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HomeMy WebLinkAboutPermit Building 1981-03-09INSPECIION IINE 72&3769 CIIY OF SPRINGFIETD COMBINATION APPTICAIION/PENMIT INFORMA'ION I.INE 7283753 rob Addresr 962 North 6th Street Lesor De:criprio" Tax Lot 800 Map 17 03 35 2l ETeaT *.Ft -El ect ENERGY sOU Heot Woter Heoler Ronqe Volue of Work: 48,094. 90 Sq. Ftq. Moin IJSJ - sq. Ftl. Access. 3?O -Add-Alter-Rep., Fence-Demo-Chorge/Use Other ln. Ftg.A N"* Other Larry Di I beckOwner Building Permit lnfo: Dercribe Work (i.e., Build Single Fomily Residence With Attoched Goroge)Ph""" 747-6011Address 4015 B Main Street Sinqle Family Residence; att qarSorinqfield. 0reqon 97477 Conslruclion Lender rlreplace co lJo HFOr Addresr (oddress) (lics. no.) (expire:) (phone no.)DESIGN TEAM (nome) Primory Structurol Electricol Mechonicol (nome)(oddrers)(lic:. no.)(expirel)(phone no.)CONTRACTORS 7 47 -60t1ek V & M Plumbing La Erectricor Daves El ectri c 20-9SC itachonicol Laf fy Di I beCk ETECTRICAL MECHANICALPTUMBING FEE CHARGEFEECHARGENO.CHARGE NO.NO.FEE 6. 0025. 00 1 rtOS:0001;;,, x *"flT5"t ,0. r,.Eoch rinqle fixture Applionce vent seporo le New circuits, ollerdtions or exlensions Relocoted building (new fix. odditionol) Stotionory evop coo le rSERVICES25. 00X S.f. Residence (l both) Vent fon with sinqle duct 2.00 9. 00tftoe3TemSorory ConslructionDuplex (f both) eoch Vent syslem oport from heoting or A.C.10.00 Amps.1 Additionol both Mechonicol exhoust hood ond duct 4.501Wqler rervite Wood stove/heoteri0.001Sewer Heot PumpFE EDERSSlorm Sewer Air hondler to r0.000 cFMAmpr. Air hondler over 10,000 cFM tssuANcE oF PERMTT 10. 00 29.50 TOTAT CHARGESTOTAI. CHARGES 45.0045. 00TOTAT CHARGES WHERE STATE tAW REQUIRES rhot rhc Etedricol work be done by rhe Electrical ControGlor, the elcttricol portion of this permit rholl not bc volid until o lobcl hos becn signed by on Electricol ContrEctor ond ottached to lhc electricol ponel. I HAVE CAREFUIY EXAMINED rhe complered opplicotion for permit, ond do hereby ceriify lhot oll informotion hereon is lrue ond correcl, ond I further certify thot ony ond oll work pe.formej sholl be done in qcordonce with the ordinonces of the City of Springfield ond the Lows of the Stote of Oregon p".roining to tire work described herin, ond thot NO OCCUPANCY will be mode of ony:truciure without the permission of the Building Division. I further cerrrfy $-ot my regiilrorion wirh rhe Bullder's Boord is in full force ond effect os required by ORS 701.055, thot if exempt the bosis for exemption is noted heron, ond thof Jnly subcontroctors ond employees who ore in omplione wirh OR570I.055 will be used on this proiect. qV DATE (Bo sis NFOR OFFICE USEI :-3&f&Y:i:: a -!6196 TOTAT YATUATION 1 353-_TZV 4U, Uy4. vUFlood Ploin Fire Zone Zone fype/ Conrt Bedrooms 45,054.90 3 ,040 - oonits 1 Sq' Ftg. Grorp R-3 Sq. Fts. other- lood -----_-Sq. Ftg. Access Systems Development Chorqe (1.57o) Plon Ck. Commi lnd 6595/Bldq Per Fee 55. 20 ^-,1n nn Plon Ck. Res 307o/Bldq Per fee BUILDING PERMIT 184.00 7.36 Chorge: ond Surchorges 8.10Plan Check Due--8-.T0'-oue Fe nce 305.24Totol Comb. PermitDemo Chorges ond Surchorges 45.00 ---T:A0-- PTUMBING PERMIT 15.00---rtr--ICAL PERMIT SidewolkChorges ond Surchorges 1A Curb Cut MECHANICAT PERMIT Chorges ond Surchorger 29.50 1. 18 TOTAT TZ, Phone NAME (pleose print) exemplionr A/C Povino ff ::1:-"rl COMBINATION APPLICATION/PERMIT (CAP) e.:c r l. Applicont. to f urnish A. Job Address B. Legol Description lot I00, Lone County Mop Reference I7 03 43 PERMIT VALIDATION OF SPRINGFIETD City Holl Springfield, Oregon Deportment of Public Works OFFICIAL RECEIPT No. B 559'$6 .r9 I. exomple-lox 2. exomple-Lot l. Block 3,2nd Addition lo Snrina{icl'l E"+^+^' C. Nome, etc. of owner ond construction lenc (CITY ( l D. En I 2. E. Squore footoge or voluotion, elc. I 2 ergy Sources exo mple-heot/electricol ceiling /or forc, exo mple-woter heoter /electricol z' or sol exomole-I250 s exomple-if new odd, etc. ), q. foot house, proiect, check 500 sg. fr new-if or F. Building permil informotion: l. exomple-conslrucl single fomily house r ,. :::1t;"-remodel existins eorose into I (ir' 3. exornpl-e-convert single fomily residencr iEJEu?E'nt (chonge of use) G. Volue of work os defined in Section 303 (cr {tt.- Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or conslruclion deloys, Bui {rS Stoff must be oble lo contoct oppropriote p - design informolion or iob site correclions, e ll. Abbrevioted Plumbing, Mechonicol & Electrico A. Except where blonk spoces occur in the des of the Mechonicol ond Electricol Schedules, need fill-in only the No. Boxes odiocent to I . item(s) to be instolled' B. Full Plumbing, Mechonicol, ond Electricol Sr ore ovoiloble ot the Building Division I. To conserve spoce on the permit form th hove been obbrevioted 2. lf rhe item(s) to be instolled ore nol cove _ oled schedules you should consr${re'fu C. BUILDING DIVISION STAFF WILL FILL OUT A CHARGES ON THE SCHEDULES lll. Appliconl to sign ond dote Whenever possible, the initiol opplicotion will I worksheel only. Where possible, Building Divisi prepore o typewrilten (oPy ond relurn it to the the time the octuol permit is issued for his sign< ( ( () AUIHORIZED STGNATURE PiTNIERS _ EUGENE OF 97'Ol 'a'll a t (fe f'( ( BY 6. lrl. { lJ, Amounl Received SHEL ( (lV. Fees ond Chorges Plon check fees ore due ond poyoble ot the tim ond no plons will be processed unlil these fees , other fees ond chorges ore due ond poyoble w[= is issued. V. FOR OFFICE USE ONLY rf l, Permit Clerk PROJECT CONDIIIONS TO BE SAIISFIED BEFORE OCCUPANCY:t) Additionol Proiect lnformolion: D a PLANS REVIEWED BY: 3-6.tLsignolure q dote (. t^