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Home My WebLink AboutPermit Building 1985-6-11 "'lllI I HI,PECTlDN LINE I 726-3769 . CITY UF SPRINGFIEI.D. INFORlIATlDN liNt. CDMBINATION APPI.ICATION/PERMIT 726-3753 EilERGY SOURCES: So. Ftg. I-Ia;o Heat- y"pJ ~q. Ftg. Access. l~ater Heater Y"'" Sq. Ftg. Other Rance \'\0 AlIew_Add_Alter -,~eD. __Fence__Demo__Change/Use Val~o_~;#.~:jl/~OO.- _Other BuilolnQ Permit Info: Describe Work(;~e.. Build Single Familv rlesidence l~ith ,o.ttached Garaoe) ---ty,~ U-IO I .<C 00 D t/J UMMNW.-.r> '0 ( ..r>>...... f., ~ u.. w.~ Oc1N~"^,, o.c.o...-U ",.J.... (,.......11 r '-.:. I K~l'\ ('"Lf~o~ ...... .b..u~~ (lfcs.~.) (exo;res'- 1~/.M. Job Address (}.7'7f; ~ ~1, l.egal Description -r 11 S 12. '2...W S<'t.~~ ~ I I -rv..lr Lo.,.. '*"-" 00 . 9'; 'R~ Owner 'P(a.U -rJupp/ r"hJo,a.,Tert"7 "~M"'~. Address 401 I? f()"'tItL.e... ~LDl g<<fhone~5"-oUl ~. ore.. v Cf'ZLrrlJ, <JX(~2g' Construction/Lender ~_ Address Ut~lGN f~AM (name) Primary kM- M..tlN4.1a.-v I Fe Phone (address) .~ Icn 1<0 \n ~ (ohonp no. '174 wi\\all\\Lt\-e I " .ElCQM..( U " ._- ~ 'iJ(.. . 4&': _1Ilo. l_dl;,.J 'IF;'" -q.o 'Xo Structural ." w..c. Electrical .~ ,..,"""-'- (name) ,. Hechanical CONTRACTORS " (address) flire;.. M_) (l'il{l)irpc:.\ (I)hnnp rlQ. \ .- 4b:\ -.>.,.....JI .,,~,' -, General ZG. r IlAA~~ . Electrical II~Y IA). 2~ E~^",-,- "fO.rS'l .<//I"I'i1o (,_~k Pu...__\"~ ,ltOloS C. "l.::'~; e.J.nGML ", '3 o 2/CtY 0 /o/tz/b<;'" N,*,^t1M P~\iO., E\~'I.!.Olbq kRu..... 72.1.'I~~3163S700 ~M~ kOt~ 'J2..,J2.-.\~I'~.k"" 13roO CD~1.AIIr<: ~..j::~~et""l. #338G:,Y '7h/<;,( \la.-.U g""1r ~. - I PI.UflBltlG U ELECTRICAL MECHANICAL I FEF I fHARr,E yn I I <<LIJ:IlARG.E...llll.....1 Residence of "n -7bEI/ ~I(S" -og7~ :I'{1.{-"<{2. '2.- Plumbino ~lechanical NO. I~ Each single fixture s.- 5"a..... SQ. FT. furnace/burner to BTU's I ~~L 1.cHARG.E. Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (] bath) Duplex (1 bath) each Additiona'. bath ISERVICES I I Recessed wall ~n~;p hp~tpr ~~rl vpnt 1/ H7 J1..H7P Appliance vent seO<lr<ltp Stationarv evao. cooler ~ , Vent fan wi th , ':2'.... L ... sinole duct ~~. Vent system apart from r hea t i no or A. C. Mechanical exhaust hood <lnd durt Ih- I J~ Water service E Sewer ~ Storm Sewer ;?(), - . $JS:- 7~- / ITempOrary Construction IChange in existing re<;5 (tenr~ Ilffi.IltifAf1I~ilY. COOln. or i"T"ridu<;tnan II~f~' ICO~1./IND. FEEDERS I Install/alter/relocate rtic:.tril'L fpprtprc:. Z Of ':lee> amp~ ~ ~ amps, I I~- I I :< ~..c' 1 Wood stove/heater ISSUANCE OF PFRinT '.t::V'> .. "'7.r,- /2.- TOTAl. CHARGES I'~." TOTAl. CHARGES ,.~, TOTAL CHARGES WHERE STATE I.