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Home My WebLink AboutPermit Building 1980-7-22 CITY UF SPRINGfiELD COI1BIIIATl ON APPLI CA TlONI PERMIT , EIIERGY SOURCES: Heat Hater Heater .~ . 'jINSPECTlON LINE 726-3769 Job Address /8/:5 Ham ~fvel'+ legal Description 11-6~-3fo-::z..,1 -rL.74('.,} , Owner N(ck. l\\ ,'( \<.. \ ,,",,,,\/\ Address Phone Construction lender Address. DtSIGN TtArT (name) Phone laddress) {\ ""/\.\. \r/1 (' ~,....,'" <:.. Primary i-J,.,,\ \p '^ \;.or \: St rue tura 1 Electrical 11echan;cal CONTRACTORS (name) ~~z.,u-oo . INfORIIATlON LINt 726-3753 Sq, ftq, ',lain :q. Ftg. Access. Sq, ftg. Oth~ Ilel< Add VII Iter Rep, -Fence Oemo Change/Use -Other - - Ranqe V~lu, of Hork: 'f> -3,VDo 0,9 BuiltinQ Permit Info: Oeser be \~ork{i..e., Family ~esidence With Attached Garaael COmmeYl(a! Q /1-".l/'1-I-lIilll - -Pi/IliA'!} II~ !1Nf"> nvpyhPn.A J . New v(').rJ' (>(1-0 (lies. no.) 1 (exo;res) . ' r Build Single & o C) 9J ()J , \ ~nOV-5, *" Genera 1 .w,.., II e v\l-..p r \::," (address) (lirs no.\ (l"""'-\-V-I1L-hv5 ,~c:.fl:yI;t~f /&,/58 ~ -oX> -r!fB./ NO I I Residence of SQ. FT. INew circu~ts alts. or extenslons I SERVICES Plumbina Electrical ~lechanical PlUllBING lID. FEF r.HARr,E Each single fixture ~: Relocated building (new fix. additional) S.F. Residence (1 bathl Duplex (1 bath) each Additional bath (exnirp<:) ELECTRICAL MECHANICAL ~r:~ I r!1ARr,r: NO. furnace/burner to BTU's Floor furnace and vent I Recessed wall Sn~rp hp~tpr ~nrl I amps. I Apol iance vent seoarate I Stationary evap. cooler I Vent fan with sinale duct I Vent system apart from I heating or A.C. I Mechanical exhaust hood nnd rlurt ~Ia ter servi ce Temporary Construction Change in existing rp<;idpnr:r Imuftif"amilY. COI1T!1. or Tnrlll<:trial Sewer 10f ICOMM,/IND, FEEOERS IInstall/alter/relocate rli<:trih_ fpprlpr<: IOf amp~1 I I I Storm Sewer TOTAL CHARGES () I TOTAL CHARGES HHEnE STATE L\\~ REQUIRES that the Electrical work be done by an shall not be valiJ until the label has been signed by an Electrical I I I I I I nl TOTAL ISSUANCE OF PFRIIIT CHARGES Wood stove/heater (OhO"p 1'1(\ , vpnt I ~~r: I I I I I r~ARr.:r: I I I I I Electrical Contractor. the electrical portion of this permit Supervisor and returned to the Building Division D I HAVE CAREFULLY EXMlINED 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 Ore~lOn pertaining to the work described herein. and that rw OCCUPAIlCY will be made of any structure without the permission of the Ouilding Division. I further certify that my registration with the Builderls 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. IWIE(please print) Zone C 4 Fire Zone I' _ Flood Plaill Type/const.~Units 8edrooms --- Occy load Stories \ Occ,Y Group R~ S IGilr.TVRE FO~ OFFICE USE mil Y Sq. Ftg. f1ain Sq. Ft9. Access Sq, Ftg. Other BUIlOING PER/lIT Charges an~ Surcharges , 6 og . Plan Ck, _d_~______ 65%/Bldo / 12. Plan Ck. , --- 30%/B1 do Fence Corrm/lnd Per Fee Res Per Fee PLU'1BING PERMIT Charges and Surcharges Demo " " , ELECTRICAL PERr:1T Charges and Surcharges ITECHAlIlCAl PERMIT Cha rges and Surcharges 'Sidewalk I AIC Paving I Curb Cut I DATE x Value x Value x Value TOTAL VAlUATlON~'700, II.!!. rece.;pt 5~Z.q '$'r> iw 7-7-80 ISystems Oevelopment 'iI".. - Charqe (1.5%) I I I I jS. ~ '1, 3_2- d. cr. f3> 7;~ ITotal Comb. Permit I I TOTAL ~., f . I " COMBINATION APPLICATION/PERMIT (CAP) r. Applicant to furnish A. Job Address B, Legal Description . \ 1. example- 'Tax Lot 100, Lane County Map Reference 17 oj 43 2, example- Lot I, Block 3. 