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Home My WebLink AboutPermit Building 1981-11-25INSPECTION ]INE 7263769 CITY OT SPRINGFIETD COIVIBINATION APP1ICATION / PERI'III ]NFONMAIION lINE 726{753 ENERGY SOURCES: Heot - Sq. Ftg. Moin 129 Mohawk Blvd Sq. Ftg. Access. Woter Heoter Sq. Ftg.Other Legol Description New.X ldd-1,h".-Rep. Volue of Work: -Fence-Demo Chonge/Use -Other Building Permit lnfo: Describe Work (i'e., Build Single Address Phone Fo Residence With Add drive u Co Add ress Phone DESIGN TEAM (nome)(oddre (lics. Pri Structurql Electrico I lics. Generol Plumbing Electricol Mechqnicol PTUMBING ETECTRICAT MECHANICAL NO.rEE CHARGE NO.FEE CHARGE NO.FEE CHARGE 3 Eqch sinqle fixture 7 .50 22.50 Residence of fr. furnoce/burner lo -BTU'S Relocoted building (new fix. odditionol)2 New circuits, olterotions or exlensions 15-00 Applionce vent sepo rqle S.F. Residence (l borh)SERVtCES Stolionory evop. coo ler Duplex (l both) eoch Temporory Conslruclion Vent fon with sinqle duct Additionol both Amps. Vent syslem oport from heotinq or A.C. Woler rervice Mechonicol erhousl hood ond duct Sewer Wood stove/heoter Storm Sewer FEEDERS Heot Pump Ampr. Air hondler to r0,000 crM Air hondler over r0,000 cFM ISSUANCE OI PERMIT TOTAT CHARGES 2?.50 TOTAT CHARGES 15 nO TOTAI, CHARGES WHERE STATE LAW REQUIRES rhqr th6 Elcctrical work be done by tho Elcclricol Conlrsclor, lqbel hss been signed by on Electricol Controclor ond sttoched to the clectricol ponel. , thr .lcctricol poition of this parmit sholl nor ba volid unril o I HAVE CAREtUtty EXAMINED the completed opplicotion for permit, ond do hereby cartify thol. oll infomotion hereon is lrue ond correct, ond I further certify thot ony ond oll wo.k p"rfo.-ej shsll bo done in occordonce with the Ordinonces of rhe city of springfield ond the Lows of the stote of oregon p"*i^lig to tire work describei herin, ond thot NO oCCUPANCY will be mode of ony structure without the permission of the Building Division. I further cerrlfy th-ot my registrotion with the Builder,, Boord is in full force ond effect os required by OR! 701.055, thot if exempt tha bosis {or exemption is noted heron, ond tnot Jnty subcontroctors ond employees who ore in complione with ORS 7OI.055 will be ued on this proiect. Bosis for Builder's Boord exemplion:il-SIGNATURE DATE / t-z NAME (pleose print) roR oFFrcE usE I Kx f zon" C-2 rype/con3r.-y:N-Units 1 sq'Frg. AAiin x -_--VolueFire Zone-Bedrooms occY Lood Ftg. Access x --lslsg Flood Ploin Group R2 sq. Ftg. other- .000 00 BUITDING PERMIT 44.00Chorges ond Surchorges L.76 Plon Ck. Comm/lnd 65%/Bldq Per fee 28.60 Pd System s Chorge Development (1.5%)120.00 PIon Ck. Res 3ool"/Bldg Per Fee 11-20-81 #85755 I PLUMBING PERMIT ___ 22.50_Chorges ond Surcho rges Fence Demo Totol Comb. Permit 84.76 ETECTRICAT ] Chorges ond Surchorges ___ 15.00_Sidewolk A/ C Povino MECHANICAT PERMIT Chorges ond Surchorges Curb Cut TOTAI $204.76 City of Spfd 17-03-25-33 T.l. l6o0n o*n". AlDpnrosp Dairv g0 60 COMBINATION APPLICATION/PERMIT (CAP) l. Applicont to furnish A. Job Address B. Legol Description l. exomple-lqx lot 100, Lone County Mop Reference l7 03 43 2. exomple-Lot l. Block 3,2nd Addition to Springfield Estotes C. Nome, etc. of owner ond construction lender D. Energy Sources L exomple-heot,/electricol ceiling/or forced oir gos 2. exdnpG-woterTf iTelEEtriEol / or 29lE, - E. Squore foologe or voluotion, etc.l. exomple-l 250 sq. foot house, 500 sq. foot goroge 