~W REQUIRES that the Electrical work be done by an .Electr;cal Contractor, the electrical portion of this penoit shall no.t be vali..J until the label has b~en signed by an Electrical, Supervisor and returned to the Building Di.v~si9n I '. '. \ . . . , " I HAVE CAREFUlLV EXAm NED the completed apnlication for permit. and do hereby certify that all information hereon is true and correct. and) further certify t.hat .any and all work oerformed shall. be done' in accordance with the Ord~n~nces of" the City of Springfield and the Laws of the State of Oregon pertaining to 'the work described herein. and that NO OCCUPAI~CY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon. and that only subcontractors and employees who are in compliance with OP.S ](')1.055 will be usei:l"on. t~is project. \<o~'11f\. A ~~~e.V\,j) iI-r;?, , h_' ,,1/ ;: UArlE(please printl:}(YUl;! A 11....L\.,'OA__ --- SIGilATURE ~~ DATEM//f?~ '~_n FOR OFFICE USE OW.Y 'I \' 1 , Zone--A!J;./ TYDe/Const. t5YV ~Units--tY.4. Sq. Ftg. '1ain~'~_~~""alue Eire Zone ~ot/., Bedrooms~;d Occy l.oad-8E Sq. Ftg. Access~ .~12S<<J11 Value_~~~'- flood Plai'nfl...4. 5tories-L"'~ Occ.y Group 15-:2 SQ. Ftg. Other~hw.P. ~~ Value ~.~- . . -, A P/b/"~~"'1-~JiJ'" TOTAl. VAI.UATlON"y"(tPa:>.- 1:'/4'-C Plan Ck. Commflnd 'f;l/ 53 /J Systems Development 5o'llr oe> .7LL. P'. 6511Bldn Per <ee . tP6/ Charoe (!.5~l /, :). ---- -----PTan Ck. Res ~ ~~. ~~ 30%/Bldo Per Fee /$t) - Fence ____..J~__...!:___ 7. ~O Demo _____X- -I Sidewalk 2/~' ~ , -I A/C Pavin9.y~~" I ____-'_~.=.~-' Curb Cut ~'~5' I . 0/'$.1 I BUII.OING PERNIT Charges and Surcharges EI.ECTRICAI. PERI:IT Charges and Surcharges zS'. ?2 1'5'.7. ~ -g~. '7~ K:;A~~ ~ ~~ I I .. 83.~ Pl.ur1BING PERMIT Charges and Surcha rges ITotal Comb. Permit ,/()3',<8 I - -- '---~ i 6,() 6 cr. 'I~ , MECHANICAl. PERMIT Charges and Surcharges I I TOTAl. ~\ . COMBINATION APPLICATION/PERMIT (CAP) . I t. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II 03 43 2. examDle- Lot I. Block 3, 2nd Addition to sprlng'ield Estates ,.. . 'c. Name. etc. of 'owner and construction lender D. Energy Sources . 1. example- heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. - 1. example. 1250 sq. .foot house. 500 sq. foot garage 2.. examp.le-'if new project. check-nfw - 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. 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 TEAH 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. .11. 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 WII.I. FILL OUT Al.l. FEES ANO CHARGES ON THE.SCHEDUI.ES 0:' 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 char'ges are due and' ;',.) payable .when the permit is issued. . V. FOR OFFICE USE ONI.Y PROJECT CONDITIONS TO BE' SATISFIED BEFORE OCCUPANCY: . . . a",MEHr ~..&" S zx::. i!!7P ~ ~""/t,D/k"~ /"5 ~€c:P~~b_ CH.A'"~~E /S /lh/J Ar .?HE .. PERMIT VALIDATION !J?f/Cl;p. / .J~U-P[L- co .;' (i1\D b ...... .~ " ~~ Permit Clerk ~ ~ '. ' PutS ~ CdMP~~~k ); M.6" c:::?~~ "'PA'.lY'~ Y Permit applicant exempt from registration with the Builder's Board because: ',1...... .... :--- '.' '- Add.i ti ona 1, Projec't Infonnatfon: . - ',' '". .. ~ . .. ..... ". .... '., ..... .' PLANS REVIEWED BY: .' ';' , . ......'. .'-' . " ; ...; ,. . , .r " ~~m~":.'LbR/l/tS ~~~~~~'g~~tur date fj-J-JB6'" ~ . _. \ ~'.. -;.. CITY UF SPRINGFIEI.D COMBltIATlON APPl.ICATlON/PERMIT EilERGY SOURCES: Heat 'f"::' I/ater Heater Y"'" Rance \'\ 0 Val~o~lqrt.: .