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HomeMy WebLinkAboutPermit Building 1988-8-11 .. ....... \ I INSPECTION LINE ' 726-3769 " Job Address 35'20 OLYMPIC Legal Description l') 0 ;;2, 3 tJ 00 . q 4- 5"- " CITY UF SPRINGFIELD COMBINATION APPLlCATION/PERMIT ErlERGY SOURCES: ~ea t et...ee::.. CO ( ?z t I"~ater HeaterEU3C , Range t-JA _ ~lUE of l'lork: ...... ~ /97 '202. - Phone~U1 SBuilliino Pennit Info: Describe Work(Le.. Build Single crrr Familv nesidence With Attached Garaael //1) ~ rfJ Jl vt I.J II"I/) 0 .J, tf'w J:1~ (J , INFDRlIATIDN LINe 726-3753 Sq. Ftq. '.lain ~q. Ftg. Access. Sq. Ftg. Other =,~.w --1lew__Add~lter-"~ep. Fence Demo Change/Use Other -- -- i1? C3 ~. (2; ~ E Owner UP5. % PA~1.. +l~~f1- Address G."'~ '2. OllJEJ...lS 0/2. p~~ ,CA. Construction lender (41'7') Address Phone Ut.::dliN ItAr.1 (name) (address) flies. no.) Primary MOIZ.fZ-IS, JZc::vu=oJ ~ -."..-+. ''3'0 ~~ (Z..V. ~45 \exniresl e1 (ohone no. \ ~,-"'5( I Structural ~~6 Electrical ~6 Mechanical ~ ~.,c CONTRACTORS (name) {addres~) ('i~~. no. \ (~xDirp~' General C)~LL ~nf-.l:,. 2~ 6A'4'~/ ~'.,~ ~'&:.N,e: Plumbina C ' (ohnnp M 1 <<8.<:;:- SI? // Electrical " ~'echanical PLUI1BltIG ELECTRICAL MECHANICAL NO.1 ;3 Each Single fixture Relocated building (new fix. additional) I FH I fHARt;l= NO I Residence of I lILIJ:I!AB.IiE..llll.... 7.50 :?z:!2 SQ. FT. furnace/burner to 7 ~a> ~ RTll's I,d(/ nt.........-;, ~ ---::"" Floor furnace .~-05' .,/ i;!ld vent // "" o/;P/:f'''''''''''''~~ Recessed wall ~~~~p kp~tp~ ~nrl upnt I.E" I r"'1BliL I ~ 7~ 7<'~52 S.F. Residence (l bath) Duplex (1 bath) each .........-New circu!ts alts. v or extenslons ..,.:>,I? ~/'5~ SERVICES ~.,.. :3'.<.- Storm Sewer Of amps, Appliance vent ~.poar~tp Stationary evap. r.nol{!r I V'ent fan wi th ",inale duct j Vent system apart from I heatina or A.C:. Mechanical exhaust I hood and durt I Additional bath Water service Temporary Construction Change in existing fPS- j rjp.nrp multifamily, corrm. or Jnc1ustrial Sewer COffi1./IND. FEEDERS Install/alter/relocate rl;~tri~ fpprlp~~ Z Of /4JC>?n ::>= amp~ :<.Z~ 7"5""' I I I TOTAL CHARGES ::?::? 'SO TOTAL CHARGES C:;;?, SP - TOTAL CHARGES 9< ~ WHERE STATE L\I~ 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 Wood stove/heater /:3 I a......./.?"'YC~ I I ~.s<s ISSUANCF OF PFRfllT 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 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 UO OCCUPAHCY 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 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 7Ql.055 will be used on this project. IWIE(please print).:::n ~ ~~ SIr.IIATURE~ - - ~fJ. FOn OFFICE USE OIIL Y Zone MAl Tyoe/Const. :2-,,</ Units Sq. Ftg. flain x Value Fire Zone Bedrooms Occy Load ~J Sq. Ft9. Access x Value Flood Plain Stories / Occy Group ;;?-? Sq. Ftg. Other8?"~<:..~. .::<><;"~Value 199. 2"2.~" ^ - 7:),/ &;......- c- .4 '2> c.' ~...' c> t'. TOTAL VALUATION r.~./ "'= ,~#~oc...;;J ff4('/~ (,..Jl=.l5'y .'7~.~ ,...... ,,-({-..I<" BUILDING PERHlT /".e:' Plan Ck. Corrrn/lnd {-? fll tl Charges and __Il?~."" 8,_'.:'~__ 65%/Blda P.l'r Fpp ",0 "l.1_ 57.7/ Surcharges <0 ~ Plan Ck. Res :/ 2. 7'0 3D%/Bldo Per Fee ___-;;:??::..~=:.__ Fence /./3 ____~?::_~__ Sidewalk :3'.,;?~ AIC Paving ____?J2::~__1 Curb Cut r:?S- I DATEe,-Ii-f>!!. PLUHBlNG PERMIT Charges and ..-.' Surcharges' Systems Development ,J ~ Charge (1.5~). ~ ~ - 7J",,,,,, L".Q=<- '" ~~ "'#.AJ'~ 7" ~t/N2lGIi'?~ d27.?'-. 0;'9 _ DIIflIO ELECTRICAL PERI~lT Charges and SurCharges ITotal Comb. Permit 8&'''5. /6 1/58'/~.1 MECHANICAL PERMIT Charges and Surcharges I I TOTAL - '- COMBINATION APPLICATION/PERMIT (CAP) .,1 \ j .; I. Applicant to furnish A. Job Address B. Legal Description I. 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 O. Energy Sources 1. examole- heat/electrical ceilinq/or forced air Qas 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, cneck add, etc. F. Building permit information: 1. examole - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exa~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 TEAfl 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 8. 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 fu 11 schedu 1 es 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. --- Ill. 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. .,. '. ,j j V. FOR OFFICE USE ONLY .PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: i, . . . PERMIT VALIDATION .)- (rvV~ qAo . Permit Clerk LY JI Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: ". PLANS REVIEWED BY; name LO/7/9'"-= h~~ signature~~, '/ ._.. -~--? , P'" da te .B . ':? 9-8'Sit