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HomeMy WebLinkAboutPermit Building 1980-9-12 I HISPECTIOII LIrIE....." ()/ '- 726-3769 ~ II" n 0 (ll\tl JII T, ,.,". .. . CITY OF SPRlilGFIELD - '. '~.:~') COIIBIIIATION APPLICATION/PERMIT q -I.;?- ([g.... .-' -. Job Address Legal Description INFORlIATlON LINt 726-3753 Sq. Ftq. 1.la;n ~q. FtlJ. Access. Sq. Ftq. Other flew Add XA lter Pep. -Fence Oemo Change/Use Other - - W D D OJ. +> ..... 1802 Market Street Lot 20 Block 3 Northridge .1 ~~;~GY Sf!~~Ct= I' Hater Heater t.1 ec L Elee]; Owner Brenda Fossey Address 1476 Pleasant Phone Range Val u, of l'lork: 9,000.00 Builiina Penmit Info: Describe Work(i.e.. Far:lil v nes i dence \./i th ~.ttached Ga raae) Bui ld Single Construction Lender Address DES I GN TEAll Install wall to convert to Duplex Structural Primary Drawing Servi ce Inc (name) Phone (address) 59 Co burg Road, Eugene (ohane no.. 687-0293 Electrical 11echanical CONTRACTORS (I ics. no.) (exniresl (name) (address) 409 Suburban Eugene , I i I i1ohone '1.Q.. ) 6$9-1935 ! I (lies. no.) 02027100 (exoires) Plumbina Curt Filler Co. Genera 1 : Electrical ,,_. :.~,.s..hanical PLUIIBIrIG I '--'.-'--', i MECHANICAL i ELECTRICAL --.-......-"'". NO. .--->.~, "F rlJARliL Each single fixture ==--_ -, ~,., _.~ ~FEE'" . CHARr,E ..line I". n__.__~~ ..EEL': S.IlARGf. Residence of SQ. FT: furnace/burner to BTU's Relocated building '.1 (new fix. additional) 1 1 'I 1 I I -NO: 2 S.F. Residence (I bath) Duplex () bath) Additional bath Ha ter serv i ce Sewer Storm Sewer 5.00 10.0C 2 New circuits alts. or extensions 15,00 Floor furnace and vent SERVICES Recessed wall I Soacl:' hl:'ater and vpnti each Temporary Construction Change in existing r~~ i rtp,.nce multifamily, comm. or Industrial Appliance vent c;.eoa ra te Stationary evap. cnnler I Vent fan with sinale duct I Vent system apart heatina or A.C. 1 Mechanical exhaust hood and dud I Hood stove/heater I 1 I I I 1 , 1 Of amps.] 1 ~.51) from C0I1H.1I NO. FEEDERS Ilnsta11/alter/relocate rlic;.trih. feeders IOf amps. 1 I I 1 ISSUAtiC, OF PFRIIlT 10.00 TOTAL CHARGES lV. VU TOTAL CHJ.RGES b. UU TOTAL CHARGES 1'1. ~v WHERE STATE L\li REQUIRES that the Electrical work be done by an Electrical Contractor. the electrical portion of this pernit shall not be valij until the label has been signed by an Electrical Surervisor and returned to the Building Division I HAVE CAREFULLY EXN11NED the completed apr1ication for permit, and do hereby certify that all information hereon is true and correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordina~ces of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that rw OCCUPAUCY will be made of any structure without the permission of the Building Division. I further certify that my registration with the'Builderts Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 7n1.055 will be used on his project. . (\~~. SIGiV\TUR~ ~":Jh.: ~ IIAI-IE(please print) JOHN HASCALL DAT~ '712. ~/ ~ J Zone 1\-' ~ -.! F~~ orF I CE USE Oi~L Y r1ain Tyoe/Const. Units Sq. Ftg. Fi re Zone Bedrooms Occy Load Sq. Ft!]. Access Flood Plain NO Stories 1 Occy Group R-3 Sq. Ftg. Other BUILDING PERMIT Charges ane Surcharges PLU'1BING PERMIT Charges and Surcharges ELE~TRICAL PERr~1T Cha rges and Surcharges 11ECHAII I CAL PERI'I! T Charges and Surcharges x Value x Value x Value TOTAL VALUATION 9. nnn. no 48.00 ------1:-gz--- Plan Ck. Comm/lnd 65%/Bldq Pe- Fee Plan Ck. Res .- 30%/BldQ Per Fee Fence Syster.'ls Development Charoe (1.5,,) 14.40 PO 10.00 --------:-40--- Demo 15.00 I Sidewalk ------------IH .60 A/CPav;ng 14.50 I Curb Cut ------------1 ..56 Total Comb. rermit -- TOTAL 91. 00 .. , j , ~ [1 , J ~ ~ I' d 1 , ~ i i ...-- J . . ... A.", .. ..