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Home My WebLink AboutPermit Building 1981-4-16 53. Centennlal Boulevard 17-n3~26~3~4__1800~ I INSPECTION LINE 726-3769 I J.,b Add e~ I Legal De c pt Ow Robert Klnvon Add" 1 093 East 25th Eugene, Oregon Co t ~tn L de Add DESIGN TEAM ( orne) P me y 'lWnpr St t oj EI ct 01 M he col CONTRACTORS ( orne) G e 01 owner PI mb (:l Ele t al Me h cal PLUMBING NO FEE Eo h !=lIe f xl Rela aled bu Id 9 (ew fx addle (1) SF Re de e (1 bath) Duple (l bath) each Addlo I b th Wale se 1 Sew 51 rm 5ewe TOTAL CHARGES , CHARGE NO I 15 001 I I 10 001 I I I 25 001 CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 ENERGY SOURCES H t_eJectocBR Wat H t~ elecJoc_ Rooae _e I ectoc Val of W k O'lU Sq FIg Me Sq FIg A 5q FIg Oth _New_Add_AIt _Rep _F _Demo_Cho ge/Us _Olhe _HQU5e~O.ve_ co o N U1 W Ph. $16,000 00 B Id 9 P m t I fa D b Wo k ( B Id 5 91 485-=..30?1. Fern Iv R de W th Attach d Go O'Qe) Move slngle famlly resldence complete to code fnr occuRancv Ph. (add e $) (ph no) (I cs 0) (e pes) (add e ) (I c no 1 (e p e) (pho no) ELECTRICAL MECHANICAL FEE CHARGE NO I CHARGE I FEE R deaf -99~ N,w . t o e/b r '0 'lU Appl a e . pa 1 S. 10 0 Y op cool V . fa w.h !:lIe d t V n. sy 'em apo . from ha'goAC Meehan col exha I hodaddu' q It . alte 10 . SERVICES Tempo a y Co I u 10 Amps I new serV1CR I I FEEDERS I Amp I I I I I 1 ~ 00 Wood sto.... Iheate H t P mp Air handle t 10.000 CFM Air hondl o\' 10000 CFM ISSUANCE OF PERMIT TOTAL CHARGES 15 00 TOTAL CHARGES WHERE .;ITATE LAW REQUIRES thai the Eledrl 01 wo k be done by the Electr col Contrador .ho elect leal po II n of thiS perm' hall not be val d nt I a label has been gned by an Electr cal Conlractor and attach.d 10 the .1. I col po el I HAVE CAREFUllY EXAMINED.h comple.ed appl a' 0 fo pe m tad do h by . fy tho' all nformat on h r 0 s tad correct and I f th t fy th . a y d all wo k pe formed hall be do a co do c w th the 0 does of the C ty of Spr "gf Id a d the laws f tn St t of 0 ego p 10 g t th wo k d b d h d Ihat NO OCCUPANCY w II be mode of a y . t e w th ut.h pe m so of the B Id ng D I fu th ce Ilfy that my eg SIT ton w Ih the Bide s Boa d f II fa ce d effe . (] q d by ORS 701 055 .h t f mpt the bas fo x mpt a sated :~E f:,:,~::t ~5ii~; :;~~:~ /1 n ~mpl aSl~N~T:R~RS 701 055 w" be d. th 2}t{fl- OATE I FOR OFFICE USE ONLY ~ 'nIl,. Ftg Mo ~oundatJon~x VI -3,DOO-OD- n-ccy lood Sq Ftg Ace x Val Occy Group q 3- Sq Ftg Other x Val TOTAL VAlUATlON~nnn nn z I{-l Typ ICo . Bed ooms V-N F e Zo e Flood PI -N0 <',to e BUILDING PERMIT Chagead S ha ges 24 00 96 PLUMBING PERMIT Chagsad S charges 25 00 I 00 elECTRICAL PERMIT Charges and Su cho 9 15 00 -----60 MECHANICAL PERMIT Cha 9 s d Su cha ges Pion Ck Comm/lnd 65~/Bldg P F e PI Ck Re 30%/ Bldo Pe Ft't' Sy tern De lopme t Cho Q (1 5%) 22 80 pald 4-10-81 recel pt-#5628C 240 00 Fe Demo I S dewolk I Ale Pa I Cu b C t I I Tot I Comb Pe m t fio_Sfi .2D-- I elect lab.eJ_#__ a I I TOTAL $306 76 1 (CAP) ~ COMBINATION APPLlCA TION/PE~~'I I Applicant to furnish A Job Add ress B legal Description 1 exomple tox lot 100 Lane County Map Reference 17 03 43 2 example Lot 1 Block 3 2nd AddItIon to SpringfIeld Estotes C Name ete of owner and construction lender o Energy Sources 1 example heat/electrical ceiling/or forced air gas 2 example water