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Home My WebLink AboutPermit Building 1989-2-24 Owner l)~ ~C~~ ?Uc/)J.<v//Y . Address //.:5 =3 0 ~ I ~ /l=>( Phone - -' , ~ 7;7 -="'/ / ';;~c.-P'. ?>~, "7?"Y/? Construction lender /' ~' <' I"SI'EClIO" L1"E 726-3769 . Job Address legal Oe~cription ..\Jdress DESIG" lEAIl Primary Structur,ll Electrical !Iechanical COtlTRACTDRS 1'10& lilY uf SI'RI"GFIELU ., ~ COIIBIIIATlON APPLICATION/PERMIT ~ E!IERGY SOURCES: /7'.I~/// ~ . Ileat Ua ter Bea ter NfORlIAT:.:1 LI..-. 726-3753 Sa. ftq. "lain ~C). Hl). Access. SQ. FIg. Other Uel1 Add A ter ~eD. --rence Demo Change/Use Other -- - C\} ~I I ~ I Oescribe I~orklj.e," Build Single II ~J /i /I,ttached r.araCle) U~ C~sc:,,;r~ ~ 6.r/-S?/~ &5,,___,-:::<. i 1/...... I#u:. lr"%-~/~n ~-........"",-~ I 1~/l:eT ff=~s . II ' ,n".oo.' '"'"* ,_. "".' Rantle j Valut' of Hark: ~.~ [luilt;inQ Permit Info: Far.lilv f'lesidence Hith (name) Phone (address ) I ./ ! (l1afll~' (addreo;" ) (pxoi rp<;,; f 1 ire;. nn. \ fohnn,. nn \ Plumbinn ~.v<5e General Electrical ~l~chanicit 1 PLUlmlrlG ~ ~f( CII^RGE Jill.-' Residence of 7.9; 1fS',e> ,- 7;;U;if. . ELECTRIC^L MECHANIC^L ;:U. J 0/ Each single ~;~tu;~' -I Relocated buTfdi,i"cj (new fix. additional) "5. F. r.es i dence (] holtl,) -----IOuPlex (l bath) each -----'Additional bath TOT^L CHARGES l'II1Er.E ST^TE L ill REQUIIlES shall not be valH until the ~!a ter serv i ce Sewer I Storm -, I I -, I I SeNer 1.JIL.ClJARGI. II ~ J:JJAl!liL' furnace/burner to BW's I Floor furnace . and vent I I I I Recessed wall II _____ c;n"r-p hp"tpr "nri ..,pnt L-- 1-I-~:;::'~f.&.~7.~ I~.- I I Stat ionary evap. I coolj)r I 2../ V,:nt fan ",'i th 1::2 - """-,. <1nol. duct ;/. I <<p. I I Vent systeM apart from I I hpCltlnq or A,C. I I Nechanical exhaust I ,. hnod ilnd rlur-t I I Uood stove/heater I I I I I / I I I I I I I I I I TOTAL CIIARGES ;?P'/N'. h'f':''-' Electrical Contractor, the electrical portion of this perrait Surervisor and returned to the Building ~ivision SQ, F1. e,....o'..tlew circuits alts. or extensions -,~~ ~"'fi~ ISERVICES I I r- I I I IOf '-'/- 00- -Iconn,nlm, FEEOERS I I I'nstall/alter/relocate ri;~trih fpprlpr~ I I IOf amps,l I I I I I I I I I I '~$:"""" I TOTAL CHARGES that the Electrical ''Iork be done by an lithe! has been signed by an Electrical Temporary Construction ICllange in existing rp~id~nr:~ Imultifamily, coorn. or Inrill<;tri<ll all1Ps.1 I I I I ':Z::<- Sc> I SSIJANCF OF PFmll T r IlAVE CAP.EFULLY EXNlItlCD the comr1eted aprlication for Qermit, and do hereby certify that all information hereon 1S true and correct. and I further certify that any and all work nerformed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Ore,:!on pertaining to the work described herein, and that UO OCCUPAIlCY \'1111 be made of any structure without the permission of the Guildin!"! Division. I further certify that Il1Y re!"!;stration \>/ith the Guilder's Goard is in full force and effect as reCluired by Or.S 701.055, that if exempt the basis for exemntion is noted hereon, and that only subcontractors and er.lployees who are in comnliance with Or.S 7'"'1.055 \'1111 be used on this nroject. 1I^:IE(please ['lrint) Zon~ C,..-: Fire Zone FlOOd Plain BUILOlllG PERI,"T Chitr']es an~ Surcharges PLU'IBING PERMIT ChJrges and Surcha rges ,CLECTRICf.L rERI~1T Charqes and Surcharges /1ECHAN I CAL PEP./1 I T Charges and Surcharges Tyne/Const. Ged rooms Stories / S 1f.i'ATURF. FO~ or FI CE lISE DilLY Sn, O~,TE Uni ts rtn. Ilain x Value Ft~. Access x Value Ftg. Othcr.#_#-"l'&'<~E<' Value' TOTAL VALUATlO~1 --- Occy load "Occ,v Group $-:z So, Sq, .-00;' '"",;.-.- -- Plan- ck-:- 6St/Bldn Plan Ck, 30t/Bldn .,...~'R~E:::' I,,?:z= ':2 :5:0::j 7-4'2 ;/~. Corrmli'rid Ppr Fpp Res Per Fpp ___J'"~,-~<?__ /. "7:3 . y..s.:. At? I Fence --- :::<~;-i--I Demo ___2?.::5:0 I Sidewalk /. /'3 I A/C rav!nq Is:.. -- I Curb Cut --- ~?S-I Isysteras Development Charoe (I. S') ITotal (omb. rermit I I WTfIL /2;7.0~ ," 4' . , -, I ~ . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION f. Appl icant to furnish A. Job Address B. legal Oescription : 1. example~ Tax lot lOa, lane County Map Reference 1/ oj 43 Z.o example'" lot J. Block 3, 2nd Addition to SprIngfield [stales _':C. Name, etc. of owner and cons.tru~'t'ion lender D. Energy Sources. .. 1. eXdmple~ heat/electrical ceilinqlor forced air QdS Z. examole- waterhealer/electrical/or solar E. Square rootage or valuation, etc. - 1. examole- ]250 sq. foot house. 500 sq. foot garage 2. example- if new project. check new _ if addition. check add, etc. F. Building pennit information: l. examole - construct sinule family house with an attached garage 2. examoJe - remodel existing garage 1nto family room 3. examole - convert single famity residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. OESIGN TEAl,! ANO COIlTRACTORS To avoid design or constr'uclion 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 \'Ihere 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, Nechanical. 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 1 J schedu 1 es ,C. BUIlOING OIVISION STAFF Will FIll OUT All' FEES ArlO 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 labe1. - III. Applicant to sign and Qate Whenever Possible, the initial application will be used as a worksheet only. Where Possible, Building Division Staff wi)1 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. .' ~tt. )3~75 . Permit Clerk d.Q"J,OLa.._ ~ -!::2 -.l - ~? I V. FOR OFFICE USE OlllY PROJECT CONOITlONS TO BE SATISFIED BEFORE OCCUPArICY: Permit applicant exempt from registration with ,the Builder's Board because: " " Additional Project Information: r. " ." PLANS REVIEWED BY: J name L~/yg ~~~ '. Signatur~..:>. ~, _ ~ r/ ~~,- ,. da te "7-':?~Z5'7'