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Home My WebLink AboutPermit Building 1981-7-6 (2) -......... CITY OF SPRINGFIELD ~iHATIt.~N APPLICATION/PERMIT /' '4oeJJ~I."n) ~:::G~iAf~~ QQ.cr Waler Heater L1I901 O.,uiptio_" RonQe '-...... --""/ .\r) U~d. ~L\l) ~~IVal"eafWa'k' OW".' ~- ~~ [)"('\ \\Il I c\\ \ (\ 'l( Il 'i\ "' Add,... .~ If(. JI Sl lil\ L I\ pilon. co",,~:3:.~~ Qp ~ 0 Electrical I Mechonical I CONTRACTORS (namel (address) ! G.n.,aIYQ,,'I\ \10 \~t'L\\~b rv~) plumbinQ \j ~ INSPECTION LINE 726-3769 " ~1'7 Job .Addrl!11 Add,... DESIGH TEAM (nomei Primary Structural Electrical Mechanical PLUMBING NO. , Each .;"gl. filltur. R"locor.d building ("lIW fill. additionol) S.F. Ruiden~. (1 both) Oualu (1 bothl eoeM Additionol bo,h Wal., ,.,,,ice I S.w.' I 510r,m Se.....r I, JYI'l'J TOTAL CHARGES .. INFORMATION LINE 7'26-37 S3 Sq. fIg. Main Sq. Fig. Accen. Sq. fIg. Oth.r _New_Add._Alt.r_Rep. ___fence_Cerna_Change I U ie ~ ::;::::--Olh.;r-. " ,- ./ Sui/ding Permit Info: Describe Work (i,e., Build Single Familv Residelu:e With A.ttoched Garaoe\ Phone IL 11 f\~L \\-."ic\Q.~~ . (addreu) (lies. no.) . (u;pires) (phone no.) ." (ljcs. no.) (phone no.) (expires) , " ELECTRICAL MECHANICAL fEE I CHA.RGE I NO. fEE CHARGE I NO. C-HARGE I 1 I /1 I i I j I FEE I , I I I I I I i I/~OJ I I Residence of furnace/burner to IlITU', Appliance vent seporato Stationary evap. cooler Vent fan with single duct Vent system apar' from heatinCl or A.C. Mechanical exhaust hood and duct SCl:ft. Ne..... circuits, alterations or extensions SERVICES Temporary Construction Amps. Wood stove/heoter fEEDERS Heat Puma Air handler to 10,OOr) CFM Air handler over 10.000 CFM ., Amps. J JrLH / ().c '.) I 'A,cO I 10. Od TOTAL CHARGES ISSUANCE 'OFtlPfRMIT TOTAL CHARGES WHERE STATE LAW REQUIRES that the Elfettical work be done by the E!er1ricol Contro"ol, the electrical portion of this permit shall not b. valid until a Igbel has b_n signed by on Electrical Con'radar and attach.d to th. .I.drical panel. I HAVE CAREFUllY EXAMINEe the completed application for permit. and do hereby certify that 011 information h.reon is true and ~"ect, and I further certify that any and all work performed shall b. done in accordance with the Ordinances of the City of Springfield and th_e Lows of the Stat. of Oregon pertaining to the .....ork descrii:Md herin, and that NO OCCUPANCY will b. made of any structure without the permission of the Building Division. I further Cltrtify that my rcgistTotion .....itn the Builder's Board is in full force and eoffect a s required by ORS 701.055. that if .J(.~mpt the basis for exemption is noted,' h.ron, and thot only slolbcontrocfars and emplo)'ees .....ho are in compliance- with ORS 701.0~5 .....ilI b. used an this project. Basil for Builder's Board exemption; NAME (pleas. print' ..,:, Ov :.v e. Zone Fire Zone flood Plain ." BUILDING P~RMIT Charges and Surcharges PLUMBING PERMIT Charges ond Surcharges ELECTRICAL PERMIT Charges and S"'l(horges MECHANICAL PERMIT Charges and S...rcnorgel -r <.'<../< </ ". I~~-t / OATE 7- 6-lrl c:.1GNATURC fOR OfFICE USE ONLY Type/ Canst ~drooms "- v-\ Sq. ftg. Main Sq,: fIg. Accen Sq. Ftg. Other '1.'01...0 Vol.... Volua TOTAL VALUATION clorie' qnih ;)ccy load "ccy Gra...p x x c!JSCD Plan Ck. Comm/lnd 65'l;'/ BIde Per Fe., Plan Ck. Res 30%/ Bide Per Fee SYSlemS Development Char"8 11.5~1 \"::;00 (PO In.OO . 