Loading...
HomeMy WebLinkAboutPermit Building 1981-7-28 <.J: "'JI!.!.\ULjfj[.II.~j"L,~~II\L__ :"_I'.:~ INSPECTION LINE 72W769 Job Address c;,3D-Ed~.omt"\n+_-Wa,}J logal Do"dpHon 1 7~0:k34=l3-(n30n Owner Jnp n;lvic:. Address 530 Edaemont Way Sprinqfield. Oregon State GI Construction Lender Address DESIGN TEAM (name) Pdma'y Hochstein Construction Structural Er~ctrical Ml'lchcnicol CONTRACTORS (name) Generallio.c.b..s..tpin rnnc;;trIJc.:tinn PlvmblnoA 1 ert Pl umbi nq ElectricolnflVP, Fl p.r.t.rir. Mechanical PLUMBING NO, FEE t CHARGE Each sinqle fixture I Relocated building I (new fix. additional) S.F. Residence I (1 both) Cupltlll: (1 bath) each I Additional bath I I Water service I I Sewer I I Storm Sewer I I I 3 Relocate fixturds 115.00 I I I I I I I I I I I I TOTAL CHARGES 15.00 ..... J ~~!.~!~!!JI.Wl..tl'!,lXI,:t4,;~~'i,\!'k~;,l~~:I~~;:..."'mJ!!~~.\:_~'~}>lJ+,i~11~\! CITY OF SPRINGFiElD COMBINATION APPLICATION/PERMIT ENERGY SOURCES: l'l"ct Heat Water Heater Ranq- Value of Work: \ 10,000.00 Building Permit Info: Describe Work (i.e.. Build Single Family Residence With Attached Garaae) Phone 726-1 Q70 addition tn l'xi,tino ,inn1" f~mi1v r", 97477 Phone (address) (lies. no.) INfORMATION LINE 726-3753 ~ ~ IS "" ~ l>Il X ex> I-' CD ..,. ex> I-' P.O. Box #7624. Euoene. Oreoon (address) (lies. no.) Sq. Ftg. Main Sq. Ftg. Access. Sq. I'=tg. ~~er -,-New_Add_Alter_Rep. _Fence_Demo_Change! U se _Other (expires) (phone no.) p n R"x #76?/1 ""-9ono ~:>S2~ 10 Van Buren. Euqene P 0 Rnx It23....3nri nqfia1 rl. ElECTR ICAl NO. ' I FEE -I I CHARGE I Ii 5:'00 I I /1R4_QQ/1/i (expires) (phone no.) Residence of so. ft. ..__...~ 2 New circuits, olterations or extensions SERVICES Temporary Construction Amps. FEEDERS Amps. ~_A? 4A~4/i 345-3055 z..46-~640 MECHANICAL NO, FEE CHARGE furnace/burner to ATU's Appliance vent separa Ie Stationary evap. cooler Vent fan with sinqle dud Vent system aport from heating or A.C. I Mechanical exhaust hood and duct I Wood stavelheat~r I Heat Pump I Air handler to 10.000 CFM I Air handler over 10.000 CfM X Extend htQ SVS. 14.50 I I 10.00 I 14.50 TOTAL CHARGES ISSUANCE OF PERMIT 15, 00 I 10T Al CHARGES I 'nits n.'Y Load Occy Group D_~ WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not 1M valid until a label has bHn signed by an Electrical Contractor and attached to the electrical panel. I HAVE CAREFULLY EXAMINED the campleted application for permit, and do hereby certify that 011 information hereon is true and correct, and I further .:.rtify that any and all work porformed sholl be done in accordance with the. Ordinances of the City of Springfield and the Lows of the State of Oregon pertaining to the work described herin. and that NO OCCUPANCY will b. mode of any structure without the permission of the Building Division. I further cartrfy that my registration with- the Builder's Boord is in full force and effect 0 s required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. . 8asis for Builder's Boord exem'ption ~ . / ~ NAME (ploa.o p,;n') ~A/.A//--y.JI m, ./?,,. JI5'!r.