HomeMy WebLinkAboutPermit Building 1981-02-24NCIIFIED
CIIY OF SPNINGFIEI.D
COiIBINAIION APPTICATION/ PERIAII
INSPECIION TINE
726.3769 INFORMATION I.INE
72G3753
463 South 32nd Str eet
Lot 8 Gerle9 ol Dcscription Subdivi ton Woter Heoler
ENERGY
Heot
Daryl Al berts
Volue of Work:
41,969.14
Sg. Ftg. Accer:
Sq. Frg. Orher
l- New-ldd-Alter-Rep.
- Fence-Demo-Chonge/Use
-Other
Sq. Ftg. Moin
Addre:s 1432 North treet Phona
Building Permit lnfo:Describe Work (i SiBuild.e..ngle
S.F.RES., ATT GAR
Address Phone
@
oO!5
DESIGN TEAM (nome)(oddress)no.)(expires)no.)
Pri
Mechonicol
tte
Owner
Owner
E lectri col
lllechonicol
PI.UMBING ETECTRICAT MECHANICAL
FEE CHARGE NO,FEE CHARGE NO.FEE
Eoch single fixture 1 nlfgpe ot
--sq.
tt 15. 00 furnoce/burner lo
..-.BTU':
Relocotcd building
(new {ix. odditionol)
New circuits, olterolions
or extensions
Applionce vent
sepo rqle
1
S.F. Residcnce
(l bqlh)25.00 SERVTCES
Stotionory evop.
coo ler
Duplex (l both) eoch &Temporory Conslruction -ffi)2 Vent fqn with
single duct l. 00 6. 00
Additionol both Amps
-Vent syslem oport from
heoting or A.C.
Woler rervice 1
Mechonicol exhousl
fiood ond duct 4. 50
1 Sewer 10.00 Wood rtove/heoter
Slorm Sewer TEEOERS Heot Pump
Ampr.
Air hondler to
10,000 cFM
Air hondler over
10,000 crM
rssuANcE oF PERTA|T 10. 00
TOTAT CHARGE5 35.00 TOTAI. CHARGES 20.5035.00TOTAT CHARGES
WHERE STATE LAW REQUIRES rhot thc Electricol work be dom by lhe Elcctrical Controclor, thc elcclricol portion of this pcrmit rhall not bc volid untit c
tobcl hcr bcen rigncd by on Electricol Conlroctor ond orsched lo lhe eleclricol pcnel.
I HAVE CAREFU11Y EXAMINED the completed opplicotion for permil, ond do hereby certify ihol oll informqtion hereon is lrue ond correct, ond I further
certify thot ony ond oll work perforrcd sholl be done in occordonce with the Ordinonces of the City of Springfield ond the Lows of the Stote of Oregon
pertoining to tire work described herin, ond rhot NO OCCUPANCY will be mode of cny rtructure without the permission of the Building Division, I further
cerflfy thot my registrotion with rhe Builder's Boord ir in full force ond effect os required by ORS 701.055, thot if exempt the bosis for exemplion is noted
heron, ond thot only subcontroctors ond enrployees who ore in omplionce with ORS 701.055 will be ued on lhis proiect.
SIGNATUREA 3;*,,-o /(//-,t k DATE 2=14 ,rtBosir for Builder's Boord exemption:
NAME (pleo:e
FOR OFFICE USE ONTY
ll,ll3: f;:"W:rffi;:
--4I;669;T4
1 37 .354.27
4,5L4.87ToneType/Const.
Bedrooms
TOTAT VAI.UATION
Llll,s lue
lue
5q. Fig. Other-x-[qlqe
628.04Systems Development
Chorqe (1.5%)
Plon Ck. Comm/lnd
65%/Blds Per tee
Plon Ck. Res
3,o/"lBld,s Pet tee PAtD 2-4-81
BUITDING PERMIT
Chorges ond
Surchorges
163. 00
6.52
aTemp Labe'l
Fe nce
Totol Comb- PermitDemo
PTUMBING PERMIT
Chorger ond
Surchorges
35.00----1-.4I-
7.76sidewolk 77 .6
A/c Povino
Chorger ond
5u rcho rge s
&5.00----1160
PERMIT
11-80Curb Cut 18'TOTAT 'ffiChorge: ond
Surchorger
__lpJ0__
.82
MECHANICAT PERMIT
T
)a1 2i
qml
,.=. --, \'
CoMBINAILON APPIICATION/PERMlr (CAP)
l. Applicont to furnish
A. Job Address
E. Squ ore foologe or voluotion, etc.
l. exom le-l250 sq. foot house,
proiect, check
500 sq.
