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HomeMy WebLinkAboutPermit Building 1988-2-24 (2) I INSPECTION LINE 726-3769 Job Address . 1/)10 M,Alto....l oescriptionl '70 ~ 3S c.(( Legal Owner tit CITY Uf SPRINGfiELD INfOrolATION LINe COMBINATION APPLICATION/PERMIT 726-3753 EilERGY SOURCES: Sq. Ftg. 1.lain Heat ~q. Ftg. Access. Water Heater Sq. Ftg. Other flew Add Alter Pep, Range --Fence Demo Change/Use ValUE of Hork~S rfJl)f),. Other- - BUlloinQ Permit Info: Describe Work(i.e., Build Single Familv n&sidence With Attached Garaael /~f)d() tlJ~ ~ ~/Lt'...P ~ ;:) (J/ ~OO ~ o<V C) Address "5es1LO ~ I Ut-j 1m.. J Phone Construction lender ~ Address Ue>IGN leM (name) Primary ~"t' ~.:.5- Structural t:',1L,L 6J~""v Electrical ~r Mechanical ~JF=; CONTRACTORS Inamel General r-",,>I..lp"-1U~ Il y~ Plumbino ~~'pVA/1e'( Electrical ~Vll... ~o-, t:::/ ~ flechanical &A~ ttth PLUI,IB I NG ND.I Each single fixture I Fff" I r:HARGF Relocated building '1>' (new fix. additional) S.F. Residence (1 bath) Duplex (1 bath) each Additional bath ~Ia ter serv; ce Sewer Storm Sewer 7.~ '?G1- =. () Phone f address) (l ics. nn. (exoiresl (nhone 110. \ I.L "14- Jf')h/~~ ?-~~~ . -- - -- ---- 7~.?, J1/~/#? 4etO. (1;('<:'.110.) (pxniresl Cohon!" nn '.0 -11e>f"'> ~l?i (.,e'2...-""U~ I "2n -IX lo-I-t,t> ~-~'l2. 4~'U;1 1'2.+ee> :7,4,d. -24 f, I I r MECHANICAL "2...OJ1l"-> tJIA~ ) . 2~ (address' ~~"IIM1et:>{; Ql.Mfcn. RP. ~~e 4:VY(JV r;il+ ELECTRICAL Nn I Residence of t ~n. I rl-lARG.E. NO. I I HI=' I rl-l.;&G[ furnace/burner to BrU1s SQ. FT. tl.. _ <~" Recessed wall So~rp hp~tpr ~nrl vpnt ~ ~-New circuits alts. ", or extensions ~ "2 a"l", ~c SERVICES <'2 sz: Floor furnace and vent Temporary Construction Change in existing rps i dJ'nr:p multifamily. camm. or Tnrlu,t.r;;tl Appliance vent "poa ra te Stationary evap. con'~r Vent fan with sino 1 educt Vent system apart from heatina or A.C. Mechanical exhaust hnnc1 find rllJrt. Wood stove/heater ..- ,f.t,TQ<i' D~ €.xn<'WO />~ n~.JL.7'v../~AN'" .s?..w. /7 ,- Of amps. CO~1./IND. FEEDERS Install/alter/relocate didrih_ fppnprc;, Of amps. ISSUANCE OF PFRr1IT TOTAL CHARGES 3&. "! ~ TOTAL CHARGES "2 :?' Sc:> TOTAL CHARGES ;""'':>0 WHERE STATE LA1~ REQUIRES that the Electrical work be done by an,'Electrical Contractor, the electrical portion of this permit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXAMINED 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 Springfield and the laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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 ORS 701.055 will b ed on this project. NAI.IE(please pr;nt)JA~~ Zone cr:. Fi re Zone Flood Plain BUILDING PERHIT Charges and Surcharges PLUt1BING PERMIT Charges and SurCharges ELECTRICAL PERI~IT Charges and Surch~r~es . MECHANICAL PERMIT Charges and Surcharges ':::?~4' ",,0 Plan Ck. Conm/lnd ~~~ 65%/Rlda Ppr Fpe --- ----- Plan Ck. Res .;~. ~~ 30%/Bldo Per Fee "'3,a "'.!"'. I Fence ____-'~~.l..I.:.;___ /. 5" I DeRlO 2-:? $0 ISidewalk ------/..-;.3hl.,A/C Paving. ____f.:r;_~__ Curb Cut .?S tqr"cA Type/Const. Bedrooms Stories ,<;':'R / DATE~h~jM - ( Units Occy load Occy Group SIGtI URE FOr. OFFICE ii:SE 011 Y \ Sq. Ftg. t1ainx Value Sq. Ft9. Access x Value B-2 Sq. Ftg. otherk7.!!="A''''''''fi~/~alue&T--''--'.:''"''' TOTAL VALUATION .Q. -12-~ i; (0'133 syste.ms .Development CharQe (1.5%) :z., ~ , .:>() . '. " I I ITota' I' I TOTAL 7178. Z8 I I Comb. Permit. I , " .. - .. COMBINATION APPlICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. legal Oescription 1. example- Tax Lot 100. Lane County Map Reference II 03 43 2. example- lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. exam~le- heat/~lectrical ceilinq/or forced air Qas 2. examyle- waterheaterjelectrical/or solar E. Square footage or valuation, etc. 1. 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 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 TE~l 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 ~ou should consult the full schedules C. BUILDING 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 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 charges are due and payable when the permit is issued. /099/ V, FOR OFFICE USE ONLY ~-2<1-B-~ Permit Cl erk /"//,..: ,_ _, _ /f' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: . PLANS REVIEWED BY: name L~RNG 'A.G~ signature ~~........, date -;2-2 Y-$S5, , / 'Q', "