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Home My WebLink AboutPermit Plumbing 1986-3-4 ..,.,.,- ~ -'. ____.__.______.._.__..__.__~---:~:'-.--~.-----.~.~ . - n_ _ __.._n...._._ CITY UF SPRINGflECD COMBINATION APPLICATION/PERMIT EIIERGY SOURCES: Heat l~ater Heater Ranqe ValuE of Work: ~o~ T BuilriinQ Permit Info: Describe Work{i.e.. Build Single Familv Residence With Attached Garaqe) b.....,_ ( :;r____.z:-~ 'PJr?~Ve-_J7~~ 7)7"'-'V/cF .. . , .4 S77?~:r. ~-.----_.- ~._'-~--'~.--:-."'.: - ...-"~ IHFDRltATIOH LINt 726-3753 Sq. Ftg. 1,lain ~q. Ftg. Access. Sq. Ftg. Other lIew Add Alter Rep. -Fence Demo Change/Use Other- - , I dJ b vJ r::P jINSPECTIOII LINE 726-3769 Job Address 14)~ fu~r legal Description Owner/.~7) :~'\.~ ~AZ-T~/C5 Address ll:JC; ~/ 4 ~ _ Phone . ., - -- ~ Construction lender Address Ut~JliN h:.A11 I name I Phone faddressl (lfcs.no.) (exoires) (ohona no. \ Pri ma ry , Structural Electrical Mechanical CONTRACTORS {name} (address) (1 ire;" no.) (pyoirp,,) (ohnnp no ) General Plumbino li/&dn- (.A/4-,.... PcP<#R/~,. ?C>-~K ~ ~,,\. ~/~iF:V--C;. Electrical -? :2~-~~ ~'echanical PLUIIBI NG ELECTRICAL MECHANICAL ~ Each Single fixture FFF rHARr;F..1Jn ~~C..c..HAR.G..E.. ~Jn Residence of furnace/burner to SQ. FT. BTU's '.EEL .Q!ARU.E. Relocated building (new fix. additional) S.F. Residence 11 bath 1 Ouplex (I bath) each Additional bath New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wall Snarl" hp~tpr ~nrl vpnt Stonn Sewer L (J~if:/.#<-<~UC.F /'50[; Of amps. I App 1 i ance vent S2paratp I Stationary evap. cooler Vent fan with ",inole duct Vent system apart from heatina or A.C. Mechanical exhaust honr! ilod durt I ~Jood stove/heater Sewer ITempOrary Construction IChange in existing re') 1 qrJlcp multifamily. COnJl1. or Tnrlllc:.t,rirll Water service COMM./INO. FEEDERS Install/alter/relocate die;,trih. fppriers Of amps. TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be vali1 until the TOTAL CHARGES ISSUANCE OF PFRItIT TOTAL CHARGES that the Electrical work be done by an 'Electrical Contractor. the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXAMINED 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 OCCUPA~CY 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 comoliance with ORS 7Ql.055 will be used on this project. NAf.IE(please print) K,'cdrl--wt9'/ PIv",,6,Woa, SIr,NATUREg~ ~' FO~ OFF I CE USE .Btll Y Sq. Ftg. liain Sq. Ftg. Access Sq. Ftg. Other OATE :; -'-('- s-r;; Stories Units' Deey load Occy Group x ZonE> Fire Zone Flood Plain Type/Canst. Bedrooms x, Value Value Value x TOTAL VALUATION BUILOING PERftIT Charges and Surcharges , Plan Ck. Corrm/lnd ____________ 65%/BldC'l Ppr Fpp Plan Ck.,Res 30%/Bldo Per Fee j~ c:r,C> Fence --- ~ 60 I Demo I 'Sidewalk I AIC Paving -Systems Development Charge (1.5~) . PLur~BING PERMIT Charges and Surcharges ELECTRICAL PERlm Charges and Surcharges Total Comb. Permit TOTAL I i IS. t::e> MECHANICAL PERMIT Charges and Surcharges Curb Cut . . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II oj 43 Z. examole- lot 1. Block 3, 2nd Addition to Springtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceiling/or forced air Qas 2. example~ waterheater/electrlcalJor 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, checl< add, etc. F. Building permit information: 1. example - construct single family house with an attached 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 8. 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 Z. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUILOING 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.~ 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 signa 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 OSE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION ~l,b061 '--1~%(P ""3- Permit Clerk ::) Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: na'me ~W€ /P.c..; .~:9 signature ~ - -, . .' ., ,. . ~"':'_ -, date 3 -7"~B6 , 1 . . CITY OF SPRINGFIELD APPLICATION AND AGREENENT FOR SEWER HOOKUP , Application is hereby made by the undersigned property, owner for permission to connect the following described property to a city sanitary sewer line, owned and maintained by the City of Springfield, and I agree to pay such a hookup charge of $4.50 per front foot of the property for the first 150 feet in'depth to be served by such city sewer line in lieu of an assessment against the described property. An additional $0.03 per square foot will be charged for any additional, property beyond the first 150 feet. Property Description: Address: 155 West 'A' Street All, of Lot 9, the north 30 feet of Lot 10 and the north 80 feet of Lots 5,'6, 7, and 8 in Block 45,. Map of Springfield,as platted and recorded in Volume I, Page / I, Lane County, Oregon Plat Records in Lane County, Oregon Except the east 150 ,feet as determined by'a line parallel to the west line of Mill Street. LATERAL Sewer hookup charge: front feet @ $4.50 per front foot = 11,995.6 square feet @ $0.03 per sq. ft. = $ 359.87 This agreement has been computed as being one-half (!;;) of the equivalent cost / of an eight (8) inch lateral sanitary sewer at the rate of $4.50 per abutting front foot and does not include the cost of a house connection to said city sewer, sewer user charges, plumbing permits or other such costs to be assumed by the, property owner. CITY OF SPRINGFIELD, OREGON By: ,<.L{j)A/?< Y1/'lftd~~ , Da~:: dd/X-t(ttLCI </ //73- f c1 " " ' P;r1ERTYOWNERS:. 'rJ ~', ~ ~-.J df>ah~~ t7~/rJdd1~. STATE OF' OREGON), ) ss County of Lane ) BE IT 'P.EME_NBERED, that on this.A- day of -.> t:r ~ 19 l' ':!..- before me,' the undersigned, a Notary Public in and for the said County and State, personally appeared the within named ..J)-e .l.d.lur&1('C F. /AJilITG known to me, to be the identical individual ~ described in and who executed the \<ithin instrument and acknowledged to me that H C- executed the same freely and voluntarily. WITNESS my hand and seal this day and year last above written. , ~<-d-/r# ~ -~. tyary Pub lic . /';/~',v" ~~,.2t- //7.<:~ My--Cotnmission Expires " . - , 155 West "A" r. "'-'Ii" . ,,' " '.'''''11''''''''-'''''''' "',,, ", ",\/" .satll SSl ---' ' /5s CJ~1- A 'I~f / c# {)4- cI (fl v f GJ ~ (;tv', , '. " ," \', \ ~' ' ...-----"'----- ~___~ ' c....1', ~_ ~ uJ,- (J. J \16 , IJjc}v~ \ V))tc"cl ~f.~ k ~J f""D \ /" , '.' .s '911 B