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Home My WebLink AboutPermit Building 1982-01-11INSPECIION IINE 1763769 CITY OF SPRINGFIETD COMBINAIICN APPI.ICAIION / PERIAIT INfORIAATION TINE 72&3753 2 00 .lob Addrerrt 1n field,0R T-l- 34Lesol Descriptio" 17 -O2-31 -4 Sq. ttg. Other -New_-Add X Alte.-Rep. - -Fence-Demo-Chongel Ure $15,000.00 -Other ec r c Ro ENERGY SOURCES: Volue of Work: Heo I Woter Heoler Sq. ftg. Acceir. Sq. Itg. Moin Wavne D. Cohen & Glen GoodwinOwner Building Permit lnfo: Dercribe Work (i.e.,8uild Single Fomily Re:idence With Attoched GoloSgI-Ph.^. 683-4455Addrer: Al terLender @ O(Jl (^)(rl Addrerr Phone (phone no.)(lics. no.)(expires)DESIGN TEAM (no me)(oddress) Primory OWnef Slructurol Electricol ne no.)( nome) I ACTORS Generoi 0wner Plumbinq OWnef MECHANICAT ARGFCHARGE ETECTRICAT FEENO.CHARGE r t Fat PLUMBINC E lectrico I Mechonicol OWn furnoce/burner !o --BTU'S Residence oi sq. ft.Eoch :ingie fixture 15.00 Applionce vent 5epo rote2 New circuilr, olleroiiors ot extensrcn! Relocarcd building (new {ix. odditionol) Stotionory evop coole;25. 00 SERVICESx S.F. Reriden5e (l both) 2 Vent fqn with sinqie duct 3.00 6. 00Temporory ConstructionDuolex (l both) eoch I Vent syslem oport from heqtino or A.C.Ampr.Aciditionol bolh i 1 Mechonicol exhousl hood ond duct 4- 50Worer rervice Wood stove/heoter1n oo,l Sewer Heot PumpFEED E RSSlor.m Sewer I Air hondler ro I0,000 cF.tiAmpr. Air hqndler over r0,000 crM tssuANcE oF PERMTT 10. 00 WHERE STATE LAW REOUIRES rhor the Elactricol work bc done by the Elcrlricol Contro lobal hor bccn :igned by on Elactritot Controclor ond attoched to thc oleclricol ponel. I HAYE CAREtUtty EXA,,{INED tha compleied opplicotion for permit, ond do hereby cerlify thot. oll informotion hereon is lrue ond correcl, ond I furthar certify thot ony ond oll work perforrej sholl ba donc in ocrcrdonce with the ordinoncer of the city of springfield ond the Lows of the stote of oregon pertoining to tire work described herin, ond rhgl No occuPANcY will bc mode of ony structure withoui lhe permission of lha Building Division. I further cartify th-ot my regirtrorion with the guilder,s Boord is in full force ond effect os required by oRS 70t.055, thot if exempl the bosis for exemption is noted heron, cnd thot only rubontroclors ond employec: who ore in omplionce wirh oRS 701.055 will be u*d on lhir proiect. Borir for Builder's Boord excmplion! const.-ll=-N--Unitr L sq' Fts. MoinP.lR1 cor, tha clectricol porlion of this pcrmit rholl not bc vqlid until o Zone Sq. Fig. Access FOR OfTICE U5E ONI.Y SIGNATURE Flcod Ploin ----I--5torie F ire Bedrooms NAA{E (pleose print)E- ar r^..t TOTAT VAIUATION TOIAI CHARGESTOTAI. CHARGESIOTAI. CHARGES Lood- Grorp R3 Sq. Frg. Other-- . Yolue x Vo lue a -Volue 35. 00 Choroe ( I .59',") Sy5rems DevelopmenlPlon Ck. Comm/lnd 65"/6/Blclo Per Fee ,1 An21 50 Drre Plon Ck. Rer 30o,1,/Bldg Per Fee BUITDING PERMIT Chorger ond Surchorges Fe nce 1 48. 20fofol Comb. PmilDemo --35-00- 1 -40 PTUMBING PERMIT Chorges ond Surchorges Sidewoik A/C Povinq ELECTRICAL PERMIT Chorger ond Surchorger 60 _15-00- Curb Cut TOTAL I I __20-50_ 92 MECHANICAI. PERMIT Chorger ond Surchorger Single Fami]y Residence, Remodel &Eugene, Oregon FiE NO.N.)r 20.5015. 00 ql 0.. -A.F,-,Q.