HomeMy WebLinkAboutPermit Building 1980-7-18
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I INSPECT 1011 LIIIE
726-3769
CITY Of SPRlilGFIELD
C0I1BIilATIOfl APPLICATION/PERMIT
lNFDRIIATION UIIE
726-3753
Sq, Ftg, f.:ain 36b4
~q. Ftg. Access.
Sq, Ftg, O~er
flew Add Alter P.ep.
--Fence Demo Change/Use
~Other-- --
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Job Address
806
North A Street
l7 03 3S 42 TL 2600
\.later Heater
~~;~GY ~~ltt' Hea t Pumo
I: lea-
legal Description
Address
Bi 11
223
Fitch
North A Street
Phone
Range
Value of Hark:
.4S ,000. 00
BuiHiina Permit fnfo: Describe l"lork(i-.eq
Familv nesidence With Attached Garaae)
Build Single
Owner
Springfield, Oregon 97477
747-338l
Remodel existing commercial building
Construction Lender
Address
. Ot.~lliH II:.Nl
Primary
(name)
Art Paz, JR Arch
Phone
(address)
220 North Sth Street
(lies. no.)
(exo; res)
(ohon~ no.l
747-8823
Structura 1
Electrical
!1echanical
CONTRACTORS
enamel
Ordell Construction
Harvey & Price 20lS
(address ).
2300 Oakmont Way,
Nugget Way
(lies. no.)
(pxoires)
fohonp no.
4gb-I~/ 11
746-l621
Genera 1
Eugene
PlumblnQ
Electrical
t.1echan; ca 1
Harvey & Price 20lS Nugget Way
746-1621
PLUI1BIIIG
ELECTRICAL
FFF (HAR(;F "n
Residence of
S.OO 40.00 SQ, FT,
New circuits alts.
X 0'2 e~Nnn18~'e
SERVICES
MECHANICAL
110,
~~~ r~ARr,~ NO_
I='~I=' (I-lAQr,l='
Each single fixture
8
furnace/burner to
8TU's
Relocated building
(new fix. additional)
lS.OO
Floor furnace
and vent
S.F. Residence
(1 bath]
Duplex (1 bath) each
Additional bath
Recessed wall
SD~rp hp~tpr ~nrl vpnt
Hater service
Temporary Construction
Change in existing
rp<:;idence
multifamily, camm. or
TndlJstrinl
Of amps.1
CDr11,I./I NO, FEEDERS I
Install/alter/relocate I
rlidrih. fppdprc;
Apoliance vent
seoarate
Stationary evao.
cooler" '
4 I Vent fan with
sinale duct
Vent system apart from
heatina or A.C.
Mechanical exhaust
hood and duct.
Wood stove/heater
Il2,or
Sewer
Storm Sewer
Of
amps. I
I
I
I ISSUANCE OF PFR!IIT
::0.. 1'S, OQ TOTAL CHARGES
I
I
10.00
22.00
TOTAL CHARGES
WHERE STATE L~W REQUIRES
shall not be vali1 until the
40.00 TOTAL CHARGES
that the Electrical work be done by an Electrical Contractor, the electrical ror'tion of this perlilit
label has been signed by an Electrical Supervisor and returned to the Building Division
I HAVE CAREFULLY EXNlINED 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 oerformed 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 rw OCCUPAIKY 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 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 7nl.055 will be used on this~ect.
C'\ (j,./L,.u 9,,-...;/
SIG!I.~TURE?('''''l ~h ;0~
FOr. OFFICE USE arrL Y I V " /
, "
Sq. Ftg. t1ain x
Sq. Ft9. Access x
Sq, Ftg, Other 3654 x
BILL FITCH
DATf) 7--/ S~,Z (]
IIAI,[E(please print)
C-3
Zone
Fire Zone
Flood Plain I'IU
Tyoe/Const.
