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HomeMy WebLinkAboutPermit Building 1984-7-31 . t' I INSPECTION LItlE 726-3769 Job Address \.4 ()\\ 't\ ~ \ "''' ~\ Q.E, ~ legal Description\'" O'L ~\ "-\ \ " ~ . CITY OF SPRINGFIELD COMBIIIATlON APPLlCATlON/PERMlT EilERGY SOURCES: Heat Hater Heater _Range_ - --. _ r . ... "- ValuE of I'JllI;,I).~ _ ~r0 .rm' , BuilGinQ Permit Info: Describe Work(Le., Phon~~c\~<Q Familv nesidence Hith Attached Garaael (')~~('0 Owner "'-')\I...'{\ 1,E \J... 'I E.. ~~ ~ Address 9, (., ~ '" C, LO'2 ~")f." ~ '\ j.:'\..)~~,\..)t=. \'>'Vff.....[')"0, Construction lender Address Ut:.::llliN H.AH (name) Phone (address) Primary L\::l..~~'-t l;).Ll.(;.~.... Structura I \:'")('\\.." L \'\."l.F Electrical Mechanical CONTRACTORS ~\.'\ ~c.\",~..:,,~ ~ Genera 1 Plumbino (name) 'i<.~'Is?C"l "'~~~ ~<:'<:(')~-O\- "i<.\..\ c-,)i.'1-?'l<4.' \:)Q C=. ~F~~~ {; \., FC'"'8 \c... Electrir~l ~lechan;cal ..Jill. Each single fixture PlUI.IBI NG FFF fHI1Rr.F ." Residence of Relocated building (new fix. additional) INFORl1ATlON LINt . 726-3753 Sq. Ftq. I,'ain ~q. Ftg. Access. Sq. Ftg. Other\\Jl\l~ New Add Alter Rep. Fence_Demo _Change/Use _Other ~O uJ N rv J r Build Single ('N\.\~{=~ ~QFt:l. (')\~\.1..l ~ "VL~~ II ics. no. ) (exoiresl -'.br ~ flies. no_ \ (pxr:J;rps) (ohane no. ELECTRICAL \ )<~~ ~HARGF I MECHANICAL <<< rl-l~ NO SQ. FT. furnace/burner to BIU's ..H'e'W circuits alts. ./ ,<::- \c:.<::I:>. v or extensions ~v. \0 ? c-...-.l-\r'\Or-' r\~\\.~ SERVICES Floor furnace and vent S.F. Residence 11 bath \ Duplex (1 bath) each I I I I I I I I I I I . ~li;, ~",.....(~\,,~~~~') I ISSUANCf OF PFR!1lT TOTAL CHARGES \('1.00 TOTAL CHARGES \ s,. <:x::) TOTAL CHARGES WHERE STATE L'\\~ REQUIRES that tile Electrical work be done by an 'Electrical Contractor, the electrical portion of this pernit shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building ~ivision Additional bath ~later service ,J"'4~ Sewer Storm Sewer Recessed wall ~n~rp hp~tp~ ~nrl vpnt IOf ICO~1./IND, FEEDERS I Install/alter/relocate rli,trih_ fpprjprc:. Of amps.l amps.1 I I Appliance vent seoaratp Stationary evap. cooler Vent fan with s;nnlp rluct Vent system apart heatino or A.C. I Mechanical exhaust hood and r1urt, I Hood stove/heater I I I from Temporary Construction Change in existing , rps i rtp..nl"'P Imultifamily, comm. or Tnrlll<:;tri<ll 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 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 OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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. HM1E(please print) Zone ....cr Fire Zone Flood Plain BUILOING PERfIlT Charges and Surcharges PLUr~BING PERMIT Charges and Surcharges ELECTRICAL PERI:IT Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges Type/ConstE:X\~ \\\ -\'lUnits Bedrooms Oeey load Stories Occy Group ~-""?-. S I(:!IATURE FOn OFFICE 'USE Oill Y Sq. Ftg, Sq, Ftg, Sq. Ftg, \ \ t:=... C:C' Plan Ck, Canm/lnd ___L\.'!J~_____ 65%/Bldo p.pr FfIfI , L\ CeJ:) Plan Ck. Res "\. 30%/Blda Per Fee ___\.O_o_c:<:?__J, Fe. nce \..\0 D~mo \ 'S C;C) IS1dewalk _____.L______ <DO I A/C Paving \" " I Curb Cut ___~_t::\-n__1 DATE t1ain Access Other \ a. ~ '" x Value Value Valup x x TOTAL VALUATION ? (" I OJ . \5.cx>(.