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Home My WebLink AboutPermit Building 1980-3-31 ...' { ~- <f!-.._ ., INSPECTION LINE J 726- 37 69 , , Job Address l Z-J I :, ...... lNFO:Rr1P:TION'LlNt 726-3753 Sq. Ftg. r'1a i n :q. Ftg. Access. ~Sq. Ftg. Othe~.~~ Ne\~:XAdd Alter Rep. --Fence Demo 'Change/Use ---'-Other -- -- CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT ..&u~'~ sL3;;,7,J.-e/jI ~~~~GYc:;~CE~2J I/-'I<- . . U !;later Heater ~M ;Range ~7J!J~ legal Description ~. '-1lwner' StEveJ .::J. AL.Lc:rI ').ddress -Z;Z J I 13€Vdc-,' $T. i / Construction Lender A/ / jI , / Val~t=n , BuirC:inq Permit Info: Describe t.Jork(i'.e. ,-Build Single Family Residence l~h Attached Garage) -Ct:m(jwr::;(Jh~ ~ 10 ,.ky,,,;,/y FJrYM ~ UP() U T o...J. h.;>.../1, , u u; ,.. . Phone 7l&7 yt'o , Address 'DESIGN TEAM (name) :--Primary S'~U<,. 4/&."... Phone (address) ~2-I( ~ S~ : Structura 1 , , , " j ~, ortri,"';:'" I" ,-"' - ,- _. ,--_. 1 t1echanical i CONTRACTORS (name) +General, t](tZp:y j ~~~J~ i Plumbinq KH C~IJ~'~ i Electrical19~ (address) 1 ~1echanical ,.. PLUr1BING 'ifl;;~S' - FFF rHARGF NO, furnace/burner to BTU's ELECTRICAL NO. FEE Each single fixture CHARGE ' NO, Residence of SQ. FT. Relocated building (new fix. additional)' New circuits alts. or extensions S.F. Residence (1 bath) IDuPlex (1 bath) each I jAdditional bath l\tIater "ervice /SERVICES I JO. 00 I ITempOrary Construction IChange in existing residence multifamily, comm. or Industrial Of amps.1 ICOMM./IND. FEEDERS I 'Install/alter/relo~ate I distrib, feeders ' 10f amp~1 I I I Sewer Storm Sewer (lics. no.) ~,~L4 (exoires) (phone no.) (1 i cs. no,) 7u::'-7rj~o (r~lS1lzt41 l j j I ""\ I (exoires) (ohone no. ) 4$ 4r3B3 MECHANICAL FFF CH,oc,F 1 I Floor furnace and vent I I I I I I I I I I I I I Reces sed wa 11 Soace heater and I I App 1 i ance vent seoarate I Stationary evap. J cooler ~ Vent fan with sinale duct Vent system apart heatinq or A.C. I Mechanical exhaust hood and duct I t'lood stove/heater I I I from vent' , ~ OC=O' .,,> ' : TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the 10. ~. TOTAL CHARGES that the El ectri ca 1 \~ork be done by an label has been signed by an Electrical ISSUANCE OF PFRI1.IT /0, dO : TOTAL CHARGES / 3. ..~: :Electrical Contractor, the .electrical portion of this permit r" Supervisor and returned to the ,Building Division I HAVE CAREFULLY EXAnINED 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 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 NO OCCUPAr~CY will be made of any structure without the permission of the 8uilding 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 w 11 be used on this project. rW1E(Plea~e print) sk~~S, MIl(., Tyoe/Const. ~'-i.Sf . , Bedrooms Stori es S I GrV\TURE FOr. OFFICE USE o;~L Y 6. / Sq. Ftc]. 11.'inl Sq. Ftg. Ac ess Sq. Ftg: Other Zone /<.1 Fire Zone ~ Flood Plain Units Occy load Occy Group 'R. - '3' BUILDING PER~1IT Charges and Surcharges Plan Ck. 65%/Blda Plan Ck. /. 1';1" 30%/Bl da Lt:). tlJIO I Fence ----- -~y~--I D@mo I Sidewalk I A/e Pavi ng I I I I. 'I I '2.s. ..~ Comm/lnd Per Fee Res Per Fee PLU~1B I NG PERMIT Charges and Surcha rges -~ ELECTRICAL PERrlIT Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges _____j_:r.._~~_, Curb Cut , $2. g>. 