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Home My WebLink AboutPermit Plumbing 1989-4-26 ; UIII'ECT lUu LUll III Y ul II'RUlLf I [LV 726-3769 .. COI1BUIATIOM APPlICATIOM/PERMIT Job Address ,-, Lb<~ I E!IERGY SOURCES: "/'} 5!:7 L/<. 7-~.P/t ~./ Ueat Le9al Oe<eriPtion/?,,"c3'_<5"_9'/ ,,;?tS~-=C=> 11./ater Ueater /' I RanCle I . ~(\ i ~i ~! Uui It;inQ PerlUi t Info: Uescrlbe Hork( l.e.. flui Id Single 1;;../1, .' F.1r.lily P.p.sidencc \lith J\ttached r..lraoel \l\ Yh-/c?f ./.:? 6?yE'j i -;C?.....#"=-" h"~P/T--c. I ' I ' Owner (AI"CS-"__-,~./ I/>nt'''-~_~ A,IJress 7: 7;g~ 0,.( r....--?'?/C $;s- .---j-PrL z::;> --7".3' - . ' / Construction Lender Value of I-lark: /?7t?, -- Phone q:r~p .7t:.: , . ,\Jdrcss U!.)ILirl ILJ\/l "hone (c1~drp.ss I lllJmeJ ( 1 ics. no.) PrimilrY Structurill Electrical !1cchanicd 1 COMTRACTORS (rhlme) (addre.... ) (1 ;"0:,. nn, \ General Pl umbi nil Vb'S" p,~~--::.., / . ( . .7/'?/-:r.:? ~ Electrical - -_ "? -:> <.. v.f:h' P;";/r" F-<- _ , / f1er:hanicill PLUrlRlIIG ELECTRICAL ;:0.1 ~IEach sin91e lixture -----IRelocated building (new fix. additional) IS.F. P.esidencc II b.llh I -----IOuPlex (1 bath) each IAdditiOnal bath I~!ater service jSe....er I Storm SCI'/er -----I I -I -----I I I I 1-' I I , 1 I I I I I I '-E[LI.CJUillGE C/lARGE JIL Residence of SQ. fT. INew circu!ts alts. or extenSIons 'SERVICES -----I I Temporary Construct ion IChanl'Je 1n existing rp'lidrnr~ Imultlfamlly, conn. or Inc1l1"trial 10/ I COI~I. II MD. FEEDERS H- Install/alter/relocate _ .futrih fppc1pr" . . Of amps.1 amfls.1 I I I TOTAL C/lARGrS y/~. /:5:. .---.. ! TOTAL C/lARGES H/lEr.E STAT[ l.111 REQUIRES that the Electrical "ork be done by an shall not be valH until the label has been signed by an Electrical maRtiAl: .:1 ll..:. 726-37;3 So. flQ. Haln ~q. ft/). Access. So. Ftq. Other /le'" Add ^ Iter ~cp. --ren~ Oemo Change/Use Other - -- (clI.nires) (phone no. J (pxnir,." , I i i CI e:')-~/I , :\ I i riCJUillGE' I I L! I I I I I I fohn.,,. nn l 4'- ,?..". ~"5 MECIIAM I CAL furnace/burner to DTU's I Floor furnace and vent ,. I Recessed wa 11 ~n~rp hp~tpr ~nrl '-----I I I I I I I I ""nt I Appj iance vent "Pf);,,'''''t,. I S'tationary evap. cooler I Vent fan with sinal@ duct I Vent system apart from I heatinn or A,C, I ~lechanical exhaust hood .lnd rlurt I HOOd stove/heater I I I ISSIJAtICF or prmllT Electrical Contractor. the electrical l1ortion of this perl;\it SUl1ervisor and returned to the Building O.vis'on TOTAL CIIARGES I HAVE CM~EFULLY EXArlIrl(D Ull~ coml1leted application for ~ermit. and do hereby certify that all information hereon is true and correct. and I further certify that any and all ,...ork oerformed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Oref)on pertainin9 to the work described herein. and that 110 OCCUPAIlCY ,.lill be made of any structure without the ncrm1ssion of the Uuildinfj Division. J further certify that fTlY refjistration \'/ith the Builder's Board is in full force and effect as required by Or..S '701.055. that if exempt the basis for exemotion is noted hereon. and that only subcontractors and e"'rioyees "ho are in comoHance "ith OPS ml.D55 ,.lill be used on_thi~72~ I/N1E(please rrintlMIl'I/K tfu,/d4tfL," SIr.IIATURE~ ~#"'_ FO!