4n Fence Demo Total Comb. Permit Sidewalk Ale:. P,:,vin.. Curb Cut O\.CO 1 TOTAL COMBINATION, APPlICA_MIT (CAP) I: - ~ PERMIT VALIDATION I. Applica.u. ta furnish A. Jab Addre;s B. legal Description 1. examole-tax lot 100, Lane County Map Reference 17 03 .43 2. exompie-Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D., Energy Sources 1. exomole-heot/electric:al ceiling/or forced oir gas 2. exam ole-water heater: electrical/or solar E. Square footage or valuation, etc. - 1. examole-1250 sq. foot house, 500 sq. foot garage 2. examoie-ji new project, check ~.if addition, check odd. elc. F. Building permit information: 1. exomole.construct single family house with an attoched garage .2. exomo/e.remodel existi.ng garagE:- into family room 3. example.convert single family residence into restaurant (change of use) G. . Value a/work as deiined in Section 303 (a) of the Structural Specialty Cade . . H. ,DESIGN TEAM AND CONTRACTORS . To avoid design or construction delays. Building Division Stoff must be able to contact appropriate persons re99rding . design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & E:lectrical Sched~les ~', Except where blank spaces occur in the description portion or 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 . ore available at the Building Division . 1. T oconserve,space on the permit form the schedules have been abbreviated 2. If the item(s) to be instal/ed are not covered on the abbrevi~ aled, schedules yuu should cansultthe full schedules C, BUILDING DIVISION STAFF. WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES " " .- '. , \ \. , III. Applicant to sign and dale .Whenever poss(ble. the initial applicotion will be used as a worksheet only. Where possible, Building Division Staff will prepare a typewritten 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 ore 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. :, Vo FOR OFFICE USE ONLY _ Permit Cler~ r PROJECT CONDITIONS TO BE'SATISFIED BEFORE OCCUPANCY: ~ Additional Project Information: PLANS REVIEWED BY, "amf" ",ignatur- ..Jatf" :.~ INSPECTION LINE 726-J769 'iP&"' , ' , ~ CITY OF SPRINGfiElD . , . ~IN'ATir:::N APPLICATION/PERMIT INFORMATION LINE 726-J7SJ bJ .. " ,!)/~ ) 0 '10l2 lJ\&\~I.'n ') , EN ERG>; SQ';)lCES, Q ---V. H.a. ~/f-l ,-0 0" f'_ \ Watf!'r Heater Ow." ~~-,~ ~\()\i f\() ]\\\ {\\(C li / I AddT~~CA ~~ ~ 6\LV\ ;..rt P.an. I Conu'uClion leWr CONTRACTORS (no".,.1 (address\ ~ \ - ~ ' <:O..,~I'-..--, Q n 'iI \ '0' \ J\ \'\.. \\ ~ ),1 011 ' PlumbinQ \~ Job Add,'!u legal Description Addr." DESIGN TEAM (namei Primary Structural Electrical Mechanical EI..ctricol Mechanical PLUMBING l'o.lC).1 I Eocn ,inqle filltur" ,!ll:dIOCOI.d bl"lilding (I\ew fill. additional) I S.F. R.,;d.n~. (I both) I Duolu: (1 bOlh\ .od, I Additional balh I Waler ,.r...ic. I S.w" I St::lrm Sew., I ( )/iN I I '.1- f' I TOTAL CHARGES I f~r:. I CHARGE i Sq. fig. Main . I Sq. fIg. Acun. Sq. Fig. at".' j _New _Add _Alte' _Rep. ~._Fenc:-:oema_Chan9"i Ui. _Other ~ ./ Building P~rmit Info: Oelc,ib" Work ii.!!., Build Single Fr-mily Re,idf!nce Wi,... AthlCh!!d Garooel .......' r-" J ..c: ..r::: LJ\ I i I I i I I I i IhsOP I I I I~,C() Ronqe _ Value of Work: Ptlo",' LJ\ f\{"\\.. 'L "\-.''',((\ Q {J ,,\~ (addren} (li($. no.) (upire,) (phon. no.) f1ie,. no.) (upir.,) (phon!! na.l , ~'.: I ElE"CTRICAL MECHANICAL NO, FEE ; CHARGE I NO. FEE I CHARGE ...1/ Relidenc. of furnacel burnlt' to i3TU', Applianc. ....nt separato ~Q: ft. New circuits, alterationl 0' ellten,ion, SERVICES Stolionory ....op. cooler Vent fan with single dud Vent system aport f,om heatinq or A.C. Mechanical "xhau,t hood and dvct Temporary Construction Amp,. Wood sto...e/heoter FEEDERS Heat Pumo Ai, handler to 10.00') CFM Air handler o..."r 10.000 CFM Amp,. J _nlN /()C 0 WHERE SlATE LAW REOUIRES that Ih" Elect,ical wo,k b. done by the E!er-t,ical Cont,auor, the .I.ctricol portioll of ,his permit shall not b. valid until a 10b.1 has be.n signed by an Electrical Contractor ana attached to Ih. .I.ctrical pan.l. I TOTAL CHARGES I 10. od ISSUANCE OF..PfRMIT I TOTAL CHARGES I HAVE CAREFULLY EXAMINED the completed gpplication far permit, and do hereby certify that 011 information hereon is true and correct, and I furth"r certify that any and all ....ark performed ,hall b" don" in occordgnce wit" the Ordinances of the City of Springfield and '"e Lows of the Stat. of Oregon pelloining fa ttle work de,crio.d tlerin. and tho, NO OCCUPANCY will b. made of any struetu'. without the permission of the Building Division. r further certify that my ,egistration with the Suilder's Boord is in full forc" ond e.ffec' as required by ORS 701.0,S5. that if u."mpt th" baiis far "x"mptian is noted. h.ron, and that only ,ubcontractoll and employees who ore in compliance with ORS 701.0.5.5 will be uurd on ,his project. Balis for Builders Board e.llemptionl NAME (pleas. pri"') ..