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Home My WebLink AboutPermit Building 1980-7-21 ". r~OT:FIED JUL 2 1 .1Q80 .", INSPECT ION LlrJE : 726-3769 Owner Richard P. Ferguson Address 80 Cl ear vue Lane Springfield, Oregon 97477 CITY OF SPRINGFIELD C0/1BliJATION APPLICATION/PERMIT ' ErlERGY SOURCES' Heat lia ter Hea ter Range-=...: . Va 1 UE. of I-/ork . 5,683.20 BU1lc.1nq Pernllt Info Fam1ly Res1dence Illth , . , INFORt1ATION LI.'n: 726-3753 Sq. F tg. t1a 1 n CO ~q. !'tg. Access. 768.00 g Sq Ftg. Other en r~e\~ Add Alter Pep iO --Fence Demo Change/Use --Other -- -- Job Address 80 Cl ear Vue Lane Legal Descnpt10n 17 03 27 1 7100 Phone Descnbe 1-/ork(l e., BU1ld Slngle J\ttached Garaqe) 746-1348 Residential Garage Construct1on Lender Address Phone r. DES I GN TEAt1 (name) (address) (llCS no ) (exD1res) (phone no ) " Pnmary Structural El ectn ca 1 t1echan1 ca 1 CONTRACTORS (name) (address) (l1 cs no ) (exo1res) (ohone no ) General Owner Plumb1nq Electr1cal - ~1echaOlcal PLUt1BING ELECTRICAL FEE I CHARGE NO. I FFE CHARGF NO Res1dence of furnace/burner to SO. FT. BTlI' s MECHANICAL NO Each slngle flxture FFF) I fHARGF Relocated bU1ldlng (new f1X. addltlonal) New clrCU1ts alts or extenslons Floor furnace and vent IS.F. Resldence (l bath) IDuPlex (1 bath) each IAddlt10nal bath ~!ater serVl ce I I I ITemporary Constructlon I /Change ln eXlst1ng resldence I I mult1famlly, coml'l or Industnal ~ Of amps I '-----ICOMM./IND. FEEDERS I I I Install/alter/relocate d1str1b feeders Of amps I /SERVICES I I Recessed wall Soace heater and vpnt I I , , TOTAL CHARGES J TOTAL CHARGES WHERE STATE L'\.l~ REQUIRES that the Electncal \~ork be done by an Electncal shall not be val11 unt1l the label has been slgned by an Electr1cal Supervlsor I , I I I I TOTAL CHARGES Contractor, the electr1cal port1on of th1S permlt and returned to the BU1ldlng D1v1s1on I Appllance vent seoarate I StatlOnary evap. cooler I Vent fan w1th slnole duct I Vent systel'l apart heat1nq or A.C I Mechanlcal exhaust hood and duct IIJOOd stove/heater I I I from Sewer Storm Sewer I ISSUANCE OF PFR/1IT I HAVE CAREFULLY EXA/1INED t1e completed apnllcatlon for nerm1t, and do hereby certlfy that all lnformatlon hereon lS true and correct, and I further cert1fy that any and all work performed shall be done 1n accordance w1th the Ordlnances of the Clty of Spr1ngf1eld and the Laws of the State of Oregon oerta1n1ng to the work descrlbed here1n, and that NO OCCUPANCY wlll be made of any structure wlthout the perm1sslon of the 2u1ldlng Dlvlslon. I further cert1fy that my reglstratlon w1th the BUllder's Board 1S 1n full force and effect as requ1red by ORS 701.055, that 1f exemot the baS1S for exemptlon lS noted hereon, and that only subcontractors and employees who are ln comDl1ance wlth O?S 7n1 055 11111 be used on thlS proJe~t. /~ ./1 ~p _ NAr1E(please pnnt) RICHARD P. FERGUSON SIGiIATUFE//r..("Y4/~#kY/!V~"/"'~ DATE FO:; OFFICE lJBf:.0:1LY-- " 'r I Zone R-l F1 re Zone NO Flood Plaln Tyoe/Const Bedrooms Stones V-N Uol ts Occy Load Occy Group So. FtC). t1aln Sq. Ftc). Access Sq. Ftg Other /b~ x Value Value Value :J,b~j.':::U M-l x TOTAL VALUATION 5,683.20 BUILDING PER~lIT Charges and Surcharges 36.00 ------------ 1.44 Plan Ck. 65%/Bldq I Plan Ck 30%/Bldq I Fence Dtlmo Comm/Ind Per Fee Res Per Fee Systems Development Charqe (1.5<Y,) 10.80 PLUI1BING PERMIT Charges and Surcha rges ELECTRICJ!L PERr'IT Cha rges and Surcharges Sldewalk ------------ I A/C PaVlng ___________-' Curb Cut I /Total Comb rerm1t LOT' II AL 37.44 1 r1ECHAN I CAL PERrlIT Charges and Surcharges -- .