2. exEmFiE-iT;& proiect, checkE*-if oddition, check odd, etc. F. Building permit informolion: I. exomple-conslruct single fomily house with on otloched goroge 2. exomple-remodel existing goroge into fomily room 3. exompfe-converl single fomily residence inlo i6liEE?6nt (chonge of use) G. Volue of work os defined in Section 303 (o) of the Slruclurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construclion deloys, Building Division Stoff must be oble lo contoct oppropriote persons regording design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the description portion of the Mechonicol ond Electricol Schedules, the opplicont need fill-in only the No. Boxes odiocent to the oppropriote irem(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve spoce on the permil form the schedules hove been obbrevioted 2. lf the item(s) to be instolled ore nol covered on the obbrevi- oted sohedules you should consult rhe full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Appliconl to sign qnd dote Whenever possible, rhe initiol opplicotion will be used os o worksheet only. Where possible, Building Division Stoff will prepore o typewritten copy ond relurn it to the opplicont ot the lime the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ol the time of the opplicotion, ond no plons will be processed until these fees ore poid. All other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VATIDATION Permit Clerk PROJECT CONDIIIONS TO BE SAIISFIED BEFORE OCCUPANCY: Additional Proiect lnformotion: PLANS REVIEWED BY: dotesignolurenome,{r ,2"2,#2>< "liEW=tfffiW tffi INSPECTION I,lNE 72&.3759 2 Mohawk Blvd Legol Descriptio" LOt 3 Block 5 Owner CITY OT SPRINGfIETD COilBINATION APPTTCAIION / PERMII INFORMATION tINE 726-37s3 Rq ENERGY SOURCES: Heoi - Woter Heoler -N"*JLldd-Alter-Rep.Fence-Demo-Chonge/ U re --Other Sq. Ftg. Moin Sq. Ftg. Access Sq. Ftg. Other $8.000. 00 Fomily Residence With Attoched Gotegg) Building Permit lnfo: Describe Work (i.e., Build Single PhoneAddress POrtland- flrp66n Add drive up windows (2)v consrrucrion lunde, Al penl^Osg Dai fy @ o@Fr PhoneAddress (oddress)(axpires)(phone no.)(lics. no.)DESIGN TEAM (nome) Str ucturol Electricol neNTRACTORS Generol Plumbing Eleclrico I }lechonicol MECHANICATETECTRICATPIUMBING FEE CHARGECHARGENO.FEErEECHAR.GE NO.NO. furnoce/burner to 22.50 Residence of fr.3 Eoch sinqle fixture 7. 50 15-00 Applionce vent seporole2 New circuits. ollerolions or extensions Relocoted building (new fix. odditionol) Stotionory evop. coolerSERVICES S.F. Residence (l bqth) Vent fon with single ductTemporory ConslructionDuplex (l borh) eoch Vent syslem oport from heofing or A.C.Amps.Additionol both Mechqnicql exhousl hood ond duclWoler service Wood stove/ heoterSewer Heot PumpFEEDERSSlorm Sewer Air hondler to r0,000 cFMAmpr. Air hondler ovar 10,000 cr^ ISSUANCE OF PERMIT TOTAI. CHARGESTOIAT CHARGES 15 nnTOTAI CHARGES 22.50 WHERE STATE tAW REOUIRES thot rhc Elcctricol work be done by thc Elcctricol Controclor, thc clactricol porrion of this pcrmit sholl not br volid until o lobel hor been signed by on Electricol Controctor and ottochcd to lhc etectricol ponel. I HAVE CAREFUttY EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is lrue qnd correcf. ond I further certify thot ony ond oll work performed sholl be done in ocordonce with the Ordinonces of the City of Springfield ond the Lows of the Stota of Oregon pertoining to tLe work described herin, ond thot NO