HomeMy WebLinkAboutPermit Building 1984-12-21 (2)
CITY UF SPRINGFIELD . INFDR11ATIDN LINt
COMBINATION APPLICATION/PERMIT 726-3753
E!IERGY SOURCES: Sq. Ftg. 1,1ain 'A.
Heat ~q. Ftg. Access. \Jj
lIater Heater Sq. Ftg. O~h r-
Ilew Add lter Rep. -,--,
Range Fence_ em _Change/Use D
Va 1!!Al of lIork' r?"'l Other "'"
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Buil~inq)Permit Tnfo: Describe Work(i'.e., Build Single ~
Familv nesidence With Attached Garaoel ~
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I INSPECTION LlIIE
726-3769
Job Address ] Of} I J
Legal Description
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Address /7) f) f) n () '17 ~ 1 ~~:r'
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cons~lt;~ende,l
Address
Ut::iJliN I~ {name}
Primary , ~ hi}(1 . C\.~\..Cl..U2-.J
Structural
Electrical
Mechanical
CONTRACTORS Iname)
Genera.. \)~ \ (>
Phone
(address)
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Jaddress) (lies. no. 1. (pxnirpsl
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Plumbina
Electricall\~ U .If\ 71 0
~'echanical
NO.
PLU/IBING
ELECTRICAL
FFF r.HARr,F ~n~
Each Single fixture
Residence of
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TOTAL CHARGES TOTAL CHARGES \ ~,CO TOTAL CHARGES
WHERE STATE L~II REQUIRES that the Electrical work be done by an,'Electrical Contractor, the electrical portion 'of this permit
shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division
each
f) INew circu~ts alts.
L-.. or extenslons .
ISERVICES
I
Relocated building
(new fix. additional)
I'S.F. Residence
(] bath 1
IDuplex (1 bath)
IAdditional bath
I Wa ter servi ce
JSewer
I Storm Sewer
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1lAf,IE(please print)
ZoneJ.:~ V
Fire Zone -
Flood Plail'\_
BUILDING PERHIT
Charges and
Surcharges
PLW1BING PERMIT
Charges and
Surcha rges
ELECTRICAL PERI~IT
Charges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
SQ. FT.
ITempOrary Construction
Change in existing
rpsictrnrp
multifamily. COnln. or
Indll~tritll
IOf
ICOMM./IND. FEEOERS
IInstall/alter/relocate I
rli~trih_ fppdpr~
jOf amp~1
Da"J
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I HAVE CAREFUllY EXMlINED 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 Oregon pertaining to the work described herein, and that NO OCCUPAIKY 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 ORS 701.055 will be used on this project.
5 Ir.IIATURE /J(lJ A. 1 i
Fon OFFICE USE OIlL Y
Sq. Ftg. 11ainf''1.'\m\\.~t\
Sq. Ftg. Access x
Sq. Ftg. Other x
Type/Const. ~- \ """"
Bedrooms -
Stories ?
Units
Occy Load
Occy Group \.~. (_
'^ a:J Plan Ck. ConmlInd
__..l\....L'-______ 65%/Rlrlo P.tr Fpp
I '0 Plan Ck, Res
. ""'\ 30%lBl do Per Fee
__~I t::.. I Fence
I 10_
\ ~.~ 'Sidewalk
-------00-- A/C Paving
---~h__J Curb Cut
I
amps.1
~~~ r~ NO
(olYlnP l'l0,,)
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MECHANICAL
furnace/burner to
BTU's
IT.L ..cHARliE.
Floor furnace
and vent
Recessed wall
SOtlrp hp~tp~ ~nrl v~nt
Appliance vent
5~Oartltp
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart from I
heatina or A.C.
I Mechanical exhaust
hood and duct
I Wood stove/heater
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ISSUANCE OF PERrIIT
DATE ('2121/8"'/
Value
Value
ValuE'
TOTAL VALUATION
Systems Development
Char~e t1.5~) "
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ITota1 Comb. Permit
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I TOTAL
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COMBINATION APPLICATION/PERMIT (CAP)
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PERMIT VALIDATION
I. Applicant to furnish
A. Job Address
B. legal Description
1. example- Tax lot 100. Lane County Map Reference
II U3 43
2. examEle- Lot 1, Block 3, 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. examole- heat/electrical ceilinq/or forced air Q3S
2. examyle- waterheater/electrlcal/or solar
E. Square footage or valuation, etc.
1. examEle- 1250 SQ. foot house, 500 sQ. foot garage
2. example- if new project. check new - if addition,
cneck add, etc.
F. .Building pennit information:
1. example - construct single family house with an
attaChed garage
2. example - remodel existing garage into family room
3. exa~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 Pl~mbing, 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. ---
Ill, 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 charges are due and
payable when the permit is issued.
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V, FOR OFFICE USE ONLY
Pennit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Infonnation:
PLANS REVIEWED BY:
nam~~'f;\ '-;\ \ ~l n
SignatuJ--<,,- ~
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A PROFESSIONAL CORPORATION . ARCHITECTS & PLANNERS
23 October 1984
Don Bainter
United Pacific/Reliance Ins.Co.
1077 Gateway Loop
Springfield, OR 97477
Subject: Proposed Workroom
Upon your request I evaluated the structural impact of the
workroom on the existing floor capabilities.
The expansion of the proposed workroom over the initial proposal
does not cause any structural problems. The room could be
enlarged as shown as long as storage is located where shown on
the schematic drawing. The enlarged space would not allow for
stacking of storage materials or files in the center or open
space of the room.
If further information is required, please call.
Sincerely,
~W~
Linn West, AIA/CSI
TWO HUNDI=IEO SOUTH MLL STREET. SPFm'\/GFlELD, OREGON 97477, TELEPHONE (5031 746-8231
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