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Home My WebLink AboutPermit Electrical 1990-1-24 ,Q)\),Q \)\-\()(\c;~_/N\~ to \)\(\\(1G 3~4-0g,g~ . I INSPECTION LINE . CITY uF'SPR"lNGFil.;o-. . INFOR/IATlON LINl '.. 726-3769 OMBINATlON APPLlCATIONIPERMIT 726-3753 Job Addres~'" .\ ~\~:' .,;;~ . ,'nno(j:(' . \' \',i . 9'~ I ~~~~GY SOURCES:.~~:. :~~: ~~~~ss. Legal De"riptfon (:..' 'h... \ f:'11 :!1'1I', , ,:' X . Hater Heater Sq. Ftg. Other _ Yl a \. CJ . flew Add Alter P.ep. I I Range. ._=_. -Fence Demo Change/Use val^~ fntxJ.ro Other- - BuildlnQ ~enllft .Info:. Deser,be Work(he.. Bulld Slogle Family nesldenee Hlth Attached GaraQe) -0 3 o -; ~ '. Owner~\\\~f\ V}.OQS)m_9,.f\' :J~3 ^~drmqm ~. \tJ~()tP)'0ono41\1 Vnr-\-: \C'9. rY\ ~ C\7cO.l, I - Address Ol5lli~ 'tN' Primary tnamej Phone (address' ~dtVflJ\~"S- VlXvon-J 'LJ.<( C=-CT?? / ~ . ?>4<:"\:)7~ Hies. no.' (exDtrE'~\ l..ehPn,:,no__ i , Cons truct I on Lender., Structura 1 Electrical Mechanical CONTRACTpRS ( name \ (address \ Genera1,\~qf>. G\\\(\\ \() '\\ .\....J,.~~ O.u " . \ / Plumbino Electrfcal~~ I#~R~7, Hechanical flies. PQ._ \' rpxoiresl ~~q\ {ohone no ~ ',,<cP/YSL I ,0Y~ ~~ " NO. FEE C~ JIll ELECTRICAL MEClfANICAL PLUIIBING _Hr nJARGt Jill..... I..E.EL .cIlARGL SQ. FT. furnace/burner to BTU's Each single fixture Residence of Relocated building (new fix. addltfonal) .,/' New cf rcults a Its. or extensions 2~~' SERVICES ::;z5 .' Floor furnace and vent Recessed wall I SOAtt-hp~tpr An~ vpnt S.F. Residence 11 both) Duplex (1 bath) each Additional bath Sewer Temporary Construction Change In existing rlE'''I~pnce multHamlly. .con111. or Indudrial Appliance vent .._eJ~ ra t@ Stationary evap, --~~ Vent fan wi th !i:tn~le d\lct Vent system apart from heatinq or A.C. Mechanical exhaust hood and clud Wood stove/heater I Water service Storm Sewer Of amps. COMlI.IINO. FEEDERS Install/alter/relocate rli<trih. ;pprlpr< / Of;;;"~ amps. I ~-Y'. ISSUANCE OF pmlllT TOTAL CIIARGES \ TOTAL CIIARGES . ," ~.5:"'- ! TOTAL CllARGE5 WIIEnE STATE L,\I/ REQUIRES that the Electrical work. be done by an..E1ectrical Contractor, the electrical portion of this shall not be vall~ untf1 the label has been signed by an Electrical SUpervisor and 'returned to the Bulldlng.Divlsion "'1 ." peml t I IlAVE CAREFULLY EXAttINEO the completed application for permit. and do hereby certHy 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 Ore~on pertaining to the work described herein, and that 110 OCCUPAIICY will be made of any structure wfthout the permission of the Building Division. I further certify that my registration with the Dullder'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 7QI.055 will be used on this project. lone Fi re Zone Flood pl.ln Units Occy Load .Occy Group SIGIIATURE ~ ((c4). FOr. OrrlCE USE DilLY S~. Ftg. riain Sq. Ft!). Access S~. Ftg. Other r-llo.qO 1516i r.:! '::2 fo..!..