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Home My WebLink AboutPermit Building 1982-3-24 .,.~,o:,~,"~;;:::.", \- ""-":~.",~" .""...-.". '.. . ""...., , .. .~.<',,~~-~,l!;.-.!!-J;..~J 'i~'~'" ;~~"';';;'.; ~~. J:~:;-";I~~'i"'~'~~~;':"-~' "~"'~'g:'-~' ';":"""';--' , """,~ "-- "" -"""'",~;"~':..:,-'-'-, "'..':'. "':-' "< ,,' - ';- '-":'-' ",.~-.._....,:' ,..: ' . ,-', ",.' ..~..'.-;,.,~,'.:.., .,' '\ -. ~;;~.r~"':1k~.\1l~,!~~j~~A:..1~:';'~~-~~!~~~~~E~'~~!~~~~-?~1;t;~.~41-~~:Z'J.=~~~-~~;~',.~~....y': NOTIFiED, r.'''~?'' ''lM .~~~:;.' '-.,,"" I INSPECTION LINE 726-3769 . CITY Of SPRINGFIELD COMBINATION APPLICATION/PERMIT C\ LtlO INFORMATION LINE 726--3753 Legal Description 17-03-35-41 L L. 8000 ENERGY SOURCES: Heat Water Heater Range Value of Work: Sq. Fig. Moin 1 tllJU Sq. Fig. At:cen. Sq. Ftg. Other _New_Add_Alter_Rep. _Fence_Demo_Change! Use _Other 00 N o ..- 00 en Job Address 1117 Sout.h "A" St.rppt Add.... 1117 Sout.h "A" St.rppt. Snringfiplrl. nR 07477 Phone 771\-1071 $}5_000.00 Building Permit Info: Describe Work (i.e., Build Single Familv Residence With Attached Garaae) Owner Ni rn 1 n ; rnmnnnv Lunch room and rest'room addition Construction lender Address Phone DESIGN TEAM (name) (address) (lics. no.) (e"'pires) (phone no.) Pdma<y Auqust Construction 30002 Structural.lnhn Hp.r-Y'; rk' Electrical AIInIJc::t rnn<::+Y'I,rti"n M.,hankal Auaust Construction CONTRACTORS (name) (address) (lies. no.) (expires) bhone no.) G.n.,a! Auaust Construction P 0 Rox ?355 3lJOO? 84 4.a5diol\l Plumbina Electrical ownpr Mechonieol PLUMBING NO, n Each single fidure Relocated building (new fi"" odditionoll r S.F. Residence (1 bath) I Duolex (1 both \ eoch I Additional both Water service 1 Sewer Storm Sewer ELECTRICAL MECHANICAL / FEE 'CHARGE NO.' FEE I CHARGE NO. I I Fer ! CHARGE Temporory Construction 3 furnoce/burner to DTU's Appliance vent' seporate Stotionory evap. cooler Vent fan with sinqle duct Vent system aport from heating or A.C. Mechanical e",haust hood and duct lnn Q nn Residence of ? s9' ft. New circuits, olterations or e",tensions 5_nn 1\5,nn 15,00 SERVICES Amps. In_no Wood stove/heater FEEDERS Heat Pump Air handler to 10.000 CFM Air handler over 10,000 CFM Amps. ISSUANCE OF PERMIT 10.00 TOTAL CHARGES 75.00 TOTAL CHARGES 15,00' TOTAL CHARGES 10 nn 10ne_M ~ 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 Q label has been signed by an Electrical Contractor and attached 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 ony and 011 work performed shall be done in accordonce with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herin, and thot NO OCCUPANCY 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 ond effect os required by ORS 701.055, that if e"'empt the basis for uemption is noted h.,an, and that only .ub<a,"adan and .mplay... who a," In <amplian'" W'~'(JI be se n this proiect. Basis for Builder's Boord exemption: . / I NAME (pl.a.. p"nt) ~p / &l 'YI :721 1 l-l<::: I'J N SIGNAT RE , _ 1 A"A ..un~ DATE ~/q L FOR OFFICE USE ONLY 1 _Sq, Ftg, Moln --..1i.4R S2 Sq. Ftg. Access H3 Sq. FIg. Other Typ./Can.tV-N SPKI n Bedroom' '" "clue Flood Plain <:torie~ ? Units nccy load _ nccy Graup x 54 01 Valu. ..