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Home My WebLink AboutPermit Fence 1981-9-15 ~rISPECTION LIHE 726-3769 ob Address A:9 V5 Legal Description . ,,;. . INFORlIATION LINt 726-3753 ,Sq. Ftg. 1.lain ~q; Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Demo Change/Use -Other- - h'7.& //V CITY UF SPRINGFIELD . COIIBHIATION APPLICATION/PERMIT E!lERGY SOURCES: Heat Hater Heater \ rlG;) '?1 :SC\ \ \ IOwner /.1&.J?d I . r ).Address 903 (" , \I ~\o#N..so-v ..5 5'67# o ?)c::...r..r" Range '~fialuE of Hark.: 'f.... ~?J~ BuilGlna Permit Info: Oeser.be Workli.e., Phone~. ~q~ ? Famil v Residence Hith P.,ttached GaraQe) Build Single '\) ~ ~ ~ (name) Phone (address) ~ Construction Lender Address DESIGrl TlAH fiies.no.) {exniresl (ohone no.) Primary Structural Electrical Mechanical CONTRACTORS lnamel X . General , <;;0.;:: Plumbina (addr~ss ) (l ies. no.) (pxoires) (ohone [.0.1 ...:i I , , , Electrical ~ ,J Jf. PlUllBING ELECTRICAL MECHANICAL ~ ==--.-=<-:. ! I ..,._Ij:JjARli( i i t.lerhani ca 1 Each single fixture FEE r.HARGF Nn I=I=LI...c..t:iAB.iiE Nn_ Residence of furnace/burner to SQ. FT. BTU's NO. Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (1 bathl Duplex (1 bath) each Additional bath SERVICES I I -I I I I Recessed wall So~~P hp~tpr ~nrl vpnt i f' Storm Sewer Of amps. Appliance vent sJ!oaratl:i Stationary evap. cooler Vent fan wi th sinale duct Vent system apart from I heatina or A.C. Mechanical exhaust hnnrl ~nd du~t I I I I Water service Temporary Construction Change in existing res j ctence multifamily, comm. or Industrial Sewer COI~t./IND. FEEDERS Install/alter/relocate distrib. feeders Wood stove/heater Of amps. ISSUANCf OF PFRr1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L\H 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 EXA~1INED 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 performed 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 OCCUPAHCY will be made of any structure without the permission of the Building Division. I further certify that my registration 'tlith the Bunder'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. NAI'lE(please print)~#./# V, S?'..?I,A/.5<"..-v SIGNATUREa/) p.~ /' FOR orFl CE USl!-1lllL Y' 1'/ Sn. ~tg. 'lain Sq. Ftg. Access Sq. Ftg. Other DA T.E...i' ~/....> ~ · Zone Fi re Zone Flood Plain Tyoe/Const. Bedrooms Units Occy Load Occ.y Group .x Value Value Value x Stories x TOTAL VALUATION BUIlOING PERfIIT Charges an~ Surcharges , Plan Ck. COllll1/1nd ____________...Q..S!~Rldo P,rr Fpp Plan Ck. Res 30%/Bldo Per Fee Fence 'Systems Development Charae (1.5~) PLUMBING PERMIT Charges and Surcha rges Dgmo 'Sidewalk ./I *IA.CD I I I I I Total Comb. Permit i/; f eX) \. , '-, ELECTRICAL PERr~1T Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges A/C Paving I Curb Cut I I I TOTAL ~ '~ . .' ,- COMBINATION APPLICATION/PERMIT (CAP) " Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 4j 2. examele- lot 1. Block 3. 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. exarnDle- heat/electrical ceilinQ!or forced air Qas 2. example- waterheaterjelectrical/or solar E. Square footage or valuation, etc. i. exam~le- i250 sq. foot house, 500 sq. foot garage 2. example- if new project. check new - if addition. check add, etc. . F. . Building permit information: 1. examele ~ construct' single family house ~;th an attached garage 2. examele - remodel existing garage into family rcom 3. exam~le - 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 TEAI'I AND CONTRACTORS To avoid design or construction delays, Bl~ilding pivision 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 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 electrical contractor for signature supervisor. The general contractor 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 sfgnature. 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. I. 'j . , be delivered to the by his electrical is .!!.Q.!. authorized ., IlL IV. V. FOR OFFICE USE ONLY .-.....q , -a;"J.,..! , ...,..01_"' .~ ....', . ..,l.....,..... II. ..-.. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . " J ,\ PERMIT VALIDATION , I j , 1 i ., ., I 1 , , J i 'j , " '.~ i ;~ " , 1 1 I j j ~ ;j i i I J ,. ~ 1 ., .. i , I ~i .~ '1 " ~i ;1 ;1 , i ,! , .... 1 , I. '. .r I 1 I Permit Cl el'k ,-~ - .,., ~,' j Permit appl i cant exempt from regi strati on with the Buil der' s Board because: Additional Project Information: PLANS 'REVIEWED BY: name signature .~ - ._ I 01' 01. ..... ..._, . date ..' . i Mechanical CONTRACTORS Inamel > . General ~;:: Plumbina I IrISPECTIOII LIIIE 726-3769 , ; kOb Address AX Y::5- , Legal Description ~ 10wner /'r1I..;J/I r ).Address 9t:'3 / \ Construction lender Address OESIGll TEArl Primary Structural Electrical I Electrical M~~h~nic~l . ~..