- 1 ' \ COMBINATION APPLICATION/PERMIT (CAP) I. Appllcant to furnlsh A. Job Address B. Legal DeSCrlptlon 1. example- Tax Lot 100, Lane County Map Refere 17 03 43 2 example- Lot 1. Block 3, 2nd Addltlon to Sprlngfleld Estates C. Name, etc. of owner and constructlon lender D. Energy Sources 1 example- heat/electrlcal celllnq/or forced a 2. example- waterheater/electrlcal/or solar E. Square footage or valuatlon, etc 1. example- 1250 sq ~oot house, 500 sq foot 9 2. example- lf new proJect, check-new - lf addl check add, etc. F. BUlldlng permlt lnformatlOn 1. example - construct slngle famlly house wlth attached garage 2. example - remodel eXlstlng garage lnto famll 3. example - convert slngle famlly resldence In restaurant (change of use) G. Value of work as deflned ln Sectlon 303 (a) of tl Structural Speclalty Code H. DES I GN TEAr1 AND CONTRACTORS To avold aeslgn or constructlon delays, BUlldlng Dlvlslon Staff must be able to contact approprla, persons regardlng deslgn lnformatlon or Job slte correctlons, etc. Abbrevlated Plumblng, Mechanlcal, & Electrlcal Schedl A. Except where blank spaces occur In the descrlptl( portlon of the Mechanlcal and Electrlcal Schedule the appllcant need flll-ln only the No Boxes ad, to the approprlate ltem(s) to be lnstalled B. Full Plumblng, Mechanlcal, and Electrlcal Schedul are avallable at the BUlldlng Dlvlslon 1. To conserve space on the permlt form the sche have been abbrevlated 2. If the ltem(s) to be lnstalled are not coverE the abbrevlated schedules you should consult fu 11 schedu 1 es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A~ CHARGES ON THE SCHEDULES . D. As noted on the CAP, the label must be dellvered electrlcal contractor for slgnature by hlS electr supervlsor The general contractor lS not author to S19n the electrlcal label. --- Appllcant to slgn and date Whenever posslble, the lnltlal appllcatlon wlll be us a worksheet only Where posslble, BUlldlng Dlvlslon will prepare a type wrltten copy and return lt to the appllcant at the tlme the actual permlt lS lssued for slgnature. Fees and Charges Plan check fees are due and payable at the tlme of th appllcatlon, and no plans wlll be processed untll the~ fees are pald All other fees and charges are due ana payable when the permlt lS lssued. II. I I I. IV. V. FOR OFFICE USE ONLY ~l"'u.. ~II:i.JI~llll.!jO.I.';', ,loll.. '-,.11'.1.0...,1 "II.'lIll,-".~~.-u.~,"I~.t.r.~L 1..I~LoiIi:.ILl iio.l!Ii"i,J.:... 1111Illll:; ,,,.iII.ilo~...1I. I .,I~lii. PERMIT VALIDATION 1 ~ CITY OF SPRINGfiELD City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT No. 54121( B Ige 19~O Date -7 '.::; ~C-::;- Rec'd From k\ ( M () ~-O ~ r-:ev"j' L<"',rr,v\ Address 9-, () C \Q(), 'r \/ d 11 L 0 V'\iL ( \~'P~ ( .~ l n ... ~ b do l--i(.JI/ VY\ \ \- of' J '! \ P-. ,.......r, lo~o :.::? c- - V"'!-' c~ \ d ,,_ 1/, ~ \, --- - --- '-' '----~,. ( Received For ( Or, /..I'O.eR ,j j {.:> L--:\ Ct ~~loP? J ( L-f r7/CJ I.L..!Y \- (a Amount Received '/f;....5 7. Lf._t.f> 0 <J". ~/1tA/ ~~~ ( (1 BY I' AUTHORIZED SIGNATURE ..." . ( SHELTON TURNBULL PRINTERS EUGENE OR 9'401 \. ~ Permit Clerk " .4! PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 1I:i~.:Iiiilld",,,"1 ,.~.... ~,ll;~~.:IIbk;I,r;,.. .1~"Ui..."llioIi;,li.1 Bl:,jil :",'lIlIo,I..I.. ill....,;l,,_IlIijjlIllI"'~1 ~1oL.. ...,_....Jl.... ;;~~IIIJI,l:Il.i..~.11 ,,",oM! I Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: signature iJa.-,~ . , . PLANS REVIEWED BY: ,...1111.. gll~ ''''Ill...... .llLI.,.MI ..1liII. "..10".,111 ;.i~:.'" IU."I ..0.101 al. 0 I I ".. I. 'II ,'.1 name DAN SMITH ,ul. 1101".1,1.' ...loiICl...!.IIIIOlI.....' l.lI;IlliIL!lhlll;lI~1 h...,llljl.ll,iJI. ,III.Io""III,M_IM::aW.~.Ll.lil.:iQlii.,... I ollll...I.I..II",III&.llllOlll I.IM. ~ II~I.. 111:,.11, I. 1:II1i.. .11 ""I '.11'" ~~fl!j.1 , ,,~ date 7-17-80