaratp Stationary evap. cooler Vent fan with I sinale duct 'I Vent system apart from heatinq or A.C. !Mechanical exhaust , hood and dul"'.t. Wood stove/heater ~Iater service Sewer.\ ...-. Storm Sewer Of amps, I COMI'!. /IND. FEEDERS I Install/alter/relocate rlic::t.rih_ fppl'tF.rc: IOf amp~ I .I I ISSUANCE OF PFRIIIT ~ <::) ~ I~ ccc 1..cJJARG.E I I I I I TOTAL CHARGES TOTAL CHARGES -::z ':l.5"P TOTAL CHARGES WHERE STATE L\IJ REQUIRES that tile Electrical work be dene by an' Electrical Contracter. the electrical pertien ef this permit shall not be val;~ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED 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 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 rm OCCUPAUCY will be made of any structure without 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 ORS 701.055 will be used on this project. IW1E(please print) dw,.. 6Lr,"".~~ aa'4 Ji~IGrMTURE~L ~ FOr. llP'F1 CE USE DIlLY d" Sq. Ftg. 11ain 960 <fI1 Sq. Ft~. Access Sq. Ftg. Other DATE '7'- Y-6'tJ Zene-<::::,/"_ Fi re Zone Flood Plain TYDe/Censt:~~ Bedrooms x Value Value Value x Y~.""'" '5 -c{-H TOTAL VALUATION :?A.~~ /H!iio Shstems Development /Y'-A . C arqe (I.5~) . I I I I I .ITeta', G9mb.' ,Permi t~,. - -"1, I" 7~36 I I TOTAL . Units Occy Load Occy Group / s.;z Stories x BUILDING PERIIIT Charges and Surcharges //d ~ Plan Ck, Cenrn/lnd __ _Z2'.:.q~____ ~/Blda Ps>r F~~ "2 Plan Ck. Res .~.2-" 30X/Blde Per Fee Fence PLur~BING PERMIT Charges and Surcharges O~RIO -::i?:<'-S;~ I'Sidewalk _ _n--;.Ii--~I ~/C Pa~;ng 'Curb Cut ELECTRICAL PERlm Charges and SurCharges '''; MECHANICAL PERMIT Charges and Surcharges : IlII""" - . COMBINATION APPLICATION/PERMIT (CAP) '.1:. ..:_ ~ PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description I. example- Tax Let 100. Lane County Map Reference Il 03 43 2. exam~le- Lot I. Bleck 3, 2nd Addition te sprlngfield Estates . C. Name, etc. of owner and construction lender D. Energy Sources . 1. example- heat/electrical ceilin~/or forced air oas 2. exa~le- waterheaterjelectrical/or solar E. Square footage or valuation, etc. - I. example- 1250 sq. foet heuse, 500 sq. feet garage 2. example- 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. exam~le - remodel existing garage into family room 3. examyle - convert single family residence into restaurant (change of use) G. Value ef werk as defined in Sectien 303 (aJ ef the Structural Specialty Cede H. DESIGN TEAM 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 enly the No. Bexes adjacent to the apprepriate 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 net cevered en the abbreviated schedules' you should censult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES O. As noted en 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. --- Ill, Applicant te 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 Permit Clerk ~~e..L,,,,,r PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .> ., . ,\ cf ~--U~ //5~o Permit appli~ant exempt from ~egistration with the Builder's Board because: t.:-~::~ .,'. Additional Project Information: ." PLANS REVIEWED BY: ~, name k:R/Y€ ?~~ Signatur~..-.c-r~'. " P' - " - . da te S'l,,""8B