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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 ( ( ( o .6() Db( \rl C (. ( ( 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 ( f