$3~1, 600.- =1)""'8 17"- BuilGlnq Permit Info: Describe Work(i.e., Build Single Familv nesidence Hith P..ttached Garaoel -ty4""W!~ U-,u I .<C OOD t/J UMMNW.-.r>'.. ( .."'".., ~,jl!&.Lt. Wl~ p"""~,,^,, o.c.O..iu ",.J.... ("....11 .-t.k,'\ rl,f~f'L:a..-: ';... J.....1~~ (11e5. ~.) (exniresr- . . E..qM-{ " - "'fJ.U. <.oJ IlilSPECTION l.lNE ! 726-3769 Job Address (). 7'7 f; . ~~1, l.egal Description -r 11 S 12. '2...W \~/. M, S<'t.~~ ~ I I -rv..lr Lo.,.. '*"-" 00 Owner ..,.,/.. -r'I. '" ~.-r -r 9'" 7<....e<r r ....U ..'~IA,Jo,a.,I_"7 .....,,~..,.,.~ Address 401 ~,I ()"'tItLM!.. ~LDl g<<fh~ne~5"-oUl ~ ore.. - Cf~Lrr>)' (15<(~2g' constructio/Lender ~. Address DESIGN TEAM In~me\ Primary E.vv-M-"M~a.-v. Fe . . INFORltATlON lI~< 726-3753 Sq. Ftg. '.lain ~q. ~t9. Access. Sq. Ftg. Other lllIew__Add__Alter__~ep. _Fence_Demo_Change/Use I '''''' __Other vv (VJ en <0 \n I~ Phone {address} '174 wi\\QlI\\Lt\-e. (ohane no. I Structural .,,\Mot Electrical ~ Mechanical CONTRACTORS ,..."""-'- lnamel (address) .. 4&': -"". I--~~ 'IF;'" -'to 'X() .. " (lir~" no_' 'pxT}irp~' 'o"on~'I& ~..~...JJ ~' -..J "n -7"glj ~'iS"-og7lf.: :I'f<(-"'h '2... General ?.G. r "1A"~. 1\1.'-4 IA). 2.~ S~^^-'- "fO.rS'I .<lif.!'(b Plumbino ('VZI.~ k. Pu.u.....1.,~ . lorr E_ i.~>..~ e.A!,-llML -4 '302/2tJO 10/ Ill;., v I . 0 Electrical NHv.f,1AA P~'\iO\ 1:\<<..".'.0/"" L...Ru.... 12J.'I~~~'>i3';:;3S?&O ~hl;.~ 'lechanical ko~L... 12..~.yA.I,..,"""!"t(o ~PfQ9 c.oW"'^'" ~"FAlerJ\4J 1i338"Y 91'1/",( U"--C g~ ,~. -:L PLUMBING {J ELECTRICAl. MECHANICAL --1lQ... FFF CHARCF !ill- FFF r I S- Residence of furnace/burner to ,/I Each sin91e fixture <": _ (V , vIP. SQ. FT. BTU's Recessed wall __~kp;:>TP" "'nrl wpnt I I 1/ Rf7 'R..H7P I Ill" App 1 i ance vent IIv. s~oar~tp I Stat; onary evap. cooler I <'? Vent fan wi th ..... sinole duct I ?L'.c I' Vent sys tern apa rt from I I?~ heatino or A.C. I I Mechanical exhaust , hood and duct I I~sta~l/alter/relocate I I Il~OOd stove/heater. rilc:tl"lh fppdpr.. amD~ ~I~ I Relocated building (new fix. additional) INew circuits alts. or extensions , ' S.F. Residence f1 bathl Duplex (I bath) each Additional bath I SERVICES -, I="H" r~~ Floor furnace and vent &- 12S' ~Ia tel'" servi ce E Sewer ~ Storm Sewer / ITempOrary Construction IChange in existing rpc; j dJ'nrp Il!!.liltif~Til.Y. CQrTI!l. or i'Jnrlustrian I 10f 11M ICO~1./IND. FEEDERS 4~~ I I I ISSUANCf. OF PFR'llT .. .; TOTAl. CHARGES Is:? .. I TDTAI. CHMGES 75-.1 TOTAl. CHARGES /2. - WHERE STATE I.'W REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this penolt shall n~~.be va1id until t~e label has b~en signed by an Electrical Supervisor and returned to the Building DiJisi~n . ' .. . t' . '. I. . . ., '.. -.' . I HAVE CAREFUllY EXM1INED the completed application for permit, and do hereby certify that all information hereon is true and correct, and, I further certify t.hat 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 OreC]on pertaining to the work described herein, and that NO OCCUPArKY 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 ons 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 7Ql.055 will be useij'on.t~is project. . ~1A J.)'