Loading...
HomeMy WebLinkAboutPermit Building 1985-3-13 r' I INSPECTION LitlE 726-3769 Job Address /001 . . CITY Ur SPRINGFIELD COMBINATION APPLICATION/PERMIT E1IERGY SOURCES: Heat \~ater Heater Ranqe INFORltATION LiN" 726-3753 So. Ftq. t.laio ~q. Ftg. Access. So. Ft9. Other New Add Alter ~ep. -Feoce Demo Cha0ge/Use Other- - Msin SIr<.€.+ Legal Descriptioo 17~(?3-"!>-r:~/, Q';,y.oo ""- I'::r- ~ <;J ~ ~ I Owoer 5priY1tfAeM L-!+i/ify BcerJ Address 1001 l>'1ain sf. 5oriYld:",J) Phooe74t,.B15, oJ ValUE of Hork: l3,o+'?':!' BuilriinQ Permit Info: Describe Work(i.e., Build Single Fam;lv ~esidence With Attached Garaae\ Construction lender I ns-laJ/ ~v BooI-h , N()r1~ I (ohane no.) Address UI:.~lliN lEAt1 (namel Primary Mel1-hiwJ I HlElYlr7S A55ll': Structural ~~~ Electrical Meehan; ca 1 CONTRACTORS Phone (address) (1 ics. no.) {exniresl 0~'?J?fi7 A/A ~ OlIve s+- 4 -JL ~ <<:>1w1e $&1'1-(.. (namel (address) (1 ir.s. no.) (exnirl'>C:) ~nn.\ -----.....'........ ( ~4~.1/M /' --- ' #:5.....)t; 7 6~ '"1~' //P~/ t!..cm fY1.p .truAJ Genera 1 Mc.ku1ti./. Plumbino Electrical ~1echanical .....1!Q.." fJ~ W 5e.LJ.,Y/ L Ave_ :?Ti1s1. &/~'? - , J'I.1J'Y11~ - ..J f- ~tk_ H~1"l/el.-1 fr mrtV', ~ PLut1B7 ' ,~ Ore. 97~/ ~q&i<..e. a. C?1M EL~RICAL ! >>> r"I\IlliE.JlQ.....1 MECHANICAL FEf rHARr.F Nn 1.il..E- I J:liARliL Residence of furnace/burner to BTll's Each single fixture SQ. FT. IRelocated building (oew fix. additiooal) Is.F. Residence (] bath 1 IDuPlex (I bath) each ]Additional bath I I I Storm Sewer I jOt L (fx7l9YL:> M~ ICOM1'I./IND. FEEDERS .-'Jl__ IInstall/alter/relocate I ~ nKoS ~~65'1? rli,trih. fpprlpr, ;')~j;r€/n _ I 10f amp~1 I I-6R -pJpfi'l'P> I I I I I I I I I I I I I SSUANCF OF PFIUIIT TOTAL CHARGES ~ -- TOTAL CHARGES la -I TOTAL CHARGES n /N . /Q ~ WHERE STATE L'\\~ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pennit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division Wa ter servi ce Sewer / New circuits alts. or extensions I~OC Floor furnace and vent ISERVICES I Recessed wa 11 So~~P hp~tpr ~"rl vpnt ITempOrary Construction IChange in existing rp~; rteonC'P Imultifamily, conm. or Inrlustrial 4 Appliance vent seoarate Stationary evap. cooler Vent fan with sinole duct Vent system apart heatina or A.C. Mechanical exhaust hood i'!.nd duct '/.~ amps.1 from / Wood stove/heater ;2"'" I HAVE CAREFUllY EXAr1INED 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 Soringfield and the laws of the State of Oregon pertaining to the work described herein, and that UO DCCUPAUCY 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 701.055 will be used on this project. Type/Const. Bedrooms Stories (l..l7l\'1l:;,);. ~SIGtl^TURE .J1 If, -A FO~ OfFICE USE ~ Sq. Ftg. ria;n ,x Value Sq. Ftg. Access x Value Sq. Ftg. Other x Value 1# t,</'?,f/ ~ TOTAL VALUATION "1"7 '''l fJ.n !J3"plS:Vstems Development f/ A -.Ii "l'ro<OUZt:;1 dItharqe(I.5~) /)('/'r' , 'r I I I NAt.IE(please prio~ .H\MlS:c, /' - Zooe .....E...I.. , Fi re Zone Flood Plaio BUILDING PER~tlT Charges and Surcharges PLurlBING PERMIT Charges and Surcharges ELECTRICAL PERI~IT Cha rges and Surcharges 11ECHANICAL PERMIT Charges and Surcharges ~ ' (ll c. ,DATE~I h0 l- .: Units Occy Load Occy Group //8 <>0 Plao Ck. CorrrnlIod ---J.:-_~o-_. ~f:~B~~~ ~.=~ Fpp /. /;;a 3D%/Bldo Per Fee 1-0. oc> I Fence ---- --~~o-I Demo /a~ I Sidewalk _____n~Y~-1 A/C Paviog ____Le"-~ Curb Cut --70 ITotal I iOTAL Comb. Permit I g /. /"2.. PI 8t:I<' . COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A. Job Address B. Legal Oescription 1. example- Tax lot 100. lane County Map Reference II 03 4J \ 2. example- Lot I. Block 3, 2nd Addition to Sprlngtield Estates ' . ' . C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air Qas 2. example- waterheaterjelectrlcal/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 new - if addition. check. add. etc. F. Building permit information: 1. example. construct single family house with an attached gan~ge 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 Structura). 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 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 fu 11 schedu 1 es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULE5 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. pajd. AI) 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 Ju" ~ :' Permit applicant exempt from registration with the BiJil"der"s Board' because: Additional Project Information: PLANS REVIEWED BY: name~HC:;- ;Z>~C7-? Signatur~.,.. , " . ~ date? ~ -:; ,;:;'S" r