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Home My WebLink AboutPermit Building 1981-5-5 ..," .. _ - .. J'.' -: . ,;.: ".:,~~~.;:~ic~"""::': ;.;r'~1r;~~~11JMf#~~"-"!1_"";;"~}~~i' . "' \ ~ .' ~ . '.. - . -\.- :-:;' ~'., '"' f"Y:" '.1 ""(A~_~~~l-'~:{"'f",T~.~~~~~~r~~ ~~ ~~~~~~. . f \ . . . . - '>:~ '.... ; '.' ". :,,'.:)./ 'f..,,;;,~...j..'"t~!Jt.::;.~::...$( ~~~~...,'~ -"3~~r7~; 'F;~ .' \J),.. /"F' . . ~:' ;.,'''. I J:,:,' ." "7,:~~:'itl'-\!!.:"'f~~ .." "iI'- "~,~~'~,"';""~i't,,,;,i<"- '> ,. ---.~ .... .:"7- ,,"'~'.""'~' ";/;"j'- .'1'" _!'.f"-.~.'2: ~::'~N~t._-'r'--;"::~~~"" INSPECTION LINE 726-3769 CITY OF SPRINGFIELO COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 17 03 27 43. TL_5BOO Owner Gene & Bernard Hiatt, Sidney Thwinq A~~?sEd~~3dW~~~dCentenni a 1 B1 vd phone 741-1420 S !ITingfield.-.Qreg 0 rL....97 4 7 7 Pacific First Federal I ENERq:( .,sOU~CE.'i,: Heat tlect Heat Pump I' Water Heater...Elect. Range Value of Wark: Sq, Ftg. Main YOn Sq. Ftg. Access, SX' Ftg. Other _,.New ___Add_Alter _Rep, _~Fence-..DemamChange / U se __Other l.,Omp ete 3,500.00 lease space Building Permit Info: Describe Work (i.e., B~ild Single Family Residence With Attathed Garage) co I-' :::> N \.0 :::> Job Address 549 We..s_UenJ~,en!liCl] legal Description Retail fahLiL -SalE' Construtlion lender Address Euqene DESIGN TEAM (nome) phone (oddress) (Iics. no.) (expires) (phone no.) Primary Van Voorhies PC 13~, Rprt~; P 0 ROX 27~~gene 343-7378 Structural Electrical Mechanical Harvey & Pri ce 2015 Nugget Way, Eugene 746-1621 CONTRACTORS (name) (address) (Iics. no.) (expires) (.,hone no.1 Ge~rol Hiatt Brothers Investments Plumbing Tw; n Ilil'e.rs Pl urnb; ng Electrical Pense1in Electric Mechanical Harvey & Pri ce 741-1420 Fugenp Sprinqfie1d Sorinqfie1d #?n-q" #20-48C ~w~- 1 LL 1 LL 741-1186 746-1621 PLUMBING ELECTRICAL MECHANICAL Duplex (1 bath) each FEE CHARGE NO. 5.00 ~O.OO I I I I 11 FEE CHARGE NO. FEE CHARGE NO., Temporary Construction 1 furnace! burner to 8TU's Applionce vent separate Stationary evap, cooler Vent fan with single duct Vent system apart from heatirg or A,C. Mechanicol exhoust hood 0 nd duct I 13.00 I I I :.2.00 4 Residence of Eoch single fixture Relocated building (new fix. additional) S.F. Residence (1 bath) sq. ft, New circuits, alterations or extensjons SERVICES Additional bath Amps. 100 15.00 Water service 1 Sewer 10.00 I FEEDERS Wood stove/ heater 2 I Heat Pump I Air handler to 10,000 CFM I Air handler aver 10,000 CFM I Storm Sewer Amps. ISSUANCE OF PERMIT 10.00 TOT Al CHARGES 30.00 TOTAL CHARGES 15.00 TOT Al CHARGES ?" nn WHERE :iTATE lAW REQUIRES tho' the Electrical work be done by the Electrical Con'ractor, the electrical portion of ,his permi' shall not be valid until a label has been signed by an Electrical Contractor and attached to the electrical panel. I HA VE CAREFUllY eXAMINED the completed application for permit, and do hereby certify that all informotion hereon is true and coriect, and I further certify tha' any and 011 work performed shall be done in accordance with the Ordinances of the City of Springfield and the lows of the State af Oregan pertaining to the work described herin, ond that NO OCCUPANCY will be made of any structure without the permission of the Building ,Division. I further certify tha' my registration with the Builder's Boord is in full force and effect as required by ORS 701.055, that if exempt the bosis for exemption is noted heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will be used on this project. Basis for Builder's Board exemption: NAME (pleose printl, PE j/ lV' S G- 1-0 c/L-7 ( 'IGNATUR0:1~ ~~--r 5..5'~?f J DATE FOR OFFICE USE ONLY \ Zone r_? Fire Zone Flood Plain Type/ Const, Bedrooms 'itorip'" V-,,-.V,! R Units, ()ccy load ()ccy Group 23 I3-L ~q, Ftg. Moin ~q. Ftg, Acce" ~q. Ftg. Other '( Value x Value x Value TOTAL VALUATION ~. 