HomeMy WebLinkAboutPermit Building 1981-12-02INSPECIION TINE
726-3769
TNFORMATION IINC
726F3753
CITY OF 5PRINGfIETD
COATBINAITON APPUCATION/PERiIII
Job Address 470 S. 2nd St
lesol Descriptio" 17-03-35-?j T I lOnO Ronge
ENERGY SOURCES:
l.leot
Wqter Heqler
Volue of Work:
$250.000. 00
Sq. Ftg. Moin
'-Rep.
Use
-Other
Sg. Frg.
Sq. Ftg.
owner BOfden InC
Building Permit lnfo: Describe Work (i.e., Build Single
Fomilv Residence With Attoched Gorooe)ehone 7 46-R461Address {/fl $- 2nd Street-
Phenolic Resin rl.ank - llrearehin & TankSpringfiel d, 0R 97477
Spill Containment - Settlinq Tank - TruckConstruction Lender NOne
Wash
@HoNO
G)
PhoneAddress
DESIGN TEAM (lics. no.)(nome)
Slructurql
Eleclricq I
IMechonicql
Electricol
Mechqnicol
ETECTRICAT ,tricH,lNtc,qLPTUMBING
FEE CHARGE NO.FEE CHARGE NO.FEE CHARGENO.
Residence of
fr.
furnoce/burner to
-Bf
U'SEoch sinqle fixture
1tr nn
Applionce vent
sepqro le IY
New circuits, olterotions
or extensions
Relocohd building
(new fix. odditionol)
Slolionory evop.
coo lerSERVICES
S.F. Residence
(l borh)
Vent fon with
sinqle ductTemporory ConslructionDuplex (l bolh) eoch
Vent syslem oport from
heotinq or A.C.Amps.Additionol both
Mechonicol exhousl
hood ond ductWcler rervice
Wood sfove/heoterScwer
Heot PumpTEEDERSStorm Sewer
Air hondler lo
10.000 cFMAmps.x New Pioino &
30. 00
Air hondler over
r0,000 cFMDrain Lines
I
ISSUANCE OF PERMII
TOTA,L CHARGESTOTAT CHARGES 15. 00TOTAT CHARGES 30.00
WHEnE STAIE LAW REQUIRES rhot rho Elcdricol work bc done by the Electricol Conlroclor, *rc elsdricol portion of this permit shsll not ba volid until o
lobel has been signed by on Electricot Controcror ond oftochod to the cleclricol ponel.
I HAVE CAREFULIy EXAMTNED the completed opplicotion for permit, ond do hereby certify lhot oll informotion hereon is irue ond correcl, ond I further
certify thot ony ond oll work performed sholl be done in occordonce with the Ordinonces of rhe City of Springfield ond the Lows of the Stole of Oregon
pertolning to tire work described herin, ond thot NO OCCUPAN€Y will be mode of ony structure without the permission of the Building Division. I further
certlfy th-ot my registrotion with the Builder's Boord is in full {orce ond effecl os required by ORS 701.055, thot if exempl the bosis for exemption is noted
heron. ond thol mly subcontroclors ond employees who ore in complionce with ORS 701.055 will be used on this proiect.
SIGNATURE oxe J*-1)8L-
Bosis for Euilder's Boord exemption:
NAME (pleose
FOR OFFICE USE ONLY
Fire Zone-Bedrooms ---------------Occy
Flood Ploin Slories-OccY other
-
ioro, ro,uol, Jli szuooo:oo-
Accass
Zone x Volue
x Vo lue
t42
Lood
--'-'--Sq.
Ftg.
Grorc M2 5r. Ptr.
.Type/Const.-Unils
-Sq.
Ftg. Moin
Systems Developmenl
4lroe (l-5%)3 - 750- n(L332.80 Dd 10-14
Plon Ck. Comm/lnd
65%/Blds Per fee
#P.57 437
PIon Ck. Res
30%/Blds Per Fee
BUILDING PERMIT
Chorges ond
Surcho rges
I
Fence
57q ^28Totol Comb. PermitDemo
PTUMBING PERMIT
Chorges ond
Surchorges
Sidewolk
A/C Povins
Chorges ond
Surchorges
15.00PERMII
Curb Cut
MECHANICAT PERMIT
Chorges ond
Surchorges TOTAT
$4,329.?B
-
-I-
i:<
er
e3t.
(phone no.)(oddress)(expires)
Primory
(lics. no.).6NTPACTONS (nome')(oddress)(expires)(ohone no.)
1AA2 6.R7 -OaA.q<;.narar R-A- Chambers 1819 Garden Avenire- Fuoene- 0R 1030 Feb ?7
l^Plumbino
2n L9.
IlaOL
?o nn
't ?o
-50
COMBINATION APPLICATION/PERMIT (CAP)
l. Applicont to furnish
A. Job Address
B. Legol Description
l. exomple-tox lot 100, Lone County Mop Reference I7 03 43
2. exomple-Lot I. Block 3, 2nd Addition to Springfield Estotes
C. Nome, etc, of owner ond construction lender
D.
PERMIT VATIDATION
CITY OF SPRINGFIELDEnergy SourcesI. exomple-heot/electricol ceilingz'
2. exffiFlE-wo re r TEETI .ilFect ri co I
'or forced oir gos (
or solor '
CitY Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAT RECEIPT
E. Squore foologe or voluotion, elc.
I. exomple-I 250 sq. foot house, 500 sq. foot goroge
2. exEmFiE-iT new proiect, check new-if oddition, check
od4 etC.
F. Building permit informotion:
l. exomple-construct single fomily house with on ottoch'
goroge
2. exomple-remodel existing goroge into fomily room /3. exomple-convert single fomily residence into i
reEGuront (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 conslruction deloys, Building Division
Stoff must be oble to conloct oppropriote Persons regord r
design informotion or iob site correclions, etc.
J{0. B 57698,
Dote
Rece For:
(
ll. .Abbrevioted Plumbing, Mechonicol & Eleclricol Sc,hedules
A. Except where blonk spoces occur in the description portio
of the Mechonicol ond Electricol Schedules, the opplicont, need fill-in only the No. Boxes odiocent to the oppropriol
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 the schedules
hove been obbrevioted
2. lf the item(s) to be instolled ore nol covered on the obl
oled schedules you should consull rhe full schedules
C. BUILDING DIVISION STAFF WIL[ FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
tll. Appliconl to sign ond dote
Whenever possible, the initiol opplicotion will be used os o
worksheet only. Where possible, Building Division Sroff will
prepore o typewritten copy ond return it to the oppliconl ot
the time the octuol permit is issued for his signoture.
Fees ond Chorges
Plon check fees ore due ond poyoble ot the lime of the opplic
ond no plons will be processed until-these fees ore poid. All (
other fees ond chorges ore due ondloyoble when the permit
is issued. - ') ' +-
FOR OFFICE USE ONLY
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Amoun I Received
BYl.
SIGNATURE
EUGENt. ot 07401
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Proiect lnformotion;
10- 16-81signoluredotenomeDan Smi tlr
PLANS REVIEWED BY:
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