HomeMy WebLinkAboutPermit Building 1989-5-4
~ IrISPECT lOll
1716-3769 .
Job Address
~d>7 ~';g' 5)
2 "Ltf <f 7r
LIlY uF SPRIrlGflLLU
l\Blll~TlON APPLlCATlON/PERMIT
E!IERf;Y SOURCES:
J Ileat
l"Iater Ileater
RanI'Je
.
INfORllAT:.:1 u..=.
7,6-3753
So. ftq. Hain
~q. rtg. Access.
Sq. Ftg. Other
/let., Add Al ter ~eD.
--rence Demo Change/Use
Other - -
.
77't- ~..nr;
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I~:
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II
(phone no. J
I.egal De~cription
Owner 6 b iJ~ mJIo ~
"<id,ess!, (J, t5i'J Y ,"5--z..
0/:Jr"//7~'e1c(
Construction Lender
Pnonc
ValUE: of Hark:
"2' 73C::: ...-e
Gui ltdna Permit tnfo: Descnbe Hork( l.e..
f'Aes;;je :'~araQe)
~L At.- / 1>h~ 7f -<./' dO
irl -11- ;.
(1 ics. nD.)
BUIld Single
AJdres5
OESIGrl TEAll
(nallle)
Phone
(address)
(exnires)
Primary
Structural
Electrical
!1echanica 1
CONTRAClOR.YJ {name)
General ttl1f~
Plumbino
~~cBj;/K;:;;'~') 1/4/J /Il/ h~~~;
a / /
C:40k 7
(pxoirp<:; \
/2/rf9
PLUllfilllG
ELECTRICAL
'IL J:Jil\.RGJ rilL
MECHANlCAL
(nhonp nn I
3l!..I=-O 7v'9!
I
I
I
I
~/^.e.-..
Electrical
tl~chanical
-.--ill!..:. I
FEF I l':UARr.F
.1l0
SQ. FT.
furnace/burner to
aw's
1.ilL J:IlARliE.
I
I
Each single fixture
Residence of
Relocated buildiru)
(new fix. additional)
INew clrcu~ts alts.
or cxtenslons
I SERVICES
I
Floor furnace
and vent
Is.F. r.esidence
r 1 b,th I
Duplex (1 bath) each
Recessed wa 11
~nncP hp~tpr nnd vpnt
Additional bath
I
I
I
I
ITempOrary Construction
Chanqe in existing
rr>5-idpnrt:
mult1famlly, con~. or
Indtl<;tria I
Sewe r
I Storm Se\'/cr
I
Of
COI<ll. II NO. FEEDERS
Insta II/a 1 ter/re locate
di~trjh. fppdpr~
amps,
I Apol iance vent
~POill'atp
Stationary evaa.
cooler ~ .
Vent fan ,"ith
sinole duct
I Vent systerJ apart
heatina or A.C.
I ~lechanica 1 exhaust
hood and duct
I Uood s.tove/heater
I
I
I
from
~!ater service
Of
amps.
I
I
I I
TOTAL CHARGES I TOTAL CHARGES
\.IlIEP.E STATE l \\~ REQUll1ES that the Electrical \"lork be done by an
shall not be val iJ unti 1 the label has been signed by an Electrical
ISSUAIICF OF .fR'IlT
TOTAL CHARGES
Electrical Contractor, the electrical portion of this permit
Supervisor and returned to the Building Division '
I HAVE CAREFULLY EXN1H/CO the completed aprlication for f')crmit, and do hereb,v certify that all information hereon is true
and correct. and I further certify that any and all work nerformed shall be done in accordance with the Ordinances of the City
of Soringfield and the Laws of the State of Oref)on pertaining to the work described herein, and that UO OCCUrAIKY \...i11 be made
of any structure without the permission of the Ouilding Division. I further certify that my re~istration with the Builder's
fioard is in full force and effect as required by Or.S 701.055, that if ex t the basis for exemntion is noted hereon. and that
only subcontractors ~A-mpl/oYee;:;h/O a~~~comOliance with Or.S 7nl. '~~~h:S, n.'o~~
IIA:\Elplease print) -fA- !75 /=-/( r /dLc-- ~I OP.TE.w 1ft 9
Zone L L
Fire 70ne
Flood Plain
FO~ Off ICE USE
Tyne/Cons t. Units S~. Ftg.
