HomeMy WebLinkAboutPermit Building 1982-3-26
"
, '
,. '* It'
, ' ,
,.',,~~~::::~~~~:'.::;._.::]:n:hli::~i.:l~"~ ;-~~~~!~:;~~!~~~J!..;::~,"~~,~ ; 'f:~,~~~~~~;: '''':I.~'I~'~'' >", i~; '1,~~:.:~'~:."~'~-::~:,:~'.:i2'~-'-~I~~~ ~;"L~;~"'-'= ~. ,.",' :..
.
.. ~.~..... ,.:___'''''"___,._~. __. "."",.~~=-__~_.",.._.~.~__._r'''",-,",
CITY Of SPRINGFIELD
COMBINATION APPLICATION/PERMIT
I ENERGY SOURCES:
Heat
I Water Heater
, Range
1 Volue o~ ~O~k: 000. 00
Building Permit Info: Describe Work .i.e., Build Single
Fomil.. Residence With Attached Garaael
\ INSPECTION LINE
726.3769
I Job Add"" 1117 South "A" Street
Ilegol Description
Owner
Nicolai Company
1117 South "A" St.
Snringfie1d. OR
South side 30'
M.!:In11f'O,..f-11""';T'\g r'.anr ';:1I1rH t"i n"""
x 1000'
Address
Phonn6-1971
97477
Construction lender
Address
phone
DESIGN TEAM
(nome)
(address)
(lies. no.)
388 High Street, ,-Eugene, OR
(expires)
(phone no.)
485-8383
Primory
Schaudt, Stemn and Walter
Structural
Electricol
Mechanicol
CONTRACTORS
(name)
(oddress)
Wcs. no.)
General
August Construction Co.
PO Box 2355, Eug.
30002
Plumbing
Electricol
Mechanical
PLUMBING
NO,
1 Each single fixture
Relocated building
(new fix. additional)
S.F. Residence
(1 bath)
Duplex (1 bath) each
Additional both
Water service
Sewer
1 Storm Sewer
10.00/100 l.f,
1600 1. f.
I
CHARGE I NO.
5,001
I
I
I
I
Amps.
ELECTRICAL
1 FEE
I CHARGE
FEE
Residence of
59' ft.
New circuits, alterations
or extensions
SERVICES
Temporary Construction
FEEDERS
Am.n.
,60.01)
TOTAL CHARGES
165.0') TOTAL CHARGES
INFORMATION LINE
726.-3753
Sq. Ftg. Main .JU. UUU
Sq. Ftg. Access.
Sq. ftg. Other
_New_Add_Alter_Rep.
_Fence_Cemo_Changel Use
_Other
OJ
~
,
(exoires)
(~hone no,)
485-6961
1983
I
MECHANICAL
NO,
I FEE
'CHARGE 1
1
furnace/burner to
~TU's
Appliance vent
separate
Stationary evap.
cooler
Vent fan with
single duct
Vent system aport from
heating or A.C.
Mechonical exhaust
hood and duct
1
1
Woad stove/heater
Heat Puma
Air handler to
10.000 CFM
Air handler over
10,000 CFM
ISSUANCE OF PERMIT
TOTAL 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 Contrador and atta~ed to the electrical panel.
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 ond the Lows of the State of Oregon
pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission af the Building Civision. 1 further
certify tnat my registration with. the Builder's Boord is in full force 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 ORS 701.055 will be used on this project.
Basis for Builder's Board exemptio"' f ~ /\
NAME (pleo~ p,;nl) ~AYI P(JIIISON SIGNAT~ d\./0.'<"'A .I()~
FOR OFFICE USE ONLY
Zone M-~ .
Fire Zone 1; ft.
