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HomeMy WebLinkAboutPermit Building 1980-2-4 (2) /' .' ~ 'I iNSPECT ION LINE 725-3769 Job Address 73) P:J1taV3. legal De,eription r,Clt fi 8 lIke VUb;:e O\'mer Grep;;'s Electri..c Address 27.37. ")1 vnr-; i. e . ": .' - CITY OF SPRWGFIElD . CDMBI;IATION APPLICATION/PERMIT . - - - - 'EilERr;y. ..sp,uRCE~:. Heat l:.l",.C v J. .C . \iater Heater E1ee t:'~e I Ranqe Eleqtri2-____ I Valu, of \iO;k~- Ine 42.027.00 Pho ,...,,..., - ,.. 64,Q<;;nQ PerntH Info: Describe I'Jork(i .e., Build Single r;::_-:c :1,131;0 hBat:"lv nesidence l'lith A.~.tached GaraQe) birzLe fRmLlv wi DGt. ~Br&~e J:' ~~ C.Jt}sc. Construction lender Fi.rs t 1'1,;1 t. Sa ":: k Address Ut>IGN TEN. Structural Primary':,'ieSi,ern Desi:!gr.. Ass. (name} ___ Electr; ca 1 11echan; ca 1 CONTRACTORS (name) Phone (address) 40.2 ~. 13th (lies. no.) i2,,'.lg. Genera 1 G r e ~ 's E 1. e e t. .'1,. C").' st. (address ) 2757 :JlYITIl: ic (lies. no.) 0.,855 Plumbind;")nt""'l(~t Pl:111b. Electrical Gr;?g:'s T::lecc. &. C "lnSG. [Lie 20'38 N. 2nd Svrfc. 2~)-1l4 20-<:8 ~lechanica1 R..,lf' Pp'1'~in= )l....th:::; ,')sr, V.81ov f,'-~Y',t:> c.?~7 '}L'ym~ie f.:=- '.~ r. p~" -;. ");:"4 I rlO. PlUlIBlIlG ElECTR I CAl """ (,l-lAQr.~i "'."'r-r ~....~".v FFF rHARr,F Each single fixture Relocated building (new fix. additional) S.F. Residence (l bath! Duplex (1 bath) each !.--- ! Additional bath Water service Sewer I Storm Sewer IdSOO I NO I I Res i dence of ~ !/,..n.'J SQ. FT. !New circuits alts. or extensions I SERVICES I I I I ------L..J "I /D~CU --:- Temporary construction~' ' ... - ~ I Cha~ge in existing I rp'l- ] dJ'nrp I multifamily. COIll!!. or I .. 'ndlJ~trial .: I I ,I I I I I I I I I I I I I I I I 3.s~O!? I TOTAL CHARGES that the Electrical work be done by an label has been signed by an Electrical TOTAL CHARGES WHERE STATE l~\i REQUIRES shall not be va1iJ until the IOf I C0I1'-1. fIND. FEEDERS Install/alter/relocate d;~trih f~pdpr, Of amps. amps. lNFORllATlON liNt 725-3753 Sq. Ftq. I.1ain 1 ,:;.)~ ~q. Ftg. Access!JC'O So. Ftg. Other Y.-11e"_Add_Al ter -,~ep. __Fence__Demo__Change/Use _Other ~ ~ V I I (exnires1 (ohone no. 6B8-~787 (exoirpc;) (ohonp no 1______ 7;:;)- ::.4:14 7'-15-0220 '7<: 6-54:)4 6/23/8B 5/1g/80 .-;" '/'-1) '..:) ./...... '-" 1;:' /1 "'I,",) ("::;?-;:'';,''.F\ MECHAN I CAL Itn I """ (,~AQr.~ furnace/burner to BTlI's Floor furnace and vent .. Recessed wa 11 SOnrp hp~tpr ~nrl vpnt Appliance vent <;.eoaratp I Stationary evap. cooler I Vent fan wi th sinole duct Vent system apart heatino or-A.C. Mechanical exhaust hnod nnd durt I Hood stove/heater I I I }.j~ -?-::') from /., -- ~...~u ISSUANCf OF PFRillT I/}. t:U _).