HomeMy WebLinkAboutPermit Building 1981-03-31It
I
T NOTE: HAVE ATTACIIED AGREEMENT SIGNED UPON ISSUANCE
26.50
Jort:IED *-7_-
MECHANICAL PERrrtlT
Chorger ond
Surcho rge r
CIIY OF SPRINGTIETD
COA{BINAIION APPTICAIION/ PERMII
INFORMATION tINE
7763753tNSPECItON tINE
72(-3769
Addresr 1963 7th Street
electrRq
ENERGY SOURCES:
Heot
woter Heoter elect#-C
L7-O3-26-L-3
Volue of Work:
47,302.45
LNew-Add Alrer-Rep.
Fence-Demo-Chonge/ Use
Other
Sq. FtE. Moin L27 4
Sq. Frg. Other
ttg. Access.5t),\
3ui
nce With Attoched Gor
Permit lnfo: Describe Work (i.e., Build Single
Single resid.ence a ttached
Dowers
ield 97 477
Consiruclion Lender
il Phone
Ore
Denton & Jud
@Ho
N)
rp
PhoneAdd ress
res)(lics. no (phone no.)DESIGN TEAM d rers)(nome)
DrawinP
Structuro I
Electrico I
Mechonicol
RS
nerol
Beaver
Electri co I
Mechonicol Dillbeck 4015 Mairt Street 7
MECHANICALELECTRICATPTUMBING
CHARGE NO.FEEFEECHARGENC.
furnoce/burner lo
,sResidence of
fr.t le fixtureEoch
00 3. 001Applionce ventNew circuiis, olterotions
or exlensions
Relocqted building
nerv fix. odditionol)
Stoiionory evop
coolerSERVICESI
S.F. Residence
00 3. 00010. o 1 Vent fon with
ductTemConslruclionDeoch
Vent syslem from
orLAdditionol borh IO
Mechonicol exhousl
Woler rervice
Sewer
.00 6. 001HeqiF EEDERSSlorm Sewer
I
Air hondler lo
Am
Air hondler over
I CFM
tssuANcE or pERMlr 10.00
TOTAT CHARGESTOTAT CHARGES 35.00$3s.TOTAT CHARGES
WHERE STAIE LAW REOUIRES rhar the Eledricol work bo donc by the Electri<sl Conrqclor,
lobel hor been signed by on Electricol Controctor ond ottochad to lhe cleclricol ponel.
the electricol portion of this permit rholl not bo volid unril o
I HAVE CAREFUtty EXAMINED rhe completed opplicotion for permit, ond do hereby cerlify thot. oll informotion hereon is lrue ond corect, ond I further
certify thot ony ond oll work p"rformej sholl be done in ocordonce with the ordinonces of the City of Springfield qnd the Lows of the Stote of Oregon
perto'ining to t'he work dercribed herin, ond thot NO OCCUPANCY will be mode of ony structure without the permission of the Building Division. I further
cerrify thot my registrotion wirh the Builder,s Boord is in full fore ond effect os required by ORS 701.055, lhot if exempt the bosis for exemption is noted
heron, ond thot o=nly subcontroctors ond employees who ore in complionce wirh ORS 701.055 will be used on this proiecr.
ATURE DATE Ih.\
Bosis for Builder's Bobrd exemption:
NA,lvtE (pleose print)
FOR OIFICE UsE ONIY
zone RA Type/const. V^N Units
Fire Zons --- Bedrooms J occy
Flood ploin nO Sbries 2 Occy Group---R.3-Sq. Ftg. Other-
T2L4
5I3L
Ftg. /vloin
-So.
Iood
a 3i - ?O vq1u" 4) rA)4-2O
TOTAT VATUATION
ftg. Access , 9-5O yo1r.
x
-Yolue
7 09.54Plon Ck. Comm/lnd
6591 Per Fee
s Development
Plon Ck. Res
34"/.Per Fee
181.00
7.24
Fence
Totol itDemo
BUITDING PERMIT
Chorges ond
Surchorges
ITPTUMBING
Chorges ond
Surchorges
35.00
1.
6. 00Sidewqlk 60 t
c
ELECTR!CAL PERM
Chorges ond
Surchorges
35.00
Curb Cut 18 t
$1,015. 94
r. 06
TOTAT
tl
I
coMBTNATTON APPLICATION/PERMIT (CAP)
l. Applicont to furnish
A. Job Address
B. Legol Description
I.-exompleilox lot 100, Lone County Mop Refere,nce l7
2. eEmFIE-Lot l. Block 3, 2nd Addition to Springfield Est
C. Nome, etc. of owner ond construction lender
D. Energy Sources
l. exomple-heot,/electricol ceiling/or forced oir gos
2. exo mFle-wo te rTEdte-ElEiiii-co I i or g
E. Squore footoge or voluolion, elc.
l. exomple-1 250 sq. fool house, 500 sq. foot goroge
2. exEmi-lE-i-f new proiect, checkiE-w-if oddition, check
odd, etc.
F. Building permil informolion:
l. exomple-conslruct single fomily house with on oltoche'
goroge
2. exomple-remodel existing gorctge into fomily room
3. dAmEfe-convert single fomily residence inlo
re-liEffint (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Slructurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Division
Stoff must be oble lo conloct oppropriole Persons regordi,
design informotion or job site corrections, etc.
ll. Abbrevioted Plumbing, Mechonicol & Electricol Schedules
A. Except where blonk spoces occur in the description portior
of the Mechonicol ond Electricol Schedules, the opplicont
need fill-in only the No. Boxes odiocent to the oppropriott
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ol the Building Division
.1. To conserve spoce on the permil form the schedules
hove been obbrevioted
2. lf the item(s) to be instolled ore not covered on the obh
oted schedules you should consult rhe full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
lll. Applicont to sign qnd dote
Whenever possible, the initiol opplicotion will be used os o
worksheet only. Where possible, Building Division Sroff will
prepore o typewritten copy ond relurn it to the opplicont ot
the time the octuol permit is issued for his signoture. +-
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the lime of the opplicotion,
ond no plons will be processed until these fees ore poid. All
other fees ond chorges ore due ond poyoble when the permit
is issued.
V. FOR OFFICE USE ONTY
PERMIT VALIDATION
CITY OF SPRINGFIETD
Ciry Holl
Springfield, Oregon
Deporlment of Public Work:
OFFICIAL RECEIPT
No. B 56562
Rec'd From
Address
Received For:
Amounl Received
D SIGNATURE
STELYOX.YUiNBULI PRITIERS -
'UG'XT
Oi I"OI
Permit Clerk
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PROJECT CONDIITONS TO BE SAIISFIED BEFORE OCCUPANCY:
t.
Improvement agreement for North 7th StreetAdditionol Proiect lnformoiion:
PTANS REVIEWED BY:
Tom Sheirbon 3-31-81
sig nolu re dotenome
CO
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