heater/electrical/or solar E Square footage or valuation ete 1 example 1250 sq foot house 500 sq foot go rage 2 example If new prOlect check new If addition check add etc F Budding permit information 1 example construct single family house wIth an attached garage 2 example remodel eXisting garage Into family room 3 example convert Single family residence Into restaurant (change of use) G Value of work as defined In SectIon 303 (0) of the Structural Specialty Code H DESIGN TEAM AND CONTRACTORS To ovoid deSign or constructIon delays Building DIvISion Staff must be able to contact appropnate persons regarding deSign information or lob sIte corrections etc II Abbrevloted Plumbing MechanIcal & ElectrICal Schedules A Except where blank spaces occur In the descnptlon portion of the Mechanical and Electncal Schedules the applicant need fill In only the No Boxes adlacent to the appropriate Item(s) to be Installed B Full Plumbing MechoOlcal 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 abbrevl ated schedules you should consult the full schedules C BUILDING DIVISION STAFF WILL Fill OUT ALL FEES AND CHARGES ON THE SCHEDULES III Applicant to SIgn and date Whenever possible the Initial application will be used as a worksheet only Where poSSIble BUIlding D,VIS,on Stoff will prepare a typewntten copy and return It to the applicant at 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 application and no plans WIll be processed until these fees are pOld All other fees and charges are due and payable when the permit IS ISSUed V FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY Additional Prolect Information PLANS REVIEWED BY n~me G)Cln ~ enJ tt slgnatur'" " \ () I '~~RMIT VALIDATION 1 , .... \ , PermIt CierI- rlete " ( 4--I(n~ I INSPECTION LINE 726-3769 ~ CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT ) INFORMATION LINE 726-3753 lidn J b Add 535 Centennial Boulpv~~ 17-03-76-3-4- 1ROQR L gal Dee pta Ow Robert Klnvon 1 093 Fil~t 25th pho e Eugene. Oregon 4R<;_~n?~ -- - Add en Cnttolede Add DESIGN TEAM phone ( me) ( dd P m y n""no..- SI ct 01 EI (I cal M cho Ie I CONTRACTORS (name) (address) Ge 01 owner Plumb q Elect 01 Me he cat PLUMBING NO fEE CHARGE NO Re de ce of -O!'" '9 It New t alt Ian 1 !i.J)f (I e te '0 1 Eo h nqle f xl re Relo cled b Id n9 (new fl add t (I al) SF Res d c fl hoth) SERVICES Tempo y Co st cfon Amp neJN c;,prvir..p 10.00 FEEDERS Amps I I I I I 25 001 TOTAL CHARGES D Dr x (l hath) eo h Add t (I I both Waf ervce 1 Sewe StomSwe TOTAL CHARGES Sq Fig Me Sq FIg A Sq FIg Oth _N w_Add_Alte _R p I_F _0 mo_Cho 9 fUse _Oth House Move ~16 nn(1 nn B Id - 9 P . m t I fa De c b Wo k ( B Id 5 91 Family Res de e W th AHa h d Go age) ENERGY SOURCES H t ~le~tri~ RR Wate Heat p 1 pr:t. ri r Ra g ~1 or~wo'l'" I Valu of Wo It ()., ~ o N Ul ..., r:l\rlPl T'nr (1rrl~!",~n"'~' Move Slngee faml1v residente comolete to (I n) ( p (pho eo) (phone no) FEE I CHARGE I I I I I I I I I WHERE STATE LAW REQUIRES that the ElectrICal wo k b. done by the Eled cal Contractor the elect I al po t on of Ih s p8 m t shall not be val d nhl a label has been s gned by ~n Electr cal Contr~ctor a d attache..d to the led cal bel , "" I HAVE CAREFutli'i?x\':a,~ th;/. ",~ill.J\~n~ foC:ji'"m t ~d(>dii'h~d,y ""t~ fIla~ II ;!!o,~~1'I. eo\;;'\ hue ~nll-'a,~e't').