HomeMy WebLinkAboutPermit Building 1986-6-24 (2)
, 'C I TY Ur SPR1NGH ELD ..
. -:-: ,'<':';- 'COHBH1ATlON APPLICATION/PERMIT,. <;'
EIIERGY SOURCES:
2380 Main Street H~t Gas
Water Heater
;,",-'
. ,;~
,
\
~
111",<" lvll L1I1E ,
726-3/69
\ Y'<~....;'
Job Address
.:
,~io\ @ ,
(
/r;(J '33 t/J 4/
'"gal Oe<er;ption see attached
D/~{)J
lNFORltATlON LIN. I
. 726-3753 .
Sq. Ftg. l'lain
!:q. Hg. Access.'
.~.~ ,.Sq..Ftg.Other .
, flew' Add. Al ter Rep.,:
Range~ -Fence Oemo Change/Use
VahIE.nf. Wl"lrk~__. -Other- _ - _
<7~~. 4tr6 . . see ~Jl\",.;.1.Ub~U
I~UllolnQ'Penmlt Info: Oescrlbe Work(i.e.. Build Single
'.\familv nesidence \~ith Attached Garaol!l
l
Owner Dino Caldwell
AddressOld Dominion Body
2380 Main Street
Construction lender
A.ddress
Ol~l(JN ItAn
(name)
The Amundson Associates/200 South Mill
Primary
Structural
Electrical
Mechanical
CONTRACTORS
(name)
General NA
-Plumbina NA
Electrical NA
~'echan1cal NA
PLUIIBING
Nn.
9-
Each single fixture
Relocated building
(new fix. additional)
J
/
I
S.F. Residence
11 bath 1
Ouplex (1 bath) each
Additional bath
Water service ~54!!)'
Sewer < So '
,
Storm Sewer $I sa;
"~
,
,: "'~'";'
.......r
'..;.-.'j
& Frame Phon'46-77
Springfield
Renovate and add to auto body'''and
frame shop: add paint ventilation
system
~
~,
"J
Phone
(address)
(lies. na.l ]exniresl
St..' SpAin~field.
~~
j~
'" ......
(ohane no.
OR
97477
I{J./b -Y.;2,"l1
(addrel).~)
nice;. no.)
(~xoil"'P~l
fohnnp nn.l
ELECTRICAL
,'.'
MECHANICAL
FEF IJdjARr.F
~ I,7.~C
""LJ:IlAB.Iif..Jill
'li-'
Nn~
Residence of.
furnace/burner to
BTU's
SQ. FT.
..-- New circuits alts.
" ~ e~s~s~E
SERVICES
Floor furnace
and vent
:n$ ·
A
B
Recessed wall S"C'!I-
C::,n:a,/"e.... "~:ll+~'" ...ft;i7l.t~ftt
Y~b~
Appl ianee vent
'i~oaratp
Stationary evap.
cooler
Vent fan with
sinole d\Jct
Vent system apart from
heatino ar A.C.
Mechanical exhaust
hnnrt i'fl;rl ri,lrt
Temporary Construction
/L"" Change in. existing
, :;1. rp$ j ~eprp
?A" multifamily, COnln. or
~ Tnrlllc.tri;:,l
"1~<<J1ttII Of gee> amps.
COHfl./INO. FEEOERS
Install/alter/relocate
~ic.trih_ fpp~prc. .
A of2dD-lIe:tr>amps.
If
.,1St /
Wood stave/heater
3'/.51> ........ 4>~ 'l'lP/Y1lZ.
2.-
'\ I I ISSUANCE OF PFRPlIT
T~L CHARGES 1'97. SO TOTAL CHARGES H57. SO TOTAL CHARGES ~.c:lIO
~ERE STATE LAW REQUIRES that the Electrical work be done by an Electrical Contractor. the electrical portion of this permit
shall \ot be vali1 until the label has been signed by an Elect~ical Supervisor and returned to the Building Division
-' : HAVE CAREFUllY EXM1INEO the completed application for permit, and do hereby certify that all information 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 Soringfteld and the laws of the State of Oregon !)ertaining to the work described herein, and that ItO OCCUPAI~CY will be made
of any structure without the permission of the Building 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 comDliance with ORS 7nl.OSS will b used on s project.
