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Home My WebLink AboutPermit Building 1980-1-31 (2) llllSPECTlON LINE - ,. CITY OF SPRINGFIELD' INFORlIATlON liNt 726-3769 ." COMBIIIATlON APPLICATION/PERMIT 726-3753 . ;> ,/ EIIERGY SOURCES: Sq. Ftg, 1,Iain t/ii1lJE/.PJ Job Add"", //7.., c" II.-,IF wA.<1 L./')60 Heat 1'-1 .,.~-r""<:'(Ilt.Q(Puoq, Ftg, Access. 7 \ \~ater Heater 1'1 "t--r~Ic.: 1~" Ftg, Other Legal Description i -63 -.:;1..:;2 -:::l - Yn'CLe-l.b /'>lIe" Add Alter Pep. f) Range~ . n' Fence Demo Change/Use h,,/- OF /a..l{' 1.0'; "i.'-In(') - 11 Iso my: Ic,i..BtlP V~u€ of Hork: Other- - O"ner' JA-01e", L G,t"_I'<::.. .Q,~ t(1f;O,tfJOO Buiidinq Yermit Info: Describe Work{i-.e., Build Single Familv Residence With Attached Garaqe) Address I o::A a o \:) - c:)) Phone .; 30 C",ur''-112. N IT-. <17311 I ~1-r.C1'040~ (':' MM c:; -r e.e;.,c.. T(Jt/Jlj""r< tJ jO ~ r:./...Od1Z. rP.~"'..D f'.LJ,uSTiUJr _7'~Chl./, Cons tructi on Lender i I 'OJ IJ I\, "'T . ro/U tl. L ~A^-, (4.. Address a..Ifl...1 _C .Lv-. DESIGN TEAI.I (name) Primary tv] AL-~"- N 7.1 P Structura 1 c,A>. "'- '" Electrical <6~.....\V r1echan; ca 1 S-fti..c....,/f.. CONTRACTORS (name) Genera 1 r. \-\ f}".1.G--r Plumbino T ""'0 Electrical TI',C' ~1echan;cal .,.6D NO,I Phone (addr." ) " (exo;res) (nhone no.') (lics. no.) "'?AI,(,f? /JP..S?Y, Pf. <"2&;'0 ~ W '7( 1$ T PT{,...n lJt2.F 2zLI -;6/.,1 (address) (lic:c;, nQ.1 ((>xnirpc;) -;-...., f.'NJ <;.", 111~ 409, '7 73t? I (ohnnp nn ) I jJ r_ 7,(.&4-Mm 0<::; '3"" r~A.J 1.,,",12. /J IF' PLUIIBIrIG I FEE I [HARGF I "n FFF ELECTRICAL MECHANICAL I Residence of I r~AR~1=' ~Jn 1 I H.~ I r~AQr.~ furnace/burner to BTU's Each single fixture SQ, FT. 3.3 5.00 I~ Relocated building (new fix, additional) Floor furnace and vent S.F. Residence (I bath) Duplex (I bath) each Additional bath 1~later service I Sewer I Storm Sewer I I I amps.1 - I I I I I I I I I SSUANCE OF PFRllIT TOTAL CHARGES 1t.S.tKJ ,TOTAL CHARGES ?s. all TOTAL CHARGES WHERE STATE L'\.H REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit r'. shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXA/'lINED 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 Springfield and the Laws of the State of Oregon pertaining to the work described herein. and that NO OCCUPAHCY 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. . DFrJN/~ :J, 1('C;>UD9-L SIGIIATURE ~~ ;),~EI-:S1-8t/' FO~ O"r'FICE USE mlLY V ~ I Units ~ _Sq, Ftg, Ilain t..Rlltp x 2?t'1J Value 19~ q:l;f). 'if/) Occy Loadr':-~'1~~Sq, Ftg. Access / x Value Occ'y Group...1l-:', Sq, Ftg, OtherR"':.?~SI(L.1llt x .4S'Value I(/~I./(,.'(}_ TOTAL VALUATlON.....2Il:r.. "'~ ; IWIE(please print) Zone f!.-l/ Fire Zone -rr. Flood Plain ~11 BUILDING PERflIT Charges an': Surcharges PLU'1BING PERMIT Charges and Surcharges ELECTRICAL PERI~IT Cha rges and Surcharges 11ECHANICAL PERMIT Charges and Surcharges New circuits alts. or extensions SERVICES Recessed wall ~oacp npatpr ann vpnt I ITempOrary Construction IChange in existing rp<: i n_pJ"u'''e Imultifamily, comm. or Industrial //).& I I Appliance vent seoaratp Stationarv evao, cooler ~ , Vent fan with sinole duct I Vent system apart from I heatino or A.C. I Mechanical exhaust hood and dur:t I \.Jood stove/heater I I I I I Of .lJ.J2n ICOMM,/IND, FEEDERS iInstall/alter/relocate !di<:trih_ fpprlpr<: I Of tb./JO amps. TYDe/Const,~ Bedrooms ~ Stories J _ _ ,f~ n Y...l ~O/) , ~ )~.qh _ 'n_.J~~C, Fence ; G.. iDol D~mo '15.ao I Sidewalk --------.i~1 A/C Paving/J,9th..ln I Curb Cut ------------ I Plan Ck. Comm/lnd 65%/Bldo Ppr ~~e Plan Ck. Res 30%/Bldo Per Fee I '7'7~-, /0 Syste.ms Development nUJ (CJ Charoe (1.5%) 3.0.