2nd Addition to Springfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. exa~ple- heat/electrical ce;l;ngjor forced air Qas 2. example- waterheaterjelectrlcal/or solar E. Square {Dotage 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. example - construct single 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. OESIGN 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 b1ank 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 itemCs) to be installed are not covered on the abbreviated schedules you should consult the fu 11 schedu I es 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 !. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . ~ PERMIT VALIDATION " Permit Clerk , . '1 \ Permit ~pplicant exempt from registration with the Builder's Board because: Additional Project Information: .' , PLANS REVIEWED BY: , name r,....,'M- 5\'i.JU.Ybo\A.. signa~...., . . '~.' "'.-5r ~?~~ -,JJ date 7- 7-80 . 1 J . .... '- ", .... , Owner Nl( K_ l--\ j'( \G. \.~,r,\^ Address Phone ValuE of Hark: -$ -3ill00. oS? Bulltinq Permit Info: Describe Hork(Le., Far.lil v ltes i dence \,/ith Il.ttached l1araae) ~fIJ1me.vl( it I () //~'N1 +/IJ'!-'1 - P;/ill.1J ,J':. IIMr' (")lu"ttPnrl New vr"l,0.f' ('(If l1ieS. no.) (exoires) Build Single , I, 100' i) o I~ I~ I I IrISPECTIOtl LIrlE 726-3769 ," Job Address 1 8/:5 . . INFORIIA T ION U tll 726-3753 Sq. Ftq. I,lain :q. Ftg. Access. So, Ftg.'Othe.r Ilew Add Vi\ Her Rep, --Fence 'Oemo ChangelUse Other -- -- CITY OF SPRI;~GFIElD COIIBI:iATlON APPLlCAJION/PER~lT . -- -.,.. -..- E,IERGY SOURCES: Heat ',- Legal Oe<cription /'1-c)~- 3'o-':::!'j /-lO/J1. -d5.fvel'-!- iL 74(\; Hater Heater RanGe Construction lender ('lrlO~", Address Ul> I WI Illlll (name) Phone (address) (ohone no.) Primary W,-,\ I.,,^ \,-'r \: {\~II'l\""/lr~r"'\V'<:' Structural Electrical !1echani ca 1 corHRACTORS Plumbina (name) (address) (lics. no.) j-.j,..,IIE'viNr\::.."-. C\"'^tV-(lG~'W<: ,t;f~,i'?P}f(o~f 1(,:;158 (pxoirps) fohnnp nn 1 Genera 1 ,';:;"~-lqA/ Electrical tlechanical PLUIIBIIIG ELECTRICAL l rI-1AI:U;~ NO, MECHANICAL 110. FEF rHARr,r ~ln I I Residence of SQ, FT, New circuits alts. or extensions '" '" I nH1Qr.~ I I I Each single fixture furnace/burner to BTU's Relocated building (new fix. additional) Floor furnace and vent IS.F. Residence (I bath) IDuplex (1 bath) each IAdditional bath I ~!ater service Sewer SERVICES Recessed wa 11 SOnCP hPntpr nnrl vpnt Storm Sewer Of amps, Appl iance vent sena ra tp I Stationary evap. cooler I Vent fan with sinale duct Vent system apart from heatina or A.C. Mechanical exhaust hood il.nd duct Temporary Construction Change in existing rpc: i dJ'nc~ Imultifamily, comm. or TnnlJc:trial C0I11-1. /I NO, FEEDERS I I Install/alter/relocate ~'Jood stove/heater rlic:trih. fPPdprc: I Of amp~ I I I I ISSUAtIC, OF PFRI\IT TOTAL CHARGES () I TOTAL CHARGES: n TOTAL CHARGES (':) WHEP.E STATE L_\I~ REQUIRES that tile Electrical work be done by an Electrical Contractor. the electrical portion of this permit shall not be valiJ until the label has been signed by an Electrical Surervisor and returned to the Building Division I HAVE CAREFUllY EXAr1INED the completed aprl ication 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 Soringfield and the laws of the State of Oregon pertaining to the work described herein, and that rw OCCUPA1KY 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. 1JAr.IE(please print) S IGiVnURE FO~ OFFICE USE OnLY Zone C4 Tyoe/Cons t. \71\1' Uni ts Sq. Ftg. tiain x Fire Zonl:' , Bedrooms Occy load Sq. Ftl]. Access x Flood Plain Stories \ Occy Group ~,:) Sq. Ftg, Other x DATE BUILOING PERmT Charges anG Surcharges , ")8,oS2 -~------- / 1:2- , -- - Plan Ck. 65%/Bldo - Plan Ck, 30%/Bldo Comm/lnd Ppr Fee Res Per Fee yea;ot .5~2-q -1>7'- q:::W '7'7-80 ISystems Development ;: l. - CharQe (1.5:r,) I Value Value Value VALUATlOI..,"S700. r::f:- TOTAL PLUl1BING PERMIT Charges and Surcharges Fence ------------ I Demo ___________J Sidewalk I AIC Paving Curb Cut I I I Total Coeb, rermit .:P L...