HomeMy WebLinkAboutPermit Building 1981-5-27
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I INSPECTION LINE
726-3769
I Job Address
I legal Description
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I Owner
I Address
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CITY o~'5FRihG'IELD
COMBINATION APPLICATION/PERMIT
It\l.i t
tLt4"5 Ke 11 OQ Street
Lot 44. Uke Villaae
HENERGtt'e'/!lfE~eat Pump
eal
tlect
Fleet
Water Heater
Range
Value of Work:
62,392.20
Gregs Electric and Construction
1465 Oksanna Street phone
So dng.Held.._Qr:egQn_9.I.427
INFORMATION LINE
726-3753
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Sq. Fig. Main
Sq. Fig. Access. -5Q?
Sq. Fig. Other
_XNllw_Add_Alter_Rep,
_Fence_Dema_Changel Use
_Other
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Building Permit Info: Describe Work (La" Build Single
Famih Residence With Attached Garaae'
726-1696
~,:,nltructj(>n lender
SJnglE!-Eamil~-ResJdence.;_att
Fireplace
~.,.
Address
phone
DESIGN TEAM
(nome)
(addren)
(lies. no.)
Pdma,y Western Desion
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Structural
Electrical
Mechanical
CONTRACTORS (name) (address)
Gregs electric and Construction same as above
General
Plumblna Contract Pl umbi ng 2038 North 2nd Street
Ele<ld,al Greaorv SchDankvn Same as above
Me,honkalRaolf Heatina 21865 Lost Valley Ln. Dexter
(lies, no,)
8865
2D-1M
2024
PLUMBING
ELECTRICAL
NO, .
fEE I CHARGE NO. I
I fEE 1 CHARGE NO. I
x
Each sinRle fixture
Relocated building
(new fix. additional)
S,F. Residence
(1 bath)
x
1\e~1ie!l'e of
_lLi:::~_sCl.ft.
New circuits, alterations
or extensions
25.00
25.00
SERVICES
Duplex (1 both) each
;;!'
Temporary Construction
J4f::SO
1
10.00
Amps,
Additional bath
Water service
1
10.00
Sewer
Storm Sewer
FEEDERS
Amps.
(expires)
(phone no.)
fiRR_nA7
(expires)
(phone no.'
6-23-81
6-19-81
726-6404
726-0220
12-15-81
937-2688
MECHANICAL
I FEE I CHARGE
4
furnace/burner to
~TU's
Appliance vent
separate
Stationary evap.
cooler
Vent fan with
single duct
Vent system aport from
heating or A.C.
Mechanical exhaust
hood and duct
4.50
3.00 12.00
1
Wood stove/heater'
1
6.00
Heat Pump
Air handler to
10,000 CfM
Air handler over
10,000 CfM
TOT At CHARGES
45. or TOTAL CHARGES
.:l" nn TOTAL CHARGES
ISSUANCE Of PERMIT
10.00
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WHERE STATE LAW REQUIRES that the Elemical work be done by the Eledrical Contrador, the electrical portion of this permit sholl not be valid until a
label has bHn signed by an Electrical Contractor and attached to the .Iedricol panel. .
I HA VE CAREfULLY EXAMINED the completed appllcation for permit, and do hereby certify that all information hereon is true and correct, and I further
certify that any and all work performed shall 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. made of any structure without the permission of the Building Division. I further
certify that my registration with the Builder's Boord is in full force and eff.ct os required by ORS 701.055, that if exempt the basis for exemption is noted
~"~"'fO:n:UI::::,:::,:u:::::i:::' and employ... who a,e In ",mpllon," with ORS 701.055 WI::~ uoed on Ihl> p,.~~. /
NAME {please print)~~"'&"/"" ~ ~~"7" .r-ffi-4 ...~. "'I~// SIGNATUR. ~-~-~ - ~~ ~~. ~~.- DATE ~~.;:l> -p/
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FOR OffiCE USE ONLY
Zone R-l Type/Const.-.J -~ Units Sq. F'g. Main ~--lt/1 : 1~. 58 Value -5~,,~t~..~
fire zone~A Bedrooms -i ntcy Load c:.,.., Ftg. Access . U Value . .