Flood Plain N()
Type/Canst. VN _ SPR
Bedrooms
Stor;G'~
H_"l
Sq. Ftg. Main
Sq. Fig. Accen
Sq. Ftg. Other
30,000
Units
n.cy Lood
'Jccy Group
1
BUILDING PERMIT
Charges and
Surcharges
Plan Ck. Comm/lnd
65%/ Bldq Per Fee
Plan Ck. Res
30%/ Bide- Per Fee
58176
405.93
PD 3-9-82,
624.50
24.98
165.00
6.60
PLUMBING PERMIT
Charges and
Surcharges
Fence
Demo
ELECTRICAL PERMIT
Charges and
Surcharges
Sidewalk
AI C PavlnC"
MECHANICAL PERMIT
Charges ond
Surcharge~
Curb Cut
DATE ::?'/;ZC/9. Z-
x '"alue
x Value
x Value
TOTAL VALUATION
j:l),UUU
jLJ,UUU
Systems Development
Chorae (1.5%'
4,875.00
Total Comb. Permit
821.08
TOTAL
5,696.08
-.-,~--<~.
,
l,;~J:7;ji[i:.t~~:",~,.:C~:r~~.:.,:~:~~~A!~i.~~!!,~~~,~~~1;~;,~,;1~~~'_~~L~1,~1." !~';J~~'~~~_.~~.~;~~aLi~J,:!~:~~~~~~' .~-'-- ,..v-_.__~~,~
,!
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example~tax lot 100, Lane County Map ReferencE
2, exomple.Lot L Block 3. 2nd Addition to Springfiel,
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, che
.. . . odd, etc.
F. Building permit information:
1. example-construct single family house with'an att(
garage
2. example-remodel existing garage into family roan
3. 'example-convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Str~ctural Specialty Code
H, DESIGN TEAM AND CONTRACTORS " "
To avoid design or construction delays, Building Oivisi
Staff must be able to contact appropriate persons rege
design information or job site corrections, etc.
II. Abbreviated Plumbing, Mechanical & Electrical 'Schedules
A. Except ~~here blank spaces occur in the description pOI
of the Mechanical and Electrical Schedules, the applic(
need fill-in only the No. Boxes adjacent to the appropl
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
oted schedules you should consult the full schedule!
C. BUILDING DIVISION STAFF Will FILL OUT ALL FEES AN
CHARGES ON THE SCHEDULES
~~~:
III. Applicant to sign and date
Whenever possible, the initial application will be used as l
worksheet only. Where possible, Building Division Staff wi
prepare a typewritten copy and return it to the applicant (
the time the actual permit is issued for-his signature.
PERMIT VALIDATION
~r
CITY, OF SP~INGFIELD
City Hall
Springfield, Oregon
Deportment of Public Works
OFFICIAL RECEIPT
"""" No. B 5 8 2 80 ( I
Ddte~\\.,-!)lD 1~ '
Rec'd ~r..: A\ ~I ,& ~ (I
Add~~cs.h~ JJ6S~1 YDo. J
-. (J '(I
(I
(
(
(
(
(
Received For:
~,
,
n
\J(:\~
\~~~ m \)
[.;y1iJ
l~' ,SO
Mo ^04.u'R
\ l('lS' 00
LlD'n - 1 n . (00
- \ b:?)\ e:; 00
I
{n
n
(I
(
(I
c
('
q
( -A~""'-;~.'~~~ Iddfo a;tt:,~~'J
( ~"' C,[ ~- "--" {~...~" 1\" (]
SHILTOH.TlJ"".lJLL ~",..rll"s . IllJOIl"Il, 0" .7.0' s..".. _
()
,
,
IV, Fees and Charges l-
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
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
...:....
, ,
"
Permit Cler~
,. "'.'''.'-
_,;:.. I' i.....,
Drier to installation.
Additional Dlans are required for electrical and fire sDrinkler syste~s
l> ,..
'i~ ^,~~~/~ date
I Accrr ~
..
. Additional Project Information:
. .l.
PLANS REVIEWED BY,
nom""
Lorne H. Pleger
'..',
F.
j, .".
I,"
3-25-82