- ' oo* t - lt-.ga t1 ^o on ' CoMBINAT|ON AppLtcATtoNipERMtT (CAp) l. Applicoru ro furnish A. Job Address B. Legol Descriprion l. exomple-rox lot I00, Lone County Mop Reference lZ 03 43 2. exompie-Lot l. Block 3,2nd Addition to Springfield Estotes C. Nome, etc. of owner ond construction lender D. Energy Sources l. exomple-heot/e_!ec!!icol S.eiling /or forced oir gosz. exomole-worer heoter electricol,,,or solor E. Sqro.. fioroge or rrolrotioilf,]- l. exomple-I_250 sq. foot house, 500 sq. foot goroge 2. exo-FlE-iT;& proiecr, check nEi-ii oddiiion, cieck odd, etc. F, Building permit informotion: L exomple-construct single fomily house with on oltoched goroge 2. exomple-remodel existing goroge inlo fomily room3. dE;Fie-converr single fomily residence inlo restouront (chonge of use) G. Volue of work os defined in Secrion 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Division Stoff must be oble to contoc, opproprioie persons regording design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules A. Except where blcnk spoces occur in the description porlion. of the Mechonicol ond Electricol Schedules, the oppiicont need fill-in only rhe No. Boxes odiccent to the oppropriote item(s) ro be insrolled 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 irem(s) to be insrolled ore not ccvered on the obbrevi-. oted schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILt OUT ALL FEES AND CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the iniiiol opplicotion will be used os o worksheet only. Where possible, Building Division Sroff will prepore o typewritten copy ond return it to the opplicont ol the time the octuol permit is issued for his signoture. lV. Fees ond Chorges Plon check fees ore due ond poyoble ot lhe time of the opplicotion, ond no plons will be processed until these fees qre poid. All other fees ond chorges ore due ond poyoble when lhe permit is issued. V. FOR OFFICE USE ONLY TFRMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO 8E SATTSFIED BEFORE OCCUpANCyT Additionol Proiect lnformorion: PLANS REVIEWED BY: nclme signoture dote 8 3\8\ INSPECITON tINE 72&3769 CIIY Of SPRINGFIETD COMEINATTCN APPI.ICATION / PENMII INFOPMAIION tINE 72&7753 co O(JI u)(rl ENER,GY SOURCES: ec c -Other Ro e Heo t Woter HeoleJ Sq. ttg. Acc85r. 5q. ttg. Moin Sq. ttg. Other -New.--Add LAlret-R.P. -.- -f eocc-Demo-Chonge/ UreVolue of Work: $15,000.00& Glen GoodwinOwner Euildinq Permit lnfo, $/irh AttoFo mi Dercribe Work (i.o.,Build Single 3-44PhoneAddrerr nd ernttt PhoneAddrcr r res)(phonc no.(lics. rio.)(oddres:)DESIGN TEAM (nome) Prim r lectricol Mechonicol ne no RACTORS no(o E lectrico I r ETECTRICAT A,TECHANICAL rMechonicol 0W FEE CHA PTUMBING CHARGENo.Nr (1E furnoce/'burner toResidence oi fr,{ixturcEo <h Applionce vent te15.002 New circuitr, qlteroliorrr or extensicnl Relocorcd building lix. odciiriono Stotionor; evop. cooler5. 00 SERVICES 5.F, Reridenge I both) 3.00 6. 002TeCon!lruclionI both) eochDuolex Vent iyslem oport from or A.C. !r ie duct Vent fqrr with AmA<iditionol both I I Mechonicol exhov:l hood ond duaWo ter rervicc IheoterWood TEED ERSScwer Air hondler ro F,flAm Air hondler over I CFM tssuANcE oF PERMTT 10.00 TOTAT CHARGES 15.0IOIAT CHARGES 35. 