HomeMy WebLinkAboutBuilding Building 1980-10-27)rorirrEo e1
CIIY OF 5PRINGFIEID
colrStNAIloN appltcartox/penmtr
INTORMAIION tINE
72(F375'INSPECIION tINE
72(}3769
Job 3848 Ore gon Street
r.esot Descriprion TaX LOt 3901-4100 Ma t7 02 31 41
ENERGY SOURCES:
FA - GasHeot
Wq ler
Ron
Sq. ttg. Olher
-
New --Add
-Alier-ReP.- -Fence -Demo-Chonge/
Use
-Orher
-
Sq. Flg. Moin
Volue of Work:
2,000. 00Patricia RossOwner
Building Permit lnfo: Describe Work (i.e., Build Single
Address Phone
Foundation for moved house MP#1006
ooHof\)
!PhoneA,ddre ss
(nome)ress)(lics. rrb'.)(expireDESIGN TEAI{no
Mandrel I Ross 3900 0regon Street 7 46-37 97Primo
Structuro I
Electricol
Generol
Plum
Electrico I
Mechonicol
ETECTRICATPTUMBING
FEE CHARGEFEECHARGENO.NO.FEE CHARGE NO.
furnoce/burner ioResidence of
-sq.
fr.Eoch single fixture
Applionce vent
se po ra le15.00
New circuils, ollerolions
or extensionsX
Relocqted building
(new lix. odditionol)
Stotionory evop.
coo lerSERVtCES
S.F. Residence
(l borh)
Vent fqn with
sinqle duclTemporory ConslructionDuplex (l both) eoch
Vent sysiem oport from
heoling or A.C,Additionol both Amps.
10.00 Mechonicol exhoust
hood ond ductWoler service X
I
1
n
A
Exi stChange
Dac
Wood slove/heoterSewer
Heot PumpFEEDERSSlorm Sewer
Air hondler to
t0,000 crMAmpr.
Air hqndler over
10,000 cFM
ISSUANCE OF PERMIT
TOTAT CHARGES10.00TOTAI, CHARGES15.00TOTAT CHARGES
WHERE STATE tAW REQUIRES thot rhe Electricol work be dore by thc Electricol Controctor, the electricol poriion of lhis parmit sholl not bc valid until o
lobel hos been signed by on Electricol Controclor ond ottoched to the electricol pcnel.
DATE,C
EXAMINED the compleled
oll work performed sholl City of
withoul
Springfield ond
lhe permission
ollthot nforodondnformoItio Ihereon ,rues ond ond furlherhHACAREFULT,YE certify aorrecl,erebyopplicotionpermit,
ihe ofLows Stoterhe ofthwithOrdinooftheondothqtdonebeocordqnceln Oregoncertify
of Buithe Division.furtherthqtondoccNOPANCYUbeIdemoofstruclure
ny
the dework nyscribedto ldingherin,perioining
o 70oRs I iflhotihewith5Bui lder'IBoord tn5 lorcefull e{fect .055,the srsbo Ior notedtsondthotbyrequiredexemptexemptioncertlfyregistroiionmy
,ho tnore ith 701ORS will.055 usedbe lhison cr.he thotond on ondsubcontroclors Pf on,ly employeer omplio
Bosis for Euilder's Boord exemption:
NAME (pleose print)
FOR OFIICE USE ONLY
SIGNATURI
Ftg.
Frg.
Frg.
x Volue
x Vo lue
x
-Yolue
V-N
-
So.
Sq
Sq
n
Access
0ther
U nits Moi
FOUNDATION ONLY
R-3Flood Ploin
ToTAt vAruArtoN{ggffio-
NO Sto
zon. R- 1 Type/const,
ries-Occy Grovp
Fire Zone-Bedrooms ccy lood
Plon Ck. Comm/lnd
6596/Bldq Per fee
Sysiems Development
Chorqe (1.5%)
BUITDING PERMIT 20.
.80
Chorges ond
Surchorge s Plon Ck. Res
30%/Bldq Per Fee 6.00 Paid 10-10 -80
RECEIPT 54857fence
Totol Comb. Permit 46.80
PTUMBING PERMIT
15. 00
.60
Chorges ond
Surchorges
Demo ?1-ww ,zoSidewolkChorges ond
S urcho rge s
10.00
PERMIT
A/C Povinq
Curb Cut
MECHANICAI- PERMIT
Chorger ond
Surcho rge r TOTAI.
Mt+lc6
MECHANICAL
-affi
-#'v
coMBTNATION APPLICATION/PERMIT (CAP)
L Applicont to furnish
A. Job Address
B. Legol Description
l. exomplg-tox lot I00, Lone County Mop Reference l7 03 432. exomple-Lor I. Block 3,2nd Addirion ro springfierd Esrotes
C. Nome, etc. of owner ond construction lender
D, Energy Sources
PERMIT VATTDATION
TY OF SPRINGFIETD
Ciry Holl
_ Springfield. Oregon
Deportment of public WorksOFFIC!AT RECEIPT
.:
G
o
o
I. exomple-heot,/electricol ceiling,/or forced oir gos
^. =;;;'r,*-*o,", iEEEI;EGifil?or; or soroi
E. Squore footoge or. ,rotrotioi] "I. -l. exomple-.lj!g ,q. foor house, 500 sq. foot goroge2. ex_o.mple-if new proiecr, check nE-w_ii i:ddirion,-cilkodd, etc. -
F. Building permit informotion:
'| . exomple-construct single fomily house wlth on ottochedgoroge
2. exomple-remodel existing goroge into fomily roomJ. exomple-convert single fomily residence intoresrol?Ent (chonge o1 use)
G. Volue of work os defined in Secrion 303 (o) of rheStructurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To o-void design or construction deloys, Building DivisionStoff must be oble to contoct oppropriote purro-n, regordingdesign informotion or iob site corrections, etc.
ll. Abbrevioted Plumbing, Mechonicol & Elecrricol Schedule:
A. Except where blonk spoces occur in the description portion
of the Mechonicol ond Electricol Schedules, the oppiicont
need fill-in only the No. Boxes odiocent to the oppropriote
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building DivisionI. To conserve spoce on the permit form the schedules
hove been obbrevioted
2. lf rhe item(s) to be instolled ore not covered on the obbrevi-
oted schedules 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 dore
Whenever possible, the iniriol 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 time the octuol permit is issued for his signotuie.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of the opplicotion,
ond no plons will be processed until these fees ore poid. .lll
other fees ond chorges ore due ond poyoble when ihe permit
is issued.
V. FOR OFFICE USE ONLY
No. B 55007
ro
,d For
f!
o
a
$
o
3
oo
c
o
(r
(
sHELtOr-tuFx6uL! aRlirErg
O SIGNATUR€
- EUGETE Oi 0r.or
Permit Clerk
Received
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additionol Proiect lnformorion: Ofiginal hOUSe burned. HOUSe WaS Connected tO Se,j,rer. NO. S[)C
requlred. New house nloved onto Jot uired ne$, address whr'ch is 3B4B
r'-f o, t--,1
PLANS REVIEWED BY
SMITH 10-20-80dote
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