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Home My WebLink AboutPermit Building 1990-1-9 Ge..vV~A~ c.,~, c) D ~ valug of Hork: 00 Owner Ct)~ U\~ ~o-tz..~O : \ 1...00-, Address ,-,,, ~ I ....., /) P1,t,?..Ll2.('" Builtiino Pennit Info: Describe Work(Le., Build Single l OV <:) ,.~<-I 0.., '....e."::... '"( ..., Familv nesidence liith Attached Garaae' -n 6>~~;.. ~w. OR," q 1l(2..t.l ~ h,,7' ,/YA#~-::;:,-;,~,''/~LLJ ~.N1' j)/V Construction lenti.(.l ~ '74 \ - "_, J '...:-, r/~' -f' A..72!91" ~'._-_.-- ~ Address Phone J~~6' 7l:-~; ~~ . DESIGN TEAf1 (namel (address' "(lics. no.' (exniresl (ohone no. TY F SPR NGFIElD ,COMBINATION APPLICATION/PERMIT CY \QVI~ \(~~J)'l,\ L ~~~~r,y ~O~~~S: Hater Heater ~~- Range l.--+ N Rl1AT ON 726-3753 5q. Ftg. Hain I c-,l( Sq. Ftg. Access. Sq. Ftg. Other flew Add A Her Pep. -Fence Demo Change/Use Other- - ~ I INSPECTION LINE 726-3769 , Job Address \ ~ 1'1 legal Description C) o o Primary Structural Electrical 11echani ca 1 CONTRACTORS Electrical (namel ~U,\..U;AA 00 II<- 'tt'k ~;+-k-"" - 2032.\ J.. (address' s,"lv\!> ?;0'12.1,,) (lics_, no, \ iexDires) (PDone no...L- U\ ~) \ e. ct .. 0.J\.U>c.U uf. 0 R ~ '-l,,",;llO ~-\\-ql> q '-(~-Z2.a-r So~ \\uL ~jJ.k~ Qv!W. Oe. , \.J J - ~<fZ--&1 "s' Genera 1 r'UII~ .Ill-' ~-"J PlUllBING ELECTRICAL MECHANICAL NO, ' I FEE CHARGE NO I Residence of C~ARGF NO, , HF CH.1RliE. I Each single fixture 7.S'~ SQ. FT. (F furnace/burner to BTlI's Relocated building (new fix. additional) New circuits aIts. or extensions Floor furnace and vent S.F. Residence (1 bath\ Duplex (1 bath) each Additional bath SERVICES Recessed wall ~n~rp ~p~tp~ ~nrl vpnt Storm Sewer Of amps. Appliance vent seDarate Stationary evap. cooler Vent fan wi th sinole duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct Wood stove/heater Sewer Temporary Construction Change in existing re$ i qrpce_ multifamily, camm. or 'Inrluc;.trial Water service COMfI,/IND. FEEDERS Install/alter/relocate rlic:.tl"it- fpprlprc:. Of amps. ~re<P-r~A;~ 7-2: --<7: lj/V 7?!P, :s: ~~ : ,./" . ~g'~/V # ~....~~~ .. , z:5~;' 7": I ' I SSUANCF OF PFRIIIT f ' TOTAL CHARGES ~.N _ /5"'. \ TOTAL CHARGES I TOTAL CHARGES /d./1'?'- /.:<): - WIlERE STATE L'H ~EQU'IiiE' that the Electrical work be done by an, Electrical Contractor. the electrical portion of this per~it shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXM1INED the completed aprlication 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 Orc[lOn pertaining to the work described herein. and that rm OCCUPAUCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Ooard is in full force and effect as required by ons 701.055. that if exempt the basis for xemption is noted hereon. and that only subcontractors and employees who are in compliance with ORS 7~1.055 wil1~uAed on , project. l>"~;;("7~~ 4, SO"'fJ I NC ~<e.Lr::fI NAI,IE(please print) 6e:.,,~6. C~ at. SIGrlAluKV- FOr. OfFICE Uot 0Irt. Y Ftg. II n x Value (]. Access x Value Ftg. Other ~~ Value./.2~- TOTAL VALUATIOII Flood Plain Type/Const.~~~~nits Bedrooms Occy Load Stories / Occy Group DATE.t:.3....,~ ~ Zone L:'L: Fi re Zone ",-2 BUILDING PERflIT' Charges and Surcharges , Plan Ck, Conm!lnd I I ~ -:2.-:::l.. ___-::?.::?..~_ ~/Bldo P.l'r Fee .:). c ~ Plan Ck, Res I. t!:).? 30%fBldo Per Fee /S - Fence ___..J'_~"':_____ -75" D/1R1O Isyste, r.lS Development I CharQe tJ.5~ '" Pllll1BING PERMIT Charges and Surcharges ELECTRICAL PERI\lT Sidewalk Charges and ------------ Surcharges AIC Paving Total Comb. Permit I1ECHANICAl PERMIT Charges and Surcharges ~ ~ Curb Cut ___L~_.!.._____ .?:> TOTAL J~6.