new-if2. exom new
etc,
oF SPRINGFIELD C
CitY Holl
'"Hi1r',ti^'i '-:,1*1" -Fnn
(
No. B 55895r
PERMIT VALIDATION
O SIGNATURE
. EUGERG oF 97'01
B. legol DescriPtion
i-".ro-ot"jtox lot I00, Lone County Mop Reference l7 03 43
2. e FE-Lot I ' Block 3, 2nd Addition to Spring{;olA F"^'';
C. No-llt. of owner ond construction lender ( L
D. EnerqY Sources
l. eiomple-tteot /qlecl[col Sili!g /or forced oir g<
2. exomple-woter heoter/electricol,'or solor
ITY
foot goro,
oddition, c
(
{
F. Building permit informotion:
l. exomple-construct single fomily house with on o
goroge i'?
2. ;;";;.-remodel existing goroge into fomily ror 1"
3. exfiFla-convert single fomily residence into
iEliEuT6'nt (chonge of use)
G. Volue of work os defined in Section 303 (o) of rhe f
Structurol SPecioltY Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Divi (
Stoff must be oble lo conloct oppropriote Persons re(
design informotion or iob site corrections, etc'
ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedule
A. Except where blonk spoces occur in the description p<
of the Mechonicol ond Electricol Schedules, the opplic
need fill-in only the No. Boxes odiocent to the opprop
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division
l. To conserve sPoce on the permit form the scheduler
hove been obbrevioted
2. lf the item(s) to be instolled ore not covered on the
. oted schedules you should consult. rhe full schedulel
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AN
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 Sroff wil
prepctre o typewritten coPy ond relurn it to the oppliconl o
the time the octuol permit is issued for his signoture.
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SXELION'TURIBULL PFINIEiS
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of the opp {tirqnd no plons will be processed until these fees ore poid. Al,
other fees ond chorges ore due ond poyoble when the pernk
is issued.
V. FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
!
Additionol Proiect lnformotion:
.B
2-19-81sig nolure
')'o
dote
PLANS REVIEWED BY:
DAN SMI
l.r
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UNITED STATES POSTAL SERVICE
OFFICIAL BU$ilESS
RTBRN ?
;'\ililI I
IHE HAI
PENALTY FOR PRMATE
usE, gx,o
CITY OF SPRINGFIELD
DEPARTI\.IENT CF PUBLIC woRl(s
rr
SENDER rilSrRUCnOilS
tilnt lurr nrm, rddr.rt, .il a? cod. It tlr tFcl bdor.; Gowhb bI. t, 2, t. rrd a oll tl ttv.m.r Ath6t b troil c $ucr il $tc. grulb,ffiilt. ttrrb l|Ct dlltcl..
o Edcrr rltcl. "Rftrm R.Calrl Ra$mDd"
o tdFcatil b ilrmbar.
(Clty, State, and ZIP Code)
i
IELLI,I
(Street or P.O. Box)
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o SENoE8: Complsts items 1, 2, 3, and 4.
Add your address in lhs "REIURN T0"
space on reverso.
(coilsuLT msTftirsrEn FoB FEES)
L Tho tolloiyln0 sandco ls requostsd (chsck ono).
Ehtnow m whom and dara dsti\rored
D Sno* to *t *, dalo, and addrsss ot dollvery ..
e. D Resrnrcreo oELrvERY........
(Tfia |tstthiod delw la B chagdd ln &dttot,htit ntwtwAipttN.)
IOTAT
-3
-0
-Ci_
3. ARTICTE ADDRESSED TO:Ms. Loretta Boss
463 South 32nd Street
Sorinsfield. Oreson 97478
4. TYPE OF SERVICE:
D nrorsrenro
ElesnnReo
f]upRess unl
Irrsuneo
flcoc
ARIICLE NUMEER
1 8286908s
(Always obtaln slgnature 0t sddressso 0r sg0nl)
I hav6 recsived lha articlo dsscribed abovg.
Addressoo Dfuthortredagent
#,
OF
0ll
5.
f-r -Fr
6. A0oRESSEE'S Ao0RESS forry fl
7. UNABLE TO OELIVER BECAUSE:TraEUlLoYEFSlMs,lc-*
QGPO:198237$5e3