(', 0.': u e.. Zone Fi'e Zone Flood Plain " BUILCING p~RMrT Chargel and Surcharge, PLUMBING PERMIT Chorgu and Surcharges ElEOl{ICAl PERMIT Chorge' and Su,cnorge, MECH.ANlCAl PERMIT Cha,ges and Surcharges IV':'/<'<'/ Typel Conn Q.edroom, " ""-\ O::lori., ~co \s,oo (s)O In,OO 4n <IGNATUR. . I~~"":"-" ~..L-. fOR OFfICE USE ONLY CATE _7- 6-?1 "nih n-cy Load Oecy G,oup c:~. ftg. Main Sq; Ftg. Accen Sq. Ftg. Other Value Valuo Value . . . TOTAL VALUATION Pia" Ck. Cgmm/lnd 65~~J Bldq Per Fen Plan Ck. lie, :30%/ Bldo Per Fee Syuem' Cev.lopment Ctlara" (1 .5% \ Fenc" Cema TOIOI Comb. Pot,mit Side.....alk .A'C Pc>y;nO Curb Cut 0~,CO TOTAL 1 .. COMBINATION APPLICATION/PERMIT (CAP) I. Applican:. ta furnish A, Jab Address B. legal Description 1. examole-tax lor 100. lone County Map Reference 17 C 2. examaie.Lat 1. Black 3. 2nd Additian ta Springfield Estc C. Nome, etc. of owner and construction lender D.. Energy Sources 1. examole-heat/electrical ceilinq/or forced oir qcis 2. examole-worer hearer: electrical/or solor E. Square footage or valuation, etc. 1. examaie.l,2S0 sq. faat hause. 500 sq, faot garage 2. e)(omole.if new project. check new-if addition, check odd. ele. F. Building permi. information: 1. examole-construc' single family house with an ottochec garage 2. exam ole-remodel existi.ng garagE; into family room 3. example-convert single family residence into resfaurant (change of use) G. ,Value ai-wark as defined in Sectian 303 (a) af the Structural Specialty Cade . ,H, DESIGN TEAM AND CONTRACTORS . To ovoid design or construction delays, Building Division Staff must be aolc to contact appropriate persons regardir design informc:::tion or job site corrections, etc. 11. Abbreviated Plumbing. Mechanical & Electrical Schedules A. Except where blcnk spaces occur in the description portion or the Mechanical and Electrical Schedules, the applicant need fill.in only the No. Boxes adjacent to the appropriate " " item(s) to be: in~tal1ed --"B.' Full Plumbin,g;Me<hanicol. and Electrical Schedules" "."n__ are available at the Building Division 1. To cons.er_ve space on the permit form the schedules hove been abbreviated 2. If the ite~(s) to be installed are not covered on the abb ated schedules you should consult the fuil schedules C. BUILDING DIVISION STAFF,WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES Ill. Applicant to sign ond dole .Whene\ller possible. the initiol application will be used os a worksheet only. Where possible, Building Division Stoff will prepare 0 typewritten copy and return iJ to the applicant at .the time the actual permit is issued for his signaturE.. Fees and Ch"arges" f Plan check fees are due and payable at the time af the applicl- and no plans will be processed until these fees are paid. All ". other"fees o.nd charges ore due ond payable when the permit is issued. IV. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE 'SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY: name. signatur- , CITY OF SPRINGFIELD City Hall Springfield, Oregan Department af Public Warks OFFICIAL RECEIPT \ No. B Date':\. \ ~\, \ lQ 19P\ I 00. - - Rec'd Fromq~>\ U\Q. \\.:::c\CQA, Address ,~\~ ~m,~_l~htC0 !' ...-- ~ ~- PERMIT VALIDATION ( ~, l " ( ," " I !!Ii ( ( 56858c; e ( Received For: \J\\ }\ \ ~1 f\~\ ') \\ ~y() ,O()C:U- \,' ~.oO ( l~oU ,loO ( IO.oD ,4(j ( ( ( y~ ( (;. ( ( , ~:' I~\ ,O() ~(}J AUTHORIZED SIGNATURE S,":UO""TU""'Ull .."".TIlIIS" IlUGun Oil '-"0' Amount Received ,; . Permit Clerk , '.' ~ate - . . ..-----~- , 0X:. ' ~..,,". ( ,I 'I I I