% . . M . .i COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax lot 100, lane County Map Reference 17 03 43 2. example- Lot I. Block 3, 2nd Addition to springtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. exa~ele. heat/electrical ceilinq/or forced air Qas 2. examyle- waterheater/electrical/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, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. exam~le - remodel existing garage into family room 3. example - 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 TEAM 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 B. 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. --- 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 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 Permit Clerk :. ..-... PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .1 !.~~. .. ; '" :' . ~ ;.. Permit appl i cant exempt from regi strati on with the Buil der! s'Bd~rd because: .~ . , Additional Project Information: " " .;, !i ':,It.. ~. "'~ ~. t ) ~ ~ f :' . ~ '. \. ,. ',-, ..\,." ". "-h' '.. ~...' -....... . ........,. ',' PLANS REVIEWED BY: name ~h'/'/E 72~~ Signaturv::Z /tY date I-;/.c>-;?.c:> / ---- CITY OF SPRINGFIELD ""'COMBINATION APPLICATION/PERMIT CV \OYtl't-Jr \?~W7,\ L ~~;~r,y ~lf~gS: ~:~:: Heat:':-.fl. =~-- C;~C\ c.,~, aD.!> Owner Ct .? '( ~ ~ \I~:~ \2)~ z:...~ 0 : Address I kC? 0 "\V><-1\ 0'( ~ e.. it,'!i.?- t.f2.(Q cons~~nJt ~~'I' IO(Z- q 1 ~2-~ , ELECTRICAL MECHANICAL FFF CH~RGE Nn ~r~ .c.uARGF' Nn, 1m rl~.lB.G.E.. Residence of furnace/burner to ::?SP SQ. FT. BTU's New circuits aIts. Floor furnace I or extensions and vent SERVICES Recessed wall SL~hp~tpr ~nrl vpnt 'J'.NSPECTION LINE 726-3769 " Job Address 19;' 7'1 Legal Oescription Address DESIGN TEAI1 Phone (address} (namel Primary Structural Electrical Mechanical CONTRACTORS (namel J)" ,,\_Lr ;~ D" ...- J. (address' S,M!::. Genera 1 rlU'" - ~;~'" - 2032. \ Electrical 'tf>k . ..<::i3....::__.1 PLUIIBtNG NO, I Each single fixture Relocated building (new fix. additional) S.F. Residence 11 bath) Duplex (1 bath) each Additional bath . I, , IHFORllATlON LINE 726-3753 Sq. Ftg. Main r IL>~ ~q. Ftg. Access. Sq. Ftg. Other IIew Add Alter Rep. -Fence Oemo Change/Use Other - - I .1J C) o o 'iJ j) Val Us of Hork: eI:> \t...OO- " BuildinQ Pennit Info: Describe Work(he.. Familv nesidence Hith Attached Garaae' Build Single b ~~-~/A""6.. ~aJ /=' ~ of A/c.'l'" ;?;;h-4 ,,-_.....~.-- ~ ~~~fr~; 5~~,. flies. no. l {@xnires\ (ohone no. . {lic~. no. \ Jexniresl (Q~nnp nn. \ L~ At) \ e~. (' .J'\J-bWUl 0 R 1:h. '-1, ,,,- '1 L(l ~ -11- Cll> q '-{ 2. - 2Z.lrf ~ iAor-e,. ~ ~ (Il()Jk~ <;f1Wl. Oe. , O,<f2.-.!rIIO:, ?;O '\2.1") amps., App I lance vent !..eo!'r:ate Stationary evap. ~_oQler Vent fan wi th !i:in91e d\fr':t. Vent system apart from I heatinC' or A.C. Mechan1cal exhaust I hood and duct Hood stove/heater I 'a..p~_+ Water service Temporary Construction Change in existing rp~j4rJlcP multifamily, camm. or 'nrill" tria 1 Sewer Storm Sewer Of COllft./IND. FEEOERS Install/alter/relocate fii..trih_ fppdpr.. Of amps. A /=2: =7: U..-v?#', ~~/: c.--/~/d//VA7 ~kA"/"T?