~,\;l. rvu..he, t (y tnat y a d~l wo k pe fo med n!11 be done Ln a co dance w fh. th ~O d once ~f Ih C ty of"S~.~gfLeld and th Laws of the Stot~-~f Oregon p,,~n~~~o k bed.,~ ,'lmd ,"\!t~Q,CUPA~ w II,./>... mad of aQy~~,g '!,. Wjtho\t the .. ~ "II. of Ihe Bu'ljd pg D ~"i-n r-'\ f Ihe eert thatrTi)i'reg~ato thffie S\.d~ Boo\f9 -;: 11 ~ 0 d ;ffftt~" el!l ~'Rs""cN..055) tba'f"-,.f~xeluM th bo PI \o}~~x~pfLo ~~ noted he 0 d th t 0 ly s b t acto d mployees who a e In compl a ee w th ORS 701 055 w 11 be sed 0 th p OJ t Bo fo, Bu Ide Be d e.empho I / --. /' /':'--::::> / / r NAME(pleoep t)~/'f'Ir/- j/fK/YI,VO/'l SIGNATURF :~"'~r:~./?'~DATE i FOR OFFICE USE ONLY ~ "i .!- 20 e F e Zone Flood fila Rpl U t I"'t cy Load Occy Group 1 Type/Const --y='N Bedrooms Cto e. 1 t)c BUILDING PERMIT Charges 0 d Surcharge plan Ck Comm/lnd 6510/Bldg P Fee Plan Ck Res 30%/ Bldg Per Fee ). I Fe e I D mo 24 00 96 PLUMBING PERMIT Charge and S cha 9 25 00 1 00 ELECTRICAL PERMIT Chagead S ho ges 15.00 I Sd walk -----60---1 Alc Pa no I C b Cut I ~- MECHANICAL PERMIT Cha g ~8\;\ f\i> Su ho 9 j~ I A- _I (I cs no) fe pes) ELECTRICAL MECHANICAL FEE CHARGE NO I f (lC /b to STU Appl nee nt ep at Stat (I (I y evap ooler Ve t fa w th s ngle duct V nt y t m pa t f am hetgoAC M ena al e ha st hood dd t 1 <;I\nn Wood tove/heate H t P mp A r ha dl t 10000 CFM A ha dler over 10000 CFM ISSUANCE OF PERMIT 15 00 TOTAL CHARGES :t-J c:" Fig Mo TQllnnat;~n . Val ".':'':'':'_,],] <q FIg A, . . Val Sq FIg Othe . Val e TOTAL VALUATION 1~ _1)00 00 I 1.!2 80 pald 4-10.81 I' "'..'" I...~ i!50':;OU ~ , I I 1 I I Systems Developm nt Cha ~e (1 5%) Total Comb Perm t <>lpct label # rJj tm i TOTAL - 240 00 C'i "" l;1i ?n n60 $306 76 COMBlNA nON APPlICA TION/PER~" \ (CAP) Applicant to furnish A Job Address B Legal Description 1 exomple tox lot 100 Lane County Map Reference 17 03 43 2 example Lot 1 Block 3 2nd Add,tion to SpringfIeld Estates C Name efc of owner and construction lender D Energy Sources 1 example heat/electrical cedlOg/or forced aIr gas 2 example water heater/electrical/or solar E Square footage or valuation efc 1 example 1250 sq foot house 500 sq foot garage 2 example If new prOlect check new .f addItion check odd efc F Budding permit information 1 example construct Single family house With an attached garage 2 example remodel eXisting garage Into family room 3 example convert Single famtly reSIdence mto restaurant (change of use) G Value of work as def,ned In Section 303 (a) of the Structural SpecIalty Code H DESIGN TEAM AND CONTRACTORS To aVOid deSign or construction delays Building DIVISion Staff must be able to contact appropriate persons regarding deSign information or lob site corrections etc II AbbrevIated Plumbing MechaOlcal & Electrical Schedules A Except where blank spaces occur In the deSCription portion of the MechaOlcal and Electrical Schedules the applicant need fill In only the No Boxes adlacent to the appropriate Item(s) to be Installed B Full Plumb,ng Me<:hanlcal 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 abbrevl ated schedules you should consult the full schedules C BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES III Applicant to SIgn and date Whenever pOSSible the Initial application will be used as a worksheet only Where poSSIble Budding D,VIS,on Staff Will prepare a typewritten copy and return It to the applicant at 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 application 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 V FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY Ap,Plti.