~ or F I r.E USF. OilLY OATE 0.c //if Sf"!. rtq. 1t.1 in , V.1lue SQ. Ftl]. Access x V.1lue Sq. Fl9. Other , V.l1ue TOTAL VALUATION S~ster.1s Development Caroe(1.5') ZORf~ Fire lone flood Plain Tyoe/ConSl. Op.d ro OlliS 'I/ni ts Oc.cy load (lcc.y Group Stories BUILDWG fER{.ljT Charges an~ SurCharges Plan Ck.. COlllll/lnd ____________ 65%/Rldo P,pr ~pp Plan n. Res 30%/Oldo Per Fee /52 <==:. I Fence ------~;>y-I Oome L ___ _ _ __.,. __J Sidewalk I I A/C Pavinq , Curb Cut ------------ I'" PLur.1BIMG PERMIT Charges and SurCharges . ELECTRIC/;L rERl:IT Cha rQes and Surcharges riECI/AM I CAL PEril IT Charges and SurcharC)es Irotal (oMb. rermit I_'T" /ll'I\L IS: /:5" . COMBINATION APPLICATION/P[RHIT (CAP) II. I.. App] icant to furnish A. Job Address B. legal Description 1. example. Tax lot 100. lane County Map Refer II UJ q 3 2. example- Lot I. Block 3, 2nd Addition to Spr1llgticld (states . C. Name. etc. of owner and construction lender D. Energy Sources 1. examnle. heat/electrical cf:'ilin,9/or forced 2. examole- waterhealer/eJectrrciil/or solilr E. Square rootage or valuation, elc. - 1. examole- J250 sq. (oot house, 500 sq. foot 2. eXclmple- TTnew project, checkncw . if add check add. etc. F. Building permit illformalion: 1. examole - construct sirlgle falnily house wit attached gilr.!lge 2. examoJe - remodel existing garage into fami' ,'0, J. eXdlllole - convert single family residence i restaurant (change of use) G. Value of work as defined in Section 303 (a) of Structural Specialty Code II. O[SIGN TEAI-I ANO COI/TRACTORS To avoid design or constt'uction delays, Buildill! Division Staff must be able to contact approprii persons regarding design infonmation or job sitl corrections, etc. Abbreviated Plumbing, ~lechanical, .\ Electrical Schec A. Except ,...here blank Spaces OCcur in the descripti portion of the Mechanical and Electrical Schedul the applicant need (111.jn only the No. Boxes ac 'ell to the appropriate item(s) to be installed B. Full Plumbing. NechanicaJ. and Electrical Schedu are available at the Building Division 1. To conserve space on the permi t form the sch 'le have been abbreviated Z. If the item(s) to be installed are not cover the abbreviated schedules you should consult fu 11 schedu I es C. BUILOING OIVISION STAFF WILL FILL OUT ALL FE[S A CHARG[S 011 TIlE SCI1[[)UUS O. As noted on the CAP, the label must be delivered electrical contractor for signature by his eJect al supervisor. The general contractor is not autho to sign the electrical label. - Applicant to sign and date Whenever possible, the initial application will be u. a worksheet only. Where Possible, Building Division will prepare a type written copy and return it to thL applicant at the time the actual permit is issued for his signature. Fees and Cha rges Plan check fees are due and payable at the time of the application, and no plans ,.,.ill be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued, III. IV. V. FOR OFFIC[ USE ONLY . ~- CITY OF SPRINGFIELD City Hall Sprlngftold, Oregon ;~ Office 0'. Community and Economic Development OFFICIAL RECEIPT 13676 , Date ~/L 76, 198-7 WI" , Rec'd From ~~ ~e:-'- .