HomeMy WebLinkAboutPermit Building 1982-02-22I
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INSPECTION TINE
72&.3769
INFORMATION ttNE
72C3753
CITY OT SPR]NGFIEID
CO TBINATION APPTTCAIION / PERTIIIT
Job Address 299 N. 5th Street
Legol Descriptio" Aq npr tra<Ampnf orantCd hV f-he
El ectri cWoler Heoler
Ronge
ENERGY SOURCESIx.ot F I ect ri c
Owner
Volue of Work:
$129.945.00
Sq. Ftg. Moin
sq. Fts. A€ce33. 50 sq - ft-
-Add-Alter-Rep.
-Fencc-Demo-Chonge/
Use
-Other
-
OtherSq. Ftg.
X x"*
P.0. Box 2710Address Phone 687- 5581 Building Permit lnfo: Describe Work (i.e., Build Single
Fomily Residencc With Aloched Gorose)
Eugene, 0R RIri'lrl Tnanci+ cha'l+anc *ai'la* a*q,a*q..*a.
Conslruclion Lender and related site improvements
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Address Phone
(nome)(oddress)(lics. no.)(expires)(phone no,)DESIGN TEAM
Structurol
Electricol
/v{echo nico I
CoNTRACTORS_ tS.4 (oddrers)(lics. no.)(expires)(phone no.)
Plum
Electricol
Atechonicol
PTUMBING ETECTRICAT MECHANICAL
NO.FEE CHARGE NO.FEE CHARGE NO.FEE CHARGE
?Eoch sinqle fixture Enn 1A nn
Residence of
ft.
furnoce/burner to
--BTU'S
Relocoled building
(new fix. odditionol)
New circuits, olterolions
or extensions
Applionce vent
sepqrole
S.F. Residence
(l both)SERVICES
Stotionory evop.
cooler
Duplex (l both) eoch 1 Temporory Conslruclion 1n nn 1
Veni fon with
sinqle duct 3.00
Addirionol bolh Amps. l nn 1tr nn
Venl 3yslem oport from
heotinq or A.C.
1 Wqler servica 10-0n
Mechonicol exhoust
hood ond duct
1 Sewer 125 1-f-25 00 Wood siove/heoter
1 Storm Sewer 1l( 'l f 16 nO FEEDERS Heol Pump
1 Pl ant-i no sDri nk trr Ampr.
Air hondler to
10,000 cFA{
s ys tem 5.00
Air hondler over
10,000 cFA^
rssuANcE oF PERMTT 10. 00
TOTAT CHARGES 70. 00 TOTAT CHARGES ?5-(n TOTAT CHARGES 13.00
WHERE STATE tAW REQUIRES thot thc Elcctricol work ba donc by rh. Eleclri€ol Conlrsclor, lhc rlcctricol portion of this p.rmit choll not bc votid untit o
lqbcl hor been rigned by on Elcctricol Controctor cnd ofiochcd to the electritol ponel,
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Bosis for Builder's Boord exemption:
NAME (pleo:e
toR
x Volue
x
-[qlyg
x
-[qlss
TOTAT VAI.UATION,
m
$12s-34s.0-o
N
Flood Ploin Group
Fire Zone
Zone co.rr. V-N unirs NA sq. trg. Moin
Bedroom, NA occy lood Sq, ttg. Access
Ftg. Orher-.--
Plon Ck. Comm/lnd
55%/Bldq Per fee 215.80 s Development
(1 .5o/o\
Syslem
Chorqe St -qaq rR_332.00
13.28
BUITDING PERMIT
Chorges ond
Surchorges Plon Ck. Res
3o%/Bldg Per fee
FenceChorges ond
Surchorges
PTUMBING PERMIT
70. 00
Demo Totol Comb. Permit Arl1 ,)a
??, 72
EI-ECTRICAT PERMIT
25.00Chorger ond
Surchorges
Sidcwolk 2Q1 1 C'r)!-L. l-
A/C Povino
Curb Cut
TOTAT -
.$2 .656 . 30
MECHANICAT PERMIT
Chorges ond
Surchorges ___ 13=_09_
.52
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I HAYE CAREFULTY EXAMINED rhe ompleted opplicotion for permit, ond do hereby cerlify thot oll informotion hereon is true ond correct, ond I further
certify thot ony ond oll work performed sholl be done in qccordonce with the Ordinonces of fha City of Springfield ond the lows of the Stote of Oregon
perfqining to the work described herin, ond rhot NO OCCUPANCY will be mode of ony:tructure withoul the permission of rhe Building Division. I furtherertlfy thot my registrolion with the Builder's Boord ir in full lorce qnd effect os required by ORS 701.055, thot if exempt the bosis. for exemption is nohd
heron. ond thot only subcontroctors ond employees who qre in compliono wirh ORS 70t.055 will be used on this proiect.
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coMBINAT|ON APPLTCATION/PERMIT (CAP)
l. Applicont to furnish
A. Job Address
B. tegol Description
l.-exomple-tox lot 100, Lone County Mop Refere-nce.
2. exfiple--Lot l. Block 3,2nd Addition to Springfield
C. No-", "r. of owner ond construction lender
PFPMIT VALIDATION
OF SPRINGFIELD
Ciry Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAT RECEIPT
N B 58097
C ITY
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D. Enerov Sources
l. eiomple-heol,/electricol ceiling/or forced oir gos
z. . rffi -w o re rT e o le-rl-6lEZTrko l,' o il
Squore footoge or voluotion, etc.
I. exomple-1 250 sq. foot house, 500 sq'
2. eEmFiE-iTnew proiecl, check new-if
odd, etc.
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,ini
{n
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foot goroge
oddilion, chet
F. Building permit informotion:
l. exoirPle'conslruct single fomily house with on olto
goroge
Z. Jxo.plu-remodel exisling goroge into fomily room
3. exom-F]-e-converl single fomily residence inlo
re-li6u6nt (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Struclurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construclion deloys, Building Divisi
Stoff must be oble lo contqcl oppropriote Persons reg(
design informotion or iob site corrections, etc'
tl. Abbrevioted Plumbing, Mechonicol & Electricol Schedules
A. Except where blonk spoces occur in the description po
of the Mechonicol ond Eleclricol Schedules, the opplicr
need fill-in only the No. Boxes odiocent to the opprop
item(s) to be instolled
B. Full Ptumbing, Mechonicol, ond Electricol Schedules
qre ovoiloble ot the Building Division
I. 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
oled sohedules you should consult rhe full schedule
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A}
CHARGES ON THE SCHEDUTES fu l
Rece
Amounl Received
BY
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lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot lhe time of lhe opplicotion,
ond no plons will be processed until these.fees ore poid' All
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other fees ond chorges ore due ond poyoble when the permit
is issued.
V. FOR OFFICE USE ONLY
-;Z;;H,E; ffi
SHELTOi.TURNAULL PR!XTERS - EUGENE OR 9"OI 364Ir-A
Permit Clerk
rllll. Applicont fo sign ond dote
Whenever possible, the initiol opplicotion will be used os
worksheet only. Where possible, Building Division Stoff v+-
prepore o lypewritten coPy ond relurn jt to the opplicont'o'
ih"'ti-. the octuol permit is issued for his signolure'
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PROJECT CONDITTONS rO BE SATISFIED BEFORE OCCUPANCYT
shal I
Additional Proiect lnformotion:
PLANS REVIEWED BY:
12- 15- 81dote
nome Lorne Pl eger signolure
(