HomeMy WebLinkAboutPermit Building 1982-3-9
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INSPECTION LINE
726-3769
..
CITY OF SPRINGFIElD
COMBINATION APPLICATION/PERMIT
..
INFORMATION LINE
726-3753
Own" Doroth~~ Spt'pr~
Add'".1n1 N. ?n <:trppt !iF.
phon. 747- 35 73
$13.800,00
Building Permit Info: Delcribe Work (i.e., Build Single
Familv Residence With Attached Garaqel
Sq. Frg. Main _29.3.7__
00
Sq. Ftg. Access. N
Sq. Ftg. Other ;3
_New_Add_Alter_Rep. ~
_Fence_Demo_Change/Use
_Other
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Legal Description
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ENERGY SOURCES:
Hoot
Water Heater
Range
Value of Work:
Job Add"" 446 M~JIJ Strppt
Snrin,:,Ue1r1, OR Q7aD
Masonrv shell onlv for new_cQs..t~h.op-
buildina
Conltruc1ion Lendor
Address
DESIGN TEAM
Phone
(name)
(address)
(Iics. no.)
(OXp;,..)~. (phon. no.)
~ 8Z-0?Q1
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Primary DrnWinp SPY'V; rp .
Tl'lr_
~Q-Coh"rg Rn'l.n
Structural
Electrical
,
r
Mechanical
CDNTRACTORS
(name)
(address)
(lies. no.)
(expires)
(phone no'\
!O
General Mel ean Ma!=:onY'v
Onfill Hill Roan sr~n
746-559~
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Plumbing
Electrical
.
..
Mechanical
.,
PLUMBING
elECTRICAL
MECHANICAL
j
T
NO. I
FEE I CHARGE NO.
FEE CHARGE NO.
FEE CHARGE
SERVICES
furnace/ burner to
GTU's
Appliance vent
separate
Stationary ovap.
cooler
Vent fan with
sinAle duct
Vent system apart from
heatinA or A.C.
Mechanical exhaust
hood and duct
'-
Residence of
Each sin~le fixture
Relocated building
(new fix. additional)
S.F. Residence
(1 bath)
s9' ft.
New circuits, alterations
or extensions
Duolex (1 both) each
Temporary Construction
Additional both
Amps.
Water service
Sewer
Wood stove/heater
Storm Sewer
FEEDERS
Heat Puma
Air handler to
10.000 CFM
Air handler over
10,000 CFM
Amps.
ISSUANCE OF PERMIT
. I
TOT AL CHARGES
TOTAL CHARGES
TOTAL CHARGES
WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until 0
label has been signed by an Electrical Contractor and attached to the electrical panel.
I HAVE CAREFULLY EXAMINED 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 performed shall be done in accordance with tho Ordinances of the City of Springfield and the laws of the State of Oregon
pertaining to the work described herin, and that NO OCCUPANCY will be mode of any structure without the permission of the Building Division. I furthor
eartHy that my registration with the Builder's Board is in full force and efffect os required by ORS 701.055, that if exempt the basis for exomption is noted
horan, and that only subcontractors and employeos who ore in compliance with ORS 701.055 will be used on this project.
Basis for Builder's Board exemption" / ()___.#-----
NAME (pl.o.. pdnl) f'nRn THt:11 St:7EIZ':; 'IGNATURE 'iJ./J1"7..A r-<' ~bu OATE ,) Sf. !?:;
FOR OFFICE USE ONLY
Zone~1
Fire Zone
Flood Plain
Type/Const.~
Bedrooms
c:.tori....
Units
Occy load
nccy Group
56.
R2
Sq. Ftg. Main
11;:'1. Ftg. Access"
Sq. Ftg. Other
2937
x
Vol..$13 ,ROO, on_
x Value
x Value
TOTAL VALUATION $13 .800,00
BUILDING PERMIT
Charges and
Surcharges
Plan Ck. Comm/lnd
____.$__6R: nn 65%/BldQ Per Fee
PlanCk. Res
? _ 7? 30%/ Bld~ Per Fee
$
44.20
Systems Development
Chortle (1.5%)
$
207.00
PLUMBING PERMIT
Charges and
Surcharges
Fence
Demo
Total Comb. Permit
~
7n.7?
