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Home My WebLink AboutPermit Building 1980-6-2 'I IrISPECTlOtI L1I1E 726-3769 Job Address -~-'JUN 2 ~OTlF1ED . CITY OF sPRlnGtiELo COM61;IATlO" .no, ''''TlON/PERMIT ErlERGY SOURCES: Heat Uater Heater 688 Fern Way Legal De5cription Minor Partition 607, Lot B Map Reference 18 02 05 1 2 I Range llFORllATlO:1 Uilt. 726-3753 Sq. Ftq. I-lain ~q. Ftg. Access. Sq. Ftg. Other ~lew vAdd A I ter Pep. _Fence_Demo Change/Use I. __Other -- lJ' .-D 0'. Owner Joseph P. Tabor ValuE OfOkOO J5_o'. '. .. _ ~Uu.GlnQ I-'enmt into: uescrloe '~Iork.l Le.. Family nesidence With Attached Garaqe) Address 1445 West lith Street Eugene, Oregon 97401 Constructi~n Lender Phone 683-4889 .t:#STFJ-/-L New ,8/J";:: Build Single I 115.0q I I I I I I I I I I I I I I I ISSUANCF OF PFR'HT 1 'i . od TOTAL CHARGES Contractor, the electrical rortion of this and returned to the Building Division 1~VE CAREFUlLVEXArHNEDth'e"completed applicafion for permit. and do hereby certify that all information hereon ;s 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 rw OCCUPAIICY 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 ons 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S ]()l.055 \'1ill~ be US~A-thiS project. "I. ~ i IWIE(please print) . SIG,IATURE rP l/9f.c;1!? _ FO~ OfFICE USE o;l~') \ / ' / I I 'oJ--- SO. FtC]. f)2iin . \"./, Sq. Ft~. Access Sq. Ftg. Other Address U,SIGII TEAll Phone (address) (name) {lics. no.} Primary R.r._ Rrp~~pv 144'i WF'~t. llt.h StrF'F't. 1':11!lF'nF' Structural Electrical f1echanical COIITRACTORS (name) (address) (l ics. no_) Genera 1 111.m" r Owner i Plumbino Owner Electrical ~'echani ca 1 Owner PLUIIBIIIG ELECTRICAL rm. FFF t.HARr.F tin ~~~ rHARr,~ NO. Each single fixture Residence of SQ, FT. Relocated building X (new fix. additional) 15.00 INew circu~ts alts. or extenslons SERVICES CHANGE IS.F. Residence (1 bath\ 10uPlex (1 bath) each IAdditional bath I ~!a ter servi ce I Sewer IStorm Sewer I Temporary Construction IChange in existing rp<; i rlpnrp mu'-tifamlly, comm. or Tnrluc;.trial Of COt~'I.IIND, FEEDERS I Install/alter/relocate nic;.trih. fPPdprc;. amps. Of amps. I I I I TOTAL CHARGES l'i. od TOTAL CHARGES WHERE STATE L.\H REQUIRES that tile Electrical work be done by an shall not be valiJ until the label has been signed by an Electrical Electrical Supervisor (exoires) (phone no., 683-4889 (exoi rf~s) (ohnnp nn ) MECHANICAL ~~~ rUARr.~ furnace/burner to BTU's Floor fu rnace and vent Recessed wall Soarp hp~tpr ~nrl vpnt I Apol iance vent seoarate Stationarv evao. cooler ~ , Vent fan wi th sinole duct I Vent system apart heatino or A.C. I Mechanical exhaust hood and dur:t 11./OOd stove/heater from permit Zone Fi re Zone Tyoe/Const. Bedrooms Units Occy Load Occ.y Group Flood Plain Stories BUILDING PERI,IIT Charges anG Surcharges Plan Ck, Comm/Ind -_____../_:S;..~-?J_ 65%/Blda Ppr Fpp I Plan Ck. Res , &.<0 30%/61 do Per Fee I Fence I D!JRlO I Sidewalk AIC Pavin9 PLUI.IBING PERMIT Charges and Surcharges ELECTRICAL PERI~IT Cha rges and Surcharges liECHAN I CAL PERMIT Charges and ~urcharges Curb Cut I I TOTAL OATE~~.Su-8() x Value Value Value x x TOTAL VALUATlorl~,::r;"10_o0 Systems Development Cha rqe (1. 