<?+<t- , , /2+tn.:JlI -h KJt!l;} ').- , c1t?#"'<J4/" ./ h/lu-;e ::J., V I /:J-hv-/:>_I )1"/1/<:'< Additional Prolect Information " PLANS REVIEWED BY nama Dan Sml th "Ignatur"" c>;h "ERMIT VALIDATION " PermIt Cler~ h ?J,?' <l h htJr-' c .5 e ..v~.y / f::5a-j -r <)/'rIe--- tY~f?",!4/7 j riote 4ill/81 ..... ".JIII\!.!.""~,_'''' ""~''''l''"",_" ~...,...~I~~l-.1 . """"'''''''''.!f:- ...- INSPECTION LINE 726-3769 - ,- \ \ l(111I -'It,!" '~III;'~ I,,"~"'''......I.:...,...I.!. ".!i!!~~...~!lll,. J,.,H 11I.llhl.~1 '":lI11~ . ~I , I. . III J}._ CITY OF SPRINGfiELD COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 Add Robert K1nvon 1093 East l5th ~o Eugene, Oregon 48S-.10n ENERGY SOURCES H.ol electrJc_BR Y I H I~ ~ectrlc Ro O' _eJ ect 1'..1 c I v I of Wo k $]6,000 on B Id 9 Pc m t I fo 0 sc he Wo k (e 8 ld S 91 Fern Iy R deW Ih Attach d Go 00 ) O'lU Sq Ftg Mo Sq Fig A Sq rIg Oth _N w_Add_Alte _Rep _F _Demo_Chonge/Use _Olh -Holl5e-.Moy" legal 0 c pto 535 Centenn1al Boulevard 17 -03..:.26..:.3~_1 aOOR J b Add Ow Co t eto L de Add es DESIGN TEAM (am) Pm y n\.lmpr 51 tu 01 EI t 01 M h 01 CONTRACTORS ( om) G 01 owner PI mb q EI 1 M chon 01 PLUMBING NO Eo h 01 f xlv e R 10 at d b Id g ( f x dd to at) SF Re de (1 b Ih) o pie (1 bolh) o,h Add I 01 both Wol '" 1 S.w Slo m S we TOTAL CHARGES OJ ~ o N lT1 W Move slngle fam1ly res1dence complete to code for occuRaQCv Ph ( dd (I 0) (phon no) ( p t dd (I (Dha 0 0) 0) ( po) ELECTRICAL MECHANICAL 'EE CHARGE NO 15 00 I i I I 10 001 FEE CHARGE NO FEE I CHARGE I I R d eo~ -99? Q ft N w U I olte 10 o xl /b 10 'TU Applo ce e I po 01 Sial 0 aye ap (001 Vo If w Ih s gle d ct Vo I Y t m op t f m h all"g A C M chen I xhou t hododdut SERVICES TempoayCo t 10 Amp new serVlce 15_ 00 Wood t Ih at FEFOERS H at P mp A r ho dl to 10 000 CFM A ho dl 0 e 10000 CFM Amp ISSUANCE OF PERMIT , 25 001 TOTAL CHARGES 1 5 00, TOTAL CHARGES WHERE STATE LAW REQUIRES tho' tho Elect I I wo k be dono by tho Elect eol Contract r the olectrICol portion of Ih s pe m t hall not be val d nld a lobel has boen gned by a EI tr c I Contract rod tach d to tho elect I 01 panel I HAVE CARE FUlL Y EXAMINED the ompleted oppl at 0 f p m tad do he cby C8 t fy that II fo mat 0 he eo ado 0 I and I f th t fy that a y a d all w k pe fo med hall be d a(ca dew th tho 0 d one of tho C Iy f Sp gf eld a d the law of the State of 0 gon pig to th w k d b d hod Ihat NO OCCUPANCY w II be mod fay sl ct w tho t the pe m 0 of the B ld g 0 sol f th ee tlfy thot my eg ITot 0 w In the Blder.$ Boo d f II for 0 d eff ct 0 q d by ORS 701 055 that f mpl tho b f 0 ampt on soled :: 0, /0 :. ;:01 o~: ;;:p;o, d .mploy " who o. ,ompl n<e w Ih ORS 701 o~ /."d; OL / NAME (pI o. p t)--fl-J Abt:'t-rf .df/ I!t'hVd/l SIGNATURE ~.f./r.d-:"~L/4~- DATE / 'OR OF'ICE USE ONLY //" I{-I Typ ICo I V-N U 1 I " FIg Mo JoundatJ~x lI:~d oom n y L od Sq Ftg Acee x c.to 1 n y G 0 P-!1 3 Sq Ftg Olhe x BUILDING PERMIT 24 00 plo Ck Comm/I d eho 9 o d 6S IBldq P , S h g.. 96 PI Ck R s 30/IBldq P , PLUMBING PERMIT 25 00 eho 9 o d Fe ce S ho ge I 00 Demo ELECTR!CAL PERMIT 15 00 Cho ges 0 d 5 dewolk S h g.. -----6(J-- Ale Po 0 MECHANICAL PERMIT Cho 9 d C b C 1 S h g -------- Zon F e Zo Fl ad PI --!in VI. Value Vol TOTAL VALUATION I Sy lems D I pm Cho Cle (1S"{,) 22 80 pa1d 4-10-81 ~-2;:2lpt-#56280 ~_noo 00 16,000 no 240 00 Tatar C mb Pe m t 66_56 ~ elect label # I I TOTAL $306 76 -..,.