$3.5-.noo 00 Fire Ion" x Value ~j:>,UUU.UU TOTAL VALUATION BUILDING PERMIT plan Ck. Comm! Ind Chorges and ____..$U2..'OO' 65%/Bldq Per Fe... Surcharges Pion Ck. Res 5,6R 30%/ Bldq Per Fee PLUMBING PERMIT Charges and 'I; 75,nn Fence Surcharges 3 nn Demo elECTRICAL PERMIT $ Charges and 15.00 Sidewalk Surcharges ~n A/C PavinCl MECHANICAL PERMIT Charges and ._--..$. 1q nn Curb Cut Surchorges 7~ Systems Development ~O? ~Q Prl 3-4-F;l:ha.q. (L5%1 $ 525,00 '15R150 Total Comb. Permit ?hl nil TOTAL 'l; 7RI\_nll . _ ",.,.0.',.", . /" \ ,_,,' / .. \ .'., ......,;., ^":..... ......''''v. \'.' . . , .,.... :'.~~..;:~.;l,J~~.,~i}...~L,~l~Y! '(i,~,;',;~;:;)~'~;!4h~)~'~i~:~::~}~K......,~~..,..~,:,> ,';~'~~7.h~:I~'~f'_~ !::.:>.-j~';.:iI.!:~~,.:"~t:.:::!;!:~j~I,~:!AA~~~1~_~:<,},~.,!~,:~j"~;:~\:::,~~~,],~~lJ !.il(~,~,~;::~~';t':~~~,,~,.A.:~. I. Applicant to furnish A Job Address B. legal Description L example-tax lot 100, Lane County Map Reference 17 03 43 2. example.Lot 1, Block 3. 2nd Addition ta 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. L exomple.1250 sq, foot house, 500 sq, foot garage 2. example.if new project, check n;w.if addition, ched add, etc. F. Building permit information:. (' 1. example-construct single family house with an attac 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 Oivisio Staff must be able to contact appropriate persons regar l~g design information or job site corrections, etc. COMBINATION APPLICATION/PERMIT (CAP) II. Abbreviated Plumbing, Mechanical & Electrical'Schedules A. Except where blank spaces occur in the description port of the Mechanicol and Electrical Schedules, the applicar need fill.in only the No, Boxes odjacent to the appropri item(s) to be instolled 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 0 ated schedules you should consult the full schedules C, BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AN[ CHARGES ON THE SCHEDULES , III. Applicant to sign ond date Whenever possible, the initial application will be used as a ( worksheet only. Where possible, Building Division Staff wi! . -." prepare a typewritten copy and return it to the applicant a 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 ap! . and no plans will be processed until these fees are paid. A: ( other fees and charges are due and payable when the pen -. is issued. . ~ '-V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: PERMIT VALIDATION ( CITY SPRINGFIELD ( OF City Hall Springfield. Oregan Department of Public Works OFFICIAL RECEIPT ( Dat'e~)\ '~4 19~~O. B 58260( ( ReC'dFr~\~~IN:C~ - ( C Addr...s D(~~ ~~S'\)I 0 l)~ (' ( Received For: ,,_t~ . ~ UC)n t.A{t,ri\D U 9(') c ( ~ \4r~ .U-/ ~. (of> \~ CD ~CO \SOC ,(j)n \<-1,00 U0n ,Ih , ~S,OO ( ( ( y CoO U.9n ( (' , '--.X'(\ lLC' ..,1;\ r (\1( ( Amount Received ( ....".. \ , " i " c BT ~ .HI:LTO...Tu"".ULL ....,..T'"s, I:U"'''', oil ""0' c ., Permit Clerk ~nc: -rnr .::IlJtnm;qti~ c:;:prif"lltlpl"" c:y~tpm c:.h~ll 1-1,:. Tllrn;chorl ht:'lf"f'\ro i'n~talJ..a.t.ion. ~a~ AdditionQI Project Information: '" \ i ), "---,,-.=-~:';' PLANS REVIEWED BY: nam'? Dan Smith ~ignatur'" ~ate 3-15-fl2