~~'" ~ ... / I / ;:. ilAIIE(please print) . _ ~ F;nF~:~~^~~;EQ?A/It~.. OATEq;tf!g~ I, Zone)fI'JQ TYOe/const.~Units 4'.d. So. Ftg. f1ain~.r'M~ ~-fI\,alue Fire Zone...6'<<t, Bedrooms 1"#~ ~Ccy l.o~d..-SE Sq. Ftg. Access4t;.c_~ _xLZ~ Value '25$'.eu:t:>,- Flood Plain #.A"L-Stories /f~~ Occy Group "B-2 Sq. Ft9. Other~A;,.lP. ~~ Value /!fi;..eIAIt+- .. - . -" A- ~ b(,,'1~11-~J-'iJC: TOTAl. VAI.UATlON ;:?"'?e>a:>.- I L:'J4 5'(:) I Plan Ck. Commflnd r <{;I/. 53 n /7 'ScYastreo"'e.StD,e.sv;llopment . ____.7.L.L~___._ 65%/Bldo P.fr F~~ w<:V h " Plan Ck. Res r' ~~. ~~ 3D%/Bldo Per Fpp /8f!) - Fence ____J:....__...!___ 7. ~() DelllO _____~ -I Sidewalk '2/~' ~. -/ A/C Pavingl'~~O I __n-'_<:-~_II Curb.Cut < "'!J51 I , . 1ft!>. . I ;?(), - !JS:- 75..0 BUII.DING PW1lT Charges and Surcharges' Pl.UI1BING PERMIT Charges and Surcharges EI.ECTRICAL PERi~IT Cha rges and Surcharges f1ECHANICAL PERMIT Charges and Surcharges amps4 . ~-16"- I I. I' i I.'. ., I 2S'. ~2 /5'7. - ~~. Cf"e> !~E.~L? ~,$~~ I I 5//~ OD I .. 83.~ ITotal Comb. rermit /()3$.<8 j 6,()Gr.'I~ ,- I I TOTAl. . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION .IJ. I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. l.ane County Map Reference II 03 43 2. exa~le- Lot 1. Block 3. 2nd Addition to ::iprlngtield Estates ,- .C. Name. etc. of owner and construction lender O. Energy Sources 1. example- heat/electrical ceilinqlor forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. ------ 1. examDle- 1250 sq. foot house, 500 sq. foot garage Z.. example-off 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 famiJy 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. DESIGN TE~I 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. Abbreviated Plumbing. Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description pQrtion 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 I'~ full schedules C. BUII.OING DIVISION STAFF WILL FILl. OUT AI.L FEES AND CHARGES ON THE SCHEDUI.ES 0.... 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. --- 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. !3?tfClJ.1. j,J$1. d -TJ{L- , c: .,., ft\\D .... ' " \';:"" 11 I. "'., \.... I', ~."" . '. '.3'~~' V. FOR OFFICE USE ONLY Permit Clerk (!gjtj . PROJECT CONDITIONS TO BE' SAT~SFIED BEFORE OCCUPANCY: , . . .. 'f3WMEH.,. ~F S ZX:::. ~p ~ .ff>~/l,O/JVG /~ ..R€d:>~- CHA"?~E' 1$ /1.A/..lJ Ar 7H€ PatS ~ CdMP~t!i7/6N )'l Mo <:?.c.::: ~PMl'~ Y Permit applicant exempt from registration with the Builder's Board because: l-'~ , ,.:.'" , ..." .' \.\ . .;' ~ ...\ ..', Additional.Project Information: , ,'" \" ,- ", . . , "',.. . ." \"" " .. -, ,-.' ., , ," ..~, PLANS REVI EWED BY: . .... name L~RNe ~~-.~!~::gnatur~ -e#.f:' . " l I , <? da te ~-J-~C .--