00 ,ALTOI RGECHA validbc unril olharhisof:holl notrtriE!e Conlrocror.parmit<olbcdcncthe porlionorklhcthotElcctricolbyEWHERA5r,IA REOUIRESIE to thc olclectricondntro(tor ottochcd Pqnrl.ned Eloctricoon Coho:lobel bccn rig by I HAVE CAgEtUtty EXAA{tNED rhe ompleied opplicotion for permit, ond do hereby certify thot- oll infomolion hereon ir true ond correct, ond cc?tify thot ony ond oll work p".for..j sholl be donc in o..ordor* with the Ordinonces of the City of Springfield cnd lhe Lows of the Slote o p.rioini.g ro ric work dercribeci herin, ond rhqt No occupANcy will be mode of ony srructure without lhe pcrmisrion of rhe Building Divi:ion. ertify thot my.egistrotion with the Builder'r Boord is in full force ond effcct os required by ORS 701.055. thot if exempl the bosir for exemption heron, ond thot only rvbonrroclors ond employees who ore in omplionce with oRS 701.055 will be uscd on lhir proiect' I further f Oregon I further is noted Eorir for Buildar's 8oord cxemption: t - tr-DATESIGNATU.RE 9l_pG.l outu.: i N\NAA{E (pleore prinr)C \u- - ,.1 -A**-Q* FOR OrrlcE usE oNtY V-N unitr 1 5q' Fts. Moin - x ------Yoluex Vo lue 1-Volue TOTAT VAIUATION,Flood Ploin zonr R 1 Type/Conrt. Fire Zona+Eedroomr Loqd --5q. iig. Accesr Grorp R3 ss. Fts. orher Systemt Developmeni c Plon Ck. Com-/lnd Per Fee 309',.1 Per Fee Plon Ck. Rer BUII,DING PERMIT Chorger ond Surchorger __12-0L___ nca 48.20Tolol Comb. PermitDemo _35-00.-PTUMBING PER,I^IT Chorger ond 5 urcho rg e r Sidewolk ELECTRICAT PERMIT Chorger ond Surchorger 60 __L5*00--- Curb Cut TOTAL MECHANICAT PERA\IT Chorgcr ond S urcho rge s 20-50_ r"u naa.",, 265 South 38th St. Spri ngf i el d , 0R n)-?1-L1 T I 3400Leqol Dercriptio^ 17 - clcctricsl coMBtNAT|ON AppLtcATtoN/pERMlT (CAp) l. Applicoru ro furnish A. Job Address B. Legol Description I. exomple-rox lot I00, Lone County Mop Referenc2. exompie-Lot l. Block 3, 2nd Addition to Springfie C. Nome, etc. of owner ond construclion lender D.. Energy Sources PLANS REVIEWED BY: I CITY CF^SPRINGFIELD Ciry Holt _ Springfield, OregonDeportment of public WorksOFFICIAI. RECEIPT ( ( 6 t\No. B 57851 l. exomole-heot/electricol ceilinc/or forced oir oos - z. exomote-woter heoter, electricol,,'or solor I. exomple-l ?50 sq. foot house, 500 sq. foot gorog.2. eEmilE - iT;;w p r o i e c r, c h e c k iew - i i q d d i r io.,,J odd, etc. F. Building permit informotion: I. exomple-construct single fomily house with on o.goroge 2. exomple-remodel existing gorqge inlo forriily ror3. exompG-convert single fomily residence into restouront (chonge of use) G. Volue 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 Di, Stoff musr be oble to contoct oppropriole p"r.Jn, .design informotion or iob site corrections, etc. ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedr. A. Except where blcnk spoces occur in the description. of the Mechonicol ond Electricol Schedules. the oor -,need fill-in only rhe No. Boxes odiacent to the opp Qi, irem(s) to be insrolled B. Full Plumbing, Mechonicol, ond Electricol Schedule ore ovoiloble or rhe Building Division (I. To cons.erve spoce on the permit form the schec hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on z t. oted schedules you should consult the full scher L C. BUILDING DIVISION STAFF WILL FILL OUT AtT FEE: CHARGES ON THE SCHEDULES Itl. Applicont to sign onci dote ( Whenever possible. the iniriol opplicoiion will be ,r.ho. o worksheet only. Where possible, Building Division Stoff will prepore o typewritten copy ond return it to the opplicont ot lhe lime