HomeMy WebLinkAboutPermit Building 1981-5-29
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I INSPECTION LINE
72~769
I Job Add,... 737 Main Street,
I legal Description
I
l7 03 35 42, TL 7S00
Owner
Tim M. Ueas
737 Main Street
SDrinQfie1d. Oregon
Addreu
Construction lender
Address
DESIGN TEAM
(nome)
Kathy Pierce 738 East 16th Street. EUGene 97401
(addreu)
(lies. no.) (expires) *ou,
(lies. no.) (exoiresl (phone no.)
Primary
Structural
Electrical
Mechanical
CONTRACTORS
Owner
(nome)
General
Plumbinq
Electrical
Owner
Methonicol
PLUMBING
NO,
FEE . CHARGE NO.
2
Each sinAle fixture
Relocated building
(new fix. additional)
S.F. Residence
(1 both)
5.00 lO.OO
Duplu (1 bath) each
Additional both
Woter service
1
Sewer
10.00
Storm Sewer
TOT At CHARGES
20.00
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CITY OF SPRINGFielD'
COM81NATlON APPLICATION/PERMIT
INFORMATION LINE
726-.37S3
ENERGY 'iDU~CE~, E1
H.o" tXl st ect
Water Ilealer _Elect.
Range E-lee +-
Value of Work:
Sq. Ftg. Main
Sq. Fig. A((en.
. Sq. Fig. Other
_New_Add_X.Alter_Rep.
__Fence_Demo_Chango/ Ule
_Other
oc
....
o
w
....
...
Phone
741-2512
2,500.00
Building Permit Info: Des(ribe Wark i.c., B'.lild Single
Familv Residence With AUa(hed Garaae}
97427
_Expand.i ng_bus.iness.-ta-i ncludfLaddi.tJonaL
seating & Bakery
Phane >~
(addrsss)
ELECTRICAL
MECHANICAL
FEE . CHARGE NO.'
, FEE ' CHARGE
Residence of
furna(e/burner to
ATU's
Appliance vent
separa Ie
Stationary evap.
cooler
Vent fan with
single duct
Vent syslem aport from
heatirq or A.C.
Mechanical e",hault
hood and duct
3.00 6.00
2
1
sq. ft.
New tirtuits, alterations
or extensions
15.00
25.00
SERVICES 200 amp
Temporary Constru(lion
2
Amps.
Wood sto~eJheater
FEEDERS
Heat Puma
Air handler to
10.000 CFM
Amps.
Air handler over
10,000 CfM
ISSUANCE OF PERMIT
10.00
16.00
TOTAL CHARGES
40.00
TOTAL CHARGES
WHERE STATE lAW REQUIRES that the Electrical work bfl done by the EI.ctrical Contractor, the electrical portion of this p.rmit shall not b. valid until a
label has be.n signed by an Electrical Contractor and attach.d to the eledrical panel.
I HAVE CAREFUllY EXAMINED the completed opplication for permit, and da hereby certify that all information hereon is true and correct, and I furth.r
certify that any and 011 work performed sholl be done in accordance with the Ordinances of the City of Springfield and the lows of the State of o..egan
pertaining to the work delcribed herin, and that NO OCCUPANCY will be mode of any structure without the permiuion of the Building Divbion. I furlher
certlfy that my registration with the Builder's Boord is in full force and effect 0 s requir y ORS 701.055, at if exempt the bosh for exemption Is noted
heron, and that only subcontractors and employees who ore in compliance with OR . 5 will be use 0 this project.
,
Basil for Builder's Board exemption'
NAME (please print) ~; ,...", ~ ~
Ione_r-1
fire Ion"
Flood Plain
Type/Canst. .
Bedroom'
~torie" 1
BUilDING PERMIT
Charges and
Surcharges
24.00
.96
PLUMBING PERMIT
Charge, and
Surcharges
20.00
.80
IL\{\()O 1 9
1.100 ~
--- ~~it-
ElECTRICAL PERMIT
Charges and
Surcharges
MECHANICAL PERMIT
Charge), and
Surcharges
OATE~,~9-&)
\:)y..A\-~ "GNAW.J'
FOR OFFICE US~
~ ,
1
Sq. Ftg. M.dn
Sq. Ftg. Acee!"
Sq. Fig. Other
Units
Occy Load -"013 .
"ccy Group -2
x Valu.
x Value
'" Value
TOTAL VALUATION ?, 'ino on
Plan Ck. Comm/lnd
65%1 BldQ Per foe
Plan Ck. Res
30%/Bld~ Per Fee
15.60 PO 5-7-BI
SYlteml Development
Chorl:1e n.5%1
Fence
Demo
Totol Comb. Permit
104.00
Sidewalk
AI C PaviM
Curb Cut
104.00
TOTAL
.1
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COMBINA nON APPlICA nON/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example.tax lot 100, Lane County Map Reference 17 03 43
2. example. Lot 1. Block 3, 2nd Addition to Springfield Estates
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, exomple.1250 sq. foot house, 500 sq. foot garage
2. example.if new project, check new-if addition, che< (
add, etc.
F. Building permit information:
1. example-construct single family hC?use with an attc (d
garage
2. example-remodel existing garage into family rOOrT
3. example-convert single family residence into
restaurant (change of use)
G. Volue of work as defined in Section 303 (0) of the
Structural Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction delays, Building Oivisi
Stoff must be able to contact appropriate persons reg_
design information or job site corrections, etc.
II. Abbreviated Plumbing, Mechanical & Electrical 'Schedules
A. Except where blank spaces occur in the description po
of the Mechanical and Electricol Schedules, the applicl
need fill.in only the No. Boxes adjacent to the approp
item(s) to be installed
B. Full Plumbing, Mechanicol, and Electrical Schedules
are available at the Building Division
1., To conserve space on the permit form the schedule~
hove been abbreviated
2. If the item(s) to be instolled 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 date
Whenever possible,. the initial application will be used as
worksheet only. Where passible, 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 poyoble at the time of the al
and no plans will be processed until these fees ore paid. I
other fees and charges ore due and poyable when the p'
is issued.
1-
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Project Informotion:
PERMIT VALIDATION
(
CITY OF SPRINGFIELD
'I
City Hall
Springfield, Oregon
Department af Public Works
OFFICIAL RECEIPT
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Date
Received For:
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AUTHOIUZI!:O SIGNATURI!:
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CONSTRUCTION LESS T~AN 20' FROM PROPFRTV I TN.
SHALL BE l-HOUR FIRE RESISTIVE CONSTRIIf:nON
PLANS REVIEWED BY:
name
, 'DAt'LSMllJ:j
s;gnoture01rJ)-nriJu LGo
date2
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