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Home My WebLink AboutPermit Building 1981-2-25 INSPECTION I.INE 726-3769 . -,. tf. CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT .. INFORMATION LINE 726-3753 Sq. Ftg, Main 1,) U U Sq. Ftg: Access. Sq. Ftg. Other 6ewn_Add_,_Alter _Rep. _ _Fence_Demo_Chonge/ Use __Other cf)' ;;..-- (] Job Address 541 W. Centennial ENERGY SOjJRCES: Heat Electric Water Heater r-; LE.C:", nFL', Range Value of Work: - -=, -.-. legal Descriptian CentenniAl r.enter /7 -f)'2.,- ~ '[-1':) TL 4D62, 5306)c+S80Q Owner Hiatt. Hi;:tft. Tn'NiDg & Wood. 663 W. Centennial l~~-1420 Springfield, Or. Comtruction Lender PFF - EU2:ene 12,260 I Buiiding' Permit Info: 'De'-cribe Wo~k (i,e" Build Single Familv R~!~ti~~,=~ With A!toch~cl Gorooe) Address Restaurant t\!f1Sti J )JOV(1 ~ - --I Address Phone DESIGN TEAM (nome) (address) (lies. na.) (expires) (phone no,) Primary Strudurol Electrical N\.echonical (ONTRACTO~S (nome) (address) Springfield Eugene Springfield Springfield (lies. no.) (expires) (phone no.) 741~1420 683-1414 741-1186 746-1621 I I I I Plumbing Hiatt Bros. Twin Rivers Pense1in Harvey & Price 20-96 20-48C General . Electriccl Mechanical PLUMBING ElECTRICAL , MECHANICA.l Each single fixture RelocaTed building (new fix, additional) S.F. Residence (1 bath) FEE I CHARGE I NO, ls:~n 14t5:l'<> I , , I I I I I I / F;::;: I CHARGE I NO, FEE I CHARGE NO, 91 Temporary Construction :t furnace / burner to "'TU', Appliance vent sepo ro te Stationary evap. cooler Vent fan with single duct Vent system apart from heating' ar A.C. Mechanical exhaust haod and duct / Residence of sq, ft, New circuits, alterations or extensions SERVICES ,Duplex (1 bath) each ;3,C(J a, t)r-> Additional bath Amps. ISO ;<5.ro Water service 63 ~So ,(3:$('J J Sewer /IJ,!)O 'Wood stove/heater .s-S.co TOTAL CHARGES I I 10,00 I I I (.,./X) k.;.J.m I I I / Amps.ISO /5co :J-. Heat Pump ./ Air handler to 10,000 CFM Air handler aver 10,000 CfM Storm Sewer FEEDERS TOTAL CHARGES ISSUANCE OF PERMIT I TOTAL CHARGES /tJ,Oo 3 st.,O() WHERE STATE LAW REQUIRES thai the Electrical work be done by the Electrical Contractor, the electrical portion .af this permit shall not be valid until. a label has been signed by an Electrical Contractor and attached to the electrical 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 i,n accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon 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 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 heron, and that only subcontractors and employees wha are in compliance with ORS 701.055 will be used 'on this proiect. Basis for Builder's Board exemption: NAME (please print) p ~ /./ /VIe, ~t.6(/tE" ~IGNAT~~~/~ ~ij&/~. FOR OFFICE USE ONLY Units I ~q. Ftg. Moin J'5"OO C'lccy load J.l7 <;q. Ftg. Access C'lccy Group..B-,;{ Sq. Ftg. Other '--:2--y-?:J DATE / n _"I Zone ~ ~. Fire Zone Flood Plain Type/ Canst. v...... 1 t-f e. Bedro~m' - x 'torip" / Value Value Value TOTAL VALVA nON x I /::J..la00.~ J ~.3, 90 BUILDING PERMIT Charges and Surcharges 14 '/,00 d'Sc' . J)Son ;;.;At) , -'It; .00 I. Ion .3 ~ro Curb Cut -----',3& I Plan Ck. Comm/lnd 65~'o1 Bldg Per Fee I Pion Ck. Res 30%/810g Per Fee I Fence I 4\ .~oo I \ 'SSSlO d--\q-g, Syst~ms Development Chorqe (1.5%) PLUMBING PERMIT Charges and Surcharges I Total Comb. Permit I I I I TOTAL dot); ~ J.. ELECTRICAL PERMIT ,Charges and ' Surchargc :i MECHANICAL PERMIT Charges and Surcharges #384, ,,~ ."'.. ~ .'0; Fees and Charges Plan check fees are due and payable at the time of the apptk'ullon, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. COMBINATION APPlICATION/PE. (CAP) I. Applicant I>() furnish A. Job Address B. Legal Description 1. example-tax lot 1 DO, Lone County Map Refe ~I'- 2. example-Lot I. Block 3, 2nd Addition to Sprir, I., C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air, 2. exomple-woter heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foot house, 500 sq. foot gar ~ 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 fomily r< 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 Div Staff must be a ble to contact appropriate persons re design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedult A. Except where blank spaces occur in the description p of the Mechanical and Electrical Schedules, the applil need fill-in only the No. Boxes adjacent to the approf item(s) to be installed 8. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedule, have been abbreviated 2. If the item(s) to be installed are not covered on the ated schedules you should consult the full schedule! C. BUILDING DIVISION STAFF WilL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULES Ill. Applicant to sign and date Whenever possible, the initial application will be used as 0 worksheet only. Where possible, Building Division Staff wil prepare a typewritten copy and return it to the applicant a' the time the actual permit is issued for his signature. IV. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: ~&~~ 4 c/o ". ,.,f ____!/1/'1Y.....tJ/ad"'/~~ PLANS REVIEWED BY: A{) namp ',ignature . PERMIT VALlDATIO~ I CITY OF SPRINGFIELD City Hall Springfield, Oregon k Department of Public Wor s OffICIAL RECEIPT N 8 55910 o. 19 <6l ,-, ( I .,r ( ( Received For: ( ( r~p (, L\D16 c w ~61 ~ I') ( (~r ~p ( ( " \, =,' I f \. ~ ,","0."'" "0" ^' ".:' ".., SHEL.TON-TURNBUL.1.. PRINTERS' EUGENE. (/, BY ....!,. (, ( (l \\.. . ;".' :.. Permit Clerk .:/!/~ {/ --LSJlY~. () ~~ (/, date 2. ...;t 3" 8"0 I f ~ .