HomeMy WebLinkAboutPermit Building 1986-6-24
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"-JrISPECTION LlIIE
111 726- 37 69 ,
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CITY UF SPRINGFIElO
" 'COMBHIATION APPLICATION/PERMIT.,
EIIERGY SOURCES:
Heat Gas
l-later Heater
INFORlIATION LINt
. 726-3753
Sq. Ftq. I"oin '
~q. Ftg; Access.'
Sq. Ftq. . Other
New Add, Alter, Rep..'.
Range -Fence Demo Change/Use
Va1.JJE..nf.~W(\r.!!.:..-_. -Other--
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),Bu;IGlnQ~Permit Info: Descrlbe Work(i.e., Build Single
..lFamil.v fl.esidence l-lith Attached GaraQe\
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Job Address
2380 Main Street
'"gal Oe5Cription see attached
lname)
Phone
(address)
Renovate and add to auto bodv'''and
frame shop; add paint ventilation
system
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Owner Dino Caldwell
AddressOld Dominion Body
2380 Main Street
& Frame Phonl/46-77
Springfield
Construction Lender
Address
UI:.:::dliH II:.Ar.'
(lies. no.l
(exoir@s)
{ohone no.
Primary
The Amundson Associates/200 South Mill St., Sorinafield. OR
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11' ....flics. no.l
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97477
If If fo - 'i.2,3/
Structural
Electrical
f1echanical
CONTRACTORS
(name)
(address)
(exnire,,)
(ohone no. l
Genera 1 NA
Plumbina NA
Electrical NA
~'echanical NA
PLUliBI NG
ELECTRICAL
MECHANICAL
~JI) .
Each single fixture
FEE CHARGE Jlll
7.~ {.7.1>~
rrr r~~ NO.
rr:r: r~~
9-
Residence of
SQ. FT.
furnace/burner to
BTU's
Relocated building
(new fix. additional)
~ New circuits alts.
'l1 e~~sJe.:tsN-i'~
SERVICES
:zzS< :0
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$
Floor furnace
and vent
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S.F. Residence
11 bathl
Ouplex (1 bath) each
Additional bath
~Iater service ~5~'
Sewer < So '
,
Storm Sewer '~Sifr,
Recessed wa 11 s.:~"-
~n~rp hp~tpr ~nrl vpnt
6.-
'7.:;i;
Temporary Construction
I~.. Change in existing
J. r~~1d..eJlc~
.,b,.... multifamily, COnln. or
~t . Inrlll"trii'll
.,~.,..." Of gee amps,
CO~~./INO. FEEOERS
Install/alter/relocate
rli"trih. fpP~pr" .
A- Of 2<<:1 - CI t::Ir> amps.
()
Y'~b~
Appliance vent
~J~oa ra t~
Stationary evap.
cooler
Vent fan with
sincle duct
Vent system apart from
heatinq or A.C
Mechanical exhaust
hood and rturt
Wood stove/heater
31.Si:J .....-' 1$-15 l'l P.m:;..
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BUILOING PERmT
Charges and
!'/.t-~~ -
PLU'~BING PERMIT
Charges and
Surcha rges
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TOT,AL CHARGES 1'97. S <:> TOTAL CHARGES /57. SO TOTAL CHARGES :::?::?~ c>o
--~WHmE STATE L\l/ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pemit
shall'rot be va11J until the label has been signed by an Electrical Supervisor and returned to the Building Division
: HAVE CAREFUllY EXAMINED the completed application for permit. and do hereby certify that all infonmation hereon is true
a,,_ correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Ore(]on pertaining to the work described herein. and that UO OCCllPAUCY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
Board is in full force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon. and that
only subcontractors and employees who are in compliance with ~P.S 7nl.055 Wil~~used ~s projec~.
IlAIlE(please print) ])Ef\tV CALDUJEl..l- SIGrl^TURE.dt~ W~ OAT~.g:;
Fon OFFICE USE OIIL Y'
Tyoe/Const. IZ-1..t:t&...units Sq. Ftg. t1ain...1:l;=VV x Value
Bedrooms Occy Load e;-Q Sq, Ftg. Access_B~,)I/N'-; x. Value
Stories ;>.- Occy Group6-iN,z<1'AI-"". Ftg. Other A'-~ 'N x Value
r2 lfa [ 03 TOT^L VALUATlOrl
= v ~ 7/,1, GOC
;tl.Q '6'6 ,05 I..:' ~rstems-Development I'I-?Ao 00
4( CharQe (L5~) lJ, /V,
,~c::::'"N~ re€tJrl:QT~~
bJ~7N6'/T ... 7/.$>
ISSUANCE OF PFR!1IT
Zone ~ Co
Fire Zone
Flood Plain ~
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L6;~
94.~
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ELECTRICAL PERI~IT
Charges and
SurCharges
?:?8,-
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I 3. I':!
__'-?Z.~~_
7.9t>
___l~Z_?~__
~.30
----~::?=~~-
/ . :Z8
Plan Ck. Comm/Ind
65t/Bld~ P~r Fpp
Plan Ck. Res
39~~~ ~~~
Fence
Demo
Sidewalk
/19'
2,7.65
/98. So
z7.6S
Total Comb. Permit
11ECHANICAL PERMIT
Charges and
Surcharges
A/C Pavlng..",_
Curb Cut 0~~ ~~
TOTAL
9B7.~()
'Z(!)S<. 7~
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PLANS REVIEWED BY: j(?6Yt--~/tt'NY #/ ~.~9-~
~. , ~';l. ~-~ ~-S~
name Lc:R#6 ~~~ Signature~~ r1 ~'"-? date l/~<t-8b
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Additional Project Information:
Permit applicant exempt from registration with the Builder's Board because:
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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Permit Clerk
V. FOR OFFICE USE ONLY
COMBINATION APPLICATI9N/PE~MIT (CAP)
t. Applicant to furnish
A. Job Address. .'
B. Legal Description
.1' ." 1., example- Tax lot lOa, Lane County Map Reference
17 03 43"
2. examole- lot 1. Block 3, 2nd Addition to
sprlnglield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources . , "
1. examole- heat/electrical ceiling'lor forced air Qas
2. examole- waterheateriefectrlcafJor safar
E. Square footage or valuation, etc. ------
1. example. 1250 sq. foot house. 500 sq. foot garage
2. examole- if new project, check-new - if addition,
check add. etc.
F. Building pennit information:
1. example - construct single family house with an
attached garage
2. example - 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. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design infonmation 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. '~.nd Electrical Schedules
are available at the Building Division
1. To conserve space on the~penmit.fonm th~ schedules
have been abbreviated' .", ..
2. If the item(s) to be installed are not covered 'on
the abbreviated schedules you should consult the
fu 11 schedules
C. BUilDING OIVISION STAFF WILL FILL OUT ALL FEES ANO
CHARGES ON 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 sign.the electrical label. ---
Ill. 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 , . "I .
Plan check fees are due and payable at the time of the.'
appl ication, and no plans will. be processed until these
fees are paid. All other fees and charges are due and
payable when the penmit is. issued.
..or .:..
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PERMIT VALIDATION
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