-:l en ,)5ysteCls oeveloPI11C~t T)-0. -;: ,1\(\.<:. p'.rqe tl.5~ DATE /~.;L y -?u &.E",c;T- C::;;/?7'if' . IWIE (p 1 ease pri n t) W)\~ Ge........,'\.\,o'I...,"'::t,.. x Value Value Value Type/Canst. Bedrooms Stories x x ,TOTAL V^LUATlOtl BUILDING PERIIlT Charges and Surcharges ------------ . Pion Ck. ConmlInd 65%/B1da ~pr rpp Plan Ck. Res 30%IBlda Per Fee PLU'~BING PERMIT Charges and Surcharges Fence ------------ ;. .J,' ,'..' ':.l:':"'~"""~'.I'""":q,,,':I'" 'D~..F"";l."":'~""J .:;. , :, .' "t," ELECTRICAL PEnI:!T Charges and Surcharges L{::S: e>:9 .. 'Sidewalk ___7.!:-_____~_ .. " '2. ,::::25 AlC Paving Total Comb. Perml t NECIlANICAL PERMIT '.7.~"""'-,--~ .Curb.Cut".....:. '~Charges and '''--.'1- -:Fr' _~._..:;..:;,~.LI~...;:.,;t-~- Surcharges 1';.1..\:, . .'\ TOTAL ...". :7'2/'S- . ..~~... .. - ;. . . . " ...., ",.' '.il. . ""'ii'''::',' . " , ...1, /. I ". '.101,1,:1..1: !I.'lhlj ,/11 J, il , :".., ,"~': ',:,-: ." '. ,., ,i'- . . ,I.. r'!" . :, .'".,..... .......~.....-r..~-....,,,.... ......~~.._..........;.~~....:.... ..........j."..,~.,.,., ':'I~,ll.\.",q;. . \ ::...~'~:!~~., !,,"J.J '." r ... '::,"..:': . " ;"'\1.'11\ II:. .f"(' t . .'. ..i,..:..... " t.'. "'. . ...\.,_'1r.!!I'.... ..... ... "'......' ..... ._...I'!.,..,.t1!'.,o'V..,,"":.......I..".. .......' '.. COMBINATION .~P~~~C~;;~N/~~~RMh':;~~~) . ': " "":.,;',.;;'; ,:::: ! '":'~::~,1i: . , I". 1 J. ... .. '. '.... . . _ '. 'I" ~. r r .; , ! . J. Applicant to furnish' j ., . .", ....: A. Job Address ( '} 'j . '. "":'. ':'" 'r .J. '1 .,:~ r' B. legal Descrfpt10n...i.: ".....1) 1;.;'/ Cl,,\ 1. ~~a~~I:j~~x:LO~)09,,}a~~,co~n.ty.~ap R~~.~.nce" jll'i,~ 2. exam~le- Lot' 1'. 'Block''"3'- 2nd Addition t~'.. ; . '\- ~pr1ngt.ield Estates .. . .' , } .: c. Name, etc. of. Owner and"construction lender\ \. f O. Energy Sources: :..1 I Jl : I,. ; .: It! ' 1. example- heat/electrical ceilinqlor forced air qas 2. examl2le- waterheater/e!ectrlcal)or ~. : E. Square footage or valuation, etc. , . 1. .xam~le- ]250 sq. foot house. 500 sq. foot garage ~.' example- Trilew project, check new - if addition.. cneck add, etc. F. Building permit information: I. example - construct Single family house with an attached garage 2. example - remodel existing garage into family ,oom 3. examyle - coovert single family resideoce into restaurant (chaoge of use) . G. Value of work as defined io Section 303 (aJ of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays. Buildiog Division Staff must be able to contact appropriate persons regardiog design informatioo or job site corrections, etc. II. Abbreviated Plumbing, Mechaolcal, & E)ectrical Schedules. A. Except where blank spaces occur in the description portion of the Mechaoical 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. aod 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 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 applicatioo will be used as a worksheet ooly. Where possible. Buildiog 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 PROJECT CONDITIONS TO BE SATISFIED. BEFORE OCCUPANCY: . J7~~{! ,~.:~ '~;', ;f,' ,I 1'~::'~~J:.