-/L) SIGNA1URE~;"'-~~,~DATE 7-..;;J]-P/ ~~~~ I 1 '" "g. Main -176 x Volvo 1 0.000. 00 c,. Ftg. Access' x Value Sq. Ftg. Other x Value R-l VN Type/Canst Bedrooms ~torie4 1 Zone Fire Zone Flood Plain r01AlVALUAlION 11l,nOIl IlO BUilDING PERMIT 52.00 Plan Ck. Comm/lnd I I Systems Development Charges and 65%/ Bldc:t Per Fee Charae f1.5%) Surcharges 2,08 Plan Ck. Res ~5.60PO 7-22-81J 56943 30%! BldQ Per Fee PLUMBING PERMIT I I Charges and l~_lln fence Surcharges ,60 I I Total Comb. Permit Demo ElECTRICAL PERMIT [ Sidewalk I I Charges and 15.00 Surcharges I AI C Pavina I I ~n MECHANICAL PERMIT 14.50 I I I Charges and Curb Cut . Surcharges ,---~-:-SS----I I I TOTAL 100.36 '. ":, ~L" ~...~,,~..J,~~,''''t!J'.:,~. .~. '- ;Ii!.!IJIL~'.'~'!!Ul.l'l.~;_i! C .)IL~_'J!"]J.~_~::_...___ , __~L,._.__1m~ I. Applicant to furnish ,A. Jab Address B. legal Description 1. example-tax lot 100, Lane County Map Reference 17 03 43 2. example-Lot 1. Black 3, 2nd Addition to Springfield E.tntp.. C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example-~oter heater/electrical/or solar~.;.; E. Square footage or valuation, etc. 1. example-1250 sq. foot hause, 500 sq. foot garage 2. example-if new project, check new-if addition, che- . add, etc. F. Building permit information: 1. e"xample-construct single family house"'with an afte garage ' Rec'd 2. example-remodel existing garage into family roon ( 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 Divis (' Staff must be able to contact appropriate persons reg '-.. design information or job site corrections, etc. ~OMBINATION APPLICATION/PERMIT (CAP) II. Abbreviated Plumbing, Mechanical & Electrical Schedule, A. Except where blank spaces occur in the description pc of the Mechanical and Electrical Schedules, the applic need fill-in only the No. Boxes adjacent to the approF item(s) to be installed B. 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 schedul, C. BUilDING DIVISION STAFF WilL FILL OUT ALL FEES AI CHARGES ON THE SCHEDULES III. Applicant to sign and date (' Whenever possible, the initial application will be used a~ worksheet only. Where possible, Building Division Staff " prepare a typewritten copy and return it to the applicant - the time the actual permit ~s issued for his signature. ( IV. Fees and Charges Plan check fees are due and payable at the time of the a ec. and no plans will be processed until these fees are paid. . ather fees and charges are due and payable when the p!,-..... ' is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY: name signatur-:- PERMIT VALIDATION ( CITY OF n SPRINGFIELD ( City Hall Springfield, Oregan Department of Public Work. OFFICIAL RECEIPT (I ( Date C'\'~ It c9A 1.B \ No. B Fr~mr\'&~OOn ''-B(\~j Address lJV .~. \isf-. ''1 \~~ 56968(1 . (I ,. : 1 (I CI (I (I - ('I " Received Far: .. ~~~M .~.OU '. .. \ !fin r9 aB ~f'<\D \s 00 ~ Irh \. Q Q Q1'1" \3 ex:, ASh .fr() N\~t'H, \4,'::0 \\' 49h ,:Y) ( c ( i '" 'Ci Amount Received \0') .~lo i:b ., .u~\fe} ( u ."UTO"'TUItNIULL "..'NTl'" . lUOlNll. 0" ,UOl "'11" (.. (I Permit Cler~ .'" ....otl'" ...