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HomeMy WebLinkAboutPermit Building 1981-05-15I q-ti ( INsPECTION IINE 7?t376i INFORMATION IINE 72U3753 CIIY OF SPRINGf IETD COMBINAIION APPTICATTON / PERI\,IIT 1981 North sth StreetJob Addrerr Ronge ENERGY SOURCES: Heot Woter Heoler - n? ?6 ?4 Tl 48tegol Descriptio " 17 -New-Add-Alter-RcP., --Fence-Demo-Chongc/Usa -Olher -_.=-.-_.--.=.- Sq. Fts. Moin :z38Sq, Ftg. Access, Sq. Ftg. Other Volue of Work: $1 ,213.80OwnerVirsiI Schulenberq Fomily Residence With Atloched GEroge) Building Permit lnfo: Describe Work (i.e.. Build Single Addresr 486 Lantana Street Phone 688-3874 Extend carDort and install new97 401Euqene, Oreqon 200 amp serviceConitruclion Lender PhoneAddress (odd ress)(lics. no.)DESIGN TEAM (expires)(nome) Sfructurol E lectri cq I Owner Mechonicol Electricol Mechonicol MECHANICALETECTRICATPTUMBING TEE CHARGENO.FEE CHARGENOFEECHARGENO. furnoce/burner lo -BTU'T Residence of -sq. ft.Eoch single fixfure Applionce vent seporq re New circuits, olterqtions or exlensions Relocoted building (new fix. odditionol) Stotionory evop. coo lerSERVICES S.F. Residence (l borh) Vent fon with single ductTemporory ConslruclionDuplex (l both) eoth 25. 00 Vent sysiem oport from heoting or A.C.i Amps. 200Additionol borh Mechcnicol exhousl hood ond ductWqler rervice Wood stove/ heoterSewer Heot PumpFEEDERSStorm Sewer Air hondler to r0,000 cFMAmps. Air hondler over 10,000 cFM ISSUANCE OT PERMIT IOTAT CHARGESTOTAT CHARGESTOTAT CHARGES I HAVE 5=DATE Plon Ck. Comm/lnd L.25 25. 00 b.nol u nlilvolid olhisolrhollalectricoltheConlroctot.portion parmitElcctricqlbedonetheElcctricolbythcREQUtAwlhotIRESSTAIEWHEREtheelectricoltoponel.ottochedondContlaclotElectricolonhoslsbclbeonbysigned furlhertsondlrueondollthotrmotioninfocorrect,hereonondtertifydoforherebythepermit,EXAMINED opplicotioncompleted of the oiStoteondtheLows OregonolncescilheofrhwithOrde:no ty Springf ieldocordoncenetndo furthertheDivision.without rhe of Buildingof5iruclurePermr3sronbeIdemoonyOCCUPNOANCY ts noiadifexembosisthefor70ORSexemptionthotored.055,ptfu ll ondforce effect requ!bytsBoordlnthewith will be onu sed thi sirh70roR5.055 proiect.toneorewhonIcomplond N,Ar\{E (pleose Print) D€Yelopment copi es Bosis for Builder's Zone Sq. Ftg. Moin Flood Ploin fire Zone .Type/ Consr. Per fee Plon Ck. Res Per Fee FOR OTFICE USE ONIY SIGNATURE heron, ond lhot cartlfy lhot mY BUITDING PERMIT Chorge: ond Surchorges ___ 13_-_00_ .5? , 5.10 vo1,. I --J---Volue x -Vqlue TOTAI, VATUATION. Lood -5q. Ftg. Access ororp M-1 Sq. Ftg. other- NA Bedrooms certify thoi onY perloining lo lhe .QO Tolol Comb. Permil PI.UMBING PERMIT Demo Chorger ond Surchorges ETECTRICAL PERMIT Chorges ond Surchorges __25-!0-- 1.00 Sidewolk Curb Cut MECHANICAT PERMIT Chorges ond Surchorges 4E.ffi(TOTAT r[il| ( work _D COMBINATION APPTICA RM|T (CAP) l. Applicont to furnish A. Job Address B. legol Description l. exomple-tox lot I00, Lone County Mop Reference 2. exomple-Lot I. Block 3,2nd Addition ro Springfielr C. Nome, etc. of owner ond construction lender D. Energy Sources l. exomple-heot,/electricol ceiling/or forced oir gos 2. e xo m, plE-w o te r T-EEre iTEIEiffio I /o r solE r ---i- E. Squore footoge or voluotion, elc.I. exomple-1250 sq. foot house,500 sq. foot goroge 2. exomFiE-iT-new proiecr, check-new-ii oddirion, iie odd, etc. F. Building permit informotion:l. exomple-construct single fomily house with on oltl gcrroge 2. exomple-remodel existing goroge into fomily roor 3. exornpl-e-convert single fomily residence inlo GiEITdnt (chonge of use) G. Volue of work os defined in Section 303 (o) of the Structurol Speciolty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction deloys, Building Divis Stoff must be oble to contocl oppropriote persons reg design informotion or iob site corrections, elc. !1. Abbrevioted Plumbing, Mechonicol & Electricol Schedule: A. Except where blonk spoces occur in the description p< of the Mechonicol ond Electricol Schedules, the oppiic need fill-in only the No. Boxes odiocent to rhe oppro; item(s) to be instolled B. Full Plumbing, Mechonicol, ond Electricol Schedules ore ovoiloble ot the Building Divisionl. To conserve spoce on the permit form the schedule hove been obbrevioted 2. lf the item(s) to be instolled ore not covered on the oted schedules you should consult the full schedulr C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A] CHARGES ON THE SCHEDULES lll. Applicont to sign ond dote Whenever possible, the initiol opplicotion will be used o: ( worksheet only. Where possible, Building Division Stoff \ \ prepore o. typewritten copy ond return it to the opplicont the time the octuol permit is issued for his signotuie. /. tV. Fees ond Chorge, \ Plon check fees ore due ond poyoble ot the time of the o!-prrcoond no plons will be processed until these fees ore poid. Xll ofher fees ond chorges ore due ond poyoble when ihe permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION CITY OF SPRINGFIELD City Holl Springfield. Oregon Deportrnent of Public Works OFFICIAI RECE!PT {\ ( ( B 56s07 CI (t () (t (t (t (t I9 'd From ( For: ( 11t( 6n ( ( ( .a (l aqb il BY Amount Received lron, Permit Clerk AUTBORIZED SIGNATURE ritNTfi3 - Euctxc oh tTaot !a!tt.a (r t, ..-tl,ld:l) qEo\. s-15-81sig nolunome dote PI.ANS REVIEWED BY: TOM SHEiRtsOi{ (l I