ELECTRICAL PERMIT
Charges and
Surcharges
Sidewalk
AIC PavinQ
MECHANICAL PERMIT
Charges and
Surcharges
Curb Cut
TOTAL
$
321. 92
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COMBINATION APPlICATION/P.T .P)
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I. Applicant t~ furnish
. A. Job Address
B. Legal Description
1. example-tax lot 100, Lone County Mop Reference 17 03 43
2. exomple-Lat 1. Block 3, 2nd Addition ta Springfield Estotes
C. Name, etc. of owner and construction lender " " .
D. Energy Sources
1. example-heat/electrical ceiling/or forced air gas
2. . exa mple-woter heater I electrical/or sola r'.. .:. :'1;' .,.' .
E. Square footage or valuation, etc. . _..
1. exomple-1250 sq. foot house, 500 sq. foet goroge
2. example.if new project, check new-if addition, check
odd, etc.
.. F. Building permit information:
1. ex'ample-construct single family house with an attached: ",
garage
2. example.remodel existing garage into family room
3. example-convert single family residence into
restaurant (change of use)
G. Volue of work os defined in Section 303 (a) of the
Structurol Specialty Code
H. . DESIGN TEAM AND CONTRACTORS .... ..:
To avoid design or construction delays, Building Di~isi~n
Staff must be able to contact appropriate persons regarding
design information or job site corrections, etc.
II. .Abbrevioted Plumbing, Mechanical & Electrical'Schedules
A. Except where blank spaces occur in the description portion
of the Mechanical and Electricol Schedules, the applicant
need fill-in only the No. Boxes odjacent to the appropriate
item(s) to be installed
B. Full Plumbing, Mechanicol, ond 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 ore not covered on the obbrevi-
ated schedules you should consult the full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
.
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III. Applicant to sign ond dote
Whenever possible, the initial application will be used as a
worksheet only. Where possible, Building Division Staff will
prepare a typewritten copy and return it to the applicant at
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 application,
and no plans will be processed until these fees are poid. All
other fees and charges ore due and payable when the permit
is issued.
V. FOR OFFICE USE ONLY
Permit Cler"
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. PR~~E~T.5O:N.DiTioNf j6--ilE.SATISFIED BEFORE OCCUPANCY:
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Thr~ pArmit i.~ f"n;' th;' m;.<nn",y ~h,," 'n"'~'
~.t!Il.o. '^h ~!0~~[J 4:~~ ~3-:::!~~:~1sr.JI ~lnh ~ IInrtprc:1F1h
~,_., ,__ I^::i:-~:~=~ ", ,,_H< ""ill h.. r..ouired orior to starting any work btlyond this point.
...'1.111.......,:;,. t\
;Icr:::: l\ par!~in; \.a:-~::":c: IJ.-~-! ~J:'~~;'-'~,{ ~' foha fll..Pnn-fnlJ rnmndcc:::in,:, d_'_R1 C:lJhi~ct to the
following conditions.
1. ':"::~,,'" to sign imp..n"<>m',"io ~'lr..<>m..nt f"nr future oarticioation in the purchase of land to be
used for a new off~street public parking lot which will provide required parking spaces to'
4;~1, 'r~~r~~~~' '-
Addition",' xRral.ectllnformotionl'X
1\1\1\1\1\1\'" J\'\.II\I\/i""'''..,......." ....
2. ~ir.l!r t: ::r:ltin"'J jni""-o.<<> 'p.r~ing ~"r....m..nt ....i.thjI~1t. I ~"ton as. 'lono as oarkino space
deficiency occurs. The rear parking area is to be posted with a notice stating additional
r;:rl:fr:] :.ni~:~l: 1t I.I~~~ L~r.~,,"~.
~~1~..t1~r:lal PrQj<>~+ Tnf"n~.ioinn' Pl~n r..vi..w f.... nf.~17R.75 Daid 1-27-78 for construction value
of.$93.001 to $94,000 which is enttre project value. Since this'is phased construction and
---aM~t~g::al rl=~ ~m,,'" +.~'? ,.... ....'l,lir..rl ,1.... ion i,,~ri..nll;ori..~ ~nn ~dditions 1n the plans.
an additional fee has now been charged at usual rate.
