HomeMy WebLinkAboutPermit Building 1981-03-19---r
t.lcTlFlED
INSPECTION tINE
7263769
CITY Of SPIIINGFIETD
COMBTNATION APPTICAIION/PERMIT
INFOE^^ATION LINE
72C375'
rob Addresr 473 & 475 South 32nd Street
SO.IJSCES:t-tEN € RGY
Heot
Worer Heorer El gct
*";;" -
=i.et-GerrDe
L7 02 31 34 TL 2A06
-New -Add-Altcr-ReP.
-Fence-Demo-Chonge/
Urc
-
Other
-.....--
F t9Sq.
tSq.tg
Sq. Ftg. Olher
Volue of Work:
84 .613. 20e Dil beckLarr& Can
Describe Work (i.e', Build SingleBuilding Permit lnfo:
nce With AFomil47-Addre ss 4015 B Main Street Phone
Common wall dup'lex; att gar
cl
O
(o
Ot
PhoneAdd ress
no.)(oddress)DESIGN TEAM (nome)
no.)(ex
Electri col
lics.
Larry Dilbeck 40158 Main Street
treet4015C MainV & Pl Pl umb'inPlum
Elecrricol DaV
Mechonicol
MECHANICALETECTRICAIP[UMBING
NO.rEENO.FEE CHARGE
6. 00 12.00?
lot"lud5. 00 50.002fr.t2tF'"r
Eoch fi xture
o.
Applionce vent
rqreNEw circuits. olterolions
or extensionsRelocoted building
(new fix.Stotionory evoP.
coo lerSERVICESI
S.F. Reridence
?00 ?4-OAB
Vent fon with
le duct10.001ConstruclioneochxIX Vent syslem oPort from
ofAmt20. 0010. 0(,Z
Addirionol borh q004- 502
Mechonicol exhou3l
qnd
Servtce
ler10. 0(r20. 00Sewer2
H
FEEDERSStorm Sewer Air hondler to
Ampr.Air hondler over
I ctM
ISSUANCE OF PERMIT
exemplion:
SIGNATURE
I
c)DATE 4t
NAlv\E (Pleose Print)
Bosir for Builder's
55.00
permit sholl not bc vclid unril c
, irue ond correct, ond I further
the Lows of the Stote of Oregon
of the Building Division' I further
th. boti. for exemPtion is noled
FOR OTFICE USE.
x?n ils 5 7
Ftg.Sq
.Type/ Const.
Bedroomr
Flood Ploin
Fire Zone
Zone , 9.50 vot,.
1..__-Volue
TOTAT VATUATION,crorp R-3 sq' fls' other
Lood Sq' Ftg' Acces:
2System3 DeYeloPment
REC 5607977.10 Pd,3-18-8
83.24
Plon Ck. Comm/lnd
Fee
Plon Ck. Res
Fee
Demo
Sidewolk
BUITDING PERMIT
Chorges ond
Surchorges
PLUMBING PERMIT
Chorges ond
Surchorges
259. 00
---T0-6--
90. 00
----3-0--
60ane77 .10
CA n,
8.32
Totol Comb.
60. 00
----2:4V-A
2 -18"
Curb Cut
PERMII
Chorger ond
Surchorges
23.60 1,801.15
TOTALMECHANICAL PERMIT
Chorger ond
Surchorger
55. 00---2:2{-
Wood stove/
T^-* tr'l aa*
coMBtNAT|ON APPUCATTON/PERMTT (CAP)
r\n Nc
l. Applicont to furnish
A. Job Address
B. Legol DescriptionI. exomple-lox lot 100, Lone County Mop Reference I.7 03 43
2. exomple-Lot l. Block 3,2nd Addition lo Springfield _C. Nome, etc of owner ond construction lender (
D. Energy Sources
PERMIT VATIDATION
I. exomple-heot/electricol ceiling/or forced qir Eos2. exo mFlE- wo te r TEEGiEI-ea ri co I / "
r
-E. Squore footoge or voluotion, elc.L exomple-l 250 sq. foot house, 500 sq. foot goroge
2. exEmFle--iT;& proiect, "he.[ r.te,r-ii odditi-on, cie,., odd, etc.
F. Building permit informotion:I. exomple-construct single fomily house with on ottc
goroge
2. exomple-remodel existing goroge into fomily roon
3. @-convert single fomily residence into
i6lT6ffint (chonge of use)
G. Vqlue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To o-void design or construction deloys, Building Divir
Stoff must be oble to contoc, oppropriote p".ro-n, ,"g
design informotion or iob site iorreitions, etc.
ll. Abbrevioted Plumbing, Mechonicol & Elecrricot ScheduleA. Except where blonk spoces occur in the description p
of the Mechonicol ond Electricol Schedutes, the oppiineed fill-in only the No. Boxes odiocent to the opprc
item(s) to be insrolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Divisionl. To conserve spoce on the permit form the schedu
hove been obbrevioted2. lf rhe item(s) to be instolled ore not covered on tl
oted schedules you should consult rhe full schedrC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, the iniriol opplicotion will be usedworksheet only. Where possible, building Division Stofprepore o. typewritten copy ond relurn it to the opplic<the time fhe octuol permit is issued for his signotuie.
lV. Fees ond Chorges
Plon check fees ore due qnd poyoble ot the time of th, (,
o3d n9 plons will be processed until these fees ore pol_other fees ond chorges ore due ond poyoble when ihe permitis issued.
CITY OF SPRINGFIEID
Ciry Holl
_ Springfield, Oregon
Deportment of public WorksOFFICtAI. RECEIPT
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SXEI RIZEO SIGN TURE
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V. FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additionol Proiect lnformotion:
DUPLEXPLAi\NED FOR FUTURE ZERO LOT OI
PLANS REVIEWED BY:
nome
dote -813-1signolure
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