$D.I.S- . I ~o.()" ITota' Comb. Permit I J TOTAL "5'6.5G. .I 3/,~o t. ')./ .- . . .... \ COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION 1, Applicant to furnish A, Job Address B, Legal Oescription 1. example- Tax Lot 100, lane County Map Reference II oj 43 2, example- Lot 1, Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example~ heat/electrical ceilinqlor forced air Qas 2. examyle. waterheater;electrical/or solar E. Square footage or valuation, etc. 1, examole- 1250 sq, foot house, 500 sq. foot garage 2. example. if new project. checkiruew - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an a ttached garage 2. example - 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, DESIGN TEAM 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, BUILDING OIVISION 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. 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 charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY Permit Clerk .. ,1 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: -r \ ,'~'~T Vc'r Il""1c_LLe.<..c... T"'It.tlJr ""^ ~ ; , V'Uf'll ~ rl. :h...~ "",OiA U. Xn.< o~4- k'.........\>\ Ir-r, l , PLANS REVIEWED BY: name Signature_AOa.- ~~-d.- date 1-30- &'J J . . llir'ISPECTIOII LIIIE CITY UF SPRINGFIELD INFORlIATlON LitlE , COt1BI:IATlON APPLlCATlON/PERMIT 726-37S3 726.~?69 _.. EilERGY SOURCES: Sq, Ftg, 1,Iain fiiRJfi.R Job Addrl,ss . J /71./ c-) /.\-'TIF w~ Lf')np Heat ~ I ""'T,-_'L(j)~.M Pu ~q, ~tg, Access, LegalOescription i7'^"'" _....'" _..... _ =~.~__\."'" !'later Heater 1', "",-r~I'- 1:,>, Ftg, Other v oJ ~<><..... ,-. .-> ~_ .LJ ~Ie" Add Alter Rep, I' Ranqe c'? A-'; . - Fence Demo Change/Use 'LI ~ . T'C--J{' 1-0 r ., '-[fl'" - a 1.5() 1o..t 1"'+ RJ-l. P ,"-. ~ ~ ~ - u _ _ ~ v~I~€_of l'lork: Other- - Owner JA-.0oIe:c, L G.ULII<:. "o~ t{!I:>O.l'}oo BuildinQ Yennit Info: Describe Hork{ Le.. Build Single Family P-esidence Hith J1.ttached Garaae) Address <2"u, L fC 4- () 9, .,:; ">0 c~urrL'/L N r,:., Phone Construction Lender 11'0 1J~-r''''IUjJ.L l',t!'.A.'I4. 0T3() I c: JuJ., c: -r 12v.C'~T~,U;- rP.~'J."'1&~;~O t':OHjS7 (U/," _7/cJA./, () Nc- FLOtJR.. Address <2..k..., C~L.L..--l . OESIGN TEA/1 (name) Primary M AL-kfc N 211:" Structural C*J.h..l.-1.... j?; Electrical t;,~....0{!;- Hechanical S-f"-'--'te,. CDlITRACTDRS (name) Genera 1 r: \-\ 10..1 ~-r Plumbina T ,>,0 Electrical T6,> r,lechanical ,ISD PLUllBl/IG NO. t 331 Each single fixture IRelocated building (new fix. additional) Is.F. P.esidence (1 bath) Duplex (1 bath) each Additional bath ~!ater servi ce Sewer I Storm I Sewer IlAI-lE(please print) Zone {2-if Fire Zone -rr. Flood Plain ,~I} Tyoe/Const. Bedrooms Stories BUILOIIJG PERlm Cha rges an~ Surcharges PLUf1BING PERI11T Charges and SurCharges ELECTRICP,L PERt:1T Cha rges and SurCharges /IECHAIIlCAL PERI11T Charges and Surcharges I FEF I r:HARGE 1&.00 /!,.Sa '1-M - ! Phone (address) (1 ics. no.) "26.,0 ~. vJ ~ I $ T PTl-r:J lJ/2.F 2ZLJ qq/,,'C --,?AI t'CJ Ac::.~.....E,( I JJ (_ (address) c::::: ~c:> /e_d7~_tf) J..JtP (lies. no.\ (pxnir~s' <';"'~9, "77'3t'1 ?,&;4-f/Aa? ELECTRICAL "0 , 1=1=1= 'r~ARh1=- NO. I I I I I I I I I I I I I TOTAL CHARGES fItS,!?'" TOTAL CHARGES WHEnE STATE LW REQUIRES that the Electrical work be done by an Electrical shall not be valiJ until the label has been signed by an Electrical Surervisor Residence of sq, FT. INew circu~ts alts. or ex tens 1Qns I SERVICES I I I I 1//).&1 I I !