IlAflE(please print) ])Ei\\) CALDWEll..- 'SI~N~TUR~ ~ OATpt.fl::
Zone ~ c:::.
Fire Zone
F1<<;)od Plain. -
,?,..
FO~ OfF"Jr.F "ITSfOUI y-
Units ".,.. Sq. Ft~. l1ain...l:1F=1A/ x Value Ifffi. ~
Occy Load Z:;-Q Sq. Ft~. Access ,q., 1// N/; x Value ;;:~-. Cilao:l
Occy Group8-iH.z~#1If. Ftg. Other AL-JO< IN x Value L~; t!>Cta
(5l,.Cc[ '13 ~ 7'8.~L VALUATION 9~.~
~:;l. ~ .05 ~ systems'Development 11,7-", 00
'lI Charae (1. 5~ EV. . ,
,tuN' .cH~ kctJ'LQi;._
bJ~7Nli'/T ... 7'1.$.
Type/Canst. 1[- ) tt1l..
Bedrooms
Stories
~~~ ~ Plan Ck. Comm/lnd
__-1fl___!...____~(~l~o Pj"1" ~pp
I !2 /" Plan Ck. Res
7." 301/Bldo Per Fee
__'-?Z._~_ Fence
1.9"
/S7. 5a Sidewalk //9'
-----4G:3o--1 A/C Paving~_ I
___2.:?=~_J Curb Cut IA~: ~
_~ /-28 I _ - I
BUILOING PER/lIT
Charges and
!1N~~-
PLU'~BING PERMIT
Charges and
Surcharges
ELECTRICAL PERr:IT
Charges and
Su"cha..ges
rlECHANICAL PERHIT
Charges and
Surcharges
,
"
~
Z7.6S
/98.Sc
:Z7-~
Total Comb. rermit
I TOTAL
987-~()
~(!)~. 7S"
~
.-' ..
. . ,,:
.., .-
..... ''-,r.'
...\",<:' .': :':.::':
. :~ ';")
.
,"'
J
COMBINATION APPlICATI9N/PE~IT (CAP)
. '.
'. ....
I. Applicant to furnish
A. Job Address '
B: legal Oescript;on
. - I. examp.le- Tax lot 100. lane County Map Reference
:11 OJ 43
2. 'exam2Ie- lot!. Block 3. 2nd Addition to
,i~prlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources "
I. example- heat/electrical ceilinq/or forced air aas
2!. examoJe- waterheater/electrlcalJor solar .
E. $quare footage or valuation, etc. -.
fl. example- 1250 sq. foot house. 500 sq. foot garage
/2. example- if new project. check-new - if additlon,
.,' cneck add. etc.
F. Buflding pennit information:
1.. examole - construct single family house with an
attached garllge
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
Oivision 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 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. BUllOING DIVISION STAFF WIll FIll OUT All FEES AND
CHARGES ON THE SCHEDULES ',,' '''' "
D. As noted on the CAP. the' label must be delivered to the
o' electrical contractor for signature by his electrical
's"upervisor. 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 Oivision 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 penmit is. issued.
PERMIT VALIDATION
,;" ...
...: '
"
. "
~~
~~
~O'
'.', ~.
''\'.'
'.
V. FOR OFFICE USE ONLY
Permit Clerk
\:~)
~
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
~ Additional Project Information:
l) ,
~~~ .'
?~\
:>' ,~.).\,.
"co:~"
~..." 1'/,'" ~6PLANS REVI EWED BY:
.. ...~ 0."5>
....."1f' 4.l>~, ' , ~ _ .
~o~~ '$~~l1leioCli'fH,.r; ~~ signature~~
^.'\.~(\.~-? ~ A
~<;r~<;.",
:,'" tf'
"
-;
,K'5VJ-S/i!>h #/ ~-~9-~
(" ~~ ~-~~-S~
~...,,, date '1-</-86'
~