~i\.'7~'~;"':,!~ 'fi.~,~J:.:.'Wtt."t~" , ~', ~."- . INFOR/1ATION LW' 726-3753 Sa. Ftq. 1.lain ~q. Ftg. Access. Sq. Ftq. Other rlew Add Alter Rep. -Fence Demo Change/Use -Other - - . ...... ~ -... 1-: CITY 0; SPRIrlGFIELO CO/1BI;iATION APPLICATION/PERMIT ErlERGY SOURCES: Heat Hater Heater /.274//1/ , \I ~\O#N..5Cl-'V S .$(/# Ranqe ftalu€ of Hark: 'f\ B.:>?J "3!!- Buildina Pennit Info: Describe \~ork(;..e., Phone:;::Y-6. '~('y ~ Familv l1esidence 1.lith J\.ttached r.araae) 1\:), ,~ Build Single I~ I'~ I~ I (ohane no.l (name) Phone (address) ~ eiies.no.) (exniresl r address) " t ~ fqhonp no.) ti. I ~ t I , ", ~1 (1 ics. no.) (exoires) PLurm lIlG ELECTRICAL MECHANICAL NO.1 Each single fixture Relocated building (new fix, additional) Is.F. Residence _ (1 bath) Ouplex (1 bath) each Additional bath Water service I Sewer Storm Sewer FEF CHARGE ... rlJAB.li.E ..1lO..- Nn Residence of furnace/burner to BTU's SQ. FT. New circuits alts. or extensions Floor furnace and vent I I I I I I I I I SERVICES i 1 Temporary Construction IChange in existing rP<i j tiy."!"'p Imultifamily. comm. or Tnrluc;:trio'll I I I I I Recessed wall ~no'l!"'p hp~tpr ~nri vpnt I 1--- I I App 1 i ance vent !,poil.r~tp I Stationary evap. cooler I Vent fan with ~inole duct I Vent system apart heatina or A.C. I Mechanical exhaust hood and duct . I Wood stove/heater I I I 10f ICOMfI./INO. FEEDERS I I Install/alter/relocate I di~tr;h_ f~pdpr~ IOf amps.1 I I I I I I I ISSUANCE OF PFRtllT TOTAL CHARGES I TOTAL CHARGES that the Electrical work be done by an Electrical Contractor~ the electrical portion of this pemit label has been signed by an Electrical Supervisor and returned to the Building Division amps.1 from r 1 I TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the I HAVE CAREFUllY EXNlINED the completed aP!1lication for permit. and do hereby certify th~t all infonnation hereon is true and correct. and l' 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 !Jertaining to the work described herein, and that NO OCCUPAIlCY will be made oLany 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 comoliance with. OP.S 7rll.055 will be used on this project. ...:r""#,NY~' SIGrl^TU~/.'Jp.J_- FOn OfFICE liS" lilY /? . - - ... Sq. rtg, IIain Sq. Ftg. Access Sq. Ftg. Other IW1E(please print);,JbI/'#" V. Zone Fi re Zone Flood Plain BUILOHlG PERMIT Charges anc Surcharges PLur1BING PERMIT Charges and Surcharges ELECTRICfl.L PER1~IT Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges ,/ Dm >'-/->~' Tyae/Cons t. Bedrooms Stories Units Occy load Occy Group x Value Value Value x x TOTAL V ALUA TI ON Plan Ck. Comm/Ind 65%/Bldo P~r Fpp ------------PTdn CIe. Res 30%/Blda Per Fee Fence Systems Development Charoe (1.5~) /1 Vk-/ A.CD Dt/Rlo I Sidewalk ------------ I A/C Paving ITotal Comb. Permit 1> f CXJ Curb Cut 1- l'OTAl , c. . .. . .-, COMBINATION APPLICATION/PERMIT (CAP) , I. Applicant to furnish A. Job Address B. legal Description 1. examp)e- Tax Lot 100. lane County Map Reference 11 uj '13 2. exa~le- lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. exam~le~ heat/electrical ceilinqlor forced air Qas 2. examole- waterheater/electrlcalJor solar E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. examole- if new project, check-new - if addition, cneCK add. etc. . F. Building permit information: 1. examole - construct. single family house. with an attached garage 2. examele - remodel existing garage into family fOom 3. examole - convert single family residence into restaurant (change of use) G. Value of wo,'k as defined in Section 303 (a) of the Structural Specialty Code H. OESIGN TEM1 ANO CONTRACTORS To avoid design or construction delays, B~ilding Division 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. 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 WIll FIll OUT All FEES ANO CHARGES ON THE SCHEOUlES O. 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. < V. FOR OFFICE USE ONLY I.. '.0.. .. , '" ..,1... . " ._- PROJECT CONOITIONS TO BE SATISFIEO BEFORE OCCUPANCY: , . , .. . PERMIT VAll DATION TYOF SPRINGFIELD ,~ City Hall Springfield. Oregan Department of Public Works OFFICIAL RECEIPT a No. B S7284(~ 1'-15-19>51 rom f(,~J..., /b!-;UJ"?---./ . (JI .s 90 3. ~. f1.t~ oJ.4--. ,S'p.j.t J . / ,Ii .1' '.d For: . . '0 (/ ~ ~ ~v/{u../\_ (~ (J (.A..J'~ 12 'I)' j??Ci.~ , / -f- -, j,.C...d .::-,~-' '. . &1- (j ,~ f ~ '. .$' u () (~I:.-. lt Received / X' - -,.-.- df2 ~ ...,,'. C AUTHOR1ZI[O SIGHATUIlE S"Il~TO".TU~".ULl. ~~,..T..~S . ..uG...... o~ .?"O. c permi t "C1 erk . _...1,..... .'~ ..-.-.....: ~,... ... ~ Permit applicant exempt from registration with the,Builder's Board because: Additional Project Information: PLANS REVIEWED BY: , name signature -0> ...-:;?' ~. ..... ..... date , '