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PLANS REVIEWED BY,
nome
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signaturo
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I INSPECTION LINE
72603769
I Job Add,e.. 44'; Ma i n Strppt
~al DeS[ription
17-01-35- "11
TI
-180(1
ENERGY SOURCES:
Heat
Water Heater
Range ..
Value of Work:
INFORMATION LINE
726>-3753
Sq. Fig. Main i'Q] 7
Sq. Ftg. Aceen.
Sq. Fig. Other
_Now_Add_Alter_Rep.
_Ftlnco_Oomo_Chango/UslI
_Other
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CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
Own" norothea Seter~
Add,...3n1 N. ?rl <:;tr"ct ill'.
Snringfielrl, nR Q7477
,Phone 747-3573
Ju.ann,OO
Building Permit Info; Describe Work (i.e., Build Single
Familv Residence With Attached Garoqo)
Construction Lend.r
Masonrv shell onlv for new co~tllme ~ho-p-
buil di no
Addren
Phone
DESIGN TEAM
(nome)
(address)
(lies. no.l
(expires)
(phone no.)
Primary Drawi no <;'pY'vi rp _ Tnr
~O (nb'lrg RO''''
'iR7-0?0~
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Structural
Electrical
n
~
CONTRACTORS
(name)
(address)
Wcs. na.)
(expires)
(phane no,)
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..
Mechanical
G.n"ol Mr I p~ n Mi\SOIl ry
QDh11 Hill-Ro,n. ~n~n
746-55q~
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Plumbinc:l
Electrical
:.
Mechanical
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PLUMBING
ELECTRICAL
MECHANICAL
3
.' T
FEE CHARGE:S
,.,
NO.
FEE CHARGE NO. I
FEE , CHARGE NO.
Residence of
furnace/burner to
"TU's
Appliance vent
separate
Stationary evap.
coaler
Vent fan with
single duct
Vent system apart fram
heatinp ar A.C.
Mechanical exhaust
hood and duct
Each sin~le fixture
Relocated building
(new fix. additional)
S.F. Residence
(1 bath)
'9' ft.
New circuits, alterations
or extensions
SERVICES
Duplex (1 bath) each
Temporary Construction
Additional bath
Amps.
Water senice
Sewer
Wood stove/heater
Storm Sewer
FEEDERS
Heat Puma
Air handler to
10.000 CFM
Air handl.r over
10,000 CFM
Amps.
ISSUANCE OF PERMIT
TOTAL CHARGES
TOTAL CHARGES
TOTAL CHARGES
WHERE STATE LAW REQUIRES that Ih. Electrical work b. done by tho Electrical Contrador, tho electrical portion of this permit .hall not be valid until a
label has bean signed by an Electrical Contractor and attach.d to tho .I.drical panel.
I HAVE CAREFULLY EXAMINED the completed application for permit. and do hereby certify that all information hereon Is true and corroct, and I further
certify that any and all work performed shall be done in accordance with the Ordinances of tho City of Springfield ond tho Laws of tho State of Orogon
pertaining to thll work describod horin, and that NO OCCUPANCY will be modo of any structure without thll permission of the Building Division. I furth.r
certify that my registration with tho Buildllr'. Board is in full force and eff.ct as required by ORS 701.0.5.5. that if exampt the basi. for exemption Is noted
heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will be used on this project.
Basis for Builder's Board exemption-
SIGNATURE ~!'Y7-t-<c ~
OATE') st. g;(
NAME (pleo.e p,;n') DcoRo THE.'1l .5L=TG"1? J4.
1
Units
nccy Load
n..y Group
FOR OFFICE USE ONLY
<'. F'g. Mo;n ~7
c;.,... Ftg. Access
Sq. Fig. Othllr
56
R2
x
"olueV 3 . ROn _ OIL-
Zone r 1.
Firo Zone
Flood Plain
Typo/Canst.~
Bedrooms
c.tori..
x Value
x Value
TOTAL VALUATION $13 .800.00
BUILDING PERMIT Plan Ck. Comm/lnd $ 44.20 Systems Development .~ 207.00
Charges and ____.$.._6B.1lfl 65%/ BldCl Per Fee Charroe (1.5%)
Surcharges Plan Ck. Res 'I
? 7? 30%/ BldR Per Fee 11
PLUMBING PERMIT
Charges and Fence "
,
Surcharges ,
Demo Total Comb. Permit $ 70._??