'to fat DAT~~ ~D J ~ \) ..,z. x Id,"lS Value ~t:)S-/. yo 'x Value x Value TOTAL VALUATION .!'cJSf. y~ ISystems Development Charge t1.57,) , I IT~tal Comb. Permit [ TOTAl r;;;/, C/Y cd 'I. '1~ ,;J. " . ~~ " COMBINAT'ION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. . example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources . 1. example- heat/electrical ceiling/or forced air gas 2. example- waterheater/electricalior solar E. Square footage or valuation, etc. 1. example- 1250 s~. foot house, 500 sq. foot garage . '2. example- if new project, checknew - if' addition, , check add, etc. ' F,:,' , Bui1ding permit information: , ' 1. example - construct single family house ~jth an , ~ ttached <:)arllge ;'. 2. exa~ple~' remodel existing garage intq f8mily room 3. exampl~ - convert single family residenc~ into restaurant (change of use) 'j 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, Build,ing Division Staff must be able to contact appro~riate persons regarding design information or job s~te corrections, etc. " II.' Abbreviated Plumbing, Mechanical,'& Electrical Schedules A. Except, where blank sp~ces occ~r in.,the description portion of the M~chanical and"Electrical Sch~dules, the applicant need fill-in only the flo. Boxe~ adjacent to the appropriate item(s) to be installed' " ' B. Full Plumbing, Mechanical, and El~ctricalSch~dules are available at the Building Division' 1. To conserve space on the permit form the ~chedules ,have been abbreviated 2. ,If the item(s) to be installed are not co~ered 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 siqn 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. ,,~' ,f :..J.,., . .. 1, j 1 !l ~ I ,V. FOR OFFICE USE ONLY Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . . ~ ~ . - . ! ~ ~ . . Permit applicantexempt'from registration with the Builder's Board because:' , .. ~ j ~ ~~ Additi ona 1 Project Informati on: ~ 1 . ~ 1 '.. ~ ,/ PLANS REVIEWED BY: name Lc.RNfW ~57~ signature 4~~....., date 3....3/-8c. ..;:: ,;) ~~... ~..," ItISPEeT IONL HIE 1726-3769 CITY OF SPRINGFIELD Cm1BIilATlml APPLlGATlON/PERMIT ErlERGY SOURCES z Hea t C, In- ro-,1L[j) Jh;<- \:!ater~ H~ater 6A:r ' Ranqe ~~)~ ValuE: of \'/ork: Buil(;ino Permit Info: Describe 110rk(i.e., Build Single ::i,lY ~es i den~~~tl~h ,L\ttached Garaqe) C:m\J~,r ~_^r3-kf'~ au~/./o -'-milt IJJM ~ b.': 1--1, rt; nJ;1 'JJ U . Job Addres sl t /I &u q~ st. 5,0 fdJf.ti til Legal Description ,~ner :StevEN ::J. 'At...L.d }\ddress Z. 2- J / 13,cvE:fL'/ ST' I / Construction Lender ,,;1;1 f1 I I Phone 7tG--7 Y.cD Address DESIGN TEAM (name) 'Prima'ry 5'-kJC A/h.. Phone (address) .~Zll .&.O~k, S~ , : Structural El r::ctri c~...1 I ! !1echanica1 , CONTRACTORS (name) ,.' General ?;/e&a-/J 5 &~\,~(,b~ : '- /$. I i - L ,./ S : P1umbino K Jof C'~'-I'fl1?r> I{ '~ (address) E1 ~ctri ca 16)<-,,]\;2./ I t ~1echanica1 I NFORI1ATlON LJ Nt, 726-3753 ,Sq. Ftg. "lain ~q. !"tg. Access. ,/Sq. Ftg. Other1' r:}'l. , Ne\O<Add Alter Rep. --Fence Demo Change/Use --Other -- -- ~.. (exoires) (1 ics, no,) ,'l ," ~/1kL4 NO. ,I FEE. I CHARGE NO ELECTRICAL ~ 130{ PLUfm I NG (Dhone no, ) 72G -7c(C;o (1f/t: [)ileA- ,I !' 