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Home My WebLink AboutPermit Building 1981-10-02INFOR'IAAIION I.INE 72G3753 INSPECTION I.INE 726876.' CIIY OF SPRINGTIETD COIABINATION APPTICATTON/PENMTI @rJ(f Ot5F Job Addres: Volue of Work: (phone no.)(nome) -Other Phone Fo Re f Phone Heot AC Flcc Other -New Sq. Frg. -ldd X Alter-Rep. f e dS1 Woter Heoter Sq. Ftg. MoinENERGY SOURCES: Sq. Ftg. Access. -Fence-Demo-Chonge/ Use 1377 Mohawk Blvd 17-03- 15Owner Address Add ress DESIGN TEAM Pri (oddress) 1189 Fairfield Building Permit lnfo: Describe Work (i.e., Build Single Slructuro I Electricol Mechonicol 197 N 7 47 -22 3Electrico I Plum Alert Electric Lance Pl 746-4711?o15Mechqnicol HafVeV & PfiCe Nlnnat lJ:rr Frrnana MECHANICATETECTRICALPLUMBING FEE CHARGEFEECHARGENO.CHARGE NO.NO.FEE furnoce/burner lo - -BTU'S Residence of -sq. ft.Eoch single fixture Applionce vent se po rq le15-00? New circults, olterotions or exlensions Relocqted building (new fix. odditionol) Stotionory evop. oolerSERVICES S.F. Residence (l borh) Yent fon with sinqle ductTemporory ConslruclionDuplex (l both) eoch Vent system oport from heoting or A.C,Amps.Additionol both Mechonicol exhoust hood ond ductWoler service Wood stove/ heolerSewer Heot PumpFEEDERSSlorm Sewer Air hondler to I0,000 cFMAmprPol nneti nn nf Air hondler over 10,000 ctM15. 00Fi vtrrrps Remodel HVac System 15. 00 ISSUANCE OF PER^^IT 10 . OO TOTAT CHARGES 2q nnTOTAT CHARGES 15. 00TOTAT CHARGES 15. 00 WHERE STATE tAw REOUIRES lhot lhc Elcctricot work be done by the Eleclricsl Conlroctor, the rl.Glricol portion of this permit sholl not bc volid until o I HAVE CAREFUL1y EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll informotion hereon is lrue ond correct, ond I furlher certify thot ony ond oll work perfor.ej sholl be done in occordonce with the Ordinonces of the City of Springfield ond the Lows of the Sfote of Oregon p".ioining to tie work describei herin, ond rhot No occUPANcY will be mode of ony structure without the permission of the Building Division. I further ertlfy th-or my registrotion with, the Builder's Boord ir in full force ond effecl os required by ORS 701.055, thot if exempl the bosis for exemption is noted heron, ond thot Jnly subcontroctors ond employees who ore in omplionce with ORS 7Ol.O55 will be usd on this proiect. 42 SIGNATURE DATE /ktzP lqbel hos bccn rigned by an Eleclricot Conttoctot ond ottqched to thc eteclricol pcnel' Bqsis for Builder's Boord exemption: NAME (pleose print) T{tYFOR OFFICE USE O/ x ----{slggx Volue x -Yolue TOTAT VATUATION C2 typ"/conrt. V- 1HR unit"Moi nE S15.ooo. oo Zone Flood Ploin Grorp--J2--Sq. Frg. other- lood -_==-Sq. Flg. AccessFire Zone-Bedrooms 0.5%\ DevelopmenlSystems lCho.o.BUITDING PERMIT Chorges ond Surchorges Plon Ck. Comm/lnd 72.00 2 88 Per Fee Plon Ck. Res Per Fee Fo nce Tolol Comb. PermitDemo Chorges ond Surchorges PTUMBING PERMIT 15. 00 60 Sidewolk A/ C PoYino Chorges ond Surchorges ELECTRICAL TOTAT $132. 08 MECHANICAT PERMIT Curb Cut25.00Chorges ond Surchorges Rplocatc interi^r n^ntitinnc ,| So 46.80 Pd q-l8-' #857318 , .., .a a .