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Home My WebLink AboutPermit Building 1980-9-2 I INSPECTION LINE 726-3769 I Job Add,... 18B7 Laura Street \ RC . '~<IU"_;"~'''':''''''~~~''^,1''"'"~I''''''':~~ NOTlelEn SFP ;~ 1980 . ~II T ~ SPRINGFIELD COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 '~..l_~'~~.~.:".~.:; j~..,i~:~~JJJ':~.'J, ,:.~,.I~"::'II.._...~~,,~~1I ~.~_ ENERGY SOURCES: Sq. Fig. Main Sq. Fig. Aceen. Sq. Ftg. Other _New....KAdd_Alter_Rep. [_FenCe_cemO_ChangefUs. _Other 15,000.00 Building Permit Info: Describe Work (i.e., Build Single Family Residence With Attached GoroQe) ~Illl 1m 8 CXJ Heat l.gal D.",ipHon Tax Lot 3900 Map Ref. 17 03 27 10 Water Heater RanQe I Value of Work: Owner Springfield News 1887 Laura street - Address Phone"'7l\';_l h71 springfield, Oregon 97477 Build new canoPY on south existinq wall. opening in concrete block and stud wall C"onstruction Lender Address Phone DESIGN TEAM (nome) (addreu) (lies. no.) (expires) (phone no.) Primary William W. Wilson & Assoc P.C. 1818 ,".01"" ~'-"" f (e.xpiresl bhone no.) Structural EIl'1drical Mechanical CONTRACTORS (namel (address) (lies. no.) General Hyland Brothers Construction Inc Laura Street 7dl_??a? Plumbing Electrical ~, l \"'\..... f'\\'\ \- . PLUMBING ELECTRICAL MeCHANICAL 1 1 CHARGE I Mechanical NO. FEE CHARGE NO. FEE CHARGE NO. FEE 1 New circuits, alterations or e.xtensions 10.00 furnace / burner to ~.rU's Appliance vent separate Stationary evap. cooler Yent fan with single duct Yent system apart from heatinq or A.C. Mechanical exhaust hood and duct Residence of Each single fixture Relocated building (new fix. additional) S.F. Residence (l both) '-. ft. SERVICES Duplex (1 both) each Temporary Construction Additional bath Ampl. Woter service Sewer Wood slave/heater Storm Sewer FEEDERS Heat Pump Air handler to 10.000 CFM Air handier over 10.000 CFM relocate catch basil I 5.00 I Amos. ISSUANCE OF PERMIT TOT AL CHARGES 5.00 TOT Al CHARGES 10.00 TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work b. done by the Electrical Contractor, the electricol portion of this permit sholl not be valid until 0 10b.1 has b.en signed by on Electrical Contractor and attached to th. .Iectricol panel. I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is Irue and correct, and I further certify that ony and 011 work performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining 10 the work described herin, and that NO OCCUPANCY will be mode of ony structur. without the permission of the Building Division. I further certify that my registration with the Builder's Board h in full force and effect as required by ORS 701.055, that if e.xempl the basis for uemption h noted heron, and that only subcontractors ond employees who or. in compliance with ORS 701.055 will be used on this project. Bosis for Builder's Boord e.xemption: NAME (please print) ,e I? R'1 R ~! '/ J SIGNATURE ~. , - ~ ., y //-..;;/-/ DATE 5",:J... ::; l} FOR OFFICE USE ONLY ~ M-2 Type/ Canst. Bedrooms l\l()_Storie, Units "'ccy load O"y Group C;~J! x Value Volue --15.,.00.0...0.0."':' Value Zon'" Fire Zone Flood Plain M Sq. Ftg. Main Sq. Fig. Accen Sq. Ftg. Olher x x '. TOTAL VALUATION '~.'Joc Co. BUILDING PERMIT Charges and Surcharges 72.00 L.~~ I Plan Ck. Comm/lnd 6S~~/ Bldg Pcr Fee I Plan Ck. Res 30%1 aldq Per Fee I Fen(l!" I Demo 46 80 PD 8-21- I~ystems Development . 8!'-t.:horae /1.5%1 RECEIPT # 5438C PLUMBING PERMIT Charges and Surcharges 5.00 .20 10.00 .40 Total Comb. Permit 90.48 ELECTRICAL PERMIT Charges and Surchorges Sidewalk AI C Po vi no MECHANICAL PERMIT Chorges and Surcharges Curb Cut I rd-~~~:c'4,:-~,~~, TOTAL 9Q.48 ~"'"1.,-'" III. Applicant to sign and date Whenever possible, the initial application will be used as worksheet only. Where possible, Building Division Staff v. prepare a typewritten copy and return it to the applicant ( the time the actual permit is issued for his signature. IV. Fees and Charges Plan check fees are due and payable at the time of the applicafion, and'no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. . '. /7 ". . . . ~.'~ / __.....,~.~i~:~:~,r.~_~~'. _ ~ '. ~ (J)OMBINA TlON APPLICATION/PERMIT (CAP) 8 ApplicanUo furnish A. Job Addr~ss B. Legal Description rY\ 1. example-tax lot 100, Lane County Map Reference l' W 2. example.Lot 1. Black 3, 2nd Addition to Springfield E - C. Name, etc. of owner and construction lender - D. Energy Sources . 1. example.heat/electrical ceiling/or farced'air Qas 2: "example-water 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, check' add, etc. F. Building permit informotf~n: 1. example-construct single family house with on ottac' garage, 2. example-remodel existing garage into family room 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 Divisic Staff must be able to contact appropriate persons rego design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical 'Schedules A. Except where blank spaces occur in the description por of the Mechanical and Electrical Schedules, the appliea need fill-in only the No. Boxes adjacent to the appropr 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 schedules have been abbreviated 2. If the item(s) to be installed are not covered on the ated schedules you should consult the full schedule, C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES At- CHARGES ON THE SCHEDULES .'..... V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: - r ? () 'I) -~. \ ,~;-\~~ ~ ~ Additional Project Information:. PLANS REViEWED BY: DAN SMITH name .../ / .... :/ ,e , , ';' ,.j t::;: . PERMIT VALIDATION ( CITY OF SPRINGFIELD City Hall Springfield, Oregon Department of Public Works OFFICIAL RECEIPT ( ( c ( r'\.. ~L t\ No. B 54474 ( Date L l'!.ll\.1 '0 1.0D . ( Rec'd From ~~)<\ (\~~ d f\ 0 ~ Q <is ( Address \ ffi '\ d~,L r\f") ...J ( ,.. " C Received ~M ' ~LP() ',f)\mD ", l.\g'} '- JtD () r-y q9r) {\~ ,(:U i) .6<6 ~) CYf fin \() GO IJO '( ( ( ( ( 6' ,<( c {[ ( C[ G\l ),L\0 (or ;d\~ ') \ ,-:..I"lloloRluo-SIGNATURE S..O;lTo...n.......Ull ~"""T["S. [UG['u_ 0" 'UOl 115"'. Amount._" .~~ce.i.ved c (J (I ( l- <<J ~'...'. ::,~': -.... '._,- Permit Cler~ . \ \, \..\ . ~ ,~51 <\ ")\ \ , dot. e.:.@J.:.$1J