The URL can be used to link to this page

Home My WebLink AboutPermit Building 1985-3-13 (2) I IiISPECTlON LINE 726-3769 Job Address /C'C'/ CITY OF SPRINGFIELD COMBIIIATlON APPLICATION/PERMIT EilERGY SOURCES: Heat Hater Heater RaMe I Main S/r<.e+ Legal Description 17-(?3~"!>").41. <?~,YtC>O I I NFDRlIA TI ON L. ,'c I, 726-3753 Sq. Ftq. 1.lain ~q. ~t9. Access. Sq. Ftg, Other Ilew Add A Her ~ep. -Fence Demo Change/Use Other - - , "- ';:r- I~ I \\J: Y71 ~ 'Owner 5prirJeth'el4 U+j fify Ba3rJ Address 1001 /Vti9in sf. 5priYlah'l"ld Phone 74t,.815, J Valut of Hork: a/o4-~~ Buil~lnQ Permit Info: Describe Work(i.e.. Build Single Famil v l1esidence Hi th ,Mtached Garaae) Construction lender ND....!:. Address Ut~luN ItAM (namel Primary MenhoYl I f!SVlY75 As5&:. Structura I Same Electrical Phone (address) AlA I ns-haJi ~v Boofh I (lies. no.) (exoires} ~ ol/ve s+- XL V ':::~w1e Meehan; ca 1 CONTRACTORS McfLtn0. U:mrrlPJtUaJ General Plumbina Electrical ~'echani~<ll NO. 5SWl-!. fn?,~l 'address) ~f7?J W /'1.1:1r1/, - J~~~. Ht'JYl/e.vt f~ ;o;z~V'. &-:' P~UIIB~ I FFF I rHf\Rr.f" ~IL (l its. '5eL"Ylti tWe_ no. ) (~xn;rpc:.' ~jJ1. J;/~c-; -i ~ Ore. 11#;/ ~q~ a. C?7101... I.J ELECTRICAL Each single fixture Residence of MECHANICAL ~I;~ , ru~ _~m SQ. FT. furnace/burner to BTU's Relocated building (new fix. additional) S.F. Residence (1 bath) Duplex (1 bath) / I'New circuits alts. or extensions ISERVICES I Additional bath ~Iater service Sewer each 1//."'" Floor furnace and vent Recessed wall ~ry~~p np~tpr ~"rl ~P"t !Temporarv Construction ~Change in existing II"P~irt.f>rH"'p multifamily, camm. or Tnrlu,,-tr;;tl 'l (ohone no.) 0~' '5?fi7 J I I I .I.a+Trlrl'i no, \ --:--~, ( ~4:3.1/~1 -- -I 4&3':Sh76j -;Lf(p-/{PtL/ I I I I.E.EL..I (HARr,F I I I I I I I I- I I I I I 1~S:1 I I :;? Appl iance vent seOi1 r~ tp Stationary evap. rnoler Vent fan with sinole duct Vent system apart from I heatina or A.C. I Mechanical exhaust hood Md durt amps.l +116 I I / I I I \'Iood stove/heater T -IIR 11p~ Storm Sewer Of L ~ ~~ ICOMI.I.IlND. FEEDERS r__ r ~~...,. I Install/alter/relocate ~ r/R~" '--~~ rli...tr1n fppnprc; - ~$/,<-t.,19 _'. i _ =-1 Of amp~ I I I 1 ~- /./'1.-1 A"""'- TOTAL CHARGES A:;.../. TOTAL CHARGES I'C--< TOTAL CHARGES n /N . c...-: ~ WHERE STATE L~H REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this penoit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division ISSUANCE OF PFR!1lT I HAVE CAREFULLY EXN1INED 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 cerformed 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 lIe OCCUPAr~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 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 7~1.055 will be used on this project. IIAHE(please prin:~ .:MM~'7 / Zone~ ' Fire Zone Flood Plain BUILDING PERI1lT Charges and Surcharges PLU'1BING PERMIT Charges and Surcharges ELECTRICP,L PERI:IT Cha rges and Surcharges I1ECHAN I CAL PERMIT Charges and Surcharges Cot~!l~&:~1-)\;:;l/Ulr,IIATURE~ -A FOR OFFICE USE 'bilL Y - Sq. Ftg. Hain x Value Sq. Ftg. Access x Value SQ. Ftg. Other x Value #t,<I~g/, 4-4 TOTAL VALUATION jj '7,/,;). 0 f/h/r3/J'i{,~~~~s(~~~Wpment //./1 . . I . '[ I I I I I I I I Type/Const. Bedrooms Stories Units Occy Load Occ.v Group L/.:;> oc:o Plan Ck. CO","/lnd ___..:z.R~___'_ 65%/BldC1 P.f:r Fpt.> CI Plan Ck. Res /, '" ~ 30%/Blda Per Fee ____/0, 00 I Fence , $'0 I DtJInO /a~ I Sidewalk -_-nn~r~-I A/C Paving /c:>.. ce> I Curb Cut ----./-'-:-90-1 ~ . (t r;. . ,DATE~I 00 Total Comb. rermit : TOTAL I 8f. /"2. ~ 8'/-:/<", I , I , L, " COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal~Description l~'.example~ Tax lot 100, lane County Map Reference II oj 43 , 2, ' exanyle- Lot 1. Block 3, 2nd Addition to Spr,ngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. exam~l~- heat/electrical ceilinq/or forced air oas. 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation. etc. ------ I. example- 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. exam~le - remod~l 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 Structura). Spec i a lty Code H. OESIGN TEAM AND CONTRACTORS To avoid design or construction delays. Building Division Staff must be able.to contact appropriate persons regarding des,l_gn 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 fanm 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, BUILDING DIVISION 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. --- 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. All other fees and charges are due and payable when the permit is issued. . l.\lo l,pL\ ~ l' pif V. FOR OFFICE USE ONLY Permit Clerk tj ~ : PROJECT CON,DITlONS TO BE SATISFIED BEFORE OCCUPANCY: . Permit applicant exempt from -registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name / /:iZ?H~ ?=>c..ec:r~ Signatur~ ~ ~? date :r7"'?-!!?-S .