-=> *fi/....?....;r-; [ ISSUANCf OF PFRlIIT TOTAL CMARGES ~.h' _ /~ TofAL CHARGES . TOTAL CHARGES ~/~- ,/,~ - WIIERE STATE L\I/ REQUIRE~ that the Electrical work be done by an, Electrical Contractor. the electrlc.l portIon of this permit shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EX~INEO 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 OrelJon pertaining to the work described herein, and that NO OCCUPAI4CY will be made of any structure without the permission of the Buildinl] Division. I further certify that my registration with the Builder's Ooard is in full force and effect as required by ORS 701.055, that if exempt the basis for xemption is noted hereon, and that only subcontractors and employee~ who are in compliance with Or.S 7~1.055 wil1_he~uAed on project. l>"IoJ:('("":I"~ 4, So",S INC ~~ IlAJ.lE(please print) 6e'l'v:0-.6. CJu. ob SIr.lln,u'i FO~ OrF I CE U~ oub S . Ftg. r x Value Sq. CJ. Access x Value /-2 Sq. Ftg. Other ~~ Value./.2~- TOTAL VALUATlml Zone LL:. Fire Zone Flood Plain Type/Const.~~~~nits / Bedrooms Occy Load Stories / Occy Group BUILDING PERNlT --_::?~~- Plan Ck. Comm/lnd Charges an~ 65%/Blda Per Feo Surcharges /~3 Plan Ck. Res 30%/Blda Per Fee PLQriBING PERMIT ___L::>~ .::>rIP Fence Charges and Surcha rges -7~ O~ CLCCTRICAL PERlHT Sidewalk Charges and ------------ Surcharges A/C Pavi ng IIECHANICAL PERMIT /.?:.=e' Curb Cut Charges and --- -_.!.._---- SurcharlJes ?:>" I - OATE~ I~,,~~ - Syste~s Development Charqe tl.5~ " Tot.' Comb. Permit TOTAL C6.% . - COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description I. exam~le- Tax Lot 100, Lane County Map Reference II u3 43 2. example- Lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender O. Energy Sources I. exam~le- heat/electrical ceilin%r forced air pas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. ------ I. examole- 1250 sq. foot house. 500 sq. foot garage 2. exam~le- 1lrI1ew project, check-nfw - if addition, Check add, etc. F. Building permit information: 1. examp)e - construct single family house with an attached garage 2. exam~le - remodel existing garage into family rom 3. example - convert single family residence fnto 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 ~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 adjacer to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building ~ivision I. To conserve space on the permit form the schedul, have been abbreviated 2. If the Item(s) to be installed are not covered 01 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 electrical contractor;for signature by his electrica supervisor. 'The general contractor fS.not authorize 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 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: ..' ,. .-- - - .~-~,-~ Ef --.,~.--- CITY OF SPRINGFIELD City Hili Sptlngftold, OrOllO" Development Services OFFICIAL RECEIPT '.',j r .I 15738 Date: ~ /~..... 195'.c:> , Rec'd Fromjl:!?~ a ~ e:::'7:J1Lr&. ~ Addrp<;s - _ #)} =--- . "- ~- -~6" '7?Y'2y_ ReceivedFnr:/~q~..:.-..;>~~~ ~ /-5""~' ( ~-.sz:> /~ /-0:3 ?-P. /S.~ ~ -7.s- 1~_~W'<::.=-J /"3:-73 F~ b6.~ c::-~~/ = Amount Received ~ ? 6 .!!L ~~"'!~-. ~ ~ /AUTHORIZED SIGNATURE ~ ~-,.r ~ )- r . - BUSI~ESSFO""'5.INC I$OJIJ.tlU.. ..., . Permit Clerk I .., ;,..'., . ~ ~. Permit applicant exempt from registration with the Builde~!s:Bo~rd because: Additional Project Information: PLANS REVIEWED BY: '.~ . \ ,~' " ':, !i '~.t " '",i.,... t j ; ~ f :' . \ ''', . .~. .;, :',,: ., ......~.' ......w . '". ........ ~'..' .."""', .," name~h'HE /2~~ signaturv:::?'~~ date /?""C).-;?~ /,,- v /'