5~) Total Comb. 4~' Permi t \ .-- ~s. ('p~ ...... - COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. lega 1 Description 1. examole. Tax lot 100, Lane County Map Refe 17 03 43 2. examnle- Lot 1. Block 3, 2nd Addition to Springtield Estates' C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced 2. exarr.:.Jle- waterheater/electrlca(lor sOl"d'"r E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house, 500 sq. foot 2. example- Tfinew project. check-nfw - if ad check add, etc. F. Building pen;'JiC information: 1. example - construct single family house wi' a tt<1ched garage 2. exam:.Jle - remodel existing garage into fam' 3. .exam~le - convert single family residence restaurant (change of use) G. Value of work as defined in Section 303 (a) of Str~ctural Specialty Code H. DES I Get TEAl.; AiID CONTRACTORS To avoid design or construction delays. Buildir Division Staff must be able to contact appropr; persons regarding design information or jOb sit corrections, etc. II. Abbreviated Pluffibing. Mechanical, & Electrical Sche A. Except where blank spaces Occur in the descript por~ion of the Mechanical and Electrical Schedw the applicant need fill-in only the No. Boxes a to the appropriate item(s) to be installed B. Full Plumbing, Mechanical. and Electrical 5ched are available at the Building Division 1. To conserve space on the permit form the sc have been abbreviated 2. If the item(s) to be installed are not cove the abbreviated schedules you should consul full schedu I es C. BUIL~IiiG DIVISION STAFF WILL FILL OUT ALL FEES CHARGES Oil THE SCHEDULES O. As noted on the CAP, the label must be deliverel electrical contractor for signature by his elec supervi 50r. The genera 1 contractor is not authl to sign the electrical label. - III. Applicant to sign and date Whenever possible. the initial application will be t a worksheet only. Where possible. Building Divisiol will prepare a type written copy and return it to tt applicant at the time the actual permit is issued f( signature. IV. Fees and Charges Plan check fees are due and payable at the time of t application, and no plans ~lill be processed until trl- fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY - ~ -~. .. -_. PERMIT VALIDATION (C CITY OF SPRINGFIELD City Hall Springfield. Oregan Department of Public Works OFFICIAL RECEIPT. ( c ( 'a. Date J'\ - C") Rec'd From ~ \N S4218( No. B .19~{) ~/L10f) V- I I tJ.',-- ~ ( i .n Address 144 h 111 ( ( Received For: ( ( ~p Ic;J ,OU L'f')/i . IDO ( (~s ( ( ( ( ( ( (e( Amount Received I F., roo I'--E.. ~ c (at , (~ , . (In c -/ - AUTMOIllIU:D SIGNATURE s..u~o" YU~""uU ~..,..~t~1 . luaU_I: Q~ suO, s8Slt-' ~ l \. I Permit Clerk j PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPArICY: DRIVEWAY CULVERTS REQUIRED I I I Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: SEPARATE PERMIT REQUIRED FOR ANY ADDITIONAL WORK IMPROVD,ffiNT AGREEMENT REQUIRED I J ~,,~nF)\-JED' BY; name DAN SMITH THIS PERMIT IS TO BE ISSUED AFTER HOSUE MOVING PERMIT IS APPROVED AND SIGNED I. _ . .... ,_. "... ... .._...... ..... _ ... ...... '\ 0 '-J.J signature ;in nv:}lYilfJi_ ; /J t.i \ --- . ,. . _. '" _.., I, ..... ~".. ) IQ_ Q;::""<. date'L-,-I.!..J c.~j I j )