HomeMy WebLinkAboutPermit Building 1980-7-18
I HISPECTIOII L1IIE
726-3769
Job Address
Legal Description
1045 Gateway Loop
17 0, ~~ ~_ ~ax Lot #2hOl
Owner
Address
AnT.. Rp1"'vi ~P. Tnc..
150 North 6th Street
Construction lender
Springfield, Oregon
(name)
R, Milho11en
Hunley Plumbing
3-Way Electric
Address
Ut~ Hilt TEAl-1
Primary
Structura 1
Electrical
t1echan i Cd 1
CONTRACTORS
Genera 1
Plumbina
Electrical
~lechan; Cd 1
NO.
{name) .
John Amundson
PLUI1BIIIG
9
Each single fixture
IRelocated building
{new fix. additional}
IS.F. Residence
(1 bath)
10uPlex (1 bath) each
IAdditional bath
IHater service
Sewer
Storm Sewer
TOTAL CHA,RGES
WHERE STATE L~W REQUIRES
shall not be valij until the
Zone c-4
Fi re Zone
Flood Plain
BUILOIlIG PERI,tIT
Charges an~
Surcharges
PLuP,IBING PERMIT
Charges and
Surcharges
ELECTRICA.L PERI:IT
Cha rges and
Surcharges
IIECHANICAL PERHIT
Charges and
Surcharges
I FEE
LHARr;E
.
.
5
45,0(.
-._- --...
CITY UP SPRINGFIELO
COIIBIIIATlON APPLICATION/PERMIT
INFORlIATlON LHll
726-3753
Sq. Ft9. 1.lain
~q. Ftg. Access.
Sq. Ftg. Other
lie" AddXJQ\ lter Rep.
-Fence Demo Change/Use
-Other- -
~
11'
FP
I
I
I
I
I
I
'I
I
I
I
I
I
I
45,00
EllEREY SOURCES,
HeatElect, H, Pump
\-later HeaterElect
NONE
Range
ValUE of I'/ork:
Phone
3,500.00
Builf.inq Pernlit Info: Describe Work(i.e.. Build Single
Famil y P..es i dence I-lith to.ttached GaraQe)
746-4311
Add petitions and restrooms to existing
Phone
(address)
Building
(lies. no.l (exoiresl
(nhane na.
(address 1
(lies. no.)
(pxnirp,,)
(ohonP M_ \
689-3607
746-6151
746-9743
, 'l33 Silver Lane, Eugene
367 Hayden Bridge Way, Spf1d.
4739 Main Street, Spfld,
ELECTRICAL
MECHANICAL
Nn I
Residence of
I J:l="l=" I r~ARr,!=" NO. I
11=l="l="
j rI-lAru:!="
furnace/burner to
BrU1s
SQ. FI.
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wall
~o~rp hp~tpr ~nrl vpnt
ITempOrary Construction
IChange in existing
rp<;iqenc:~
Imultifamily, COll1l1. or
Indll<;tri~l
10f
ICO~1./IND. FEEOERS
IInstall/alter/relocate I
ni <:.tritL fpprlprc:.
IOf
I
I
I
amps.1
Appliance vent
seoaratp
Stationarv evan.
cooler ~ .
Vent fan with
1 sinole duct
I Vent system apart from I
heatino or A.C.
I Meehan i ca 1 exhaus t
hood and dud
I Hood stove/heater
I
I
I
I 9,00
11
amps.
ISSUANCE OF PFR!lIT
10,00
19.00
TOTAL CHARGES
TOTAL CHARGES
that the Electrical work be done by an
label has been signed by an Electrical
Electrical Contractor, the electrical portion of this permit
Supervisor and returned to the Building Division
'"
"'"
I HAVE CAREFUllY EXMlINED 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 oerformed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Oregon pertaining to the work described herein, and that lW OCCUPAIKY will be made
of any structure without the permission of the Building Division. I further certify that my registration \'lith. the Builder1s
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in comol,ance with OP.S 7nl.055 will be_use on his project.
" "' ~ ~
llAI-lE(please print) '~;_r-/-./ //Vd<:" /" Srr,rIATURE . -/C',~, ....d;.,.._
~ ,. ,. - -
/FOR OFFICvtlSE 0110
DATE /~ ,p,:
/
./
//
/
Type/Canst. 3-1hr Units Sq. Ftg. Hain x Value
Bedrooms Dccy Load Sq. Ftg. Access Complete l~ase spall&! ue
Stories 1 Occy Group B-2 Sq. Ftg. Other 3210 x Value j:lUU
TOTAL V ALUA TI 011 1S00
8 Plan Ck. ConmlInd
2 .00 65t/Rld('l Ppr Fpp
------------ Plan-Ck. Res
1.12 30%/Bldo Per Fee
45,00 Fence
------------
1.80 Demo
Sidewalk
-----------.-1 AlC Paving
19, 00 Curb Cut
----------:76
18,20
Systems Development
Cha rqe (I. 5~)
Total Comb. rermit
I
I TOTAL
113,88 J
.
r ___~_-
-",,-,J'"
,.
'-
COMBINATION APPLICATION/PERf tiT (CAP)
11 ~.
:OJ
"
...
I.
Applicant to furnish
A. Job Address
B. Legal Description
1. example~ Tax Lot lOa, Lane County Map Reference
II 03 43
2. example- Lot I. Block 3, 2nd Addition to
~prlngtield Estates
C. Name, etc. of owner and construction lender
O. Energy Sources
1. examole- heat/electrical ceilinQ/or forced air Qi
2. exa~le- waterheater/electrical/or solar
E. Square footage or valuation, etc. -
1. examOle. 1250 sq. foot hause, 500 sq. foot garagf
2. example- if new project, check new - if addition,
check add, etc.
F. Building permit information:
1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family ro(
3. examole - 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. OES I GN TEAr-I AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacer
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Di~ision
1. To conserve space on the permit form the schedulf
have been abbreviated
2. If the item(s) to be installed are not covered or
the abbreviated schedules you should consult the
full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
O. As noted on the CAP, the label must be delivered to '
electrical contractor for signature by his electrica.
supervisor. The general contractor is .not authorize!
to sign the electrical label. -
Applicant to sign and date
Whenever possible, the initial application will be used i
a worksheet only. Where possible, Building Division Staj
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for hi~
signature.
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 pa i d. All other fees and charges a re due and +--
payable when the penmit is issued.
~
II.
Ill.
IV.
V.
fOR OFFICE USE ONLY
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PERMIT VALIDATION
( CITY OF SPRINGFIELD
City Hall
Springfield. Oregon
Department of Public Works
OFFICIAL RECEIPT
(
(
No. B 5 4 0 3 [
Date'~\\~ "-k, \S9~)
Rec' d ~rl C\ i,},) t . SQ 51 U ( t' ()\.)
\r:i=n ,,'. I \0h G:.T.
, )I. ) 1'-1 \0 \ \. '~"'"\-
(
Address
(
Received
For:
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rl J\\YJ
I\\Cif\ \--\
f\0 (:tJ
('\)f'.,
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l.JSOO
C\-96 \ '6LJ
\q 00
Cli:J" . 7h
\9-, rzO
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(\'V~-)
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rlt~ ) .
Amount Received
(
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'".ttr'fHORIZED 51G"'ATURE
.......c-
S"UYO".YU""IlUll ~",..u"s. EUGE"E Oil .HO'
(
/. Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPArlCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
~
name
Lcs.R.N~ ~c::J::;.~ Signatur~..:1"-',
~_ date 7.y~o