~('~)i~:::~. :J;:/,:):'.~'i:~iJ~;1~;:t~.; ~~?' ;.:;~ .\'.~ .. .: '.., ".PERMIT'VALr'DATION'i'i:'!li:!:I.;.~":,,.,:,. ::~--;':-'~;..:::'~~{~~i.::P!':~':~::~:::~'::"i'" " . ". ,CJ ,PZJ.;1'2C.il:~'J.W~~ ~/r.i:.t:'(/ij //) l .Ii. ..,,:': '1'" .. .(;':' -1.:0,.... ..-/- / /0' .' . Y ') '\ ..::.: .1,)_""",',V;c,.;~r1U,~_..~~\.\_,..J '. j' ,I'~\"':'I") r ''1/;~;1'' t'r.;~\ ,.,'\J../, '.. )i i ~ .1 . . .. "~' .I I ' ,... ..._....,....... ., \" ,....,..... ,,..., _ ..J, , , ,i II' I I ! I 'n, 1.,1 ..-';/ .- .( . I ,1'1; J ,"./ " , .I ',,' ,.r I .\}) i.,I, . !... \ .-... ~ .' 'j' ... .1". "".. ~ -,~. ....... . ,. ';r'" r "1,:1,,1( I I . J. t..'.I......'.'.' '" . "'" .' : ~ ., , , i, Permit Cl erk . .'i'" i' P' . .'1 'I! d:;' d.: I" '1', (" " ,', '.. ,:. ,.d.'.! ",'0(. 'd ....i'.,. .' '01,," .!. .,.,' .. : f .. , ,~; ~ ". , ..<t. r ~. . , ~. Permit appl icant exempt fromregi stration with the Builder~ S Board because: Additional Project Information: '. PLANS REVIEWED BY: r'! name signature ,.:' " " ...."' .' I' j' .1;.:\ I,. t., ~ ,\ ;., J I "'.' \. . ~ . '~.1':." . i ., W:!:. ] .'!: '" .."......,., ' ." ,(,.,...', . ..... ,.., . . ""1' . It.....'II,...'.\. , -, ...... -:...,.. , I , , I !.! . .', ,. I,','; (. ." rlate I ,- 00\),0 f)\ioQc;' ./N\~ 'Lo \J~~fiG 3q4~09;J~ m~~mON LINE ---~._- .BIN~mNO~p~m~m~~~ERMIT Job Address' \'fii~W6;r-' \'\~i.) 9.: ~~~~GY. SOURCES:. Le9alDe"rIPtionl:..Vrll.. Ill:, :'i'!r:~: '''0 Ilater lIeater ConstructIon Lender., ^~re5S ~, ~ ut.~ IIJN I tlU1 \name, , .\ rhono (address~ INFDIU1ATlON LINE II 726-37S3 Sq. Ftg. I~aln (\ '~q.. Ftg. Access. ....y Sq. Ftg. Other ~ . flew Add Alter P.ep. ____no -Fence 00m0 ChOnge/Use . Cf:.) Other- - , .' _. .... ,I 10 Bu ldlnQ en1lIt.lnfo:. Describe Work(he" Bulld SIngle ......... Famllv Residence With Attached r.araqe' ---' ~dtV'P ,C~GUf*' \~ VIXyrxflJ III ~ '~'(FCT??7~'?'4~ ('lies. no.) (exn1res' \ fohnn~\no._ i . . :. Owner lli\\llWJf\ ~10 AddrmG{(X) 1\). \tJ . ('q U)~ono41 It V()\t\('9.~. ~ C17cO.ll 1 '., , Primary " Structura 1 riectrical Plumbinn name . I1!;ddre~s ~ \ of' . G\\\('~ 10 'i\ '\.j~ DU'I llies. pQ.. \' 5::0\ (pmirplO) (ohoop no. \ tiechantcal . ONTRACTpRS . General \--1r~ Electrical A/~ w~L2C'c:..:r, '--:?O/YSG/ /0-Y~ ~~<) Hechan1cal PLUIIBING ELECTRICAL J MECHANICAL FFF r."ARf,F Nn FF' r1U11lli.E. .../lll..