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HomeMy WebLinkAboutPermit Building 1983-9-26 (2) CITY OF SPRINGFIELD CDrIBII/ATION APPLICATION/PERMIT /':. _ E!lERG'(..'iOURCES: /, Job Address I07'?~:r.e WA'~ L~p Heat HEZT. "....?, Legal Description 17~~.2<:.2C>. o2~4 \'Iater Heater , hnqe ValuE of Hark: :z:s;~ .... BuiiriinQ Permit Info: Descr,be Work(i.e., Build Single Family nesidence With Attached Garaoe) ......-: /- < -~ .-.... ,-"":JIt?j&C~L.~~'~ -IE" c ~'t- c.J,/'7'if!i!2) A-~~ ~/.A""A1~e ,V)';6"",,,,;" A":""-,,.cE '?-o~ .\ (lies. no.) (exoires) (ohane no. I INSPECTION LIr/E. 726- 37 69 . Owner ~<lII#7E1:> ~~ Address ~"'.Me Construction lender G:..s;.::;&i"?S ~~/J Address Phone UI:.:>HiN Il:.N1 (name) I address I Primary 7~ ~.....~..v #5SCC. Structural Electrical !1echani ca 1 CONTRACTORS Inamel laddress] General &N~M/4~~';~~__. Plumbino ~/1_j n:"'......,21'/~. . Electrical M~A"i:F.N':</.e= &EZ=7'. .Iechanical FYe4":l./~" ..s.,."y PLUJIBING NO. I Each single fixture FFE CHARr.E .1!(l Relocated building (new fix. additional) s:- Residence of S.F. Residence 11 bath) Duplex (1 bath) Additional bath Hater service Sewer Storm Sewer Zone C/rfR Fire Zone Flood Plain " }t< BUILDING PERIIIT Charges an;:: Surcharges ~ PLur1BING PERMIT Charges and Surcharges ELECTRICAL PERJ~IT Charges and Surcharges ,~ MECHANICAL PERMIT Charges and Surcharges - INFORIIATION UNL ' 726-3753 Sq. Ftq. 1,Iain ~.::c ~q. Ftg. Access. Sq. Ftq. Ol,h.er Ilew AddXAlter Rep. -Fence Demo Change/Use Other - - ~ \AJ N ~ , " 7Y~-8:l ~ / (li~s. nn.1 (exoirps1 (ohnnp M.) ~~~~L.w. :J.;>~ 3'srfl / ELECTRICAL MECHANICAL ... rHIlRliE. NO r IJARG.E /, ... SQ. FT. furnace/burner to BTU's ...........,New circu~ts alts. ~~~s~,.,.,~. SERVICES Type/Const.5i~"~~. Bedrooms Units Occy Load Occ,v Group B- 2 each I I " ITempOrary Construction Appliance vent I SE!oaratE! I IChange in existing Stationary evap. I I re~j1en~p cooler I I multifamily , corrm. or ....., Vent fan with "='~I L_ lndustrial ~ sina1E! duct ~ ~ I IOf amps.1 I Vent system apart from I I hf!atina or A.C. I ICOMI,I./IND. FEEDERS I Mechanical exhaust I I hnod and dur.t I I Install/alter/relocate I I Hood stove/heater I I rli~trih_ fpprlpr~ I 10f amps. 1- ;iL.~ Zkrw-,J,.__ I I I I .;-0 <. /1.7> k:"'I/-<~- I I I I I I I I I I TOTAL CHARGES M"d, /0, - TOTAL CHARGES IS: -I TOTAL CHARGES /B, ..., , WHERE STATE L.\\/ REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of 'this pennit shall not be vali1 until the label has been signed by an Electrical Supervisor.and returned to the Building Division. . I HAVE CAREFULLY EXAMINED the completed aprlication for permit, and do hereby certify that all information hereon is true and correct, and 1 further certify that any and all work performed 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 IlO 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 ~liance with OP.S 701.055 will be use~ this project. IlAI-lE(please print) PClV\',,\ M C;-Vl,.d~'- SIGIIATURE --~Ll DATE''3/~c../~ FOr. DFF I CE USE BiiL'Y So. FIg. J1ain ~aCo Sq. Ftg. Access Sq.' Fl9. Other Stories ____?~_'t.._4C 8.9~ -=<<:> . ':>0 Plan Ck. Comm/lnd 65%/Rldo Ppr Fp2 Plan Ck. Res 3D%/Blda Per Fee Fence . go Demo ____.1.-2"..,.. """1 Sidewalk ,60 I A/C Paving ____7..~_._c::...~_ Curb Cut /.' 7''1 IS- Floor furnace and vent Recessed wall ~n~cp hp~tpr ~nrl vpnt +5'':'un''UL ,"'i "'-,hI14 .* x Value :?!",~.... Value Value x x TOTAL VALUATION I Xl ("), ~--,-ll Systems Development ~ ~~.~ Charoe (1.5%) , ~'C q-~J.,-e:3 (o[f}4.S I :if ,~B<G rEi!: 73c..~c.D//'7C-" I 1lc..M/iV#(.1 M~~. I 1 ~~MIT.s .(-$q~ liM</rI I Total Comb, Permit ~tP6.- 8C> I - I I TOTAL t;a {, 80 1J/S': 00 . g ~ io COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Oescription 1. example- 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 1. examole- heat/electrical ceilinq/or forced air Qas 2. example. waterheater/electrlcal/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 pennit information: 1. example - construct single family house with an attached garage 2. examole - remodel existing garage into family room 3. exam~le. 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 TEN1 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. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES O. 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 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 ~harges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY . ;. . PERMIT VALIDATION q-ro-5~ ~ .. (Q l"l14 , , / . - Permi t cler~/JYL) !l PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: , ; Mdf?~""'#/~' N~: OD,i.J2/'#"'- r ?/ ~MB/h'.t::... n-.A'"~/ r FEeS he: J6~i9(t!Fb . - . - "1 .Y{Jttt:: ?; MR.R'~~ ??-~"""'~.P W/r#e>~7" / ~""M/ 7:S. ~ ?Ed;)O/RE"L:::> "Z ~c)ec:, soy (9) 5~Ji'/N<S~/~'-D ,.;!3~/L.b/~~ Ce:>L::>c ~~/-'o// sr?i'~T/Y~ G~~ . . Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: 5"P C. (.5 M_", 2~D C>;Z:?/6/ N ",u_ <;lJ <:::. a.c ON.F/~/SI17'FZ:> #.Pi04<~~~~ :;VNC ~ 0# h+ct:..-~ c::;,,~ < ~ (AI'~ P N re"o?? .#A'~..pr, PLANS REVIEWED BY: name/~~-?Z'C<r~ signature ~: , .. ....~- .- .'.' ~_,~. da~e 9~;;>?-Bs . "'j . ....,'~..............'."n. _ .' .....-.._~_...........~....__,_.I~. _.,.. .~". ....--,.~~;'