-, COMBINATION APPLICATION/PER}|-. (CAP) l. Applicont to furnish A. Job Address B. Legol Description l. exomple-tox lot 100, Lone County Mop Reference l7 03 43 2. e><omFlE-Lot l. Block 3,2nd Addition to Springfield Estotes C. Nome, etc. of owner ond construction lender D. En lectricol ceilin /or lorced oir gos 2.eoter /oidor- E. Squore footoge or voluotion, etc. I. exomple-l 250 sq. foot house, 500 sq. foot goroge 2. exEmElE-iT new proiect, check new-if oddition, check odd, etc. F. Building permit informolion: l. exomple-conslruct single fomily house with on ottoched goroge 2. exomple-remodel existing goroge into fomily room 3. exE;pfe-convert single fomily residence into i6stouront (chonge of use) G. Volue of work os defined in Seclion 303 (q) of the Structu rol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to contocl oppropriote persons regording design informotion or iob site correclions, elc. Il. 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 lo the oppropriote item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Division I. To conserve spoce on the permit form lhe schedules hove been obbrevioted 2. lf rhe item(s) to be instolled ore not covered on the obbrevi- oled sc,hedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os o worksheet only. Where possible, Building Division Stoff will prepore o typewrilten copy ond relurn it to the oppliconl ot the time the octuol permit is issued for his signoture. r lV. Fees ond Chorges Plon check fees ore due ond poyoble ol the time of the opplicotion, ond no plons will be processed until lhese fees qre poid. All other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OfFICE USE ONLY -- PERMIT VAI.IDATION Permit Clerk PROJECT CONDITIONS IO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformolion: Y/nome signoture - dote PLANS REVIEWED BY: .(1 - '{_+_l_-t'f- il INSPECIION tINE 72&3769 CIIY OT SPRINGFIEID INFORMAIION tINE 72U375tCOMBINATION APPTICAIION / PENIIIT @ lJOOts5 rob Addres, 1377 Mohawk Bl vd Heot AC Flec Wqler Heoler Ro nqe Sq. Ftg. Moin Sq. Flg. Access, Sq. Ftg.Other -New -.Add-X-nlter-Rep.- .-Fence-Demo-Chonge/ Use -.-Other regol Descriptio" 17 -03-25- 34 . T. L. 3901 Volue of Work: $15,000.00owner Centennial Bank Address 'l ?77 Mnhawlz P!:o.. 726:81.LL_ Building Permit tnfo: Describe Work (i.e., Build Single Fomily Residence With Attoched Goroge) Sprinqfield.0R 97477 Rel ocat-e int-erior nartitionc - Construclion Lender Add resr Phone DESIGN TEAM (nome)(odd ress)(lics. no.)(expires)(phone no.) Primory JameS Kegfe 1189 Fairfield 68q-16?1 Slruclurol Electricol Plum [.ance Pl Electrico I Alert Electric L97 7 7-22 3 Mechonicol HafVgy & P .l aa 2n1 tr,rnaa* Llrrr Erraana 7 A.6-A.711 PTUMBING - -'J --'- ETECTRICAT MECHANICAL NO.fEE CHARGE NO.FEE CHARGE NO.rEE CHARGE Eoch single fixture Residence of fr, furnoce/burner to -BTU'S Relocoted building (new fix. oddftionol)2 New circuits, olterstions or extensions 15-n0 Applionce vent seporo le S.F. Residence (l both)SERVtCES Stotionory evop. coo le r Duplex (l both) eoch Temporory Conslruction Vent fon with sinqle duct Additionol bqrh Amps. Vent syslem oport from heoting or A.C. Woler service Mechonicol exhqust hood ond duct Sewer Wood stove/ heoter Storm Sewer FEEDERS Heot Pump Rp] ncatinn nf Amps. Air hondler to r0.000 cFM 15. 00 A.ir hondler over r0,000 cFM Remodel HVac System 15. 00 ISSUANCE OF PERMIT 10. OO TOTAT CHARGES 15. 