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Home My WebLink AboutPermit Building 1980-11-12 . ~ Job ~.ddress / Q,77 ~I4TFIA/I}V Legal Description CITY Uf SPRINGFIE~D corm I IIATI ON APPLI CATION/ PERMIT EilERGY SOURCES: . ~ . Heat 1,later Heater Range --'-- Va 1 ur ?Jr'lork: '"c /,?'IJO -- BullciinQ'PeT111it Info: Describe ~lork{Le.~ Familv nesidence With Attached Garaqe) . ,10 INFORlIATIOr~}~ VI 726-3753 ,'" Sq. Ftq. 1,Iain :q. Ftg. Access. Sq. Ftg. Other lie" Add Alter Rep. -Fence Demo Change/Use -Other - - I INSPECTION LINE 726-3769 ;"ooP ~'Owner fJ~50t/~1m n/?C!rON t..V66E!12<, ~ ~Address /04('" C-/}7bWtI!:Y L.d~P --'<Phone Build Single ~' '6"- I~ I' Construction lender NllJ../E \. E"XIT3.!lJ (. "SJh.I!T/tKY SElJa- , ~,BY, 1<010/ L./AI"c Address UI:.SHjN rEAl.' lnameJ Phone (address) (lies. no.) (exo;res) (ohane no. I .J( Primary Stl'uctura 1 Electrical 'C;. t~echa n i Cd 1 COinRA.cto~s (name) (address) (1ir:5.no.) {exoiresl (ohonl:' no.) Genera 1 y.. Plumbina ?LtLu ?'(/ a. SJ0<TO,j Electrical 2....L/7s- IJuTLt-7:: PI' <JuNCTiorJ CITY OKtO "~chanical \ PLUllBlIlG I ELECTRICA~ MECHANICAL ,. ::.1.! lEaCh FEr cHARr,E Nn F="~f:' fHARr,l=' NO. '" njAl:U~;; singie fixture ''\ I Relocated bui lding (new fix. additional) IS.F. Residence il bath) Ouplex (1 bath) each Residence of SQ, FT. furnace/burner to BTU's New circuits alts. or extensions I' i Floor furnace and vent Sewer I,:,) I ITempOrary Construction I ri:ha~~e in existing I I reslcL€'flce . --..:.. __ .___.~ ._._"_ Imultifamily, corrm. or Industrial IOf I COMI,!. II ND. FEEDERS I Install/alter/relocate rlic:.trih. fppdpr~ amps. ." 'jj Apoliance vent seoil ra tp Stationary evap. cooler ') Vent fanwit!-;- sinole duct".' Vent system apart from heating or A.C: Mechanical exhaust hood and duct" SERVICES Recessed wall SOiirp hp~tpr ~nrl vpnt Additional bath ~Jater serVlce- Storm Sewer Of amps. I I I I I Wood stove/heater , .':,!,y ~:\.J.y;)- . It ...~ - ..... ISSUANCE OF PFRillT TOTA~ CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by an .Electrical Contractor, the electrical portion of this permit shall not be valii until the label has been signed by an Electrical Surervisor and returned to the Building Division I HAVE CAREFULLY EXN1INED 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 Derformed shall be done in accordance with the Ordinances of the City of Sor'ingfie1d and the Laws of the State of Oregon pertaining to the work .described herein, and that rw OCCUPArKY 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 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 701.055 will be used on this project. HM1E(p1eil5€ print) jVltl-~ i-IOt.~c:7/ t:al t'..I\M.:r, SIGrl!'TURE--t]~tt.~ l~dU~tL..-. FOr. OFFICE USE OHLY Sq. Ftg. 11ain Sq. Ft(]. Access Sq. Ftg, Other " DKiE.J/dIJ /-:! Ic.~ .. Zone Fi re Zone Flood Plain Type/Canst. Bedrooms Units Occy Load Occy Group x Value Value Value x Stories x TOTAL VALUATION BUI~DING PERflIT Charges and Surcharges Plan Ck. Comm/Ind 65%/Rlda Ppr Fee ------------""""Pl"'an Ck. Res 30%/Bldo Per Fee QV' r""\l) \.....^-' Fen c e - ~Wy- D~mo Sidewalk I A/e Payi ng I Curb Cut I Systems Development Charoe (I. 5r,) PLUt1BING PERMIT Charges and Surcha rges ELECTRICAL PERr:IT chfrg l! and Surc rges lIE ANICAL PERMIT Charges and Surcharges Total Comb. Permit I I TDTAL c90.~O . ~, ,....." ..\ ,~~ .,~ .. COMBINATION APPLICATION/PE~1IT (CAP) .' I. Applicant to furnish A. Job Address B. legal Description 1. examole- Tax Lot 100, Lane County 'Map Reference 11 03 43 2. ex~mole- Lot 1. Block 3, 2nd Addition to Sprlngfield Estates .'"G", Name. etc. of owner and construction lender D. Energy Sources 1. examQle- heat/electrical ceili~q/or forced air qas 2. examole- waterheater/electrical/or solar E. Square footage or valuationl etc. - 1. examole- 1250 sq. foot house. 