HomeMy WebLinkAboutPermit Building 1981-02-03T
INSPECII
72&.3769
oksfrrrro l-Zb'tr ,CIIY OF SPRINGFIETD
COMSINAIION APPTICAIION/ PERMII
INFORMATION TINE
726-375t
1159 Mohawk BlvdJob Addresr
ENERGY SOURC ES:
NAHeot
Ronge
Woter Heoler
-
17 03 25 23, TL L6700 G 16800Legol Description
owner McCall Market
Volue of Work:
s10.000.00
Sq. Ft9. Moin
Sq. Frg. Access. I05
New Add-Alter-Rep.
-Fence-Demo-Chonge/
Use
-Other
Sq. Frg. Orher
Building Permit lnfo: Describe Work (i.e., Build Single
Fomily Residence With Atoched Goroge)PhoneAddrecs 5480 NW Front Avenue
Construct pre-fab carwash unit adjacentPortland, Oregon 97201
to existins service station.Conslruclion Lender
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Ur
PhoneAddress
DESIGN TEAM (nome)(oddress)(lics. no.)(expires)no.)
Primory Paul Chapman 7100 V 655-3634i1 Nilanfo Mqr
Mechonicol
(nome)(oddress)(lics. no.)(expires)(phone no.)CONTRACTORS
Generol
Plumbinq
Electricol
Mechonicol
MECHANICATETECTRICATPTUMBING
FEE CHARGE NO.FEE CHARGEFEECHARGENO.NO
Residence of
-sq.
ft,
furnoce/burner lo
1 Eoch sinqle fixture 5. 00
1C-OO
Applionce vent
sepo rolex
New circuits, olterotions
or exlensions
Relocoied building
(new fix. odditionol)
Stotionory evop.
coo lerSERVICES
S.F. Reridence
(l both)
Vent fon with
sinqle duclTemporory ConslructionDuplex (l both) eoch
Yent syslem oport from
heotinq or A.C.Amps.Additionol both
Mechqnicol exhqusl
hood ond ductWoler service
Wood stove/heoterSewer
Heol PumpFEEDERSSlorm Sewer
Air hondler to
r0,000 cFMAmpr
Air hondler over
r0,000 cFrr{
ISSUANCE Of PERMIT
TOTAI, CHARGESIOTAT CHARGES 15.00TOTAL CHARGES 5. 00
WHERE STATE tAW REOUIRES rhot the Electricol work be dona by lha Electricol Conlroclot,
lqbel has been signed by on Electricol Contrqctor ond ottoched lo tha eleclricol ponel.
the clectricol portion of lhir permit rholl not bc volid unlil o
I HAVE CAREFUtty EXAMINED the completed opplicotion for permit, ond do hereby. certify lhot. oll infomolion hereon is lrue ond correct. ond I further
certify thot ony ond qll work p"rfor."j sholl be done in occordonce with the Ordinonces of rhe City of Springfield qnd the Lows of the Stote of oregon
purtoining to tile work dur.rii.d hdrin, ond rhot NO oCCUpANcY will be mode of ony structure without the permission of the Building Division. I further
ertlfy thot my regisrrorion *itf, rh. Builder,s Boord i: in full fore ond effect os required by ORS 701.055, thot if exempt the bosis for exemption is noted
h.ron, ond thot Jnly subcontroctors ond employees who qre in complionce with ORS 701.055 will be used on this proiect.
)
NAI'IE (pleo:e pri
Eqsis for Builder's Boord exemplion:
FOR OFFICE UsE ONIY
SIGNATU
x -----lVoluex Yolue
x
-Volue
TOTAT VATUATION,
2-N 10,000.00Jb5
10^000 00
So.Ftg. Other
.Units -..=.-Sq.
Flg. Acces!
Zone c-2 Type/ Const.