Oed rooms Ocey Load SQ. Ft!].
Stories Occ,V c'roup Sq. Ftg.
f1ain
,
Value
Access x Value
Other#e~-=""'R Value
101AL VAlUAllotl
-:::?? ~ ,
BUILOIIIG PERI,IIT
Charl]es an~
Surcharges
== ~ Plan Ck.
::;> C> .........,,2:) 65t:/Bldo
------7"i;~ ~6~~B;~~
Conrn/lnd
Ppr Fpf'
Res
Per Fee
Systems Developn~nt
Charoe (1.5<)
PLU'1B IIIG PERMIT
C~~rges and
Surcha rges
Fence
Df.mo
, ELECTRIUL rERI~1T
CharQes and
Surcharges
I1ECIlAIIICAL PEP./1IT
Charges and
Surcharqes
Sidewalk
I A/e Pavinq
I Curb Cut
I
Total (omb. rermit
TOTAL
'~.~
,
.
..
"
....,
J
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
.t
t. Applicant to furn1sh
A. Job Address
B. le9~1 Oescription
1. examJ.lle~ Tax lol lOO. lane County Map Reference
17 03 43
2. eXJml11e~ lot 1. Glock 3. ZIId Addition to
~prlngtield [states
C. Name. etc. of owner and construction lender
O. Energy Sources
1. exam.ple- heat/electrical cCilin<Jlor forced air qdS
2. eXdmple- w,llerheater/elecU"lCill/or solar
E. Square rootage or valuation. etc. -----
1. examole- 1250 SQ. foot house. 500 sq. (oat gdrage
2. example- 1Triew project, check----new - if addition.
Check add. etc.
F. Building permit information:
1. example - construct sinyle family 'louse with an
a ttached garage
2. eXdmDle - remodel existing garage into family room
3. examole - cOfwerl single fond ly residence into
restaurant (change of use)
G. Value of l'iOr/.;. as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM AND COIlTRACTORS
To avoid design or construction delays, Ouilding
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections. etc.
II. Abbreviated Plumbing. Nechanical. & Electrical Schedules
A. Except \'/here blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fl11~in only the No. Boxes adjacent
to the appropriate item(s) to be instdlled
B. full Plumbing, Nechanical, 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 abbreviated schedules you should consult the
full schedules.
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ArID
CHARGES 011 TIlE SCHEDULES
O. As noted on the CAP. the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is !!9J. autlloriled
to sign the electrical label.
Ill. Applicant to sign and date
Whenever possible. the initial application will be used as
a worksheet only. Where possible. Building Oivision Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit 15 'issued for his
signature.
IV. Fees and Charges
Plan check fees are due and payable at the time of the
application. and no plans. w\11 be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
s- <-f--81
d,~,~~
13758
~
V. FOR OFFICE USE ONLY Permit, Clerk
k",.r., . 'fT- -:ll:
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAtICY:
Permit applicant exempt from registration with the Builder's Board because:
Add i ti ona 1 Project Informat i on:
..
PLANS REVIEWED BY:
name
~/7#6'"~:e::-.k'
Signatur~~~____date
9 </- &:"7
.
v
y'
i.
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~:.," 1ft:;.; ''';''' , :..;:.::. rt~~, :.I!";'-o:~-. r...Y:'S.:'::'~1i;tf.~%[~'t'J.~:~~f1'i':Ut~;~X!. :'~ll!f"l\. ~~;4~vl.t~~1~1,>r:11t:-:'1~~~;;'.r.
f'
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CONT NO. 53087
tlroposal
PERFORMANCE PLUS ROOFING, INC.
1430 WI LLAMETTE NO. 578, EUGENE, OR 97401
PHONE (503) 345-0749
926,5379 ALBANY
747,3208 WAREHOUSE
'.