500.00 BUilDING PERMIT Charges and Surcharges 28.00 ----~1-~..1~ Plan Ck. Comm/lnd 65%/ Bldg Per Fee Plan Ck. Res 30%/ Bldg P"r F~~ $18.20 I Systems Development Charge (1.5%) I [Plan Check I Total Comb. Permit I 52.50 PLUMBING PERMIT Charges and Surcharges __~~..lQ...J2.0 Few 1. 20--- Demo I Sidewalk I A~C Pavina lB.....2 0 101. 92 ElECTRICAL PERMIT Charges and Surcharges 15.00 .60 I MECHANICAL PERMIT Charges and Surcharges ___~.l.~00 __~b Cut 1. 00 I TOTAL 172.62 ~W(~iim~~~:i~~~j~i~~~lt~;::i~~~:\~~.~ ,,~~~1i!tl_~j'~!,~~. lLr.I.;J~1lW.lLlI8mu:J~~ CITY 0 F S P RI N GF IE L 0 ,;gnalu,;iJ/1fl~Yi {}-)U!ap dal.5 - 5 - 6 i COMBINA TION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example-tax lot 100, Lane County Map Refen 2. example-Lot 1. Block 3, 2nd Addition to Spring C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air 9 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foot house, 500 sq. foot gan 2. example-if new project, check new-if addition, add, etc. F. Building permit information: 1. example-construct single family house with an garage 2. example-remodel existing garage into family l 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 0 Staff must be able to contact appropriate persons design'information or iob site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Sched A. Except where blank spaces occur in the descriptiol of the Mechanical and Electrical Schedules, the ap need fill-in only the No. Boxes adjacent to the apF item(s) to be installed B. Full Plumbing, Mechanical, and Electrical SchedulE are available at the Building Division 1. To conserve space on the permit form the schec have been abbreviated 2. If the item(s) to be installed are not covered on ated schedules you should consult the full schec C. BUILDING DIVISION STAFF Will FIll OUT ALL FEE~ CHARGES ON THE SCHEDULES t- Ill. Applicant to sign and date Whenever possible, the initial application will be used worksheet only. Where possible, Building Division StaH prepare a typewritten copy and return it to the applica 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 and no plans will be processed until these fees are paic other fees and charges are due and payable when the is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUP Additional Project Information: PLANS REVIEWED BY: namE" DAN SMITH City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT i 1 I ~. No. B 5 6 4. 3 4 19S1 Rec'd From~\ o....-t:-t; ~~ Address lo \1) ~ UJ, 02J\\-l" €)turt. Date h-5 - ( ( (' ~ ( ( v~ ( Llqb c' J.,p 470 '-1110 r~ {.~ f,..." .. Amount Received (s BV Ei- (.~ ( <. CITY OF SPRINGfiELD City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT ( ( (II No. B 564 3 5 5 - 5 - 19 g( ,,- ... Rec'd From ~ / a...fl &r~.:2r. (, Address &f.t;3 tv - ('tJ~. I,. Date ~ l ( Received For: 60~ ,5;). t:) {) E~ -fL~? A1-~/L 1!' :::tL RJ D30t{" ~. FD ~ ( t- \.,- c - Amount Received 7;;-3" q 0 oJ:- ~ \... BV AUTHORIZED SIGNATURE SHEL TON-TURNBULL PRINTERS' EUGENE. OR 97401 S8'1\Hl (