- Residence of furnace/burner to SQ. FT. BTU's i.QJdlli. NO. . Each single fixture S.F. Residence (J bathl Duplex (1 bath) each Additional bath ~ New circuits alts. or extensions ':2~.r-?,RE' SERVICES -;;Z!;,' Floor furnace and vent Relocated building (new fix. additional) Recessed wall ~n~r.p hp~tpr ~nrl vrnt Of amps. Appliance vent SrPHA tr . Stationary evap. --~~~ Vent fan wt th \tn~le dvct Vent system apart from heattno or A.C. Mechanical exhaust hood and duct ~'ood s tove/hea ter Sewer Temporary Construction Change In existing rPllJ~r'1CP multifamily ,,,conm. or Industrial Water service Storm Sewer COMlI. /I NO. FEEDERS Install/alter/relocate il~t~t~ (~~~~~~ / Of ;<;'~ amps. ~~,. ,", ".: ISSUANCE OF PFRlilT TOTAL CIIARGES TOTAL CIIARGES ,': 51' ~- l TOTAL CIlARGES. WHERE STATE L,\\/ REQUIRES that the Electrical work. be done by an"Electrlcal Contractor, the electrical portion of this pe",,1t shall not be val f:.1 until the label has been signed by an Electrical Supervisor and 'returned to the Building- Division I IIAVE CAREFULLY EXA/IlNED the completed application for permit. and do hereb.y certify that all Information hereon Is true and correct, and I further certify that any and all work perfonmed shall be done in accordance wlth the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein. and that 110 OCCUPAIICY will be made of any structure without the permission Of the Oulldlng Dlvfslon. I further certify that my regIstration with the Oullder's Board is in full force and effect as required by DRS 701.05S, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are In compliance with OP.S 7nl.D55 will be used on thIs project. c- .,C/r.C::;;/?7'if'. IWIE(please print) wJ\U! C;e,->',~.,. '. ~1r.IlATURF. ~/{cX) I DATE /~.;J.{- fw Zone Fire Zone Flood Plain Type/Cons t. Bedrooms S tori es Units Occy Load .Occy Group FOP. orFICE USE DillY ~q. Ftg. llaln Sq. Ft!]. AccesS Sq. Ftg. Other r-llo.qO ISl6i r.J ':2 t-.!..-:l ca. IJ.systems oeveloPlllOnt TY;J. -:: ;n\IT."-fllarqe 11.5~ ., , Value Value Value , .TDTAL VALUATIOfI BUILOING PERfllT Charges an~ Surcharges ------------ Plan Ck. Comm/lnd 65%/Bldo Per Fpp Plan Ck. Res 30%JBldn Per Fee Fence PLUI~BING PERMIT Charges and Surcharges .' ------------ :. ",:_,":~!::h'~,""~',j'~"f':':;-:,'''' 7D~r,F,":I.,"':'~': ;'. ':; . ;. ' .;.t.;..... '1',,:. :;t, "\: ELECTRICAL PERI:IT Charges and Surcharges ___~~~_S1dew"lk ... ., "2. ,:25 AlC Paving Tota' Comb. rerm1t IIECIIANICAL PERMIT -.' .."..~.".,._--,~-- 'C-' b'C ""'''', " . ~.\ ".' ur Ut. \'~~~~~:~9:~d.. .,. ",' -;.;:,_.::.:...:..'.:..''-"'"'--- .::_ J .'1:.. .. I TOTAL"". 7"'2/'.) .....:. . ..1'.1",..,,,;, ';..~: '~7-r1""""""'" ,...._'~~'::',-:"l.~i7,~.f.::~-.:.'.-.. . '. " I ".... .. ,..'.-" .. ..... ,.~. "j. I.. ...' . .,/, : " ','-' I" ..., ,.,.,.. . ." , :"'111 '1":1.:" COMBINATION'APPLICATION/PERMIT '(CAP) . . . ",...1" 1..,.._'''''' '1.';[(.... I. Applicant to furnish ". I . ...... "'." A. JobAddre.. .. . ('')''''.' . ,':' :,."r,. I .- 8. legal Description-....:!.::. .:.!', J ).1,1,' I I.' example- .Ta(Lot }OO..' Lane..couoty Map' Referenc, 11 UJ 43 I." ;". :<"." .:t.