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HomeMy WebLinkAboutPermit Building 1988-6-22 I INSPECTION llNE . CITY UF SPRINGFIElD .. INFOR/lATION llNl . 726-3769 COMBINATION APPlICATION/PERMIT 726-3753 ,- ! EilERGY ~URCE~ Sq. Ftg, 1.lain Job Address /~9 -71.?/Yc~ ~h"~r ..:;-_~; \ Heat C;o;1"5 rLf/- ' ~q, Ftg, Access, legal De<cription Ilater Heater ~ . Sq, Ftg, Other ~ -1lew_Add_A1ter-,~ep, Range ' __ Fence Demo Change/Use ValUE of Hork: ~Other /~7'cl!'TE Owner \(.f:\)U,) F ItJ~WlI\~ ?~ S~. ""'" ,"~-S -:.. -~,- Address D.O. DO\!' "'$'1 r)~ I--.. "p Phon""'" l'tI/;. BUil!;nQ P~rmit Info: DescrIbe Hork(Le,. Build Single f I 0 ~ c- ~ t::::l\.I[;;t,.. \J.... "f~'" ~ I Famllv ~esldence l~ith Attached Garaael ~;&JIlET<!!5 L_.,_"':" Fa/? ~/~ s-~E r~ Construction lender H lu...W1^)J .fR9~fS AddresstlOo t!;-OMAIM~IC.1)u.iVfl ~~ho~-'1111 DESIGN TEAM lnamel (address) - flies. no.l Primary H(~~J AtM_. L2..Z.(iloO .;, S'll,vrzf0~,E:. p~ ~"12.li Structural ~~t//FAJ.l.,f,f., e.lh-. Wt.. 701 C;,~. mlL..L..f:.e. ~ Of.i'u:n- Electrical n4.f=,LA. M.. 2.00'7 ~.e. ASH POftf. tf72../t.t Mechanical I' · If". If CONTRACTORS lnamel (address] General s:u.tJ rf\~sr ~. B~v 702.'16 E./Jf.; Of~l (exoi res) (ohone no. I ~ ~ \j I ~&f,-Zl6" 2"iI-0711 z..9't-~ II 11 ;r:c;.. nn.' (~)'I)irp,,' (p/ RI, lohnnp nn ) 4t<X.. i f?lL !SJ '52..1 Plumbino P Electrical P ~1e(":hClnir.,,1 t I .., . , <2..00 'I - \.11' ME~~ICAl PlUl,lBI NG ElECTRICAl NO. HF rHARGF Nn !:'~L...cHA.RG.E. Nn g Res ir~cOe OOf /A. SQ, FT, \ furnace/burner to ~,)t..,:- BTU's Floor furnace and vent Each single fixture 7.'"::C @ ~ Relocated building (new fix, additional) New circuits a1t5. / ~ extensions 'L c--.<ro '""~ (0 SERVICES f'22.~ S.F. Residence (1 bath) Duplex (1 bath) each Recessed wall ~o~rp np~tp~ ~nrl vpnt Additional bath Appliance vent s.eoaratp Stationary evap. cooler Vent fan wi th sinole duct Vent system apart from heatino or A.C. Mechanical exhaust hond and duC':t I Hood stove/heater I I I ~/ater service Temporary Construction Change in existing rp} i d_p.nrp multifamily, camm. or lndustrial \ Sewer Storm Sewer Of amps. COMl.!. lIND, FEEDERS \ ,. crr rUq&GL (.... cb I I:\cc> I ~,~ I ~ I 1 1 Install/alter/relocate d A (Hctrih f.:.pdprc;. -b 7, I I IOf' amps.! I:, I -..D") I I "-i...... - ''fJ.j I r l.L) I 'I?;' I I - , ISSUANCF..!!. PFR!IIT TOTAl CHARGES '(q'l.~ TOTAlCHARGES 2?,.5\:> TOTAl CHARGES\\~\).~.A\o\:7 \~~ HHERE STATE lAW REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division 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 oerformed 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 OCCUPAIlCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s Board is in full force and effect as required by ons 701.055, that if~xemPt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 7Ql.0 will be used on this project. . 1lA/'E(please print) J\AlJll\ RAPKJtJ SIGII^TURE j~~ DATrUk/~ FOr. OFFICE USE o;~LY ! Type/Cons~\\ \,,\_~-,lQ.Units ~q, Ftg, Hain x Value Bedrooms Occy Load Sq. Ftn. Access x Value Stories \ Occy Group \~.'I_ Sq, Ftg, Other x Value ttJ.' '-"'-Kg!1i 1171? 1'<5: S"c:; Zoner" . Fire Zone Flood Plain ~\ 1D \( l-:t C):) Plan Ck. Coom/Ind ?- __l~~'-~5--- ~~:~B~~~ ~':; F.. -, , 30%/BldQ Per Fee PlU'1BING PERMIT Co'1. s::> Fence Charges and r---' -------- Surcharges:> ~,~ Demo ELECTRICAL PER.m (Z2. 'd:> I Sidewalk ~~~~~;~g:~d 1../ - --- - \ ~\~ ---I A/C Paving ,'ECHANICAl PERMIT \ t::.. ex::> I Charges and l,o _ __ "'- .::>L._ _ _ __ _ , Curb Cut Surcharges . '1 '5 I I I TOTAl '<)\f2, , C\\ 155. "'lL BUILDING PERHIT Charges and Surcharges .-rOT^l VAlUATION c)"1l Sys terns bevel opment l.\L) r\ ~ Charqe (!.5~) .re... ITotal Comb. Permit it . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I I I. 1, Applicant to furnish A, Job Address B. legal Description I, ~xample- Tax lot 100, lane' County Map Reference II U3 43 '-,' 2, examele- lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D, Energy Sources , 1. examole- heat/electrical ceilinq/or forced air qas,. 2. examjJle- waterheater/electrlca(/or solar E. Square footage or valuation, etc. - I, examole- 1250 sq, foot house. 500 sq, foot garage 2. example- if new project: check-new - if addition, cneck add. etc. F. Building pennit informatfon: . .... 1. example - construct single family house with an attached garage I . . . 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 $tructural Specialty Code ' H, 'DESIGN TE~1 AND CONTRACTORS To avoid design or construction delays, Building ~ivision 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 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. - 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. " ., ~ ,,(I", . \ V. FOR OFFICE USE ONLY ~ ~ 1177t/- Permit Clerk rJ ,GB. J.u nJ , 'o-.iil.~-~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: <7\\1\ \. ') ~~ \.. y...,\- "'\.. 'Ie\., 'C'\..(:>('\ ~s.~n\- c,"...- ~~\~~,,~~ - \ . " PLANS REVIEWED BY: '~ ~V' '\ \ .H'\. \~ " ~ Signatur:~ _\ ~_"- datec.,-'(l-~ X- naroe\ J