-C-y ~> /."'-:;' ~~- ~ '-..=.....-"..-.~ ?:2<::. l'?-7CC'- -? r -.(?r.., r . Address 5~ ,~_ -97Y/ ? /' I ' ReceivedFor:~p~7 ~_ ?~ //').=-- l<-. ~= # ;..s--- r- /;p?;;?z ( /S-: A) ~%~ /c:;;g; v- ~ I ;;'5'- ~S-- Amount Received . A I ~~~~''''-''- /~ORlZEOSlGNATUM /'. : .v' q' ..en .!!LA a~ R '- Fnrntler eUSINESS FOAMS. INC. 11143)342.1'.. Permit-Clerk PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPArICY: I Permit applicant exempt from registration with the Builder's Board because: Additional Project Infonnation: PLANS REVIEWED BY: name I ",;::r h'G h ~~ -- -';,. - I , I . t .//'. .---..>r~ slgna ure/-h._..->_....-.... .__._. '//, .' ,. .~ v , da te [/-?&. 5 :;; , .' . Jr/SI'ECTIOII LIllI. . LIlY UF SI'RJr/GflElO NfORIIAT:.:1 L.", 726-3709 C0I1BIIIATION APP.~~ATlON/PERMIT . 726-375j Job Address ?'")~? Q. ,..........,.,p;'t:' ~"Y J' ~~~~r,y SOURCES: ;~: ~:~: ~~~~". \l\~~ Leg. I De<<ription p-e> 3'-.;cs--"",/ .:?'tS ~__c. \./.ter He.ter So. ftq. Other Rile," Add fo.ller ~eD. /' anile _-_-___ -rence Demo Change/Use t\. ( ./ / V'IU/1!);.IO~;.. Other- - I\) Owner Ar~'7'"~Ao>' /'</I"~""._~ f,vC/. ~ ' , r Pl,onc Built;ina Permit Info: Oescribe l~orktj.e., Build Single II~f .\JJrcss '< 7:E~ /51' '}>'/??.z:,.....C ~ f.~ilv nesidence lIith ~ttached Gar.nel ~\ ~'PrL7?_ 6~ C:'jt~z:; S2--h?-E.?f /:? ~E' I Construction Lender / V.z---.! ;'-~V-./"'7l9/_=-, /~~P~ J . I, ,\Jdrcss ULSIGrl IlAl\ (nallle) Phone {address 1 (I ics. no.l (exnires I 'nhone nO.1 Primary StructurJ 1 Electrical ~lechanicd 1 CONTRACTORS Plumbino )/b5 ;:::; , -' --.-. ( - - _._ - .....-_.1 .. .-2r:.::;;:....f4':.Q?4:?r~. :?r?/~ 7?7-3 4'-?~-g"5 . ! i C/ii?:~~/i > '-- I J j (ohone no.) (name) (address ) ( I ics. no. I (exoiresl Genera 1 Electrical 1'p.chClniCCll PLUIIB IrIG ELECTRICAL MECHANICAL -illL. .B:.L. . CHARGE .lID..... Residence of '-EEL '.ClJARlif.' /I furnace/burner to BTlI's Storm Se\'/er IOf I CO"II. II NO. FEEDERS Ilnstall/alter/relocate di~trih_ fppdpr~ 10f amp,l I I I I I I amps.1 I Floor furnace and vent I I Recessed wa 11 l\1');l("P IJ..e..a.1.e.r .;l.,tt I-I I I I -+-1- I I I I I I w.nt '.rrLrlAIili( I i -, I I I Each single fixture sq. fT. -,Relocated building--- (new fix. additional) IS.F. r.esidence (j ho1thl -Iouple. (I bath) Additional bath I- I each J I I I I un-I- I I I I New circuits alts. or extensions I /SERVICES -, ~!ater service I Temporary Construct ion Chanqe in existing r io multifamily, cant!!. or IndlJ<;tri;ll I Apol iance vent 'jcofll'atp I Stationary evap. cooler I Vent fan ''lith sinole duct I Vent system apart from I heatino or A.C. I rlechanical exhaust hood C1nd durt I tlood stove/heater Sewer , -I TOTAL CHARGIS M/~. /:5:.""'" TOTAL CHARGES HI/EnE STATE L \IJ REQUIRES that the Electrical work be done by an shall not be valH until the label has been signed by an Electrical ISSIIANCf OF PfP.tllT TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Sunervlsor and returned to the Building Division I HAVE CAREFULLY EXArllNCD t~e completed application for f)ermlt, and