HomeMy WebLinkAboutPermit Plumbing 1982-6-4
.
~ WSPECTIOII LIliE,
1726-3769
Job Address
1117 South "A" Street
17-03-35, Tax Lot 100
Legal Description
Owner
Nicolai Company
1117 South "A" Street
Springfield. Ore~on
Construction Lender
Address
Address
Ul::::dlifl fEN1 lname)
Primary IVi1dish Construction
Structural
Electrical
11echanical
CONTRACTORS
(namel
IVi1dish Construction
IVi1dish Construction
Genera 1
Plumbinq
Electrical
t,lechanical
PLUIIB IIJG '
NO,
FEE r.HAR~F Nn
Each single fixture
Relocated building
(new fix. additional)
S.F. Residence
(] bath)
Duplex (1 bath) each
Add 1t; ana 1 ba th
~!ater service
Sewer
85 Storm Sewer 10,00/1(0 L.]'.
10.0r
TOTAL CH~,RGES
HHERE STATE L~H REQUIRES
shall not be valiJ until the
l.U.VU
.
CITY Uf SPRIIJGflELO
COIIBWATION APPLICATION/PERMIT
EilERGY SOURCES:
Heat
\-later Heater
INfORtIATION LItlE
726-3753
Sq. Ftg. f.lain"
:q. ftg. Access.
Sq, Ftg, Other
flew Add Alter Pep.
-Fence Demo Change/Use
-Other- -
:'\l
S
""'-
C)
-....
~
Phon'72h~ 1971
Ranl1e
ValUE of l'lark:
61,775,00
Bui1c~inq Permit Info:
Famil y rl.esi dencc 1,lith
Describe Work(i~e., Build Single
/l.ttached Garaoe)
97477
Parkinry lot n~nfinO" ;:1nrl ::lilrlit-inn
Phone
(address'
(1 ics. no.)
{exoires'
(phone no. 1
5001 Franklin Blvd,
695
10/8/82
746-2571
{address)
(lics. nn.'
(pxoire<:; ,
(ahonp nn.
5001 Franklin Blvd,
5001 Franklin Blvd,
74.h-2<;71
746-2571
695
695
10-8~82
10- 8~ 82
ELECTRICAL
MECHAN I CAL ,
FF~ . rHARGF NO.
FFF I rHA~
I /
Residence of
furnace/burner to
BTU's.
SQ, FL
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wall
SD~rp hp~t~r ~nrl vent
Temporary Construction
Change in existing
rp<:;irlpnrp
multifamily, comm. or
lnrlllstri(ll
Appliance vent
seJaratp
Stationary evap.
cooler
Vent fan with
sinale duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hnorl rind rlur:t
Wood stove/heater
Of
amps.
COMM,/INO, FEEDERS
Install/alter/relocate
rli<:;trih_ fpprlpr<:;
Of
amps.
ISSUANCE OF PFRtllT
that the Electrical work be done by anl'Electrical Contractor, the electrical por'tion of this per17li
label has been signed by an Electrical Supervisor and returned to the Building Division
TOTAL CHARGES
TOTAL CHARGES
I HAVE CAREFULLY EXNlINED the completed application for permit, and do hereby certify that all information hereon is true
and correct, and I further certifv that any and all work performed shall be done in accordance with the Ordinances of the City
of Springfield and the la\>ls of the State of Oregon pertaining to the work described herein, and that rw OCCUPA!KY wll 1 be made
of any structure without the permission of the Guilding Division. I further certify that my registration with the Builder's
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in compliance with ORS 701.055 will be used on this rroject.
Units
Occy load
Occy Group
SIr,rL~TURE'~" lk.., ~~
FO~ OFFICE USF QiLL Y
Sf!. Ftg. t1ain
Sq. Ft~. Access
Sq. Ftg. Other Paving
x
tiAf.IE(please
print)l.Ja. Zf'V' c:._l...').. \~o...'-c ""-"t....V
\
om '2 JIL;/t5.t,
Zone M- ~
Fire Zone
Flood Plain
Type/Const. Pavi no
Bedrooms
Stories
x
x
Value
Value
Value 61,775,00
TOTAL VALUATlOiI
Syste~s Development
Charqe (L5~)
BUILOIlIG PERilIT
Charges an':
Surcharges
Plan Ck. Comm/lnd
65%/Blda Ppr Fpe
------------ ~n Ck. Res
30%/Bldq Per Fee
10,00 Fence
PLUI1BING PERMIT
Charges and
Surcharges
926,63
.40 D@mo
ELECTRICf.,L PERt~IT
Cha rges and
Surcharges
t1ECHAm CJl..l PERt1IT
Charges and
Surcharges
Sidewalk
AIC Paving
211.00
Total Comb. Permit
221. 40
Curb Cut
$1,148,03
TOTAL
o
CO:~B!ljATlOH !,PPLICATlON/PER,.IlT le!'p)
I.
II.
Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100. lane County Map Reference
II uj 43
2. examole- lot 1. Block 3. 2nd Addition to
Springtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. examole- heat/electrical ceiling/or forced
2. exampJe- waterheater/eJectflcal/or solar
E. Square footage or valuation, etc. -
1. examole- 1250 sq. foot house. 500 sq. foot
2. example,- if new project. check-new - if add
check add. etc. (
F,' Building permit information:
1. example - construct single family house witl
attached garage
2. examole - remodel existing garage into fami~
3. examole - convert single family residence ir
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of t
Structural SpeCialty Code (
H, DES I GN TEAI.I AllO CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropria
persons regarding design information or job site ("
corrections, etc. .
Abbreviated Plumbing, Mechanical, & Electrical Sched
A. Except where blank spaces occur in the descriptii
portion of the Mechanical and Electrical Schedull (
the applicant need fill-in only the No. Boxes ad;
to the appropriate item(s} to be installed
B. Full Plumbing, Mechanical, and Electrical Schedui
are available at the Building Division (
1. To conserve space on the permit form the sche
have been abbreviated
2. If the item(s} to'be installed are not covere
the abbreviated schedules you should consult
full schedules
C. BUILDIrIG DIVISION STAFF HILL FILL OUT ALL FEES AN
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered Eh, l
electrical contractor for signature by his e1ectr
supervisor. The general contractor is _not author
to sign the electrical label. ~
Applicant to sign and date I
Whenever possible. the initial application will be USE ~
a worksheet only. Where possible, Building Division ~
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for
~51gnature.
Fees and Charges
Plan' check fees are due and payable at the time of the
application. and no plans will be processed until thes (
fees are paid. All other fees and charges are due and '~..
payable when the permit is issued.
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FOR OFFICE USE ONLY
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PERMIT VALIDATION
CITY'OF SPRINGFIELD
City Hall
Springfield, Oregon " \
Department 01 Public Works ' -,"I
OFFICIAL RECEIPT -Q!l03 :.'
\ No.B~",-,,-.
Date ~iS_~~~ 19 ~2-1 \, ~. "" '
(00 Rec'd From\\ _I), ,u\ ~~, ~~GY\\ \ (
Address \ \\ lClD 1-'1 U;,\0Li,j-
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Receiveo For:
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Amount Received \ \ Y-~ ,_,_~
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BRIGGS PRINT.ERS/LITHOGRAPHERS. EUGENl!:, OREGON
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Permit Clerk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
"
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Permit app1icant exempt from registration with the Bui1der's Board because:
Additional Project Information:
See Job 820200 for prior storm sewer work
wnirn -nrmr;np,.-l t~n -frl1''' t'hi" ;oh
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PLANS REVIEWED BY:
name
Lorne W, Pleger
Signature4~
,
,
,
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