~ -~.".,. COMBINATION APPLICATION/PERMIT (CAP) I. I!. Applicant to furnish A. Job Address B. legal Description 1. examole- Tax Lot 100. Lane County Map Reference 11 03 43 ,2. example- Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heatl,electrical ceiling/or forced air" gas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. - 1. example- 1250 sq. foot house, 500 sq. foot garage 2. examele- if new project. check-n€w - if addition, ch~ckadd,ett. .i -r-'. lIunding. perm"it 'informc:tion: L . Example .'." C:O:1si:ruct. single family h0USE: .~!it:l ('.il attach~l( gaia.ge ' "2. examD'le.. remodel ex~~.-i:;ng gari.ige into t1;nily rocm 3.,- ~~~~E~" COilvert. S"j":lg1"e famiJy rcs:idei1C~,. -ini"ll restaurant (change 01' use) G. Vil'lue of.work tiS (iefii1:?G 'jn Se::ction 303 (a) ~f .thE. Structural Spp.ciali::y Codf: <l '11., DESIGN lEAI.1 AND CUNTRACTORS .i To avC"j ct dts-j gr( m'" r.onstYllC"fiofl del;;~'~. Sui rr1iW:I Division Staff must be' (l.b'le to cont?-(;-i: (lpprn~l.iate persons regr:rd'j IIg des i 9i~ i rt"!--oi-,irrl t'j on 01' :i ou ;_~ -j"i;~ . cQrrect ions. et.(;. '.; ^bbrelfiateci Plumbing. Heche-xdc81" ,& Ere(".-~i"j'_:[:'1 S"~l-,.:du'H;:-: A Except ~'Ih€re bl;;nk space~ occur in the ci..:~sr.r'lpt.ioil portion of 'l:he Nechanical and E'tect.richi SdJ'(;:duh:s. .the appl.;cant need f"in..in oOlly..trn: 1\0.. BCIXCt. adjaceirt tathe appropriatE'! 'item(s-): to be iilstJn~d " Pi.. Full. Plumbing, '.r-lfchhn"ica.l, an(\;' F:.Jel.:,t.rir.al SC;1ecll.11:-,s . are availeble. at the Bunding Oiv'jsioil . 1. . To CDn"SCi~VE:: spar:e on the rtrmh. furm th,:'.schedules haVE .been abbi~eviatp.c1 ',,; (.'. If the' itp.m(s).tu b::: 'jnstalled. are not ('"c;vered on . the' 'nbbr:evi;:,ted sci,edld(:s yin' sh.ould COilSUlt the full st:hedules . C. BUILllJNG DIVISION STAFF ~ILl "FIl.l 'OUl ALL rl[S AND CHARGeS ON THE SCHEOULES , ' n. As noted o'n the CAP, ihe...label' ml!st be .del"ivt~rerl co.thQ elertrical contractor for signat.ure by his electr-jca'J ,supe-rvisor..' The general cor.tractor'.is not outl1orize(] to s19n the electrical la.bel, -- . Applicant to sign and date . Whenever possible. the initial application will tie used ~s a worksheet unly. Where possible, Buil'di'ng ~ivision Staff will prepar~ a type written copy and.return it to the applicant ~t the time the actual permit -is issuen fur' his signature. Fees and Charges Plan check fees are due and payable at the time of the application. and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. PI. IV, . PERMIT VALIDATION :ITY OF SPRINGfiELD ( , 1 City Hall Springfield, Oregon Deportment of Public Works OFFICIAL RECEIPT . . \, " ~. B 54705 ( ~) C'*J .P.l~ ~ -,... 11,\"~~. . .. \',l''j' \ \ '\C) From \ ~ \ \. "t~~Q ~ _' '--~. ( 'ss .\0-\ ~"-\. \1J \\~ 111 ~/. .-.-- ' -tr< ( . " ~ " :, :~ J 1 I I , ~ ~ ~ , I . , , 1 1 I I 1 - u (nO, . ~--{') t;-{/i--., 49c ( i~J Int Received Cll~U m'- \, . .It\C"l Aih-l(OIHZ 0 S'G"'ATU~E c ......., J SME~"O"'TU~".U~~ ~..,..T""" . (UG("(, o~ ~7'O' .....".. " V. FOR' OFFICE USE ONLY - " ...., .- ~ :ren,li i:_~:J.<'!t'k I -- ~ ~....,...........--~_x~... -.... ........----:.- -~~--...-_.,.. , ..._..!.___. ____I '--'-.--- .. . -:-':;--'::":<0; PRO,JECT CONDJTlONS TO HE SATISFIEO BEFORE OCCUPAnCY: , .! - ..._-----_.-_.~--~--.. --'- --. -'- -----.- .-- --~'- ---.-......---..-..-.-....--.--...--.-- -.. ........-: .---- --.--..-----------.-- , Permit appl icant: exempL, ';'rom regi'stration .lith' the Bui lder' S Board because: l Additi anal Project Informati on: ----- jP_- ___ ..---".,.------.-- --;--- ..-.-..------- : .: d2 ~// .. ,. .. -... PLANS REVIEWED BY: name DAN SM ITH signature .....,..., .-1. .j dat~~_7_Q-.'HL-._:J P'I ".......;' .-:..' 'I-~ ' -