500 sq. foot garage 2. example- if new project. check-new - if addition, check add, etc. . F. Building pernit informathn: 1. example - construct single family house with an attached garage 2. examole - remodel existing garage into family room 3. examole - 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. OESIGN TEAI'I ANO 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. :xcept where blank spaces occur in the description :Qrtion 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, 1'1echanical, 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. BUILOING OIVISION STAFF WILL FILL OUf, ALL FEES ANO 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,~ authorized to sign the electrical label. III. Applicant to sign and date Whenpv~r pcss~b;c. tilt: initial application will be. used as a worksheet only. Where possible, Building Division Staff will prepare a type wr1tten copy a~d,return it to the applicant at the time the actual p€l,rjt 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 ~ 1."..1 PROJECT CONOITIONS TO BE SATISFIEO BEFORE OCCUPANCY: . PERMIT VALIOATION Perllli t Cl erk ~ Permit applicant exempt from reg!stration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date ,. ; -, " ,.: ;1 '" '. .. J . \ 'i I . '"';;~,,........ -'''!f.'~'''''-'''~"''1':">''~!''' , Nll)JE -.. CITY OF SPRUluFIELO-- COI1BI;tATlON APPLICATION/PERMIT E!/ERGY SOURCES: Heat \ola ter Hea ter I Ranqe~_.__~._.____ Value ?Jtl'/ork: d'<-7 -vo - Buil~inQ Permit Info: Familv l1esidence Hith 1\ I' ,I .' I --"~./ I NFURlIATIOl'j.liilj ~ 726-37S3 ,,>..' Sq. Ftq. Ha;n ' ~q. Ftg. Access. f~' So, Ftg. Other ~ Ijeli Add A Iter ~ep. 1'<. Fence_Demo_Change/Use K _Other '::) (:'0 1--..: " 'I INSPECTION LIIIE 726-3769 .0< job~Address '/ I) 77 #-JiTFWi1V Legal De~cr;ption t..oo? , "><: Owner fJ j50c;~7I. ..:- -Address 104'; /..'A7r-"/Ji-Y L" ~ p , "><phone Describe Work(i.e.~ Build Single Attached GaraQe) Construction lender E Xt@,;,/ (\ 0~t7Y (. "<:i,"M!TIT;~V 1(.;)/ () / .Pel.ler ,i.,.,,.-:- Address Ul>IGlj TEAll (name) Phone (address) .I (l ics. no.) (exo; res) (ohane no.) ~ Primary Structural 't' Electrical I :~echdnical COiiTR;.CTD::lS (name I (address) (llr<;. no.) (exoirp<;) (ohon~ no. ) Genera 1 Y Plu"bino 'l?;..iLu ,=-t/ <t.-5.?"xTf) J Electrical '2,,, Lj 7,..,-lfu Tt..t"l: 7;>1) (JuNCTFo/'v CItY ~iF "~C;..~.,ica 1 ?lUrm I t:G ELECTRICAL flECHAII I CAL sq. FT. furnace/burner to BTlI' 5 l I ~T::: rIlIHU~: , , FE:: ! CHARr.:f ~JO j i="1=i=" 'rtJARr.;: NO. rEacn singie fixtur~ l?eJocatea ~~ilding (new fix. additional) IS.F. Residence (1 bath] Duplex (1 bath) each Residence of INew circuits alts. or extensions !SERVICES I , " Floor furnace and vent '.ll'. Recessed wall So~cP hp~tpr ~nrl vpnt Sewer ITemporary Construction' IChange in existing I r~<; i d~f1(':'" .. - . ~ multifamily, comm. or TnrllJ<;trlaJ Of amps..l I I I I I'::':" I Appl iance vent <;poflrtltp I Stationary evap. cooler . I Vent fan wi q:- sinnle (hJct . Vent system apart heatinq or A.C. Nechanical.exhaust hood ,:lnr! duct, Wood stove/heater I I fro~1 Additional bath ~!ater service Storm Sewer COI'lI'l.11 NO, FEEDERS Install/alter/relocate rli<:.tril-, fporl....c: Of amps. I ,',01- _'. .?....:.t. I I TOTAL CHARGES J TOTAL CHARGES I-IIIERE STATE L,\!l REQUIRES that tile Electrica' work be done by an shall not be va1i1 until the label has been signed by an Electrical I' .',. ISSUANCE OF PFR'HT TOTAL CHARGES Electrical Contractor. the electrical portion of this permit Supervisor and returned to the Building Divisfon I HAVE CAREFUllY EXNlINED the completed .apf"llication 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 Ore(]on pertaining to the \'Jork 'described herein. and that ilO OCCUPAllCY \.,.i11 be made of any structure without the permission of the Building Division. I further certify that my registration Iolith the Builder'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 emnloyees who are in compliance with ORS 7~1.055 will be used on this project. IJAf.1E(plei'!