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Home My WebLink AboutPermit Mechanical 1981-9-28 . '.; ~ ,; . ': i,.J -------- Job Add.." 1117 South "A" Street L.goIOmdp';oo 17-03-35. Tax Lot 100 .......... CITY Of SPRINGfiELD ,--4 COMBINATION APPLICATION/PERMIT ENERGY SOURCES: Heat "A C ~.". ".~1 INSPECTION LINE 726-3769 INFORMATION LINE 726-3753 Water Heater Range Value of Work: Sq. Ftg. Main Sq. Fig. Aceen. Sq. Ftg. Other _New_Add_Alter _Rep. _Fence_Demo_ChangefUs. _~er 00 i-' o C' ~ o Addren Nicolai Company 1117 South "A" St, Phone Building Permit Info: Describe Work (i.e., Build Single Familv Residence With Attached Goroqe\ Owner S.nr;,.,~r; (:)1 r1 Construction lender OR 77h-1Q71 Install 2 ~as, susnended heaters Address Phone DESIGN TEAM (nome) (address) (Iics. no.) (expires) (phone no.) Primary Structural Electricol Mechanical CONTRACTORS (nome) (address) (lies. no.) (expires) (phone no.) 01""1:"'01 Plumbinq Electrical Mechanical Marshall's 4131 "E" Street, Springfield, OR 747-7445 PLUMBING ELECTRICAL MECHANICAL SERVICES fEE I CHARGE NO. furnace/ burner to I\TU's Appliance vent separate Stationary evop. cooler Vent fan with sinRle duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct Woad stove/heat..., Heat Pump Air handler to 10.000 CFM Air handler aver 10,000 CFM 2 S11':;, Ht:r/VF>nt: 1 Gas pipinl:! FEE 'CHARGE I I I NO, FEE CHARGE NO. Residence of Each sinQle fixture Relocated building (new fix. additional) S.F. Residence (1 bath) ';1' ft. New circuits, alterations or extensions Duplex (1 bath) each Temporary Construction Additional bath Amps. Water service Sewer Storm Sewer FEEDERS Amps. 17 011 2.011 I ISSUANCE OF PERMIT 10 (111 24.00 TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not b. valid until a label has been signed by an Electrical Contractor and attached to the .Iectrical 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 and the laws of the State of Oregon pertaining ta the work described herin, and that NO OCCUPANCY will b. 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 tiffect os required by ORS 701.055, that jf exempt the basis for exemption is noted heron, and that only subcontractors and employees who a'r. in compliance with ORS 701.055 will be used on this project. NAME (pl.o" pdo') M.r..'" ~41 \ \.) "''\ ,," C\l\.n"<!"1~SIGNATURE ~GQl0~)~ ~. ~ DATEC,- ot'( -~I ,- Basis for Builder's Boord exemption: FOR OFFICE USE ONLY Zone M-1 Type/ Canst. Units Sq. Ftg. Main Fire Zone Bedrooms n.cy Load Sq. Ftg. Access Flood Plain "torie. '"'lccy Group Sq. Ftg. Other BUILDING PERMIT Plan Ck. Comm/lnd Charges and 650/0/Bldg Per Fee Surcharges Plan Ck. Res 30%/SJdq Per Fee PLUMBING PERMIT Charges and F..nce Surcharges Demo ElEORICAl PERMIT Charges and Sidewalk Surcharges AIC Po vi no MECHANICAL PERMIT 24.00 Charges and Curb Cut Surcharges -------- .96 Value x Value x Valu. TOTAL VALUATION Systems Development Charoe (1.5%\ Totol Comb. Permit TOTAL 24,96 III. Applicantta sign and date Whenever possible, the initial application will be used worksheet only. Where possible. Building Division Stefi prepare a typewritten copy and return it to the appliea the time the actual permit is issued for his signature. .J- IV. Fees and Charges Plan check fees ore due and payable at the time of the application, and no plans wi1l be processed until tnese fees are paid. AU other fees and charges are due and payable when the permit is issued. . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A Jab Address B. Legal Description 1. exam Die-tax lot 100, Lane County Map Refaren- 2, example-Lot L Block 3, 2nd Addition to Springfif C. Nome, etc. of owner and construction lender O. Energy Sources 1. example.heat/electrical ceiling/or forced air gO! 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1, example-1250 sq, foot house, 500 sq, foot garag 2. example-if new project, check new~if addition, cI add, etc. F. Building permit information: 1. example-construct single family house with on a go rage 2. example~remodel existing garage into family r04 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 Dh Staff must be able to contact appropriate persons rt design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedul A. Except where blank spaces occur in the description! of the Mechanical and Electrical Schedules, the appt need fill~in only the No. Boxes adiacent to the appro 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 schedl. hove been abbreviated 2. If the item{s) to be installed are not covered on t ated schedules you should consult the full schedt C. BUILDING DIVISION STAFF WILL Fill OUT ALL FEES CHARGES ON THE SCHEDULES V, FOR OFFICE USE ONLY . ,. PERMIT VALIDATION ..._i. CITY OF SPRINGFIELD ( ( City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT ( ( No. B Date ~_Afj19RI ___ Rec'd From \'\"{\ \\ ~D Address 4-\?J \ -'? I .[)-t- ~ r-7"G~ J .:i 0( ( ( -( Received For: \. (n - - t\\af\~r{ 04,OU U;;:-.., U (0 ( ( c (al ( (" ( Received~K .Y1 n_-r-~~ ( ~f{L, --_c AUTHORI%l!:O 5IGNATUIt1: ( s..I:LTO".TU~"'UU "~""I"S - luOI"I. 0" 17"01 'IS".' '. Amount ( ...!!-.. ( at ( ;- Permit Clery PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: AdditionQI Project Information: <;gnatureda"" LA7L l ~ PLANS REVIEWED BY: nam"" dote 9-/7- B-/