-=~...:- ~ - -~ ~._~I~.L COMBINATION APPLICATION/PERMIT (CAP) I Applicant to furnish A Job Address B legal DeSCription 1 example tax lot 100 lane County Map Reference 2 example Lot 1 Block 3 2nd AddItIon to Sprlngflell C Name etc of owner and construction lender o Energy Sources 1 example heat/electrical cedln9/ or forced air qas 2 example water heater/electrical/or solar E Square footage or valuation etc 1 example 1250 sq foot house 500 sq foot garage 2 example If new prolect check new If addition che add etc F BUilding permit information 1 example construct Single family house With an attc garage 2 example remodel eXisting garage Into family roon- 3 example convert Single family reSidence Into restaurant (change of use) G Value of work os defined In SectIon 303 (0) of the Structural SpecIalty Code H DESIGN TEAM AND CONTRACTORS To aVOid deSign or construction delays Building DIVISI Staff must be able to contact appropriate persons rege deSign information or lob site corrections etc II AbbreVIated PlumbIng MechanIcal & ElectrICal Schedules A Except where blank spaces occur In the descrtptlon par of the MechaOlcal and ElectrICal Schedules the appllcc need fill In only the No Boxes adlacent to the appropr Item(s) to be .nstalled B Full Plumbing Mechanical and Electrical Schedules are available at the BUilding DIVISion 1 To conserve space on the permit form the schedules have been abbreViated 2 11 the Item(s) to be Installed ore not covered on the ated schedules you should consult the full schedules C BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AN CHARGES ON THE SCHEDULES III Applicant to sIgn and dote Whenever pOSSible the initial application Will be used as ( worksheet only Where poSSible BUilding DIvISion Staff WI prepare a typewntten copy and return It to the applicant < the time the adual permit IS Issued for hiS signature -. T f.i:>.i'I~ .d ~jt~','~l!!)''''",:'''-'-.,j .I,\l.cl.' "_.,._"' i,J . A PERMIT VALIDATION (0 CITY OF SPRINGFIELD n CIty Hall Sprongfleld Oregan Department of Public Works OFFICIAL RECEIPT ( r I ( 56327(1 ~ No B Dat",-- (1 f))\ C!;)O 19 ~ \ Reed From\~~"\-\- ~r Address \\t\ ~ '- ~ Q~,. ReceIved For ~ ~ DO -~ u~ ~/(} Cft-, \iffi D . ~sro ORo ( 00 \ \ \) Q r--\- \ ~ ()(.) 6P16 lnO ,1 cv"\ (' ~ . cS)4 [) CO I.. () (J ~lo~ - .::t1 n ~ 'clAn \'(\ ~ ~ - iO r:y) ~H-€-^ ~~~.~n.foO I Amount ReceIved 0 R" .\..0 Lv C' K _ q rr;ro ) y 0 - SG- .. ( ( 1 (I ( n ("r fl ( ( '1 (\ ( q ( IV Fees ond Charges I- Plan check fees ore due and payable at the lime of the appllcallon and no plans WIll be processed until these fees ore pa.d All other fees and charges are due and payable when the permit IS ISSUed V FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY Ap,t>!&_r . , - /;:]H~~/.J/, PermIt Cler~ h -h ~Jt?;2 y ;:;'" r /;J.fru--/;J I )I"/vt:'~ dP0'2'lr / hf'"~ e Additional Prolect Information PLANS REVIEWED BY namf" Dan Smlth ~lgnature. ., 'lN' ,~~ ho"t-' c 5 e ""t!y / t?a-j r ); '--I?- e>f j?;rp/A~ /, ~ \ . date 4/16/81