the octuol permit is issued for his signoture. lV. Fees ond Chorges For: Recei ved L, AUIHORTZEOsHtLTOt.tuFt!uL! ritxTEis . SIGNATURE auoErE oi 0taot o I L{ ( ( o/( BY ( la!t t. c ( Plon check fees ore due ond poyoble ot the time of the opplicotion, ond no plons will be processed until these fees ore poid. Alt other fees ond chorges ore due ond poyoble when ihe permit is issued. V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect tnformsrion: nome signolure n dote 8,)\ 8\ ( ( ( INSPECTION LIi{E 7 25-37 69 YITJR CITY DSIGOJB JOB IIIJBER IS: -REOU I RED I iISPICI I OIIS - INSPECTIOii PROCEOURE FOR THE CITY OF SPRII{GFIELD BUILDIIiG DIVISIO|{ 346 MAIN STREET Y/o 53s I NFORMAT I OII L II{E 7?6-3753 The fol lowing indicated inspections are required for your constru ct;on at26€so. 38* sn Itistheresponsibi1.ityofthepermitholdertoseethata1linspections-@meltnateatnar]orG_ii readable from the street, and that the permit card is Iocated at the front of the property. zuIL.D II{G IIISPECJ'iO^IS : SITE IIISPECTI0N: To be made af tea excavacro-on, but prior to set- up of forms UNDERSLAE PLU}IBIiIG, ELECTRICAL & l'ltCilA',1 I CiL: Io oe maoe oerore any ffi?[-l s-co-vered F00TING & FOUj'{OATIOil: To be maoe after trenches are excavated ' and forr,rs are erected, but prior to pouring concrete UNDERFLCOR PLUIIEII.iG E TlECHANICAL: of floor insuiation or decking or decki r:g RCUGH PLUI'IB II'IG ELECTRICAL & IlECH- intlT-these inspections have been made and approved INSULATION/VAPOR BARRIER INSPEC- -tl6i'and required vapor barriers arein place but before any lath, gypsum board or wall coverinq is applied, and before any insulation is con- W00DSTOVES: After installation is comFletea- SPECIAL ItISPECTI0IIS: l.lhen re- qui red'-6y Eu i l aing Code, spgq i 6 l inspector to be present when workis in progress, A copy of the special testing report to be furnished to the Buiiding Divisiori Structural Concrete: In excess of 3000 P.s"I.. Structural l,/elds: Performed on the job . Glu-Lam Beams: Inspection certificate (by approved agency) supplied to Eujl<i ing Division befo:"e beams are placed Fire Retardant Roofing: Before Instal lation *0THER INSPECTIONST May be requireci in accordance with Building Code, to be indicated in plans or by notice from Building Inspector DRY|./ALL INSPECTI0II : after aii drywail iprior to any taping l,1AS0NRY: Stee Gifril-grout in cordance with To be made s in place, but ocation, bond r verticals in ac- .C. Section 2415 lt g0 u.8 Wrost & BE.\Y: To be made prior to lnsEal latton ot tl00r lnsulaf,l0n Prior to placing fac- als and before frariiilg FIRE & SEPARATIOII IIALL: Located & constructed'accord'ing to plans ATIIC DRAFT STOPS R00F SHEATHING AilD l'IAILING: Prior to insEal ling any rooring SIDEI{ALK & DRIVE'/IAY: Required fbr eTT coffeTE pavlnq with'in street right-of-r'ray, to be nade after al I excavating complete & form'work & sub-base material in Place CURB AND APPROACH APR0N: After @iorto.pour- ing concrete F 1 R EPLACi: ln9 i.laLLrr tion FRAlillNG IllSPECTIOil: lvlust be re- quEsC?