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Home My WebLink AboutPermit Building 1990-07-11INS 7 ?.6 COMBI L I CATI 726-3753 ORtJob Address Legal Description 04600 25-3L17-03. 04400,Tax Lots 04200 ?*, SPringfl EIIERGY SOURCES Heat l,Jater Heater Range 0wner Twin River Baptist Church Value of l.lork)3,ooo Ftg. Access._ Sq Sq Sq . Ftg . 0ther se Ftg n_ Phone 746-Address l6@ Monhawk Blvd.ngPernritlnfo: Oes@ Residence l,lith Attached Garaqe) -Bui I cii Fami 1 y-----4734 Spring field, 0R 91477 /L-qzu-y'2e,<.)/2F Construction Lender .None Zenr)- -/a/ PhoneAddress N/A 7 l-$oo 00J u0 DES I GN TEAII name address Iics. no.exDl res 1r)ne no- Primary Thomas Poage 2101 W. 10th, Eugene, 0R 6L92 4Bs-4505 Structural Nona Electrical None i,lechanical None name addres s (rcs. no.'exni res )nhonp nn- ) Qqneral Greensuns, Inc. 4139 Main St.,31366 t2lgO 726-7 t50 Springfield, ORNonePl umbi nq Electrical None I'lechanical GreenSuns, Inc. Same Same Same Same PLUI,{B I NG ELECTR I CAL MECHAN I CAL FEE CHARGF NN FFF CHARGF NO FFF CHAPGF Each single fixture Residence of FTSQ furnace/burner to BTU' s Relocated bui Iding (new fix. additional)New circuits alts. or extens ions Floor furnace and vent S . F. P.es i dence(l bath)SERV I CES Recessed wal I Snace hpatcr:nd vant Duplex (l bath) each Additional bath Temporary Construct ion Apol iance vent seoa rate l.iater servi ce ge in existing dence Cha n res i Stationary evap. cool er Sewer mu1 ti fami 1 y, Industrial comrrn. or Vent fan with sinole duct zlo Storm Sewer fu*0f s.Vent systern apart from heatino or A.C. 2 Catch Basins c0t1t'1./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/relocatedistrih. feedprs l'Jood stove/heater 0f S. ISSUANCF OF PFRIIIT TOTAL CHARGES fun TOTAL CHARGES TOTAL CHARGES WHERE STATE LAN REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this perm'itshall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed apnl ication for oermit, and do hereb.y certif oertaining to the work described herein, and that NC OCCUPAI,ICY will be madethe Building Division. I further certify that m.y reg'istration vlith the Builder's SI -,r410l,lAl.tE (pl ease pri xempt 5 wil fy the y that all information hereon is true and correct, and I further certi that any and al State of Oregon I work performed shall be done in acc ordance with the 0rdinances of the Cityof Soringfield and the Laws of structure without the permiss s in full force and effect as ion ofof any Board i requi red by ORS 701.055, that if e the basis for exemption is noted hereon, and thatonly subcontractors and ernployees who are in comcl iance with 0i?5 701.05 be used on this Droject, nt\/v4zl -/. .. FON OFFICE USE Oi,{LY Ftg Ftg Ftg Zone . t'lain Val ue TOTAL VALUATION x Load 0cc.y Gro up .Type/ Con s t Uni t lu Stories Fire Zone Flood Plain Bed rooms . Access 0ther Val ue \q?Y )i\Svstens Deve Charqe (1.51Plan Ck. Comm/Ind 65%/81dq Per Fee o pmen t 7zo,*BUILDING PERI'IIT Charges anC Su rc ha rges Plan Ck. Res 30%/81dq Per Fee Fence 5eaPLUI,IBING PERMIT Charges and Su rcha rges 4> 3 Dgmo Sidewalk Z4€?prri'-."^ - ELECTRICAL PERIlIT Charges and Surcha rges A/C Pavi ng ___b-fu_ <?/.c Total Cornbdermit /28.6ozoI4ECHANICAL PERMIT Charges and Surc ha rge s "1) /^7a TOTAL ///8.60 ,IoRS COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County l'iap Referencei7 03 432. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources PERMIT VALIDATION 1. example- heat/electrical ceiling/2. examp l e- waterh-eateTelGEtilcalToE. Square footage or valuation,G[I- or forced air gasr solar 1. example- 1250 sq. foot house, 500 sq. foot garage2. Example- JT-new project, check-i-ew - if additio;, check add, etc.F. Building permit information: - 1. -efglsl_g. - construct single fami)y house with an attached garage 2. example - remodel existing garage into family room3, example - convert single family residence into restaurant (change of use)G. Vaiue of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building 0ivision Staff must be able to contact appropriate persons regarding design information or job site corrections, etc.II. Abbreviated Piumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent, to the appropriate item(s) to be installedB. FulI Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF HILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor, The general contractor is not authorized' to sign the electrical label.III. Apglicant to sign and date I'lhenever possib)e, the initial application wil l be used asa worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for h.issignature.IV. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY )"eb-qo | 1801 Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY: Permit app'licant exempt from registration with the Builder's Board because: Addjtional Project Information: PLANS REVIEWED BY: name s i gnature date ?* €e { CITY OF SI'TIIN(;F!ELO 225 PIFTE STRBBT SPRTNGPTBLD, OREGON 97477 fNSPECTT0N REOIIBST: 726-3769 OPPICE: 726-3759 1. LOCATION OP IAGAL DBSCRIPTION Permlts are non-transferable and expireif vork ls not started wlthln 180 daysof lssuance or lf vork ls suspended for 180 days. 2. COIIMACTOR INSTAIJ,ATION OT{tI B. Electrlcal Contractor JKtr er*IzeiC rilC. Address 1\ S-7 l'ohr a) T Ct ty c DFui)Phone ']*b-qbg C Supervisor Llcense Number 3 f *& S Explration Date c Constr Contr. Number zo-zr-rC Expiratlon Date Slgnature of Supervlsing Electrlcian Ovners Name Address cl Phone OIINER INSTALIATION The installation ls belng,made on property I own vhich ls not lntendedfor sale, lease or rent. Oyners Slgnature: DATE: BIJCf,RICAL PERIIIT APPLICATION city Job N,,'b.. lu2gl3 3. COHPI,Ef,E TEE SCIIEDIIIJ BBLOI' A. New Resldentlal-Single or Multi-Family per dwelllng unlt. Servlce Included: Items Cost Sum 1500 sq;ft. or less Each additlonal 500 -sg. ft or portion thereof Each Manuf,d Home or -Hodular Dvelllng Service or Feeder $ 95.00 $ 15.00 $ 3s.00 Servlces or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: 100 amps or less -Z-101 amps to 400 amps _401 amps to 600 amps 601 amps to 1000 amps- 0ver 1000 amps/vo1ts -Reconnect Only $rs $60 $e0 $130 $3oo $3s $ 35.00 $ 40.00 $ 80.00 see trBtr Jfuo a55E 00 00 00 00 00 00 Temporary Services or Feeders Installation, Alteratlon or Relocatlon 200 amps or less 201 amps to 400 amps -over 401 to 600 amps -0ver 600 amps or 1000:6Es D. Branch Circuits Nev, Alteration or Extenslon Per Panel One Circuit Two to ten Clrcults Each Addtrl ten orportlon thereof E. Miscellaneous (Servlce/feeder not lncluded) -Each installatlon Pump or irrigation Sign/0utllne Llghting- Slgnal Clrcult or Iimited energy panel $ 36.00 siq= $ 35.00 $ 50.00 $ 1s.00 $ $ 00 00 36. 36 SUBTOTAL OP ABOVE 5Z State Surcharge TOTAL )" 7.f RECEIVED 5. sa-7s JOB DBSCRIPTION On lio-q L*T L.z[.,7,,'^;*