HomeMy WebLinkAboutPermit Building 1980-11-26irt d#ffifrffi7ct(C / /-zG tro
INSPECTION TINE
7263769
CITY Of SPRINGTIEID
coMBtNAItoN appltclrtox/ pgntttr
INFORMATION IINE
726.3153
305 h 24th STreet
L7-03-36-14 Tax Lo t 10200
ENERGY SOURCES:
Heot
-.New. -Add--Alrer-Rep.
-Fence-Demo-Chonge/ UseVolue of Work:
2,000. 00
Woter Hedier
Sq. ttg. Moin
Sq. Ftg. Access.
Sq. Ftg. Other
owner James L. Chaney
Building Permit Info: Describe Work (i.e., Build Single
Fomily Residence With Aitqched Goroqe)Address 305 North 24th street p6on" 683-1329
Attached GarageSpringfield, Oregon
Construclion Lender
@O
Ot
Address Phone
DES:GN TEAM (nome)(oddress)(lics. no.)(expi res)(phone no.)
primory Furrow Buildi.ng Supplies
Strucfurol
Eiectricol
Mechonicol
CONTRACTORS (nome)(oddress)(lics. no.)(expires)(plr"rte lS.I
Generol Owner
Plumbing
E leclrico I
Mechonicol
ELECTRICAL MECHANICALPTUMBING
NO.EgE CHA.RGE NO.FEE CHARGiNo.rEE CHARGE
furnoce/burner io
Eoch sinqie lixture
Residence of
t.
New circuits, oiierotions
or extensions
Applionce vent
sepo rote
Reloccted building
(new fix. odditionol)
Stotionory evop.
coo lerSERVICES
S.F. Reridence
(l borh)
Temporory Conslruclion
Vent fon wiih
single ductDuplex (l both) eoch
Amps.
Vent syslem oport from
heoting or A.C.Additionol both
Mechonicol exhoust
hood ond ductWoter service
Wood stove/ heolerSewer
Heot PumpSlorm Sewer FEEDERS
Air hondler to
t0,000 crMAmps.
Air hondler over
10,000 cfl
ISSUANCE OF PERIAIT
TOTAI. CHARGESTOTAI. CHARGESTOTAL CHARGES
WHERE
'AIE
LAW REQUTRES thor thc Electricol work be done by the Electricol Conlroctor, rhe eleclricsl portion of this permit sholl not ba vqlid until o
lobel has been signed by on Electriol Controctor ond oroched to lhe electricol ponel,
t HAVE CAREFUTIY EXAMINED the completed cpplicotion for permit, ond do hereby cerlify lhot oll informotion hereon is true ond correct, ond I further
certify thot ony ond oll work perforred sholl be done in occordonce with the Ordinonces of rhe City of Springfield ond the Lows of the Stote of Oregon
pertoining to the work described herin, ond thqt NO OCCUPANCY will be mode of ony slructure without the permission of the Building Division. I further
cerilfy thot my registrotion with the Builder's Boord is in full force ond effect os required by ORS 701.055, thot if exempt lhe bosis for exemption is noted
heron, ond thot only 5ubcontrsqtors ond employees who ore in omplione wirh ORS 70I.055 will be used on lhi: proiect.
Bosis for Builder's Boord exemplion:
NA}IE (pleqse print)
FOR OFFICE USE ONI,Y
GNATURE -.-- DATE
ZoneR-.|Type/Consr.VNUnils-Sq.Ftg.}v1oin-E=-*-x--=-x-Vo|,e
Fire Zone---NA-g"6roo-. NA occy Lood NA sq. Ftg. Access 5 / O , 9'5u volru
FloodPloinN0Slories+occyGroupI{15q.ftg'olher-x-Vo|ue
TOTAL VATUATION \472,.nn
5,477.tro
Systems Development
Chorqe 1t.5?,.)
Plon Ck. Comm/lnd
6596i Bldq Per Fee
xfixsuxRtxilPlon Ck. Res
30%/Bldq Per Fee
BUITDING PERMIT 36.00
1 .44
Chorges ond
Surchorges
la1 - Plan Check 4. B0
o. uu ral(]
4- 8O dueFence
Totol Comb. Permif 37 -44Demo
Chorges ond
S urcho rge s
PLUMBING PERMIT
Sidewolk
A/ C Povino
Chorger ond
Surchorges
ETECTRICAL PERMIT
Curb Cut
MECHANICAL PERMIT
Chorges ond
Surchorges TOTAI-42.24
-BTU'S
!?
COMBINATION APPLICATION/PERMIT (CAP)
l. Applicont to furnish
A. Job Address
B. Legol Descriptionl. exomple-tox lot I00, Lone Counly Mop Reference I7 03 43
2. exomple-Lot l. Block 3, 2nd Addition to Springfield Estotes
C. Nome, etc. of owner ond construction lender
D, Energy Sources
l. exom le-h eot/elesrrilgl5ej.ljnglor forced o ir gos
2 exom Fotei,GlEiiilcol/or solor
E. Squore foologe or voluotion, elc.
l. exomple-1 250 sq. fool house, 500 sq. foot goroge I2. exomple-if new proiect, check new-if oddition, checl
odd, etc.
F. Building permit informotion: .iI. exomple-construcl single fomily house with on ottsr r
goroge
2. exomple-remodel existing goroge into fomily room3. exomple-convert single fomily residence into :
EEiouEnt (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 Divis
Stoff must be oble to contoct oppropriote persons reg et.
design informction or iob site corrections, etc. i
ll. A,bbrevioted Plumbing, Mechonicol & Electricol Schedule,
A. Except where blonk spoces occur in the description pr
of the Mechonicol ond Electricol Schedules, the opplir
need fill-in only the No. Boxes odiocent to the oppro
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division
I. To conserve spoce on ihe permit form the schedul
hove been obbrevioted
2. lf rhe item(s) to be instolled ore not covered on tl
oted schedules you should consult the full schedu
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES,
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, the initiol opplicotion will be used
worksheet only. Where possible, Building Division Stof
prepore o typewritten copy qnd return it to the opplicc
the time the octuol permit is issued for his signoture.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of thr
ond no plons will be processed until these fees ore po.
other fees ond chorges ore due ond poyoble when thr
is issued.
V. FOR OFFICE USE ONLY
on\
CITY OF SPRINGFIELD
Ciry Holt
Springfield, Oregon
uep-orlment of public WorksOFFICIAI RECETPT
ilo. B
PERMIT VALIDATION
I
I
Dote 2 c 19 <2 ,/\.(1 Li
552 83
r
F m
,+t.q
ived For:
0o
.f
PC U
o\rl
Amount Rece ived
I
I
I
I
BY
AUTHORIZEDTXEIIOE.YUPTBULL,PITIEiS
EUCETa cR 97dot ,!rtt.a
(
+
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCYT
)
J
Additional Proiect lnformotion:
1 1- 17-80
nome sig no tu re dote
PLANS REVIEWED BY:
DAN SMITH
t
(
(