-TLer approval of rough plumbing, electrical & mechanical. A11 roofing, bracing & chimneys, etc must be completed. No work is to be concealed until this inspection has been made and aooroved -- Wtrura. wATER & DRAIuAGE LINES:t-.ffi ff rr'ro, ELE'TRICALFINAL PLUi.lB ING FINAL MECHANICAL FINAL FIRE DEPARTMENT All project conditions, such as the insta'llation of street trees, completion of the required landscaping, etc., must be satisfied before the BUILDING FINAL can be requested Construction projects that required approval by the City's Site PIan Review Board shall be inspected by the Review Board before .equ"riini a final buiiding inspection.- Requests for inspection by the Site Plan Review Board must be made 2 days in advance of the date you wish inspection. ffi*, BUrLDr,rG: I5r::li:,1,;lll,g.:1,;:;1,::0.:il.li.[]0,.,r.0 arter the Finar prumbine, Erectrica'r, and Mechanica'r No occupancy of CERTlFICATE OF Si gnature ICIBII.I premi ses ANCY HAS an be EEN i de ED ma unti'l the Final Building Inspection has been made and approved, and a BY THE BUILDING DIVISION AND POSTED ON THE PREMISES. Phone: ; ?r< j )o11 _oate:(t- 8 flfiffi-Your Job # is:Your Job # is Bl ocki nglSetup Connecti ons l.la te r Electrica l Connection From Service to Mobile Home Electrical Service Pedistal Accessory Building - May require Inspection as Buildings - See Build- ino'Insoections Above Final - After Porches, Skirting, Decks, etc, are completed 9na tu re 5r gnature BUILDIIIG DIVISIOI,i APPROVED PLANS SHALL REI,IAIII ON THE BUILDIIIG SITE AT ALL TIMES, ATID ALL I.IORK I'IUST BE COi'IPLETEO IN ACCCRDAiICE I,IITH THOSE APPROVED PLA|IS. Alt manholes and cleanouts are to be adiusted at no cost to the City. d ng an Pl umbi Sewer Da te pROCEOURE FpR INSpECTI0I RTQUEST - Call 726-3769 (recorder) state your City designated iob number, job address' type youwi1lbereadyforinspec{ion,contractorsor0wnersnameandphonenumbers. Requesls-received Uefore 7:00 a.m. will be made tie same day,-requests made ar-ter 7:00 a.m. will be made the next working day. Si te,/Locati on Footing or Method of Attachment El ectri ca l Qnoush Qrinat Final - After Instal lation is com- pl eted $lfitf$-Your Job # is: 5 r gna [ure Da te T tl tr tl n rl trtl il r Fence - llh.en Completed Demoiition - }lhen Completed uI] tl I u ilftl I o z 93 r ':h.,:,,:I e3 Eq?, ? ic e rrtztz autl ooZu)4t'-d z1 6vu,*"-B /ooo, o ... i 3a _@' E- cn tO, ,r 2,"3.v .,8t a o-e i2 ,e eo I @ t ' io. rd. ,A - -:\ SPRINGFIELD CITY OF SPRINGFIELD Department of Public Works December 14, 1985 CERTIFIED LETTER W.D. Cohen and G. Good 29464 Gimpl Hill Road Eugene, Oregon Dear Property Owners: The Springfield Buitding Code Administrative Code requires that, in order for a permit to rernain valid, construction work authorized by it must begin within I80 days from the date of purchase of the permit. If work is suspended or abandoned during the course of construction for a period exceeding 180-days, the permit will automatically expire. If a permit has expired and suspension and/or abandonment of work on a project has not exceeded one year, a permit to start or resume work may be purchased for one half the fee required for a comparable new permit, provided that no changes have been made in the original plans and/or specifications. If a permit has not yet expired and a permit holder anticipates the need for more time to begin construction work, the Superintendent of Building may choose to grant a one time extension of the permit not to exceed 180 days upon receipt from the permit holder of a written request explaining why the extension is necessary. The attached formindicates the rnost recent information in our records with regard to construction activity associated with your permit. Please advise this office of your intentions with regard to the permit by ten (10) days from the date of this letter. Please direct all inquiries to the Springfield Building Safety Division at 726-3753 Sincere lY' \)"^\-David J. Puent Building Inspector/Plans Examiner JP-.