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Home My WebLink AboutPermit Building 1980-8-18 ..-i~~~,r~';~~~~,"",*~, ~~G.~~.;!,\;!;.:.,~~!~;;:.:,..,~ ~;';~&'ili;2.'...":)-;;j~~~~;.t~~; INSPECTION LINE 726-3769 CITY OF SPRINGFIELD COMBINA TJON APPLlCA TJON / PERMIT / . / . !l!)UlJ.y4.J I, /?~ /~-p - ,pO _ - v INFORMATION LINE 726-3753 Owner Glen Dent ENERGY SOURCES: Heat p.l PC- t- Water Heater .elect Range .-,---e~.act Value of Work: $41,720.80 Sq. Ftg. Main Sq. Ftg. Access. Sq. Ftg. Other -xxNew _Add_Alter _Rep. _Fence_Demo_Change/ Use _Other 1298 4R4 00 o o -...J 00 V1 Job Address 7689 Bluebell Way Legal Description Lot 6, McMurrey Subdivision Address 4680 Main Street Phone 746-5499 Building Permit Info: Desc;ibe Work (Le., Build Single Familv Residence With Attached Garage) Springfield. Oregon 97477 Construction lender Equitabl e Savings Single Family with attached ~arage & Fireplace Add re ss Phone DESIGN TEAM (name) .,' (address) (lies. no.). (expires) (phone no.) Primary Stan Steel 3445 Che\tr Chase 686-9900 Structural Electrical Mechanic':'l CONTRACTORS (name) General Glen Dent Inc. (address) (lies. no.) (expires) (phone no.) ;.. 4680 Main Street:. 469 June 1981 746-5473 Plumbing .Tonn Anh~11Y Electrical. '3'}TT\mi. t 1: !::!. ':'':: 1: ~ i. ': Glen Dent Const. Inc. Mechanical PLUMBING MECHANICAL FEE CHARGE NO. ' Duplex (1 bath) each furnace/burner to . BTU's Appliance vent separate Stationary evap. 'cooler Vent fan with single duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct 3.00 12.00 Each single fixture Relocated building (new fix. additional) S.F. Residence (1 bath) x 1 Additional bath 4.50 Water service Wood stove/heater Sewer Storm Sewer FEEDERS Heat Pump Air handler to 10,000 CFM Air handler. over 10,000 CFM Amps. ISSUANCE OF PERMIT 10.00 26.50 TOT AL CHARGES 35.00 TOT AL CHARGES 35.00 TOT AL CHARGES WHERE STATE LAW .REQUIRES that the Electrical. work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until a label has been. signed by an Electrical Contractor and attached to the electrical panel. I HAVE CAREFUllY EXAMINED. the completed application for permit, ond do hereby certify that all informotion 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 herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building ,Division. I further certlfy that my registration with the Builder's Board is in full farce and effect a s required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with O~RS701.055.;.i ...--,11 be used on this pr~ect. _________. Basis for. Builder's Board exemption: ~r ~ //~ NAME (please print) GLEN DENT SIGNATURE_ \. .. ~n .1-J: ./ / DATf~/de FOR. OFFICE USE ONLY x 28. AO Value 3..7 1?? RO_ 9.S0Va.lue 4:598.00 Zone R - 1 Fi~e Zone Flood Plain NO Type/ Const. Bedrooms <;tories "_N 3 1 Units 0ccy Load Oeey. Group R-3 c:~. Ftg. M"in c:q. Ftg. Access Sq. Ftg. Other l?a~ 484 x " Value TOTAL VALUATION 41,.12.0...80 MECHANICAL PERMIT Charges and Su.rcharges 163.00 6.53. 35.00 1.40 35.00 1.40 26.50 Plan Ck. Comm/lnd 65%/ Bldg Per Fee Plan Ck. Res 30%/ Bldg Per Fee Systems Development Charc:e (1.5%) 625.81 BUILDING PERMIT Charges and Surcharges $48.90 PAID #S4.:n~ 8-14-R() PLUMBING PERMIT Charges and Surcharges Fence Demo Total Comb. Permit 288.33 ELECTRICAL PERMIT Charges and Surcharges Sidewalk 6f>.4' 6.64 A/ C Pcivinq Curb Cut 18" 11. 80 1. 06 TOT AL. I 914.14 ...-- ~/ /" .ol,_""~,,, ,I-r ..... ''':r.a.'':!OooM._ - COMBINATION APPLlCA nON/PERMIT. (CAP) I. Applicaht 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-water heater/electrical! or'solar E. . Square footage or valuation, etc. 1. example-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.'"dth an at"tached garage . 2. example-remodel existing garage into family room 3. example-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 contad appropriate persons .r~garding 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 abbrevi- ated sohedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT All FEES AND. CHARGES ON THE SCHEDULES 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 typewritten 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 aredue 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: I Additionol Project Information: . PLANS ~EVIEWED BY: name DMLSMTTH signaturp PERMIT VALIDATION (l CITY OF SPRINGFIELD City Hall Springfield. Oregon Department of Publ]c Works OFFICIAL RECEIPT No. B y.-ltt l/X(') 'TRec'd Fro~, (~ !fI7 [X) It .. ~ ' Address L\lr, ~ () '--t}')I1LPL/f['(j} /J.-; . , J . _________ ~ -- [ ,.~ [ 103.0C, to.53 35,Ov L\.O (J I 4-0 ?--t5. CO l.~() 2b.5C 1: ()(n tfl,4f.I-. o ~z -Gj. ~ J (I. iT . 544 tl Date ~r Received For: ?}P A If. py _\0) ~ <f ?P q - ~Oln I ~f-P L'-\91 0 SVJ!f /" Y f. .~f')! - 4 ( Am'ount ( BY ( '- ;., ( +-- Received 01 q l t4 ~ (~C) AUTHORIZED 'SIGNATURE (- SHELTON-T.UAN8ULL PRINTERS. EUGENE. OR 97401 58511.8 Permit Clerk date 8-18-80