Flood Plain U c:.torie" nccy Group R-1 Sq, Ftg. Other x Value -- - -- _.
TOTAL VALUATION OL,.J::1L.LU
BUILDING PERMIT 213.00 Plan Ck, Comm/lnd Systems Development 935.88
Charges and -----8-;-5~ 65%/ Bldq Per Fee Charae f1.5,*,'
Surcharges Plan Ck. Res
30%/ Bid" Per Fee 63.00 2-27-81 RI'C 55930
PLUMBING PERMIT 45.00
Charges and Fence ~. "F-
Surcharges 1.80 b ~
Demo Total Comb. Permit ~5
ELECTRICAL PERMIT 70.28 7.03
Charges a'nd ____.35..0n Sidewalk
Surcharges 1.~
AIC PavinQ
MECHANICAL PERMIT (-. . 18' l~ 8'~.~
Charges and ___,-J2..5(L_ Curb Cut 11. 80
Surcharges \ f~, - 1-:30-- TOTAL 1,293.23
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COMBINA nON APP.lICA TIO.t'YPE_C~~L '_._ _
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'-ERMIT VALIDATION';'
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I. Applica,nt to' furnish '.'-:<" ....!:':-: i.
A. Jab Address :i - ,~-:
" . B.. legal Description' :i~:~ ~"1
, , 1. example.tax lot 100, Lane County Map Reference 17 03 43
.,; ,2. example. Lot 1. Black 3, 2nd Addition 'to Spiingfield Estates
. C:' Name, etc. of owner and construction:l~nder.' . '..
D. Energy Sources
1. example-heat/electrical ceiling/or forced air gas
2. example-water heater/electrical/or solar. ,', '.'
.. ...,., ",'_'-,.,
E. Square footage or valuation, etc. L.~,ro:.. f . .
1. example.1250 sq. foot hause, 500 'sq: fex;t'garage
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 \ t, \ ';' ,
2, example-remodel existing garage into familY1room
3. example.canvert single family residence int;;" T ~JII
restaurant (change of use) ,"
G. Value of work as defined in Section 303 (a) of the -{
. .Structural Specialty Code - -
H: DES'iGN'TEAM AND CONTRACTORS ,. ~.~. .,'i:
.T.o avo}d" design or construction delays, Bu!I~.ing Division .:. ~.,..
?taff must be able to contact appropriate persons regarding
design information or job site corrections, etc.
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II. Ai>bievia,ted Plumbing; Mecha,~ical & Electric"I-Schedules;. i.'::'. '"
A. Except where blank spaces occur in the description portion
of the Mechanical and Electrical Schedules, the applicant
need fill.in anly(fhe No. Boxes adjacent to the appropriate
item(s) to be installed'l
B. F~II Plun1bi~g, IMechanical, and Electrical Schedules
are available at tl1e Buildin~Di~ision.-' i
1. To canse,rve space on the pJ"rmit: for~the schedules
have been'abbreviated I '-IN..) ~ I , '
2. If~he it~m(s) to be installed are not covered on the 'C:bbrevi-
. "..' ~ r:,". ,'ated s~he.dules you. should con~ full sch-edules
. C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
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'\ ': -lit Applicbnt to sign and date.
Whenever-possible, the initial application will be used as a
worksheet only. Where possible, Building Division Staff will
"i~ ." prepare a typewritten copy and;return it to the applicant at
the t!me the actual permit is issued for his signature.
IV: ,Fees and Charges
Plan check fees ore due and payable at the time of the application,
ond no plans will be processed until these fees ore paid. All
ather fees and charges ore due and payable when the permit
is issued. .
V. FOR OFF'ICE USE ONLY
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Permit Cler~
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~ROJECT CONDITIONS TO _ BE SATISFIED BEFORE OCCUPANCY:
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Additional Project Inform~tion:
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PLANS REVIEWED ,BY:
(:.~.~,~, ~IDAN SMITfI
nam~ I. ,
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'ignat~r}{)(l[) Am) t11. )
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3-3-81
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