~\\.,,, Shstems Development ~yo- C aroe 0.5%) . I .. I I I ITotal Comb. Permi t I I 550. Cc:Q I TOTAL - /j r . . ~ ~ COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II 03 43 2. example- Lot I, Block 3, 2nd Addition to Sprlngtield Estates C. Name, etc. of owner and construction lender O. Energy Sources 1. example- heat/electrical ceilinQ/or forced air Qas 2. examele- waterheater/electrlcafior 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, chee k. add. ete. F. Building permit information: 1. examele - construct single family house with an a ttached garage 2. examele - remodel existing garage into family room 3. example - 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. OESIGN TEAM 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. BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO 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 b~ used as a worksheet only. Where possible. Bujlding 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 Cl erk PROJECT CONDITIONS TD BE SATISFIED BEFORE OCCUPANCY,: ~ b.\...."\ ,"-"\~~,~) cr,\:>\\,\(,~\.I;-. ~ l ~"",\. ,~'"'\\ F,'C) ~8:l.,",""\.(") ~c y'\2r)\'\.~F.t"'l"'\C'\ <:.~'" ~\L'C)\.~ ""\::)\~~ 1') \)t:r)<;; ~'\:::\ '\\....,,~ ~ \N= (' ~\..\s::\c C"'I ,-C""I E't.\ 'i'.'\\ \. 'Ie;,. ~"F \.J~~'\. "\~C......F- Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: ~ /A Jt ~ _ Ft,q: ., ~ ')1 ..,,-( V- pnr -------.-- ' signature CMA~~ y- da~e"-~\-~L\ " nam~\~ ~ 'l.F."-" . l . . . .' CALCLJl-ATIOI-JS ~or 'PAFA',,=, 'FI ZeA , "FARL~~ 1::::lA/."J M c:. /I...t1Y~e. SU I L.. DE:..le: COf'IC: I"-!~~let..-DI ~C'.c,O"i Dm~:~-,mo :Z!!(.?/gL/.' ZON!:: OCCUPANCY J09 NO.1? /1.;:), '/9 GROUP UNITS OC:CUPA~-:C'( LOAD STORiES Tvp;;; CCNST. LE:':.AL DESCR'PTr~)N . ADo'r.55 4' 0 IT ---1"'1--:--------.--- --- .- .._~--_. ._._-,_.._~-------,--_. O~:~:RO;~'~:E~:-~~~~-- ALTE'R,\TIONS INDlC..,T!::D IN eel cru:a PENCiL. CH....NGE'$ OR ^._rr.R^TlC'~~S MADE 10FT R C'4T:=: ~ELO\>J SHALL eE APPROVED BY THE GUILDIN:; OFFICIAL. ApPROVED By DATE CITY OF SPR!NGr-:!ELD.. OREGON '-, . , , ',. .r' '. , ,~. INDUSTRIAL Mill INSTAllATIONS,' t.,. , , DONALD c. LITTLE, P. EI' . . Page 1 of {) ., . .' J proJectf'AEA S P I ~ - ~f'J:?JNC,F-Il~:'{...O Job H 1152 13 02 1/AlJ M ~/J.JTYIU:. J;UILJ)f"'z ByQ::..L. . Date 'Z<6 .JUIJ M .. ".__ ._._0. ,_._._ ....___ .__._~ ....../_ ".._.... ._,__ ,_.___' _~.~__._. _",,__, ",__,_" .....__._ .___n' ,,'."'.._ . ...... _,., ...._._. ,_", ..n ....... ....._.. 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LITTLE, P. ~ Project . __. u_ ._ __. ____ _.._._._____ ....___._ ...._ __ .___ , I I I ~' --'- ,.....- "--'- ,.---- ---- ,.--. --.. ----1---- ,-..-- .----. -"-_.. ---- ---- .,.-.-. --_. ....--. --.,...... . -' ..- . .~.. .,. . ... . . , . , . . DONALD C~ LITTLE, P. E~ Project . By .Q:::;(... Page ~ of 8 Job H IIs'Z ~Joz - -, Date ts .J/JtJ e,4. , ...,.....-, -...., .-,... ,-.... ...-.....,-.- c__.. .......- ._,.. .--.- --...--. ..-.. -....,.. ........ '-'F r- --"-"'-.-,. ---... ..,-. ,.-., --.., --.-, ....,. .,...... ,..... ".._.c, .....eS.TIJv\A:'q;D.._MEt/y.\13E.eH....::o ~..,_3Z... _SrAtJ_._.,_._._ _...,_ ...:. ,.., 'I ! 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