ELECTRICAL PERMIT I I,
Charges and Sidewalk
Surcharges lAIC Pavina I
~l MECHANICAL PERMIT I Curb Cut _.._L$.
Charges and ~--------
Surcharges I TOTAL
321. 92
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~T;;~U.J~~;~_~;~~~~.t~~:.~h ~"~I ~ ~~ p;~ IN .G -;"~'Efg;;-.:.':"~~.;;:'I
City Hall
Springfield, Oregon
Department of Public Works
OFFICIAL RECEIPT
COMBINA nON APPLICATION/PERMIT (CAP)
(
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I. Applicant to furnish
A.
;. B.
Job Address
legal Description
1. exomple.tax lot 100, Lone County Mop Reference
2. example.Lot 1. Block 3, 2nd Addition to Springfield
C. Name, etc. of owner and construction lender
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. .
1. example-1250 sq. foot house, 500 sq. foot garoge
2. example-if new project, check new-if addition, chec
add, etc.
F. Building permit information:
1. example.construct single family house with an otto
garage
2. example-remodel existing garage into family room
3. example-convert single family residence into
restaurant (change of use)
G. Value of work os defined in Section 303 (a) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building Divisj, (
Staff must be able to contact appropriate persons regc ....
design information or job site corrections, etc.
No. B
19 g~
( Rec.d From ~.Ad. d A L W h-- :1
Address &, I 7/. 2 d.. SUI. <..LJ
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Received For:
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Dote
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. 11.: Abbreviated Plumbing, Mechanical & Electricol'Schedules (
'" \' A. Except where blank spaces occur in the description P'OI
of the Mechonical and Electrical Schedules, the opplicc
need fill-in only the No. Boxes adjocent to the opprop' (.
item{s) to be instolled
B. Full Plumbin9, Mechanical, ond 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 schedule: .".
. C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A~ (
CHARGES ON THE SCHEDULES ~.
III. Applicont to sign and dote
Whenever possible, the initial application will be used as a
worksheet only. Where possible, Building Division Staff will
prepare a typewritten copy and return it to the applicant at
the time the actual permit is issued for his signature.
IV. Fees and Chorges
Plan check fees are due ond payable at the time of the application,
and no plans will be processed until these fees ore paid. All
other fees and charges are due and payable when the permit
is issued.
(I
Amount Received
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AUTHO"lZI!:D SIGNATUIltE
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V. FOR OFFICE USE ONLY
Permit Cler~
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
.t. .
'.
Thi s permit is for the masonry s~p 11 nnJ y. C;pp .lob 810049 fer f:l:~:a-:-+::;~., d ah !I. IInrlers l,h
~lllj!1h;ng
Arlrlitinn,l nprmit~will be reouired Drior to startinq any work bevond this Doint.
.. t..
NOTF. A parking vari?nrp wa~ ?pprnuprl hy thp PlaPnin~ ~i<<i~ 4_1_Al~lhip('t tn thp
following conditions.
1. Owner to sion imgrovement aareement for future partici9ation in the gurchase of land to be
used for a new off-street public parking lot which will provide required parking spaces for
the oroDertv. .,':'
>>.'(OO)j~Xl*X1jijtK)(j(**~;x,lI)(
2. Ownpr t.O rrmtinue joint'Hse parking ?l}rpp'lleJlt with W?J.t I ?ytnn ?<, Inn!' ?< lJ?r~ino ~~p
deficiency occurs. The rear parking area is to be posted with a notice stating additional
~~r~ing ~v~il~hl~ ~t W~lt l~ytnnc
Mrlitinnal Projprt Tnform?llin' Plan rpuipw fpp nf $178.75 nairl l-2Z::.7R fnr construction v.Qluf
of $93,001 to $94;000 which is entire project value. Since this .is phased construction and
rarJrlitinnal....pl;:\n rpvipw til'Tlej@<: rP~Il;rpn nllP to inadp-qllnr:;pc; ;:tnri Arlrli-ti..Dnc:: in t':1P nl;l.nc::_
an additional fee has now been charged at usual rate.
PLANS REVIEWED BY:
name
Lornp Plpger
--./ n..,,'
Signature~~--d~
date ?_??_A?