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Home My WebLink AboutPermit Building 1990-10-1 1 INSPECTION LINE 726-3769 . CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT EilERGY SOURCES: Heat ~::l<! Hater Heater Range Va 1 u€. of l'lark.: . INFOR/lATION llNl 726-3753 Sq. Ft9. I-lain 1 7R~ ~q. Ftg. Access. Sq. Ft9. Other Ilew AddXAlter Rep. --Fence Demo Change/Use -Other - - ~ ~ v.\ "' Job Address 1948 Marco1a Road legal Description Owner, Hillman Prooerties Northvest Address900 N. Tomahawk Is land Drive P'111"3 -4111 S 19.36';.00 BUiloina Permit info: Describe Work{i~e.. Build Single Familv nesidence With Attached Garaoe) Pn1"'tl;:lnn. Construction Lender 01"'PO'on q7?17 None Tenant Infi11 for Boutique Allison, at Mohawk Marketo1ace Address Ut~Hjr. TI:.Af~ (name) Phone (address) (lies. no.l (exoires\ Cohone no. Primary Dave Hickman Associate Architects, 700 N. Hayden Island Dr., Port, OR ~7217 Mechanical CONTRACTORS (name) r address) (l ics. no.) "* (pxnirp-c;.)" iohonf'l nn,) Structura I Electrical NO. Hillman Prooerties Northwest Tvin Rivers Plumbing, P.O. BOX 2477. Eugene, Oregon 97402 L.R. Br~bh~m. Inc.. 10-' West 0 Street. Soringfie1d. OR Harvey & Price Co., P.O. BOX 1910, Eugene, OR 97440 PLUIIBING ELECTRICAL' FEE CHARGE NO CCLI.J:JiARliE. NO, MECHANICAL General Plumbina Electrical ~1echanical ~- ~~- SQ. FT. / I furnace/burner to BTU1s I H~ I r':lARliE.. '2. Each single fixture Residence of G.- Relocated building (new fix. additional) New circuits alts. or .extensions Floor furnace and vent S.F. Residence (j bath) Duplex (1 bath) each Additional bath SERVICES Recessed wall Snac~ h~atpr and vpnt Sewer Temporary Construction Change in existing rp$ j dJ'Ju'p multifamily. comm. or Tndustrial I Appliance vent S~Daratp Stati onary evap. cooler Vent fan wi th s.inal~ duct Vent system apart from heatino or A.C. Mechanical exhaust hood and duct . j :. ..../ Wood stove/heater, ~- Water service Storm Sewer Of amps COMl-I.IIND. 'FEEDE~ . Install/alter/relocate di~trih. fppdpr~ /~- . TOTAL CHARGES Z&!. - TOTAL CHARGES TOTAL CHARGES .M/~. ?~"'- WHERE STATE L\l/ REQUIRES that the Electrical work be done by an,'Electrical Contractor, the electrical portion of this pemit shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division amps.1 I t!{;2. s::::r:- CrP.Nn/"Uj ~ ~( ~'2!V_ A- ~?A-,..jE- ~"";/r . I _~h_ ffR~/f .?5":- ' Of I ,....:;-..-- ~P./~ '2.- ISSUANC, OF PFRI1IT I HAVE CAREFULLY EXAMINED the completed application for permit. and do hereby certify that all information hereon is true and correct. and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Spri ngfi e ld and the laws of the Sta te of Oregon pertai ni ng to the work descri bed herei n. and that. UO OCCUPAllCY wi 11 be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ons 701.055. that if exempt the basis for exemption is noted hereon. and that :~::(:~::::t:::::~S ~;e~3;;~= with :::tl:::~:5Z~ 2 J DA'~h/) FOR OFFICE USE'DlIL Y Sq. Ftg. f1ain x Value Sq. Ft~. Access x Value 13-.2 Sq. Ft~. Oth~r./;l.g~L~e 5P~Value/? ~~_-.. _ _ \ ~..:;-? TOTAL VALUATION L.:\\ 0'.:> Systems Development .......,4~ Lf_ . Charqe (1.5%) - ^ ./#" 7 <=> C/_ Tyoe/const.~~ -;"'~Units Bedrooms Occy Load Stories I Occy Group Zone Fire Zone Flood Plain PLU'1BING PERMIT Charges and Surcha rges _ _ _I. '1~€.e.? __ ?~t?3 1__u"2~~~__ /.- Plan Ck. 65%/Bldo Plan Ck. 30%lBldo Co,,"/! nd Per ~p~ Res Per Fee BUILDING PER~IIT Charges anc Surcharges Fence D~mo ELECTRICAL PERI:IT 'Side';alk Charges and ------------ Su':cha~rges ~/C Pavi~ng I1ECHANICAL PERMIT Charges and Surcharges _ _ _:;:?5; ~ _ __._ Curb Cut !-~,r TOTAL 19'1.78 'I~S: ~6 , - Total .C9mb. Permit., ,. .- . . , COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION : I. Applicant to furnish A. Job Address B. Legal Description 1. example. Tax Lot 100. Lane County Map Reference II 03 43 2. exa~le- Lot 1. Block 3, 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources '1. example- heat/electrical ceilinq/or forced air qas 2. exa~le- waterheaterjelectrlcalJor solar E. Square footage or valuation, etc. 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. examyle- if new project. check-new - if addition, Check add. etc. F. Building permit information: 1. exam~le - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL DOT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is .not authorized to sign the electrical label. --- Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signature. IV. 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 ~he permit is issued. - '.', ...... (9Qb (1 (qqD \ ~0C 2-- '. . Ill. V. FOR OFFICE USE ONLY " . .'Permit Clerk~(~ ......... :.' . . , ~ .. ~. ,. ...... ,. ~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . .",. '. .', , . Permit applicant exempt from registration with the Builder's Board because: ". :. A~ditional Prpject.Inf~rmation: .' , . - . ~. . ...... ~ .... PLANS REVIEWED BY: . , n'ameLRNe 7t~e;-/i" /? ~ si,gnature/~~~_. ~ ,-, , ,..., date ~~.:?':>-9c> . . ..