-s,r..d I I I I I I I ?s. CZiI ! Temporary Construction Change in existing rpc:;idpnrp I'multifamily, comm. or Tnduc:;tritll ,I Of 1'),")0 amps. C0I1H./IND, FEEDERS Install/alter/relocate d;c:;trih_ fppdprc:; Of amps. I ~ () o \:) - cj) (exoires) " (ohone no.l (ohnnp 11t"\ , MECHANICAL I I furnace/burner to BTU's I Floor furnace and vent Recessed wall Sntlcp hptlt~r tlnn v~nt 'j:H I nH\.IU~j: I I I I I I I I I I I I I I Appliance vent seoar?ltp I Stationary evap. cooler I Vent fan wi th sinole duct I Vent system apart from I heatino or A.C. I Mechanical exhaust hood and dut"t I Uood stove/heater I I I ISSUANCf OF PFR!11T TOTAL CHARGES Contractor, the electrical portion of this permit and returned to the Building Division "1'7.- I r;< /J, .LJQ t.,o.oo x '21. "Il Value /"J/. q:Zr), <;(/) Value I':"!) Value J1. ~l.I".IO I HAVE CAREFULLY EXArlINED the completed aprlication for per~it, 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 5pri ng fi e 1 d and the Laws of the Sta te of Oregon perta i n i og to the \oJork descri bed herei n. and that 1m OCCUPAUCY wi 11 be made of any structure without the permission of the Building Division. I further certify that my registration with the B4ilder's, Board ;s 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 \'Iill be used on this project. DFrJN/~ 'J /(OU.oqL SIGIIATURE ~~ ;),,~d-:Sl-gi? FO~ OFFICE USE OilL Y V Units I _So, Ftg, 11ain ("t:;,t:le, /"j../irl. :,';1 ~;,f. Occy load~L"I"" . ,:;.~SQ. Ftg. Access x Occy Group---.B" ~ Sq. Ftg. Otherll~~1~:Str'!.. ~:5f x f /// PlanCk.Conm/lnd _.....:.._,____72.:~a;:!. 65%/B~~~_~~... Coo Plan Ck, Res ~ ,1/-:0, 9{., 30%/61 do Per Fee , ,", I/,.5. !?r.1 Fence __.____J____.... &. bol Dcmo 7S.o~~ I Sidewalk --------3.001 AIC Pavingl/,q'l""", I Curb Cut I TOTAL VALUATION ~/)~, 3,\I"q() Isyste.ms Development Charoe (j,Sn I I I I 3,ostJ.l,S- ITotal Comb. rermit I I TOTAL '15'6.5C. /l3J~'OI.'J..1 . . COMBINATION APPLICATION/PE~~IT (CAP) I. Applicant to furnish A, Job Address B. legal Description 1. exarnole- Tax lot 100, Lane County Map Reference 1/ 03 43 2, examole- lot I, Block 3, 2nd Addition to ~prlngtjeld Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - I, examole- 1250 sq, foot house, 500 sq, foot garage 2. example. if new project. check new - if addition. check add. etc. F. Building permit information: 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, OESIGil TEAi,! AlIO 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. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the ~lechanical 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, BUllDliiG Dl'IISIOII STAFF WILL FIll OUT ALL FEES AND CHARGES Oil 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 ~ 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 charges are due and payable when the permit is issued. V, FOR OFFICE USE OlllY PROJECT CONDITIONS TO BESAnSFIED BEFORE OCCUPANCY: . .. 4".....__ . ~ , . PERMIT VALIDATION CITY OF SPRINGFIELD 4. City Hall Springfield, Oregan Department of Public Works OFFICIAL RECEIPT ( . No. te~ ~ ('\ , .3\ 19?f"') :'d From 0:>0<<\ ~ \- "~($\ G dress Yl ':)() C' nTh t\'} f. ", 5) \~to 4:B - ~~" f"V',. , 4 :eived For:$\(\\7\ 4?_4co () 49!t) \ iQ q (0 4 \. -\lffi b ~VJD\ \I~~~.<< c 0 t'lB:. \ ~S~S I OS~ \ 4$\rO.LrD G \. II ~ \:)7f'tZ\- \CJ 00 - ~') .4(J d t c;:A.l' , \.h nn <{)i l \,('\90 ~r' _' 6?{)~ \roa B 52683~ nount Received ' ~j)l) \ ,'d \ \ \ X\ ~l'(d -c ~tD,,!.,,"", s..nTO...Tu'....U~L ....,..ailS' I;uClnn o. ".0' ..,,,., (,. '. -, tG Permit Clerk . Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: ~M';"!'- \Jc.,p {",I .' ~P.-r I I\...? t' \.(\. w. ~r\( ~t-;.~4- k'.,..-....,V'I \t"-r. PLANS REVIEWED BY: ^_c....Le.c..c:... ........(J~rlf'V'.~-\ , , V'_(')t\\\,.., A ~, .~ , I name /' f signature AVa....... ~,,;z;L- date /-30- m