HomeMy WebLinkAboutPermit Building 1980-03-20lNsPECItOx u|,tc
1263169 0 1980 co,'rs,N:'J'YoirotJl',tifll'3,"*",,
tNtormATloN LINE
72G?753lrctrrrro0tc
202 North 20th StreetJob Addrarr
Ronqe
ENERGY SOURCES:
Woter Heoler
-
t7 03 36 42, TL 1800-1900Legol Dercription
Sq. Ftg. Moin
oaa X o,r"r-*"".
-Fence-Demo-Chonge/
U se
Other
New
Sq. tlg
Other
Sq. Ftg, Access.
Volue of Work:
$4, 000. 00owner Joseoh E. Hancock
Fomilv Residence With Attoched Goroqe)
Building Permit lnfo: Describe Work (i.e., Build Single
ehone I !,J =) Og4Address 202 North 2Oth Street
Constflret Deek nn Fxisfino CnrnortSpringfield, 0regon 97477
Construction Lender ODVA
@oHt\)5(o
PhoneAddress
DESIGN TEAM (nome)(oddress)(lics. no.)(expire s)(phone no.)
primory Steve Ruef Designs 1305 Noflh Z!h_.q!7 46-R81 6reef
Slructuro I
Electricol
Alechonicol
CONTRACTORS (nome)("dC'rrd (lics. no.)(expires)(phone no,)
The Original Remoddler 2150 Frieridly Street. Eusene 484-0070Generol
Plumbing
Electrico I
Mechonicol
ETECTRICAT MECHANICALPTUMBING
CHARGEFEECHARGENOFEEFEECHARGENO.NO.
furnoce/burner lo
=--BTU'S
Residence of
-sq.
ftEoch sinqle fixture
Applionce vent
se po ro te
New circuils, slterotions
or exlensions
Relocoted building
(new fix. odditionol)
Stotionory evop.
coolerSERVICES
S.F. Residence
(l both)
Vent fqn with
single ductTemporory ConslruclionDuplex (1 both) eoch
Vent syslem oport from
heoting or A.C.Amps.Additionol both
Mechonicql exhousl
hood ond ductWoler service
Wood stove/heoterSewer
Heot PumpFEEDERSSlorm Sewer
Air hondler to
r0,000 cFMAmpr.
Air hondler over
r 0,000 cFrr^
ISSUANCE OF PERMIT
TOTAT CHARGESIOTAT CHARGESTOTAT CHARGES
WHERE STAIE tAW REQUIIES rhor rhe Etecrricol work be done by the Electricol Conlrcclo., lhe eleclricol porrion of this permit shall not bc volid unlil o
I HAVE CAREFULLY EXAMINED the completed opplicotion for permit, ond do hereby certify thot oll infomotion hereon ir
cerrify thot ony ond oll work perform"j sholl be done in qccordonce with the Ordinonces of the City of Springfield ond
perioining ro tfie work described herin, ond thot NO OCCUPANCY will be mode of ony slructure without the permission
cerrlfy rh-ot my registrotion with, the Builder's Boord is in full force ond etfect os required by ORS 701.055, thot if exempt
heron, ond ttr"t Jnly subcontroclors ond emptoyees who ore in complione with ORS 7O1.055 will be used on this proiect.
lqbel hos been signed by sn Elactricot Controclor qnd ottoched to the electricol pcnel.
Bosis {or Euilder's Boord exemption:
NAME (pleose print)
s lrue ond correcl, ond I further
the Lows of the Stote of Oregon
of rhe Building Division. I further
the bosis for exemption is noted
FOR OFFICE USE ONIY
x
--Volue
x Vo lue
x
-Volue
TOTAT YATUATION
V-N
I\4- 1
nils
occv Lood
Ftg. Main
Sq. Ftg. Acce3sFire Zone-Bedrooms
zon" R-1 Type/const,
Sq. Ftg. Olher--Flood Ploin
-stories_..-..-OccY
GrouP
n.5%\
DevelopmentSyslems
Choroe
Plon Ck. Comm/lnd
65%/Bldq Per Fee
8.40 PD 1201908 0
Plon Ck. Res
3O%/Bldg Per Fee
BUITDING PERMIT 28. 00
.96
Chorges ond
Surchorges
REC 5s426
tence
28.96Totol Comb. PermitDemo
Chorges ond
Surchorges
PTUMBING PERMIT
Sidewolk
A/C Povinq
Chorges ond
Surchorges
ELECTRICAL PERMIT
Curb Cut
TOTAT
28.96MECHANICAL PERMIT
Chorges ond
Surchorges
$4 J,oo .co
1
'\/
coMBTNATTON AppLtcATtON/PERMrr (CAP)
l. Applicont to furnish
A. Job Address
B. Legol Descriptionl. exomple-tox lot 100, Lone County Mop Reference
2. exomple-Lot I. Block 3, 2nd Addition to Springfield
C. Nome, elc. of owner ond construclion lender
D. Energy Sourcesl. exomple-heot,zelectricol ceiling/
2. ex o mFIE-wo te r TE o G iTElEc t n-co I
E. Squore footoge or voluotion, etc.I. exomple-1250 sq. fool house, 500 sq. foot goroge /2. exomple-if new proiecl, check new-if oddition, che<
odd, etc.
{'PERMIT VATIDATION
F. Building permit informotion:
l. exomple-conslrucl single fomily house with on otto rd
goroge
2. exomple-remodel existing goroge inlo fomily room
3. exomple-converl single fomily residence inlo /.iEltoI?Ent (chonge of use) \
G. Volue of work os defined in Section 303 (o) of the
Slructurol Speciolty Code
I{ DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Divisi
Stoff must be oble to conloct oppropriote persons reg(
design informotion or iob site correclions, etc. (
ll. Abbrevioted Plumbing, Mechonicol & Electricol Sc,hedules
A. Except where blonk spoces occur in the descriplion por
of the Mechonicol ond Electricql Schedules, the opplicc
need fill-in only the No. Boxes odiocent lo the oppropr
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division' l. To conserve spoce on the permit form the scheduler
hove been obbrevioted
2. lf the ilem(s) to be instolled ore nol covered on the
oted schedules you should consult rhe full schedule
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AI.
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, the initiol opplicolion will be used os
worksheet only. Where possible, Building Division Stoff \^
prepore o typewrilten copy ond return it to the opplicont
the lime the octuol permit is issued for his signolure.
lV. Fees ond Chorges
Plon check feei ore due ond poyoble ot the time of the op-
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 ONLY
,6t, clTY oF SPRINGFIELD
4Ciry Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAT RECEIPT
No. B 56122
I
dF
For:
Amount Received (l
fl
or forced oir gos
or solor
(
{
(l
0
I
,l
br
('
\
AYlt SIGNATURE
PRINTERS , EUCENE OR 974OI !'!It.A
(l
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
nome sig notu dote
PLANS REVIEWED BY:
TO}1 SHEIRBO},I
t
Additional Proiect lnformqtion:
L2-23-80