^$- th 225 North Sth Street a Springfield, Oregon 97 477 a 503/726-3753 \ JOB ADDRESS: 265 South g8th St JOB #: 810535 LAST ACTIVITY DATE:NO INSPECTION RECORDED:xx OTHER:Pr.ooressi insnections were condrrct bv this office- however-required insnections were ?e uested bv vou (see attached sheet) - CURRENT STATUS OF PENIIT: i VALID: Holever, your permit will expire on If you wish to request an ^-extension of your permit, please notify thisoffice in writing prior to the above mentioned date. XX EXPIRED: Your permit expired on l,larch 9, 1985 If you plan to start or resume work on the project, a new permit must be applied for. * *If the rrexpired'r box, above, is checked and we do not hear from 27. 1983 (ten (10) days from the date of this letter),files of all related infornation with regard to the permit. you by December we will clear our SPIlInIGFIELE, CI1Y OF SPRINGFIELD Department of Public Works December 14, 1985 CERTIFIED LETTER W.D. Cohen and G. Good 29464 Gimpt Hill Road Eugene, Oregon Dear Property Owners: The Springfield Building Code Administrative Code requires that, in order for a permit to relnain valid, construction work authorized by it rnust begin within 180 days from the date of purchase of the permit. If work is suspended or abandoned during the course of construction for a period exceeding 180-days, the permit will automatically expire. If a permit has expired and suspension and/or abandonment of work on a project has not exceeded one year, a permit to start or resume work may be purchased for one half the fee required for a comparable new permit, provided that no changes have been nade in the original plans and/or specifications. If a permit has not yet expired and a permit holder anticipates the need for more tirne to begin construction work, the Superintendent of Building may choose to grant a one time extension of the permit not to exceed 180 days upon receipt fron the permit holder of a written request explaining why the extension is necessary. The attached fornindicates the most recent information in our records with regard to construction activity associated with your pernit. Please advise this offi-ce of your intentions with regard to the perrnit by ten (10) days from the date of this letter. Please direct all inquiries to the Springfield Building Safety Division at 726-3753. Sincere tY' \) David J. Puent Building Inspector/P1ans Examiner th 225 North 5th Street a Springfield, Oregon 97 477 a 503/726-3753 JOB ADDRESS: 265 South i8th Street JOB #: 810535 LAST ACTIVITY DATE:N0 INSPECTION RECORDED: xx 0THER : Pro sres -s i ve i n sn tions were conducted bv this office.no required insnec-ti ons wer^e sted by vou (see attached sheetl - CURRENT STATUS OF PERtrIIT: _ "_VALID: However, your permit will expire on rf you wish to request an^-extension of your permit, please notify thisoffice in writing prior to the above mentioned date. XX EXPIRED: Your permit expired on