Group
LoodFire Zone-Bedrooms
Flood Ploin
Ftg. Moin
150. 0033. 80 Systems
Chorge
Development
(1.s%\
Plon Ck. Comm/lnd
657"1Blds Pet lee
Plon Ck. Res
3O%/Blds Per Fee
BUITDING PERMIT
Chorger ond
Surchorges
52.00
2,08
Fence
88 .18Totol Comb. PermitDemo
PTUMBING PERMIT
Chorges ond
Surchorges
5. 00
.20 A.<gsidewotk 33 LF
A/C Povinq
Chorges ond
Surchorges
PERMIT ls.00
60
10. 00Curb Cul
MECHANICAT PERMIT
Chorges ond
Surchorges ,"r"rJ13,66 --i$-
Structurol
Electrico I
BTI.J'S
,lr
CoMBINATTON'.AppUCAT|ON/pERM|T (C.rp)
Applicont to furnish
A. Job Address
B. tegol Descriptionl. exomple-tox_lot 100, Lone County Mop Reference
-
2. exomple-lor l. Block 3, 2nd Addifion ro Springfield
C. Nome, elc. of owner ond construclion JenderD. Energy Sources
2.
exomple-heot./electrico I ceiling /
ex o m p I e -wo te r tr eo te /EGc t n-co I
or forced oir gos'orEIEi
E.,o.. roorog. or ro,uor,or, II
PERMIT 'ir),.,Jo,o*
ITY oF SPRINGFIELD c
CirY Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAI RECEIPT
No. Bj$8
Received For:
o8
&(t
Flu 2doo (t
,(o
1e C-t5Po
t Received
lr Y':
17 03 43
Eslotes{c
Sq
l.
2.
(
exo e- I 250 sq. foot house,foot gorog500 sq,
new-ifexomnew proiect, check oddition, cl
elc.
{
C
(
(
(,
C
(
(
(
s573$r
F. Building permit informotion:I. exomple-construct single fomily house with on ot
goroge
2. exomple-remodel existing goroge into fomily roo3. exomFG-convert single fomily r-esidence info
restouront (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To o-void design or construction deloys, Building Divi:
Stqff must be oble lo conloct oppropriote p..ro-n, ,"g
design informotion or iob site correclions, etc.
ll. Abbrevioted Plumbing, Mechonicol & Electricol Scheduler
A. Except where blonk spoces occur in the description pc
of the Mechonicol ond Electricol Schedules, the oppiic
need fill-in only the No. Boxes odiocent to the opprop
item(s) ro be insrolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Divisionl. To conserve spoce on the permit form the schedule,
hove been obbrevioted
2. lf the item(s) to be instolled ore not covered on the
oted schedules you should consult the full schedule,
C. BUILDING DIVISION STAFF WILL FILt OUT AtL FEES AN
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, the iniriol opplicotion will be used os,
worksheet only. Where possible, Building Division Sroff wi
prepore o. typewritten copy ond return it to the opplicont r
the time fhe octuol permit is issued for his signotuie.
(
(
oo (t
Amoun
,3V
lV. Fees ond Chorges
Plon check fees ore due qnd poyoble ot the time of the op
ond no plons will be processed until these fees ore poid. A (
other fees ond chorges ore due ond poyoble when ihe perp
is issued.
V. FOR OFFICE USE ONIY
AUTXORTZEO SIGNATURE
'X'LTON
TUiNBULL PTINTEhS ' EUC'NE OR 9"OI ta3l
(
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
CURBCI}T ON 16th S.TREE? AND C0I{STRUCT NElv 30 FOOT APPROACI{ VIITH 5 FOOT
CLOSE EXISTING
FI.ARES
CONSTRUCT 35 FEET OF 5 FOOT WIDE SIDEWALK 1 FOOT OFF PROPERTY LINE.SETBACK
Additionol Proiect tnformotion:
PLANS REVTEWED BY:
*.-.. . IOP.TIE PIEGER 1-12-81nomesignoluredote
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