~_'.I'''',.''~ ":<.. '..:_>:'~ ',.\ Z. example- Lot 1. Block 3. Znd Addition to ' Sprtngt.leld Estates .. . .' . \ .: c. Name, etc. of. Owner and"construction lender\ I. O. Energy Sourcesl :..,1 IA .r'; .' i..: 11... 1. exam~le- heat/electrical cellln,lor forced air It 2. examyle- waterheater/e!ectr)cal or ~. I E. Square (ootage or valuation, etc. I 1. exam~le- 1250 sq. foot house. 500 sq. foot garl 2.' example- lirIlew project. check new - if addlti, check add, etc. F. Building permit information: I. example - construct single family house with an attached garage Z. example - remodel existing garage into family r 3. examyle - convert single family residence ioto restaurant (change of use).' G. Value of work as defined In Section. 303 (a) of the. Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays. Building Division Staff must be able to contact appropriate persoos regarding design information or Job site corrections, etc. II. Abbreviated Plumbing. Mechanical. & E)ectrlcal Schedule, A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need flIt-in only the No. Boxes adjacl to the appropriate item(s) to'be installed B. Full Plumbing. Mechanical. and Electrical Schedules are available at the Building Division 1. To cooserve space on the permit form the schedul have been abbreviated 2. If the item(s) to be installed are not covered 0 the abbreviated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL DUT ALL FEES AND CHARGES ON TIlE SCHEDULES . D. As noted 00 the CAP. the label must be delivered to electrical contractor. for signature by his electrica supervisor. The general contractor is.not authorized to sign the electrical label. --- III. Applicant to sign and date Whenever possible, the Initial application will b~ 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. aod 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 rees and'charges are.due and payable when the permit Is. issued. ' V. FOR OFFICE USE ONLY c ~y OF SPRINGFIELD . . City Hell Sprtngftold. Oregon Development Services OFFICIAL RECEIPT , I 15861 Date ~~?'f '9~ Rec'd From #~ y/~ F""c;z::c7 . ',. '~g.~~..s Address ~~ -Received FO"~~~ - ol")7SY~. ( - c=:? I-~ 7'5"" ...- :?~ /~!?,y~~7Y/L~ E_~ / ~~ r--~ <,>-~ ~7?r 9 ~5?::> Amount Received 4~7"~ <0 s/ -c5 c:.:> !lL ~~ ...' . , . Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: I' ; I" I" " ,'. ',,' , , .'1 '.,-" "\:.;. ! d.: ..' "'. ,..0(. '.:.' ..,"..' .' :," '.1., " .., .' ; I ::," "!:.' . .. .~, ", ; ,,, Permit applicant exempt from.registration with the Builder~s Board because: Additional Project Information: PLANS REVIEWED BY: r! name signature. ~,.. . ,-:' I.. ;. .,-.,,'1 " :' j' '",i I,C. ;:1" ,: " , ;~" , .'! \. .' 'll"~' '1 . ....... W:!,:. .I .::1:,:::.1::.: , I -I. ,'!. . <-:., :i't,;.' ." ,'.' :',.. ~'1I ; d....t, 1ate . ~".' ... .... .... .' ,. 1 I-