HomeMy WebLinkAboutPermit Building 1981-07-09CIIY OT SPRINGFIETD COMBINAIION APPIICAIION/ PERAAlT INfORIAAIION IINE 72(-37s3INSPEC?ION TINE 72(-376i SOURC ES:Elect GasWoter Heoter ENERGY Heot Part of TL 10100, lrlap 17 1216 lttohar*k BlvdJob Addrrrr -l.sgl Dc !criptio n 03 25 33 Volue of Work, 40, 000. o0 -New --Add--}[lter-Rep. -tence-Demo-Chonge/ Use Orhe' --- LJ+ L'Sq. ttg. Moin Sq. Ftg. Accerr. Sq. Ftg. Other ownar F1eek, Wayne E. Building Permit lnfo: Describe Work (i-e., Build Single Fomily Residence With Attoched Goroqe)Addrerr 1335 l*larket Street Phone 7 26-7880 Remodeling lease space for ChineseSpringfie1d, Oregon 97477 Restariiant Conslruclion Lender @tsoF N) U.l PhoneAddress (nome)(oddress)(lics. no.)(expires)(phone no.)DESIGN TEAM Brodie HotelPri Struclurql Electricol Mechqnicol e1 RS Plumbino Electricol Mechonicol MECHANICATEI.ECTRICATPTUMBING FEE CHARGENO.FEE CHARGE NO.NO.FEE CHARGE Residence of fr. furnoce/burner to -BTU'S 9 Eoch sinqle fixture 5. 00 4s. 00 TE 15-OO Applionce vent sepqrotex New circuits, olteroiions or exlensions 2 Of m< Relocqted buiiding (new fix. odditionol) Stotionory evop. coolerSERVtCES S.F. Residence (l boih) 2 Vent fon with sinqle duct 3. 00 6.00Temporory ConslruclionDuplex (l bolh) eoch Vent syslem oport from heotinq or A.C.Amps.Additionol both onn2 Mechqnicol exhqusl hbod ond duct 4. -qoWoler service Wood slove/heoterSewer Heot PumpFEEDERSSlorm Sewer Air hondler to r0,000 cFMAmpr. Air hondler over r0,000 cFM m 6- OnAlter HVAC Svste 2.OOGas Pipins rssuANcE oF PERMTT 10.00 TOTAL CHARGES 35. 00 15.00 IOTAT CHARGESTOTAL CHARGES 45.00 WHERE STAIE fAW REQUIRES rhqr lho Elcclricol work be dona by rhe Electricol Conttqctor, rh. Gh.lricol Portioir of lhis parmit sholl not bc volid until c lobel hcs bean signed by on Elcctrical Contrsctor ond ottochad lo lhc clectricol poncl. I HAVE CAREFULTY EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is true ond correcl, ond I further ;ertify thot ony ond oll work performed sholl be done in occordonce with the Ordinonces of rhe City of Springfield ond lhe Lows of ihe Stote of Oregon pertolning to rle work described herin, ond thot NO OCCUPANCY will be mode of ony.slructure withoul the permission of the Building 'Division. I further ertlfy th-ot my registrotion with, the Builder's Boord is in full fore ond effect os required by ORS 701.055, lhot if exempl lhe bosis for exemplion is noted heron, ond thot only subconlroctors ond employees who ore in complionce wilh ORS 701.055 will be used on ihis proiect. fl1-.-Ci-le-uNcr DATE xWrPtBosis for Builder's Boord exemplion: NA.ME (pleose print) LeuLrq SIGNATURE TOR OFFICE USE ONIY 1--!6lsg 1-!6lss IOTAT VAI.UATION Ftg. Moin x --volr. 40, 000 . O0 flood Ploin 40,000. 00 194 2 Lood Flg. Access Sq. Frg. Other Zone Const. Fire Zone-Bedrooms (1.50h\ DevelopmentSystems 6horoe1n? n( Dr\ a 1< Plon Ck. Comm/lnd 65%/Bldg Per Fee JT Plon Ck. Res 3o7o/Blds Per Fee Fence )60 noTotol Comb. Pff.ll-Demo 157. 00 ----6.28- PTUMBING PERMIT Chorges ond Surchorges 45. 00 ----1;&0- BUII,DING PERMIT Chorges ond Surchorges Sidewolk A/C Povino Chorges ond Surcho rges 15. 00 -- '6U ELECTRICAL PERMIT Curb Cut MECHANICAT PERMIT Chorger ond Surchorge: 33. 00 ----T.52- 260. 00 TOTAI.i- (nome)(sddress)(lics. no.)(expires)(phone no.) L-Z I I I-]HR coMBTNATION AppLtCATtON/pERMrr (CAp) l. Applicont to furnish A. Job Address B. Legol Description l. exomple-lox lot I00, Lone County Mop Reference 2. exomple-Lot I. Block 3,2nd Addition to Springfield C. Nome, elc. of owner ond construction lender D. Energy Sources PERMIT VATIDATION G, ctTY oF SPRINGFIEID (l Ciry Holl Springfield, Oregon Deportment of Public Works OFFICIAL RECEIPT No. B 568E0 fl l9nrCnev fl Address /-151 S ( ( ( ( ( 6, ( (' ( ( ( (t l. exomple-heot/electricol ceiling/or forced oir gos 2. e xo mFIE-w o te r TETET6G-cI ri co I / o @---- 'l . exomple-1250 sq. foot house, 500 sq. foot goroge 2. exomple-if new proiect, check new-if oddition, cher odd, etc. F. Building permit informotion: l. exomple-conslrucl single fomily house with on olto goroge 2. exomple-remodel existing goroge into fomily roorr 3. exffipfe-convert single fomily residence inlo reEtoiT6nt (chonge of use) G. Volue of work os defined in Section 303 (q) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Divisi Stoff must be oble lo conlocl oppropriole persons reg( design informotion or iob site correclions, elc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blonk spoces occur in the descriplion po of the Mechonicol ond Electricol Schedules, the opplicr need fill-in only the No. Boxes odiocent to the opprop item(s) to be instolled B. Full Plumbing, Mechqnicol, ond Electricol Schedules ore ovoiloble ot the Building Division l. To conserve spoce on the permit form the schedule hove been obbrevioted 2. lf rhe item(s) to be instolled ore nol covered on the oted schedules you should consult the full schedule C. BUILDING DIVISION STAFF WILL FILL OUT ALt FEES AI CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os worksheet only. Where possible, Building Division Stoff n prepore o typewritten copy ond return it to the opplicont the time the octuol permit is issued for his signolure. U Received For: 3 Amount Received F (-. fl fl fl il (t (l il 0 lV. Fees ond Chorges f- Plon check fees ore due ond poyoble ot lhe time of the opplicotion, ond no plons will be processed unlil these fees ore poid. All other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SAIISFIED BEFORE OCCUPANCY: Additional Proiect lnformotion: Adciitional plan-s required for lightin*, EPu{a HVAC system changes required to suitethe new tenant PLANS REVIEWED BY: ... I' . LOPNE PLEGER 7-9-81signolurenomedote \+4aurHoRrzEo sTcNATURE ,'sxtrto*.rrnxtr. pir(TEis EUGENE. oi t7.or .!!rr-a ( ( fo 'o)n