OCCUPANCY will be mode of ony slructure without lhe permission of the Building Division. I further ertlfy th-ot my registrotion with the Builder'r Boord is in full fore ond effect os required by ORS 701.055, thot if exempt the bosis for exemplion is noted heron, ond thot only subcontroctors ond employees who ore in complionce with ORS 7Ol'055 will be used on lhis proiect. SIGNATURE DATE / t-r f-//c lf- Eosis for Builder's Boord exemption: NAME (pleose print) rollrFrc!r!!l Fire Zone-Bedrooms occy Flood Ploin -storier I Occy c-2 .Type/consr. V-N Units TOIAT YATUATION sB -000. 00 xZone Iood Sq, Ftg. Acess 71 sq. Ftg' A{oin G.oup R2 Sq. Ftg. orhar- x -Volue x -Volue Development2R-6n Pd Systems Choroe (L570)I 20. 00 Plon Ck. Comm/lnd 65%/ Blds Per fee 1 1 -20-81 #85765r ) Plon Ck. Res 30%/Blds Par fee BUITDING PERMIT .76 44 00Chorges ond Surchorges Fence 84 -76Totol Comb. Permit Chorges ond Surcho rges PTUMBING PERMIT 22.50 Demo Sidewolk A/C Povino Chorges ond Surchorger ___ 15.00_ ELECTRICAT PERMIT Curb Cut MECHANICAI PERMIT Chorges ond Surchorges E7 !Fr : ETOTAI.$204.76 Volue of Work: 90 AN coMBTNATTON APPLtCATIONiPERMIT (CAP) I. Applicont to furnish A. Job Address B. Legol Description l exomple-lox lot 100, Lone County Mop Reference 2. exompli-Lot l. Block 3,2nd Addition ro Springfield C. Nome, etc. of owner ond construclion lender PERMIT VATIDATION D.'or foEgdlg gg! /ol@ E. Squore footoge or voluotion, etc. I. exomple-1250 sq. foot house., 500 sq. foo.l goroge 2. exomple-i-f new proiect, check new-if oddition, cher ;d?i;erc F. Building permit informolion: l. exomple-construct single fdmily house with on ottc goroge 2. exomple-remodel existing goroge into fomily roon 3. exomplE-converl single fomily residence into iEltouTEnt (chonge of use) G. Volue of work os defined in Section 303 (o) of the Slructurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Divir Stoff must be oble to contoct oppropriote Persons reg design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedule A. Excepi where blonk spoces occur in the description p of the Mechonicol ond Electricol Schedules, the oppli need fill-in only the No. Boxes odiocent to the oppro item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ol the Building Division 'l . To conserve spoce on the permit form the schedul hove been obbrevioted 2. lf rhe item(s) to be instolled ore nol covered on tl oted schedules you should consull the full schedu C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES, CHARGES ON THE SCHEDULES lll. Appliconl to sign ond dote Whenever possible, the initiol opplicotion will be used worksheet only. Where possible, Building Division Stofl prepore o typewritten coPy qnd return it to the opplico* the time the octuol permit is issued for his signolure. 6a tbl (!| lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the lime of the opplicolion, ond no plons will be processed until these fees ore poid. All other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY Additionol Proiect lnformotion: PLANS REVIEWED BY: CITY OF SPRINGFIETD Ciry Holl Springfield, Oregon Deportment of pubtic WorksOFFICIAL RECEIPT No. B t Recei ved sH ELfOff.tutt!u!L PRTiiERS EUOaXE OR graot a65!r.6 Permit Clerk 6t, Energy Sourcesl. exomple-heot/electricol ceiling/ 2. exo - aE-* o te rI-eo iETEIEItEo I f -rn ^^J T b 5J 1 I8 d I (l I il (l ( t; ( (: BY-l ( \. I t{{ I PROJECT CONDITIONS IO BE SATISFIED BEFORE OCCUPANCY: nome sig noture dote# ( \