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HomeMy WebLinkAboutPermit Building 1982-06-16IIISPECTION LIIIE. 726-37 69 CITY OF SPRINGFiELD corlBI |IATI ot'l AppL i cATI0N/pERMII INFORI1AIION LIiiT 726-37 53 @f\)oOr Or! Job Address lll0 North l8th Street EIIERGY SOURCES Hea t l.Jater Heater Ranqe Sq. Fto. t'lain_ sq. Ftg. Access. -\*l5,8ffiiarm"- _Fence_Demo_Cha nge/ U se 0ther l-esa1 Description l7_03_25_34. 6g00 Va.l ue of l,Jork: $7 ,172.00OwnerDr. Clark W. Roeder Address I 7l 7 Centennial Bl vd. nnone/{g_g!!n In Desc i l,Iork .e. , Bui I Single G Remove a wall, alter and put in a bath Construction Lender with Z fixtures, put in a small storage Addres s Phone r00m DESIGN TEAI.I name 'ics. no.exoi res phone no Primary Darrel I 14. Wi I son Structura I ! E l ectri ca I l''lec ha n i ca I Darrel I M. l,Ji I son I71 7 Centenni a'l 584 10/1/82 ilza-ostg Electrical 3-Way Electric l'lechani ca I PLUI1B I NG ELECTR I CAL MECHANICAL I N0.FEE CHARGE NO FFF C HA ACF I't0 FFF CHARGF 2 Each single fixture 5 .00 I 0.00 Residence of SQ FT furnace/burner to BTU' s Relocated building (new fix. additional)2 New circuits alts. or extensions I5.00 Floor furnace and vent S. F. Residence(l bath)SERV I C ES Recessed wal I Soace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seoa ra te l,later servi ce Change in existing res'i dence Stati onar-v evap cool er Sewer multifamily,comrn. or Indust-rial 1 Vent fan with sinole duct 3. 00 Storm Sewer 0f s.Vent system apart from heatinq or A.C. c0r.1r.'!. / IND. FEEDERS Mechanical exhaust hood and duct Instal I /al terlrei ocatedistrib. feeders ['lood stove/heater 0f amp s. ISSUANCE 0F pFRr{IT I 0.00 TOTAL CHARGES 10.00 TOTAL CHARGES 1 5.00 TOTAL CHARGES 13.00 I./HERE shal I not STATE L.lN REQUiRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitbe valiC until the label has been signed by an Electrical Supervisor and returned to the Buildin! Division HAVE comp e ap r)ca t 'l o n fo r 0erm r t a nd do here b.y cert v that a I I n forma ti 0n hereon I t rueand correct, and I furth r cert I f_v t hat any and a1 tate of 0regon I trrO rk perfo rmed sha I I be do ne 1 n a ccordance wl th L he Ordi na nc es of the City be madeof Springfiof any stru Board is in only subcon e I d and the Laws of the Sut the permiss and effect as DC rta 'I n 1 n s to the wo r k de SC r 'I bed h ere 'I n and tha t NC OCCUPANC 'I I Icturew'l t ho I n of the Bu 'I I d 'I ng Di vl 5t 0n I fu rther cert 'I fy th a t my reg I s trat i 0n vJl th t he B u 1 1 de r q fu l I force requ i red by 0Rs 701 055 tha t 'I f e xempt t he ba s 1 s fo r exemp t 1 0n 'I not ed hereon and tha ttractorandempIoyeeswhoare'I n comD .I ,l ance WI th OP,S 701 nq 5 'I u 5 ed n th I s orojec T llAtlE(p1ease print)lL I GNATURE DA\E/'//-82 Zone ypelconst. V-N uni ts Fire Zone_fu1fl_Bedrooms ll/d Occy Load sq Ftg. Access.I Ip Flood Plain llO Stori I n.c.y Grou B-2 Ftg . other Remodel Val ue7 ,172.00 $17,172.00TOTAL VALUATI BUILDING PERMIT Charges and Su rc ha rges I 7 Plan Ck. Comm/Ind 65%/81dq Per Fee ntrLslPu ltf,ylo:f 28.60 Dd 6/14ts ivstenrs Deve' )harqe (1.51 opment Plan Ck. Res 30%/B1dq Per Fee PLUI4BING PERMIT Charges and Su rcha rges _ _ _ lQ--09___Fence D6mo ELECTRICAL PERIlIT Charges and Surcha rges Sidewal k A/C Paving Curb Cut Total Comb. Permit $85. 28 , I$es. ze IlECHANICAL PERI',IIT Charges and Surc ha rge s .l3.00 .52 TOTAL ACTORS name a ddrp< c ptumbinq Beeson P'lumbing Ftq. l'lain x Value PERMIT VALIDATION Receifi #ill$ /QrL rmit Cle 44. 00 1.76 I 0.00 .40 I 5.00 .60 .I3.00 .52 Bu i'l di ng 4% P1 umbi ng 4% E'lectrical 4% Mechani ca'l 4% TOTAL PAID $ES. ZA COf,IBINATION APPLICATION/PERMIT (cAP) I. Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17-05-4:2. example- Lot 1. Block 3, ?nd Addition toSpringfield EstatesC. Name, etc. of owner and construction 'lender D. Energy Sources1. exampl e- heat,/?. example- waterE. SquareTioGge or to the appropriate item(s)FulI Plumbing, Mechanical, a 1i or forced air gas or soiar to be instailed and Electrical Schedules e 'I r va I uat oflt II. 1. example- i250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add, etc.F. Building permit information:l. example - construct single family house with an attached garage 2. exarnple - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specia lty CodeH. DESIGN TEAIL1 AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc, Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occulin the descriptionportion of the Mechanical and Eiectrical Schedules,the applicant need fi1l-in only the No. Boxes adjacent are available at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF hllLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the'labej must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is .not authorizedto sign the electrical label.III. Applicant to sign and date Hhenever possible, the initial application wilI be used asa worksheet on)y. Where possible, Building Division Staffwil) prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture .IV. Fees and Charges PIan check fees are due and payabte at the t.ime of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Add'itional Project Information PLANS REVIEWED BY: NAMC LORNE PLEGER s i gnature date June I 5 1 982 : : '