l,larch 9 198 3 rf you plan to start or resume work on the project, a new permit must beapplied for. *If the 'rexpiredt' box, above, is checked and we do not hear from you by December 27 198 * ES all re at (ten (10) days from the date of this leinformation with regard to the permit. tter), we wi 11 clear our tIJ (, 'flIlJE 'Ite O SEI{DER: Complete items 1, 2,3, eN 4. Add yor address in the "RETURN TO".Tace on reverse. (coltsrrlT FoSf,tAsTER FoR FEE$ r. The following service is requesled (chech one). Qpto* to whom and date delivered E Sho* to whom, date, and address of delitery.. z. D RssrRtcrED DELIVERy (!he ratrictd delivery fee k charged in addition to the rctum receipt Jee) TOTAL -0--0 -0') g* 3. ART|CLE AOORESSEO TO: W.D. Cohen and G. Good 29464 Gimpl Fii1l Road Eugene,Oregon + TYPE OF SERVICE: flneersrenm l-'l E[qEurHED n flexpness rer-- I lnnclel"9963785 ilSURED coD (Ahys ottriln dgnature of addrsee oragent) SIGIIATURE D Addres"""El Authorized agent x article A AOOfiESSEEE (Only lbJ 7. UNABLE YO DEUYER SECAUSE:7a. 5. 15 s EIPIOYEES txrflArs ( SENOER Print ;i.rtr. Pl.,t,i bclor. UNITED STATES POSTAL oFFrclAL BUStltEss RETURN TO pentr#oi'ptrhre. ..--, UgE TO AVCID PAYIIEIIT oF PgSTAGE, E900 ? (Name of Sender) CITY OF SPRINGFIELD P 225 NORTH SPRINGFIELD, OREGON 974N (City, State, and ZIP Code) urd ZP Codc CITY OF SPRINGFIETD COMEINAIICN APPI,ICATION / PERMIT INFOPMAIION tINE 72L?753IN5PECTTON TINE t2&3769 NAA{E (pleose prinr) TOTAT CHARGES WHERE 5TATE LAW REOUIRES rhor the Eledricol work be done by the Elc.tricol conlrqcror, lha electricol portion of lhis permit :hall not bc yqlid until o lobel ho: bccn :igned by on Elocrricol Conlroctor ond ottoched to lhr rlectricol ponel. I HAVE CA.REFUtty EXAA INED the compleied opplicotion for permit. ond do hereby cerrify thot oll informoiion hereon is true ond correcl, ond I further <ertify thot ony ond oll work performed sholl be done in ocordonce with the Ordinonces of the City of Springfield ond the Lows of lhe Stote of Oregon pertoining ro ti,e work Cercriirci herin, ond rhot NO OCCUPANCY will be mode of ony rlruclure withoui the permission of lhe Building Divi:ion. I further ertify th-ot my regirtrotion wiih the Builder's Boord i: in full {orce ond effect os required by ORS 701.055, thot if exempt the bosis for exemption ir noted heron. ond rhot Jnly rub@nr.o€tors ond employeer who qre in emplionce with ORS 701.055 will be vsed on thir proieci. . i Bo:ir for Euilder'r Saord eremplionr C\E qq Go "o io SIGNATU.RE FOR OITICE UsE ONTY Typcl Conrt. V-N Unirr 1 Sq. Ftg. A{oin -tDATE Zone nl Fire Zone+Bedroom: Flood Ploin ----I---5torie BUITDING PERMIT 3horger ond iurchorger ILUTABING PERMIT ihorges ond urchorger LECTRICAL PERMII horger ond urchorger ECHANICAT PERAIT rorqel qnd rrcho rge: Lood --.:-Sq.G,orp R3 5o. x ----Voluex Yo lue x Volue TOTAT YATUATION. Fig. Accers Ftg. Other rln field,0R Legol Desoiptio" 17 -n2-71-41- T.l- 3400 Sq. Ftg. Accesr. Sq. trg. Other -New-Add X Alt.r-Rep. - --Fence--Demo-Chonge/ Use ENERGY SOURCES: Heot $15,000. 00 -Other ec r c Volue of Work: Woter Heo Sq. frg. Moin I en Goodwi n Dercribe Work 1i.e.,Buildinq Permit lnfo:Single WithPhoneB3-Addre:s o lJo(.'r(.)