$p. prir.t) /~ltl-t.. UN..t..c7/ CL7lLJ:iUJJ, SIG:i!'TURE----PCtt// /~dt".;.ctL.~ FO~ OFFrc.E USE OillY Sq. Ftc). i'lain Sq. Ftc). Access Sq, Ft9. Other D'-- kJ! I..., AIC.,Ht..C..-' .'-:' >2?..:.... Zone Fi re Zone Flood P1 a i n Type/Cons t. Bedrooms Stories Units x Value Value Value VALUATION Occy Load Oecy Group x x -' TOTAL BUILDWG PERfllT Charges and Surcharges Plan CK. Comm/fnd 65%/Rldo p~~ Fp!:' ------------P'Tan Ck. Res 30%/Bldo Per Fee Systems Development Charoe (1. Sn PLU'1B WG PERHIT Charges and Surcharges 'V '\ 0< ' _a-1...!-L__~__ Fence 'i<!) Demo ELECTRlt~,L PERr:IT Charges and SU~.;ha rges 11ECHANICAL PERMIT Charges and Surcharges Sidewalk ~/C Paving Curb Cu t Total Comb. Permit ----. TOTAL c90.'GO \ ' (-'\ " \ (,il . , if COMBINATION APPLICATION/PEffi1IT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. examole- Tax Lot 100. lane County Map Referen( II 03 43 2. examole- lot 1. Block 3. 2nd Addition to Sprlngtield Estates ~ C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilin%r forced ai, 2. examole- waterheater/electrical/or solar E. Square r-ootage or valuation, etc. - 1. exemole- 1250 sq. foot house, 500 sq. foot gat 2. example- if new project. check-n€w - if addit; cneck add, etc. F. Building pemit informat~1n: 1. examole - construct single family house with c attacned garage 2. examole - remodel existing garage into family 3. examale - convert single family residence lntc restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H, DESIGN TEMI AIID COiITRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. Abbreviated P1Ulr.bing, Nechanical, & Electrical Schedul A. E~cept where blank spaces occur in the descr;ptior. ::rtion .of :::e ~'~echanical and Electrical Schedules ~he applicant need fill-in only the No. Boxes adja ~~ tne approoriate item(s) to be inst~iled B. F~l1 Plumbing, :'lechanical. and ~lect~'ical Schedule are available at the Building Division 1. To conserve space on the permit form the sched have been abbreviated 2. If the item{s) to be installed are not covered the abbreviated schedules you sho~ld consult t _ full schedules , C. BUILOIi:G OI'IISIOII STAFF WILL FILL OUT ALL FEES AIIO" CH;,RGES Oil THE SCHEDULES O. As noted on th~ CAP, the label must be delivered t electrical contl'actor for signature by his electri suoervisor, The general contractor is not a~thori to'sign the electrical label. - Applicant to sign and dJte Wher.pvpr rcs:~t;;e. tjll~ initial application .....ill be. use a wOt'ksheet only. Where possible. Building Division $ will preoare a type written cooy and,~eturn it to the applicant Jt the time the actual pettit is lssue~ for signature. Fees and Charqes Plan check fees Jre due and paYJble at :he tl~e of the+- application. dnd no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. . 1 I!. I I I. IV. ~ V. FOR OFFICE ~SE ONLY ,.,..'.. L ._.. .0_ .. 'if / CITY Address (" Received For: ( ( It ~ ( Amount f ~ ~ ( . '. .,,, ,.1 . PERMIT VALIDATION OF ,SPRINGFI ELD c City Hall Springfield. Oregan Department af Public Warks OFFICIAL RECEIPT (" " No. B 55146( ,-\\\\ ') . \ G 19'7JJ " Fro"" \\U~\\(i\of\ rrmtL. ( \7')~ D\Ql"J2je:(n. .2_0r:J i \ ( ~ \ ". ~ i(1(\r\ t n li\, \\ Ci ?-VI\P-X: . j(:)( (J " c\')' \OU ,';<() CQH'fl\ ( ~J ~ 00_ ( ( ~//) Received aU. ~) '~rA I fft--> AUTHORIZED SIGN"TUIlE '''UTO''.TU'''''Ull ._"..TI"'. IV".".. 010 '7.01 cr , ( ( ""n.' t ( 1 ..1 1 I 1 P,~i t C1 oc, PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPArlCY: I I I l I I. _ Permit appliccnt exe!l'pt from registration \;ith the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature . ... .1.. . " _. . I ... ..... ..-.... I I ,,' ,...- ..-. \ ., date , ^J . , _1.- .. j