Loading...
HomeMy WebLinkAboutPermit Building 1980-12-29 r ~ CITY Of SPRINGFIELD INFORMATION LINE COMBINATION APPLICATION/PERMIT 726-3753 ENERGY SOURCES _ J / 1 liff fig Meon t""')OU Ht'cl-hL..alf2:!f1!-/:J - UQ'C~'t;q Ftg Atten Waler Heater _4dtJ-fn/ .1 Sq Fig Other ~-"~!_~"~-'.'--.-J 7-- Q.:7 ,.:JoC.. - -3d -'_ '000' _Uru:J.KLC__ _'/N.w_Add_AIt"_R.p .. ~ .......- ~ 7 ---~ -- ~~-:;flr. ~_Fe"ce_Demo_Chonge/Use --.Jf\x-Co_L..37.C>u___ -_____ ____ 7 006 a~ ,.JI''o'h" 0__, ~f~ln,;}1 ~u~"e.. j - - I ...dd,." ,~CC- -C~~~ '" ,;., - ~ho"" '~-8& -, ~~~~;~jR~~~:~tc~n~,th ~~:~~l:eed ~~rr~~'~~ Budd Single I -----.- q -== - _C.0:"'RIZ-/;OI!L-DJ' le4.s-L :y=.C(1' Co..,trun.n.. 1.1'd., - J6....... (")'.t Fr; tf I Job 'dd,~_lj:f:O__G..."'-t<:."nl.l) to o --- N ~ I \ I INSPECTION LINE 7'26-3769 Add.e.. Pl'1Q". I I 'I '1 jl ~I 11 "" ! I I I CESIGN TEAM ("0"'.' food'f'ul (I,es no) (expIres) (phone no ) Pumo.., 5bn c:::.,~..." I?, ~c... c h~"'l Cl'\d"l'~ ~t,u(lv'ol El..,',,(al M~'''o''''oJ CONr~ACTO~S 1I'lomel :oaorllHI (lIes no) (exPires) (ahone no l G"n~rol KONC.,.,..() ~,0)E\.o OO'n L.~",< IS &.b G~~....d M~......->",~\\~ ,';) NQ"~ C.lb<.:"> ~D5 ~ S4f!j. </IZ LIYlf,,)r1- ..q I '" I "E" 5tw:a.t- 4/ b /81 14\0 -3b~ '- 7210-0/</7 342.-ZllofS 747-7445 Plvmbonq Ellllctneal Mechan,cal Plu....eING ElECTRICAl MECHANICAL 1"/0 13 I I I I I I ,"fl r-J& 6=~~ ,. fEE I C!-lARGE I NO FEE I CHARGE I I I fvrncce/bvrncr to I _BTU~ /50() ApplIance venl I, seporote StatIonary evap I . cooler I II Vent fan wIth 13001 srnqle duct I Vent system apart from I I heotrn~ or A C I Meenanrcol exhaust I I heod and duel I Wood stove/heeler 1/ I Heat Pump d, OC! I I AIr handler fa 10,000 CFM I AIr handler over 10000 CFM Duol...: (I hoth) each I rEE I C'"lARGE , L'l ()I) 1/.5: o-J I I I , I NO Each I,"qle f'.'ure a.locared bUlld,ng {nlllw fli( ada,honoll 5 F R"I,de"ce (1 barh) I .z! I Relldenc~ 0 ___sqrt New C"CO,jlrl <Iltero"on~ or elllenllon~ SE?VICES Temporary Conurucl,on Add,honol bOln Amps Wof..r Il11rY'Ce Sewer Storm Sewer FEEDERS I I I I r I TOTAL CHARGES I Amps ISSUANCE OF PERMIT /O~O /9.00 / S LJO I TOTAL CHARGES /:J. 00 TOTAl CHARGES WHERE SlATE lAW REQUIRES that the ElectrICal work be done by the Electrical Contractor, the electrICol portIon of thIS permit sholl not be valid until a lobel hOI beon SIgned by on Elocf"col Contractor and attached to the electrical panel I HAVE CAREFUlLY EXAMINED the completeCl applICatIon for permIt, and do hereby certify fhat 011 mformatlon hereon II true and correct and I further cerflfy that any and all war!.; pertormed sholl be done In act;Ordance WIth the Ord,nances of the Crty of Sptl"gfreld and the Laws of the State of Oregon pertalMlng to Ihe work. descnbed herm and that NO OCCUPANCY Will be mode of any structure Without the permiSSion of the BuddIng D,vlslon I further certlfy that my reglstrahon With the BUilder's Board IS m full force and eoffect as reqUIred by ORS 701055, Ihot If exempt the baSIS for exemption II noted heron, and that only subcontractors and employees who ore In compliance WIth ORS 701 055 WIll be used on thIS project SoSI$ for Budder's Boord exemphon NAME (please print) G~).r'1 f?"2- clUP. ~ ,,",0 N t1 U) %NATURE ~'-'+' ~~ FOR OFFICE USE ONLY -J I DATE i)ec Cc f!0, I Zon- Fife Zone Flood PlaIn NO Typel Const Bedrooms Cito"e- rL-~-HK. lnlh f"lecy Load Oecy Group ~ e;-~ Sq Ftg Marn Sq Ftg Access Sq Ftg Other 9:'00 x "alue Value _ ___ 7,<,,<'10.