~~~,~I TOTAL CHARGES Electrical Contractor, the electrical portion of Surervisor and returned to the Building Division .J.g I .S"/) this permit 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 oerformed shall be done in accordance with the Ordinances of the City of Spri ng fi e 1 d and the laws of the S ta te of Orel)on perta i n i ng to the work descrt bed here in, and tha t IW OCCUPAllCY \'Ii 11 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 exemntion is noted hereon, and that only subcontractors and employees \vho are in compliance with Or-!.S 7('Jl.055 will be used on this project. IWIE(please print) S IG;IATURE FOr.1irFlCE USE mil Y Zone ..~'-.' Tvpe/Const. ~"'4 Units I Sq. Ftg. rlain /~.I)O Fi re Zone 712 Bed roorlls .3 Occy load Sq. Ft~. Access .-;Z:-r' Flood Plain ,'J"'.) Stories I Occy Group ;7/... ~ Sq. Ftg. Other . BUILDING PERI.llT Charges an~ Surcharges PlUI1BlIIG PERMIT Charges and Surcharges ELECTRICAL PERr~IT Cha rges and Surcha rges flECHAN I CAL PERMIT Charges and Surcharges )1 l Plan Ck. COlMlfInd _______..:...!..!:L.{::! 65%1Bldo Ppr Fpp Plan Ck. Res '.... '.,:i 30%/BldQ Per Fee -; ... ,.,.....,1 Fence _ _ _ _ _ _ _~......~"l!"-= ~ , .J. .,~I D~mo \ "',')o(} _ _SlS~~=:.~ Sidewa 1 k 1~ 7..':8 I .(..;\-" ","":"", .__j -rqC Paving ,?~ <"~, Curb Cut j,q I --- _ ____,~~"f!. /Istl DATE x '_1.:.t.?..') Value ?~, i?!J.OCJ x i,f)!) Value "~-.q",.?~ x Va 1 ue TOTAL VAlUATIOII 41./..7.'1. z..J Sys ter.:s Deve 1 opmen t I Charoe (1.5') L\C\ ID(I'J I, -- I I tJ.'1!.:> I /.,;~/~ .:;1 I I Total r.oMb. Permit / j ':!~ .~l! ITOTAlQr14S ;}~~ / /.1l) . COMBINATION APPlICATION/PEffi~IT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. lane County Map Reference .J/ 03 43 2. examole- lot 1. Block 3. 2nd Addition to Spr1ngfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examele- heat/electrical ceil;nqlor forced air qas 2. examoJe- 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. check-new - if addition, check: add, etc. F. Building pennit information: 1. example - construct single family house with an attached garage 2. examele - 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 (aJ of the Structural Specialty Code H. DESIGN TEM1 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 8. Full Plumbing, Mechanical, and Electrical Schedules are availabfe 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. --- III, Applicant to Sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepa~e a type written copy and return it to the applicant at the time the actual permit is issued for his 5 i goa ture. 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 ~~\. CITY OF SPRINGFIELD ( City Hall Springfield, Oregan Department of Public Work. OFFICIAL RECEIPT 52939( No. B "e :~ - 3 - 1980 c'd From~"-.t> ri' rJo,r ,t- Idress .lJ'l g ~ ~ rU-l / ~ :1/ ( ( ceiv_ed For: np .if. , 47" {10 , )(~&. 00 ~,I/I ( =i<;: ()() / '10 rJS.OO J, (J{) c;J 3,:;19 ,9'1 I g 5&; In 39. '-1/ y\ 'TCfS . 0XG -( \i~ , ( ,r: f) - I 4/u r1:. 13115 L.j 7, ) mp 49" 5-uJ d ('j_ S.o? lount Received ,( I -r AUTHOll:I:lltO SIGNATUIU SH~~TOH.TU"".U~~ ~,,,..TUls . ItUCItHIt, 0_ _7.0, ,.",.. ( , , '. Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: I: " PLANS REVIEWED BY: name signature _ADu..-_ ,'1 'V' " to f) ./ - .~ ..'?'......~j_::.~~ date ,../-<'/--,<-""1 "