do hereb,v certify that all information hereon is true and correct. and I further certify that any and all work oerformcd shall be done in accordance with the Ordinances of the City of Sor i ng fi c 1 d and the laws of the S ta te 0 f Ore~on oerta i n i nf) to the work descri bed here in, and tha t flO OCCUPAUCY \.,i 11 be made of any structure without the permission of the Buildin!l Division. I further certify that my re!listration ",ith the Guilder's Goard is in full force and effect as required by Or.S 701.055, that if exempt the basis for exemntion is noted hereon. and that ::,:,:::::'::::::;~:;'4:,:~ : :~:""" · '" ::~:,:"::t.:: ~. 'lZZ- ." 0./" ro~ Off I CE USE O;l'1. y '[Jni ts Oc.cy load Occ,v (:roup S'1. rtf!. '1.110 SQ. Hf]. Access SQ. Ftg. Other , V.llue Value Value Zon~ rire 70ne Tyne/Const. Bedrooms Stories , flood Plain , TOTAL VALUATIOII OOII.UIIIG PERIIIT Char']es an~ Surcharges Plan Ck. Comm/lnd 65X/Bld~ P~r Fpp Plan Ck. Res 30t/Bldo Per Fep Fence Syster.\s Development Ch. roe (I. 5') ------------ PlUrmING PER"IT C!larges and SurCharges /5: ==:. I ------~;,-~-I 1 OF-mo ,(l(CTRIUL rEm:IT Cha rQes and SurCharges ------------ IIEClIANICAL PEP.llIT Cha rges and $urcharl)es ------------ ITotal (omb. rermit Ie". 111.'T/\L I . ;5:/;> . ". COMBINATION APPLICATION/PERMIT (CAP) II. I.' Appl icanl to furnish A. Job Address B. legal Description I. example- Tax lot 100. lane County Map Reference II oj 43 2. examnle- lot I. Block 3, 2nd Addition to ~prl~9~ield Estales . . Co. Name, etc. of owner and cons"truction lender O. Energy Sources 1. examnle- heat/electrical ceilinn/or forced air Qas 2. examole. waterneaterleleClt'icill/or solar E. Square footage or valuation, etc. - 1. examole- J250 sq. foot house. 500 sq. foot garage 2. example- i'7new project. checknew _ if addition, check add. etc. F. Building permit information: 1. examole - construct sinyle family house with an at lached garage 2. examole - remodel existing garage into family room 3. examole - Convert single family residence into restaurant (change of use) G. Value of \'Iork as defined in Section 303 (al of the Structural Specialty Code II. DESIGN TEAN AND CONTRACTORS To avoid design or const"uction delays, BulJding Division Staff must be able to contact appropriate persons regarding design infonnation or job site corrections, etc. 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 8. Full Plumbing, t-lechanical, 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 AIID CHARGES 011 THE SCHEIlULES 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. - 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. fees and Charges Plan check fees are due and payable at the time of the application, and no plans Nill be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued, III. IV. V" FOR OFF! CE USE DilLY . i J PERMIT VALIDATION ;1 i' " i Permi t Clerk PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPArlCY: J . , Permit appl icant exempt from registration with the Builder's Board because: Additional Project Infonnation: PLANS REVIEWED BY: . name! "s7~?c~~ , " signature~~~, '// ,. ~ p da te {/-?&:. s ;; ,