(rl PhoncAddrer (lic:. no.)DESIGN TEAM r)(nome) Mechonicol A^ECHANICAT FEE ARGFCHAC'-IARGE ETECTRICAT lE!NO.I r t Fi? PLUA{BING E lecirico I lr\e<honicol fvrnocefburner io ---BTU'S Residence oi - rq. flEoch rinqle {ixturc 1s.00 Appiionce vent sepqrote2 New circuils, olterqliorrr ot exiensicn! Relocqred building (new fix. odciirionol) Stotionory evop. cooler25. 00 SERVICES s.F (t Re rid e n9e both)x 6.002 Vent fqn with :inqie ducl 3. 00Temporory Con3tructionDuolex (l both) eoch I Vent system oport from heotinq or A.C.Amo:-Acidirionol both 1 Mechoniqol exhousl hood ond duct 4-50Wo ler lervice Wood slove/ heoterln nn15ewer Heot PumoFEED ERSSlor,m Scwer Air hqndler to I0,000 cr,riAmpr. Air hondler over t0,000 cFM lssuANcE of PERMTT 10. 00 TOTAT CHARGES 15.00TOTAT CHARGE5 35. 00 Syrtem! Development Chorqe ( I '59'") PIon Ck. Com-/lnd 6596i Blcls Per Fee 21 AO flr ra ?1 6n __72-AL___ 301L1 Per Fee Plon Ck. Res t Fence 148.20Tolol Comb. PermitDemo _35-00_- _l_5-00--- .60 C Sidewoik Curb Cut (1 60 Rn TOTAT_?0-10_-- Plumbino 0Wnef 20,50 2 R9, 1An I 9l o, ^-- COMBINATION APPLIC,ATIONz/PE. .lT (CAp) l. A,ppliconr to furnish A. Job Address B. Legol Descriprion I. exomple-tox lot ..l 00, Lone County Mop Referenc2. eIE.rGG-Lot I. Block 3, 2nd Addiion to Springfie C. Nome, etc, of owner ond construclion lender D. Energy Sources { CITY JF SPRINGFIETD Ciry Holl _ Springfield, OregonDeptrlment of public WorkrOFFICIAT RECEIPT ( ( ( t\No. B 57851 I. exomple-heot/electricol ceiling /or f orced oir gos Z. exomote-woler heoter. electricol;'Or solor --.:-E. Squore footoge qr voluotion, etc.l. exomole-1250 sq. foot house, 500 sg.2. elo m pE-if-iIw proi ect, .he.k -n"*-iiodd, etc. F. Building permit informotion: 'l . exomple-construct single fomily house with on o goroge 2. exomple-remodel existing goroge into forriily ror3. eiompie-convert single fomily residence into rcstouront (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structurol Speciolry Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction cieloys, Building Di. Stoff must be oble to contoc, oppropriote persons r design informction or iob sile corrections, etc. ll- Abbrevioted Plumbing. Mechonicol & Elecrricol Schedr- ( foot gorog oddition, cl ved o I t{ ( ( D(sc A. Except where blcnk spoces occur in the description of the Mechonicol ond Electricol Schedules, the opp ltneed fill-in only the No. Boxes cd[ccent to the opp L;, item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedule ore ovoiloble ot the tsuilding Division ( l. To conserve spoce on ,he permit form the schei hove been obbrevioted & Amou nt 2. lf the item(s) to be instolled ore not covered on f L. oted schedules you should consull the full scher r- -::--- C. BUILDING DIVISION STAFF WILL FILL OUT AIL FEE: ( CHARGES ON THE SCHEDULES {lll. Applicont to sign onci dote Whenever possible, the initiol opplicotion will be ,r"t-o. o worksheet only. Where possible, Building Division Stoff will prepore o typewritten copy ond return it to the opplicont ot the lime the octuol permit is issued for his signolure. lV. Fees ond Chorges Pton check fees ore due ond poyoble ot lhe time of the opplicolion, ond no plons will be processed until lhese fees ore poid. All other fees ond chorges ore due ond poyoble when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Proiect lnformotion: PLANS REVIEWED BY: h, AUTHORIZED SHEITOI.TURNgULL PRINI€RS. SICNATURE EUGENE OR '?.Ot t !as r t.6 ( Permit Clerk nqme signoture dote 8 3\ 8\ ( (..