00 TOTAT CHARGES ?5-nn WHERE STATE tAW REOUIRES lhot lho Electricdl work be done lobel hos becn signed by an Electricol Controclor ond ottoched by the Elactricol Controctor, the electricol poriion of lhis permit shqll nol ba vslid until o to the eleclricol ponel. I HAVE CAREFULLY EXAMINED the completed opplicotion for permit' ond do h certify thot ony ond oll work performed sholl be done in ocordonce with th pe.ro|ning to t'he work described herin, ond rhot NO OCCUPANCY will be mo cerrify rhlt my registrotion with the Builder's Boord is in full force ond effect o heron, ond thot Jnly subconlrqclors ond employees who qre in complione w ereby certify thot oll informotion hereon is true ond correct, ond I further e Ordinonces of lhe City of Springfield ond the Lsws of the Stote of Oregon de of ony slructure without lhe permission of the Building Division. I furlher s reqrireJ by ORS 701.055, thot if exempt the bosis for exemplion is noted ith ORS 70I.055 will be used on lhis proiect' Bosis for Builder's Boord exemption: SIGNATURE DATE ,/dr'tzf; NAME (pleose print) FOR OFFICE USE ,Y Zone c.2 typ"/con.t. V- 1HR unir"l|loin x ---Volue x -Volue x -Yolue TOTAT VATUATION Fire Zone - Bedrooms Lood -==---Sq. Ftg. Access Flood Ploin crorp 82 sq. Fts. other- BUILDING PERMIT Chorger ond Surchorges 7?.00 2.88 Plon Ck. Comm/lnd 65ohl Bldg Per Fge 46. 80 Pd 9- 18-B1ch",qe Development (r.5,'6) Plon Ck. Res 3O%/Bldg Per Fee #857318 PTUMBING PERMIT 15. 00Chorges ond Surchorges Fence Demo Totol Comb. Permit ETECTRICAT PERMIT Chorges ond Surchorges _____u-no Sidewolk c MECHANICAT PERMIT Chorges ond Surchorges 25-_00 Curb Cut TOTAT $132. 08 ENERGY SOURCES: Fi vtr rr oc TOTAT CHARGES15.00 CoMBiNATTON AppltCAT|ON/PERMlr iCAP) l. Applicont to furnish A. Job Address B. Legol Descriptionl. exomple-tox lot 100, Lone County lAop Refer 2. exomple-Lot I . Block 3, 2nd Addition to Sprin1 C. Nome, etc. of owner ond construclion lender D. Energy Sorrrces I. exomple-heot 'electricoi cerling,/or forced air g 2. exo m pE-*o te.TEEIEr-ElEITiIIql' o-98 E. Squore foologe or voluotion, etc. 1. exomple-l 250 sq. foot housa, 500 sq. 2. exomple-if new proiect, check new-if odd, etc. F. Building permit informotion: l. exomple-construct single fomily house with qn goroge 2. exomple-remodel existing goroge into fomily r 3. exomEfe-convert single fomily residence inlo restouT6nt (chonge of use) G. Volue of work os defined in Section 303 (o) of tl.re Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building D Sloff must be oble to contoct oppropriote persons design informotion or iob site corrections, etc. Abbrevioted Plumbing, Mechonicol & Electricol Schedr A. Except where blonk spoces occur in the description of the Mechonicol ond Electricol Schedules, the op1 need fill-in only the No. Boxes odiocent to{*e opp item(s) to be instolled CtTY OF SPRINGFIELD CitY Holl Springfield, Oregon Deportmenl of Public Works OFFICIAT RECEIPT No. B .j7 ,i Li rj * Dote Rec'd Add 9 foot gor oddition,For f, ll I lfi; L-*-P i€,oa .LO I.or u e S,DI il Amount Received ,08B. Full Plumbing, Mechonicol, ond Electricol Schedule ore ovoiloble ol the Building Division l. To conserve spoce on the permit form the sched hove been obbrevioted 2. lf rhe item(s) to be instolled ore nol covered on oted schedules you should consult the full sched C. BUILDING DIVISION STAFF WILL FILL OUT AI.L FEES CHARGES ON THE SCHEDULES +_ lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used os c worksheet only. Where possible, Building Division Stoff will prepore o typewritten copy ond relurn it to the opplicont ot the time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble qt the lime 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 OI.{LY PLANS REVIEWED BY: no-" --!Qn Smi th signorure /ot-8Y n nlL- AUTHORIZEO SIGNATURE(i-SHELTOi-tUiXtULL PirXlERS _ EUGENE Oi 97'Ol lltrt 6 (b Permit Clerk PROJECT CONDITIO}IS TO 8E SATISFIED BEFORE OCCUPAhICY: Additionol Proiect Informotion: -z'\ dote -2t- ( {