PROPOSAL SUBMITTED TO
Bob U<l.m.i.f,.tan
STREET
PHONE
746-8534
I DATE
4/72/89
JOB NAME
f!o<le. ' <I V~nek,
Spk~ng6~e..ed
CITY. STATE AND ZIP coer::
JOB LOCATION
ARCHITECT
I DATE OF PLANS
EMPLOYED BY
JOB PHON E
WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR
~emove all exi6.tlng koo~lng.
Uaul away all wa6te. mateklal<l.
Zn<ltall ~3 ply hot ~~be.kgla<l<l bilet up /[006 eon<l~<lt~ng 06 Cta<l<l A FIRE
Olll!. pClf of! 28# f,.tbe./[gfaJ.d ba6e <lhee.t.
Two r.>,{'y on 1117 {,.i.1.l(~![gCI.t<l-~' p.Cy 6he.r.t mopped .to baM. <lheet w~th hot a<lphalt.
Fa/[ a ~l"~<lh, ln~tall pea g~auel <le.t ~n hot a<lphalt.
In~tal.(' 7811 mine~a.(' ~uk~aee cap <lheet on pakapet waif<l.
In<l:(;((.O' Hel(/ "1:',<:aJ~ '0/1 bae!, edge 06 ko06.
Reu~e all Oth!k metal.
S Ilr.ak .f'abo~ ~aJlk[[Y!:i.II.
* 1 ~~ YO!'. wOIL.fd )Lat!L(~}L' ?LettJe ({ m.tJHULa.f.
gkavel' {~dd
I
RATE4
!
$2,730.00
<lUk~aee ~~nl<lh ~n<lt~ad 06
$270.00 make. to above
~~gu.te .
We propose hereby to furnish material and labor-complete in accordance with above specifications, for the sum of
~FF ^'WVF
PAYMENT TO BE MADE AS FOL.LOWS:
[IJ 011 ('1)MPIEnOIl OF JOB Hi FUll
dollars ($
) i
I GUARANTEE."Scid rooF corries a gucrantee for 5 yeelrs eg.inst leoks only. We
, ue not liable for any foot traffiC, wind damage, o~of God, or dllomag8 resu t ting
I :rom work performed by other trod!;s. All material, is guarllnteed to be ilS sgecified.
I \11 work to b. completed in :I workmanlike manner .!lccording to standard practices.
i \ny ",Iteration or deviation From ab0Ve speciFications involving ~J(t:rll costs will be
I ucocuted on Iy upon wriHen orders, and will become on extra charge over t.lnd IIQove
I :he estimate. All IIgreements contingent upon strikes, accident. or delays beyond
~ )ur control. Owner to corry fire, tori'\C1do ond otner necessary insurance.
AUTHORIZED
SIGNATURE
/)
UKo-(}
/ )
i --r-:' .1/
Udl(/;(~,
NOTE: THIS PROPOSA.L MA.Y BE
WITHDRAWN BY US IF NOT A.CCEPTED WITHIN
1 V
DAYS.
If payment i;, not received within 3 days after the time set in paragraph I, we reserve the right
to place A lein on the property above as per proposal agreement.
ACCEPTANCE OF PROPOSAL The ebove prices, specific.\tJOns, end conditions
Clre setisFllctory end .re hereby o::c~pted. You ore outhctriz~d to do the work as speci.
Fied. payment will be mode as outlined above. In the event tnis Clgreem'!nt is not poid SIGNATURe
as agreed, then reasonable attorney's fees and collection costs even though no suitor
eoction is Filed will be paid, if a suit or action is Filed, the eomount of such reCllonable SIGNATURI:
Clttorney's fees sha J1 be Fixed by t:,e Court of couns in which the suit or action,
including any appeeol. therein, is tri<Jd heard or decided. IF propos,,1 is ceoncelled by home-
owner aFter acceptance, a 250/0 ch'lrge will be mode of this contract prices. DATI: OF ACCEPTANCE