Bedrooms
Stories
1
Units
Occy load
Dccy Group
D-<'
Value
Value
Value
TOTAL VALUATION 4S ,000,00
BUILD!IlG PER~I!T l72,OO Plan Ck. Conm/lnd
Charges anc 65%1Bl do Per Fee
Surcharges -- -- ---6-.88 Plan Ck. Res 111. 80
30%!BldQ Per Fee
PLU',IBING PERMIT 40.00 Fence
Charges and -------f.bU--
Surcharges Demo
ELECTRICAL PERI~IT lS.OO Sidewalk
Cha rges and --------.60--
Surcharges Ale Paving
!1ECHMI [CAL PERI1 IT 22.00 Curb Cut HandiRg~Bed
Charges and
Surcharges --------.88--
Sys ter.15 Deve 1 oplilen t
Charqe (1,5',)
Plan Check
111. 80
Total Comb. rermit
268.96
380.76
I
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lO.OO
I
I TOTAL
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COMBINATION APPLICATION/PERMIT (CAP)
I.
II.
III.
IV,
V, FOR OFFICE USE ONLY
.
PERMIT VALIDATION
C-lTY
OF
SPRINGfiELD
City Hall
Springfield, Oregan
Department of Public Works
OFFICIAL RECEIPT
No. B
o t ,-/0 199:fJ
R:C: F~omn ~II f "II en 1'1.<~:t-
Address2ti)()()}rjU,()J~~ ,___ (
-- --- IIZ.oo ,
Received For: -l~ l.~, ';.,..., ,
L\Oln (IJXJ
I ! 40 .!){)
, \ .(cO
1~0()
. (,l)
ZZDO
.bh
!llnD
/0,00
( Am~nt Receiv~_~r15~{G--CJ:~
OJ?
I ....UTl..OOlI1:EO SIGNATURE '8,,,-6 (
....(LTO...'''......"...\. ....'...n..... . ~UGE"E OR ..~40' .
re
0(-) /0
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q::) ! (';
1--1 ~ ·
,- /1.-01
'I ,71
rJ-'CF ,-
(tr -'
yIP
(~.I
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Applicant to furnish
A. Job Address
B. Legal Description
1. examole- Tax Lot 100, lane County Map'-
]1 03 43
2. example- lot 1. Block 3, 2nd. Addition \.
Springtield Estates
C. Name. etc. of owner and construction lend!
O. Energy Sources
1. examDle- heat/electrical ceilinqjor f( '>d
2. examole- waterheater/electrical!or sOl
E. Square rootage or valuation, etc. -
1. examole- 1250 sq. foot house, 500 sq.
2. example- if new project, check-new - i ~d'
check add, etc.
F. Bullding permit information:
1. example - construct single family housl
attached garage
2. example - remodel existing garage into
3. example - convert single family resider;
restaurant (change of use)
G. Value of work as defined in Section 303 (a) ~. t'--
Structural Specialty Code
H, DESIG~ TEAI'I AND CONTRACTORS
To avoid design or construction delays, Bui ~~
Division Staff must be able to contact appr{ ~at
persons regarding design information or job
corrections, etc.
Abbreviated Plu~bing, Mechanical, & Electrical S
A. Except \'Ihere blank spaces occur in the descr (io'
portion of the Mechanical and Electrical Sch
the applicant need fill-in only the No. Boxe
to the appropriate item(s) to be installed
B. Full Plumbing, ~lechanical, and Electrical Scl ~le
are available at the Building Division
1. To conserve space on the permit form the
have been abbreviated
2. If the item(s) to be installed are not cc &d
the abbreviated schedules you should cons
full schedules
C. BUILDIiiG DIVISION STAFF WILL FILL OUT ALL FEE
CHARGES 011 THE SCHEDULES (
D. As noted on the CAP, the label must be delivel ".
electrical contractor for signature by his elt
supervisor. The general contractor is not aut
to sign the electrical label. ---
Applicant to sign and date
Whenever possible, the initial application will be
a worksheet only. Where possible, Building Divisi
will prepare a type written copy and return it to
applicant at the time the actual permit is issued
signature.
Fees and Charges
Plan check fees are due and payable at the time of (
application, and no plans will be processed until t Ie
fees are,paid. All other fees and charges are due ~.~. ~
payable when the permit is issued.
54032r
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
,I I.,
PLANS REVIEWED BY:
name
DAN 51,1 ITH
Signature~ L~
......., ..0. ....I_.".J." ,.... "" ......, . ......" "....... . ..,. _.,.","._.... """""..,. .."., ......,.. _,,, "" ..
date
7 -l8-S0