HomeMy WebLinkAboutPermit Building 1982-3-3
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INSPECTION LINE
726a3769
CITY OF SPRINGFIELD
COMBINATION APPlICATIONfpERMIT
INFORMATION LINE
726-3753
Job Address 660-Ma.i n
Le9al De",ipoian 17-03-35-31
ENERGY SOURCES:
Heat
Sq. FIg. Main
Sq. Fig. Aceon.
Sq. fig. Oth.r
_Nllw_Add_Alter_Rep.
_Fenco_Oemo_Chango/U'slI
_Other
00
N
o
o
1.0
....
Owner
Barnev McCa$kill
660 Main
Phone
Water Hoc,ter
Range
I Volue af Wa,k,
f 1.3.0...0.00,..on
Building Pormit Info: Describe Work (l.e., Build Single
Fornih Residence With Attached Garaqe)
T.L. 9100
Addreu
Fire Damaqe Repair
<::~nstruclion lender
Addr."
DESIGN TEAM
Phone
(nome)
(address)
(lies. no.)
(phone no.)
Primary
Fmi.lp Mortipr, P.
P n Rox-1.39,Jugene..-0JL9J-4A0J5l6?
4R4-qnRn
Structural
Electrical
Mechanical
CONTRACTORS
(nome)
(address)
(lies. no.)
(expires)
(phone no.:
General
Plumbina
Electrical
Mechanical
PLUMBING
NO,
II Each sinQle fixture
Relocated building
(new fix. additional)
S.F. Residence
(1 both)
Duplex (I bath) each
I Additional both
'I Water service
" 1 Sewer
Storm Sewer
ELECTRICAL
MECHANICAL
.'
FEE CHARGE. NO.
FEE CHARGE NO.
FEE CHARGE
Temparory Construction
1
furnace I burner to
BTU's
Appliance vent
separate
Stationary evap.
cooler
Vent fan with
single duct
V.nt sysfem aport from
heatil'9 or A.C.
Mechonical exhaust
. hood and duct
~ nn
Residence of
5,(1n ?n,nn
s9' ft.
New circuits, atterations
or extensions
1
.~ nn
SERVICES
Amps.
'n nn
Wood slo;.1 heater
FEEDERS
Heot Pum"'l
Air handler to
10.000 CfM
Air handler over
10.000 CFM
Amps.
'1__ ": ~ I-IP rnlJ1f'V'~:u::c:. ."IV'
I
111)0
ISSUANCE Of PERMIT
1n :In
3C1,nn
TOTAL CHARGES 32.90 TOTAL CHARGES
WHERE STATE LAW REQUIRES that the Electrical work bel don. by the Electrical Contlactal, the
lab.l has b.en signed by an Electrical Contractal and atttlched to the eledrical pon.l.
I HA VE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further
celtify that any and 011 work performed sholl be done in accordance with the Ord:nonccs of the City of Springfield and the Lows of the Staht of Oregon
pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I further
certify that my registration with the Builder'. Boord is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is notod
heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will be u.ed on this project.
8o,i, la' Build..', 8oa,d ...mptian, ' - ~ ~/
NAME (plea,e p"n&~;';~~4./-/_SIGN~TURdJht t ': ~~ DATe f-f- Y?
FOR OfFICE USE ONLY
I TOTAL CHARGES
.Iedrical portion of this permit shall not h. yalid until a
Zone r ?
Fire Zone
Flood Plain
Type/Const.~N
:l,edroom.
li.torict.
Units
nccy Load
I"'Icey Group~?
Sq. Ftg. Moin
...,.... ftg. Access
Sq. Ftg. Other
x
x
Value
Value
Value
$130.000.00 I
I
TOTAL VALUATION
BUILDING PERMIT
Charge. and
Surcharge.
.___1332~00_
Plan Ck. Comm/lnd
65<:01 Bldo...!!!.. Fee
Plan Ck. Res
30%/ BId" Per Fee
~215..80J.ri
#858014
Systems Development
?_ 1 1 ~8:2..rae (1.5%1
PLUMBING PERMIT
Charge. and
Surcharges
P ?R
.___L3.Q.~nn
?n
Fenco
Demo
Total Comb. Permit
ELECTRICAL PERMIT
Chargu and
Surcharges
Sidewalk
AIC Pavinq
MECHANICAL PERMIT
Charges and
Surcharges
____$_30,.QQ.,
1.20
Curb Cut
TOTAL
$407.68
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L Applicant to furnish
',' A. Jab Address
" B. Legal Description
1. example-lax lot 100. Lane County Map Reference 17 03 43
2. example-Lot 1, Block 3, 2nd Addition to 5pringfield" ,
C. Name, etc. of owner and construction lender
0, Energy Sources
1. example-heat/electrical ceilinq/ar farced air !'Ias
2. exampleawater heater/electrical/or solar
E.' Square footage or valuation, etc.
1. example-1250 sq. foat hause, 500 sq, foat garage
.2. example-if new project, check new-if addition, chet
, add, etc, '('
.. .F~ , Building permit information: '. .
. 'r. example-construct single family h'ouse with an atta
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 5pecialty Code
H, DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building Divisi (
Staff must be able to contact appropriate persons rege
design information or job site corrections, etc.
COMBINATION APPLICATION/PERMIT (CAP)
A
II. Abbreviated Plumbing, Mechanical & Electrical 'Schedules
. A. Except where blank spaces occur in the description pOt
of the Mechanical and Electrical Schedules, the applicc
need fill-in only the No. Boxes adjacent to the approp'
item(s) to be installed
,B, Full Plumbing, Mechanical, and Electrical Schedules
are a'vailable 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 consull the full schedule,
.,' C. BUilDING DIVISION STAFF WILL FIll OUT All FEES A"
CHARGES ON THE SCHEDULES
III, Applicant to sign and date (
Whenever possible, the initial application will be used as
worksheet only, Where possible, Building Division Staff w
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 OF i,ca'
,'" and,-,!opl"ris,wiil be, processed until these fees are paid, JI-
' .- other fees and chiirges are due and payable when the perm"
. ,- isi"u~. .' .
V. 'FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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PERMIT VALIDATION
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CITY OF SPRINGFIELD
CI
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City Hall
Springfield. Oregon
Deportment of Public Works,
OFFICIAL RECEIPT
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No. B 58141(1
Date ~)...,_ '?1 19 ~2~ '
Reed-From ~ \\-0. G ~\~ ^ ~ \. ~ X:::tL.....-J
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Address\O\OC) '- I'\'QQ ~~
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Received Far:
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Amount Received
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('{70
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'Permit Cler"
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Additional Project Information,
Plumbinq. Eiectrical and Mechanical Pprmit<;',."o"i,."rl n"fn,." ~",.h
work commences.
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PLANS REVIEWED BY,
naml'"
Dan Smith
dot....
2-12-82
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