= ; I x x Value 7.oot:J /Y)I J I I TOTAL VALUATION BUilDING PERMIT L//J,(Y) plan Ck Comm/lnd Charges ond 65~o/ Bldq Per Fee Surcharges J,{dJ Pion Ck Res 30%1 B!dq Per Fee PLUMBING PERMIT /5.00 Charges and Fence Surcharges ,f#O Demo ElEORICAl PERMIT - Chorges and 15"00 Sidewalk Surcharges . {., () Air POVIO'" MECHANICAL PERMIT Charges C1nd _____L3!fXl Curb CuI Surcharges 1'1l..2 11'-?Z~'Q ..., I 0 0 'tr ),vtems Development 0'\. \,C> - ~~ ~l-orqe (J 590l Tolal Comb PermIt I TOTAL # 9:Z.S~ -" COMBINATION APPliCATION/PERMIT (CAP) Appilcant'\fO furnish A Job Add ress 8 legal Descnptlon 1 examole-tox lot 10Q, lane County Map Reference 2 example.Lot 1 Block 3, 2nd Addition to Sprlng!lel. e Name, efe of owner and constructIon lender o Energy Sources 1 example~heat/electncal ceding/or forced aIr qas 2 example~water heater/electrical/or solar E Sq-uare footage or valuatton, efe - 1 example.1250 sq foot house, 500 sq foot garage 2 example-If new prolect, check -;ew.lf addition, ChE add, efe F Budding permit information 1 examole.construct Single family house Will'- an aft garage 2 example remodel eXisting garage mto family rool 3 example-convert single family residence mto restaurant (change of use) G Value ot work as defined In SectIon 303 (0) of the Structural Specialty Code H DESIGN TEAM AND CONTRACTORS To ovoId deSign or construction delays, Budding 0'/1 Staff must be able to contact appropriate persons reI deSIgn lnfOrmCitlon or lob site corrections, etc 11 Abbrf"vlated Plumbing Mechonlcal & Electrical SchedulE A Except where blank spaces occur In the descnptlon p of the Mechanical and ElectrIcal Schedules, the apph need fill-in only the No Boxes od1acent to the appro Item(s) to be ,"stalled B Full PlumbIng, Mechanical. and Electrical Schedules ore available at the Budding D,vlslon 1 To conserve space on the permit form the schedul hove been abbreViated 2 If the Item(s) to be Installed are not covered on t~ ated schedUles you should consult the full schecu C BUILDING DIVISION STAFF WILL FILL OUT ALL FEES I CHARGES ON ThE SCHEDULES III Apohcant to sign ana date Whenever pOSSible, the initial application will be used I worksheet only Where pOSSible. BUIlding DIVISIon Staff prepare a typewritten copy and return It to the appllea the time the actual permit IS Issued for hiS signature IV Fees and Charges Plan chec~ fees are due and payable at the time of the~ and no plans will be processed untIl these fees are paid All other Tees and charges ore due and payable when the permit 1$ ISSUed V FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY .......PERh"r VALIDATION sto CITY OF SPRINGFIELD (I City Hall SpringfIeld, Oregan Department af Public Warks ( OFFICIAL RECEIPT ( No. B S 5 4 72( Dote /7 - 1..-9 19'60 tee Rec'd From t nrV) ~ rl) f!:L1L{ ti Q tsS Address I S -----n 117 ) 0. , V-- ( -( Received For { K..p ~O_OO ( Li,CYJ,., I, Ir,l') ( I ( - 1-20 ,I'?) Of) (i qC)!) (~ ( <yp i~..nh- ( ---'l 40](::; HJ (, ~p Iqrn (bl 6.- tT j ,{;; . D Amount Received q / . F) (f'J C P (JJD ( QI "' --C ~.s"e ( I .....THORIZED SIGN"TU.-E SMI:LTO" TU.....""- ~..,..TE..S "UGE..E 0.. ~7"O' ( ( > " Permit Cler~ PR.OV/J)L' 1- :U;- R,J;l.E/) F/J?E /:;<7/)/(;, LJ/SHLY~ ro BF /"co4T.ED NE/?/i: FRONT C7..'1VA/TIE-e Addltlonol Prolect Information PLANS REVIEWED BY nom,: <;Ignatur.... ~ r- - an I';; -,;{ 4- -'? () ...latf"