( '1, ..3_2- ELECTRICP,L PERI~IT Charges and Surcharges . ~ 11ECHMIICAL PERMIT Cha rges and Surcharges I TOTAL - 7'7-t'J- ;). q, r 3- r-?d. il . .. ..;'~. .~.- . } . . I \ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A, Job Address B. leg~l Description, '., 1. examole- Tax Lot 100. Lane County ~lap Reff ~ce 17 03 43 2. example- Lpt 1. Block 3, 2nd Additipn to Sprlngtield Estates C. ' Name. etc. of owner and construction lender D. Energy Sources 1. _ examo 1 e- hea t/ e 1 ectr; ca 1 ceil; nQ/or forced 2~ example- water'heater/electrical/or s~ E. Square footage or valuation, etc. - / '. 1, example- 1250 sq, foot house, 500 sq. foot 2. examole- Tflnew project, check-new - if ad! check add. etc. F. Building permit information: ( 1. examole - construct single family house wit attached garage 2. examole - remodel existing garage into fami 3. examole - convert single family residence; ( restaurant (change of use) G. Value of work as defined in Section 303 (a) of Structural Specialty Code H, OESIGN TENI ANO CONTRACTORS C To avoid design or construction delays, Buildin~ Division Staff must be able to contact approprii persons regarding design information or job site corrections, etc. ( II. Abbreviated Plumbing, Mechanical, & Electrical Schec A. Except I.,here b1ank spaces occur in the descripti portion of the r~echanical and Electrical Schedul the applicant need fill-in only the No. Boxes ad ~n: to the appropriate item(s) to be installed B. 'Full Plumbing, Mechanical, and Electrical Schedu are available at the Building Division 1. To conserve space on the permit form the sch! .e~ have been abbreviated \, 2. If the item(s) to be installed are not covere the abbreviated schedules you should consult full schedules . C, BUILOIriG DIVISION STAFF WILL FILL OUT ALL FEES AN ( CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered electrical contractor for signature by his electr ~ supervi sor. The genera 1 contractor is not author \:I to sign the electrical label. - Applicant to sign and date Whenever possible, the initial application will be US( .'~ a worksheet only. Where possible, Building Division ~ ';,f will prepare a type written copy and return it to the applicant at the time the actual permit is issued for 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 thesr-' fees are paid. All other fees and charges are due and payable when the permit is issued. I II. V. FOR OFFICE USE ONLY City Hall Springfield. Oregon Department of Public Works OFFICIAL RECEIPT No. B 5 3 9 31 ( . DoteS u\ V. 1 198D . Rec'd From I Ho\.\p~"L\:::..s'01"v'.tI((IL+>_~(1 'Dl'?'\ T.?-I( '4' 7 7 .- C' .J::> (d - Address 1 v ~, I ,<=> . ' . 'd' ,PERMIT VALIDATION . SPRINGFIELD CITY OF ( Received For: ?1)f) () (;.., 'c-,:::S j ,..-:> '+ PI[,,, 'h~. vW> I -/lO~ 1M P;'t 10 { '- 8.-p),oQ 1'2- /. - blciJ tJ 0/ A5 , -.. , ,: ~ ,"" I o r. -d ,~ f (" ( ( f.- /1 C c)~e. Amount Received __ ~"I _ ~,'JVt,U/~.. ",UTHORIZED SIGNATURE \ 7.0' ....."." !I"E~TO"'T"IlN"UI.I. ~"'NTUIS . EUGENE, 0" " " ~,' Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: \ Permit applicant exempt from' registration with the Builder's Board because: Additional Project Information: I, ,PLANS REVIEWED BY: , name I~(,,^- ::StAtU. y \:>o\A.. signa~nA~ .- ........:: ... L~, ";J~ date 7 - 7- Bo ( ( '- ( ,; 1 I I ----I ! . . : I ] < . " j I! .