'IoZ.)N 1 - I ,-,,(:Dhon~ n~, ~ , 4$ 4'38.> ' (1 i cs. no,) (exDires) , ! ; MECHANICAL SQ. FT. I FFF rHAR(;F I 'NO, furnace/burner to BTlI's Each single fixture Residence of Relocated building (new fix~ additional) New,circuits a1ts. or extensions IS.F. Residence (1 bath) I Duplex (1 bath) f IAddi~iona1 bath 1V!~ter service ISERVICES I each I I 110.0.0 I I I I amps. Sewer ITemporary Construction IChange in existing residence multifamily, comm. or Industrial 10f ICOMM./IND. FEEDERS I Install/alter/relocate distrib, feeders lor I I I Storm Sewer I I I I I I I I I /0. ~ TOTAL CHARGES WHERE STATE L'\1 REQUIRES that the Electrical work be done by an shall not be va1iJ until the label has been signed by an Electrical amps. I I I I I I , I I I I I FFF rHARGF .! Floor furnace and vent !' 'I Recessed wa 11 Soace heater and'vpn~ ApD1iance vent seoa rate Stationary evap. tooler ' -,/ Vent fan with sino1e duct, I Vent system apart heating or A.C I Mechani ca 1 exhaust hood and duct I \.Jood stove/heater I I I ;J .,QC:.. from I I I' I ISSUANCE OF PFR~1IT TOTAL CHARGES E1~ctrica1 Contractor, the electrical portion of Supervisor and returned to the Building Division IO.~' 13: ~e' thi s permi t TOTAL CHARGES I HAVE CAREFULLY EXN!INED the completed apnlication for permit, and do hereby certify that all information hereon is true and correct, and I 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 oertaining to the work described herein, and that NO OCCUPANCY will 'be made of any structure without the permission of the [Juilding Division. I 'further certify that my registration ~Iith 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 w 11. be used on this project. fW1E(p1ease print) S~c.:e..,,-.Jllt-t1C S IGW\TURE FOr. OFFICE DrlT~i) $0 12 ~ ~1tL- Zone ,0;;: - f TYDe/Const. "'.tt:- ....b'. . , Uni ts So. Ftc]. ~"'l:? x fel. .,5 Value sa-S-i. '10 Fire Zone r:rj:!:. Bedrooms Occy Load Sq. Ftc]. x Value Flood Plain Stories Occy Group }-< - 3' , Sq. Ftg. Other x Value TOTAL VALUATION ~r~ (5I~ y~ I I I I I I _ ___ __Cr.._ ~~ _ _Curb Cut I I , I I TOTAL 5~ .., . -!-_~. ~~1~,}~:;"~~_~:t...,....~~,.,___~r.>~~~~,~~;...,~_,,,,-_~;,-,'~',_~-,-~~,,,~'~~r.l>-L~~:r;.r,,~'.;;-,,-~.<;-,,~..;:.. BUILDING PER~1IT Charges and Surcharges Plan Ck. 65%/B1do Plan Ck, 30%/B1dq CommlI nd Per Fee Res Pe r Fee 2;:&. .....", /./:. PLW1B ING PERMIT Charges and I' SiJrcha rges !~ ~ Fence __..:.__L_.:..____ . 'Ie D(;mo ELECTR rCAL PERrm Charges and Surcharges '/1ECHANICAL PERMIT , Charges and Surcharges _ _ __ _ _ ___ __ _I,'Sidewa1 k I A/C Pavi ng ~~","-_'_.'._=-~~""h''''_"",~"""",,-~,~, 'i5. ftc I Sys tems Devi 1 opment Charge (1.5,) , I I ITotal Comb. Permit ,,~ I, I./'1 <11 ,/. '/'1 1 (,""...,'-'L"., ~ "..,0. ..- -- .-'._ _..b<a,,_'.. '''M'''_._'''~ ,_~~"~_,"",,,,"".' '. .."" '~""'~. ~'_" . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: '(~' , ,J'} ,~ ~~ t ,i -'" , i. ''l ..: ,.If ~,..: ; , ~/"~ l' '"T' CO~1BINATION APPLICATION/PERm-r (CAP) I. Applicant to furnish A.Job Address B. Legal Description 1. examp 1 e- Tax Lot 100, Lane Countyr'lap Reference 17 03 43 2. ' example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and con~truction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrical/or solar E. Square footage or va1uatibn, etc. 1. example- 1250 ~q. foot house; 500 sq. foot garage 2. examp1e- if new project, check-new - if addition, check add, etc: F.' Building permit information: 1. example - construct single family house 0ith an ~tt~chpd g~rage . . . 2. example - remodel existing garage into family room 3. examDle - 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 TENt AND CONTRACTORS To avoid 'design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job sHe corrections, etc. ' , II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A., Except vlhere blank soaces occur in the descriotion portion of the Mecha~ical and,Electrical Sche~u1es, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed ' B. Full Plumbing, ~lechanical, 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 schedul es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted,on the CAP, the label must e 1 ectri ca 1 contractor for s'i gna ture supervisor. The general contractor to siqn the electrical label. III. Applicant'to sign and date Whenever possible, the initial application will be used as ' a \'Iorksheet only. ~Iherepossible, 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 signa ture. IV. Fees and Charges, Plan ~heck 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. ~ , , '"..-' be delivered to the by his electrical is not authorized V. FOR OFFI CE USE ONLY'" " PERMIT VALIDATION ] :ITY Of SPRINGfiELD City Hall Springfield. Oregon Department of Public Works OFF 1 CI A L R E C E IP T r l' ' ',/2 \' (~O. B 5 316 ( ~~::,X.'\\;\ J\ ' ,(') ','. 19 ;<( ) , "~\-. f': "-, ,i \\\ " ,~\ d From "',,-,J..\ ~,~'t_\ ,\ \~~\ '\ \..) '\. \ o fj \ \ -~. \Pl..~, . .~ '" C>, 'I ress (...J U' ::\~j:1_~.\~,'\'-,U"..O !\ .....J ~ived, For: , "~--_\:=:}.t,,,'~;!)\, ~{ -\ '\."" \. ~ ...... t f'''""''...,.......... \t-'-...-..... '_. _~\-.'~,. '''''''';''' . .; '\'J \ ,_ __ - ~ \ ~ \ '0,-- ; JI'(Qo~J, (,-{::=/ -"'" \, t ( " 1'" I ~ ''''\ f j f F (' ~'1 u '-- C...._Jo.I -', { L '6 t ; \ ( -...., ,.,....,....., ". ',-"I........ -!. '. ~j t . ,yO lY~;~ , yc,,{r\ p\ (,', \__..\ \'--'-\ \ \\ )"o.___~\ \ \ ' :;j t""'-i /""', . f ") ,\.,...-L) t~' i L.-=;2 t~") L' ~ ..--:: (~,_,t( ) \..,,,)\ 10('\ ; \ Jount Received \ C;\, , l_\ L\ \,\C~ '-,r' I ' t ,"" t ..-' \~ ~ I .,..,-.(}~~--"" ;,Y,. \ \ 1\ t " j\ \'i_J~Cr~......~ '. AUTHOR'IZED SIGNAT-URE SHELTON-TURNBULL P~INTERS . EUGENE, OR_97401 ( Permi t Clerk .. ~"'.Lniooo.a...1 .... ........' ... ""-'Ii. ..............' ,..J.2-- ......_ "~ ...<'>......' ...... ...J ". oJ......_ . ..&.1Wji Permit appl i cant exempt from regi strati on with the Buil der I s Board because: 'Additional Project Information: PLANS REVItWED BY: .........~ 'w"-.J.b.iO. .h........ ';":-~~~'~~;""~"'h '-""""~ .........- ,.. 'J ......,I.,llll..ul~.....liI!.....,:i.il......;;....'....;;".llliliaol; iiit.ll!oIoiIi;"',I,IIIII,,~.o..ll.:oI...1.Iili! lo.I~IIIa.I~. name --.., L...::.RN.,;r /.:..~~ , signature ,,'~ '~' , ~ - ' ~'--.? ........-,,-';1'u.,.~ ~~ ,e.~/' date3-3/....2.c. . l._" ,