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Home My WebLink AboutPermit Building 1982-5-17 1 Sq. Ftg. Main Sq. Ftg. Accen. Sq. Ftg. Other _New_Add_Alter_Rep. I_Fence_Dema_Changel Use _Other $8,000.00 Building Permit Info: Describe Work (i.e., Build Single Family Residence With Attached Garaee) , /INSPECTION UNE 726.3769 . . CITY OF SPRINGFIELD COMBINATION APPLICATlON/pERMIT lob Addren 5B.IJ_MaJn_stree.t legal Description 1 h02=-3-~-44 I ENERGY SOURCES: Hea.lLE-, Fl f:'r Water Heater ---.-Llec N~ l.L_O lOn Ran!:!e I Value of Work: Owne' MJL Prrl"l)prt.ip~ Add'e.. ?20_NQ"th ~th ~t"ppt $.R ri ngf.ie.td_>-Q!LJ7.AD 4l:l::>-4IL~ Phone 1:LL?_hJ:\A1: l:! INFORMATION LINE 726.3753 (Xl N o -'" en w r",,,,~tructinn Li(I!nder Comolete lease soace ~e1-JQD-J'~ Rlnlqq~ - I R1Ol68-and-e!0770 I I I I I I I l~~AL CHARGES I WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until a label has been signed by an Electrical Contractor and attached to the electrical panel. Address phone DESIGN TEAM (name) (address) (Iics. no.) Primary Artpmi n P~7 Structural 11Y't-Amin P;::a7 Electrical .81oY't- ~l.ort- , Mechanical Ron Pip. rc:p CONTRACTORS (name) (address) (Iics. no.) G..neral M,lI P"(\np"tip~ (M~,,~h~l1 ~mith\ Plumbina Electrical A 1 AY't I='l.ort- Mechanical Ron P; AV"rA PLUMBING elECTRICAL NO. FEE CHARGE NO. FEE CHARGE NO. Residence of Q Each sinl=lle fixture Relocated building (new fix. additional) S.F. Residence (1 bath) ~ nn 4~ nn s9. ft. New circuits, alterations or extensions 15.0r 2 SERVICES Duplex (1 bath) each Temporary Construction Additional both Amps. Water service 1 Sewer 10.00 Storm Sewer FEEDERS Amps. 55.00 TOT At CHARGES 15,00 (expires) (phone no.) _At ~ (expires) " 747_RR?i 747-AA?i (phone no.) 485-4729 J-l:-(;J8J MECHANICAL 1 furnacel burner to _lOn.nnn_BTU'. Appliance vent separate Stationary evap. cooler Vent fan with sin!:lle duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct FEE I CHARGE I 6.00. 2 3.nn 6.0n Wood stove/heater Heat Pump Air handler to 10.000 CFM Air handler over 10,000 CfM ISSUANCE OF PERMIT 10.00 22.00 TOT At CHARGES I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further certify that any and 011 work performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I further c:erHfy that my regislTation with the Builder's Boord is in full force and effect a s required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontracton and employees who are in compliance with ORS 701.055 will be used an this project. Basis for Builder's Board exemption: NAME (plea.e pdnl) A1AR.5I.tA [[<)/11/7;'/ SIGNATURE~~.~ FOR OFFICE USE ONLY Zone DD Fire Zone Flood Plain Type/Const.J-N Bedrooms "tori~. Sq. Ftg. Main 17~~ 7Cl Sq. Fig. Access Sq. FIg. Other z Units 1 t"'\ccy Load 1 ~ nccy Group-B.? BUILDING PERMIT Plan n. Comm/lnd Charges and _____J.41L_QO 65%1 BJda Per Fee $?R.lin Surcharges Plan Ck. Res 1. 76 30%1 Bld~ Per Fee PLUMBING PERMIT $55.00 Charges and Fence Surcharges ? ?n Demo ElEORICAL PERMIT Charges and ~'~.nn Sidewalk Surcharges .60 Alc Pavine MECHANICAL PERMIT Charges and _~___.$2? nn Curb Cut Surcharges ee DATE 5-17- f1 V x 4 li4 Value ..$8..000-.00- Volue Value x x TOTAL VALUATION $R, nnn nn Systems Development Charee (1.5%) Total Comb. Permit .0TAl ~17n nil .. COMBINATION APPLlCATlON/P.T (CAP) I. Applicant to furnish A. Job Add ress B. Legal Description 1. example.tax lot 100, Lane County Map Reference 17 03 43 2. example.Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example-water heater/electrical/or solar : E. Square footage or valuation, etc. 1. example-1250 sq. foot house, 500 sq. foot garage 2. example-if new project, check new-if addition, check add, etc. F. Building permit information: 1. example-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 af the Mechanical and Electrical Schedules, the applicant need fill.in only the Na. 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~ot:covered on the abbrevi- , ated schedules you should consult the full sch~duleJ"l\J.lY C. BUILDING DIVISION STAFF WilL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES III. Applicant to sign and dote Whenever possible, the initial application will be used as a worksheet ?nly. Where possible, Building Divisian Staff will prepare a typewritten 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 the permit -.. is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . .........,..---0 ...~ ~ e -\\-~ ~~~j{\ Additional Project Information: ! PLANS REVIEWED BY, /,!/~ , ...1/1/1 name Dan ~m!t.. signatun'" ~'''.~ ,; ~~. .. PERMIT VALIDATION . ;;Jb sro5t, ~~, Lj LJ . CD '-I9b I.lip pp 55".00 '-19 () 2. 2..0 '--YJ IS ,00 '-/1v feD -n"'f 22.W if70 .~~ P lC1.Jl c.L .d:'3:IoD 11 0 . ()L I C.C- ,/ Permit Cler~ /) l Lt 1'7 r./.. j? - -.. <.:: ..... ....~~ -r.- \\,\\"(\( j)I\\\~I\~ ." ~ote H7-R? . .:.<:.,~, ,,' . , . " INSPECTION LINE 726-3769 .~, ',.' ..;-. CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT I ENERGY SOURC.fS: H.",N. P. EJj!(:, I Woter Heoter E 1 ec Ronge Nit Volue of Work: . INFORMATION LINE " 726-3753 I legal Description 1 I I I Own., 'Moll Pronprtipc: r".' ,. .,\ \ Add,... ?~O Nnrth 5th <:t....Pt . .' '., <:nr1ngf1eld. O~7477 Phone q!l:l-qt.:lI 'M?_I>'iR~ $8.000.00 Building Permit Info: Describe Work (i.e" Build Single Fomily Residence With A'ttached Goro~el .. Sq, .Ftg.. Main Sq. Ftg. Access. . Sq, Ftg, Other _New_.Add_Alter_Rep. _Fence_Demo_Chonge/ Use _Other Co N ~ 0> W Job' Address 5111t"Ma1n St.....,t , Udl?-~~-44 ,T n1.O(l CQrntruction Uinaer ComDlete. lease SDace Ref Job #'s 810199. Rlnl~R ~"~ ~ln77n Address . Phone DESIGN TEAM (nome) (address) (lies. no.) (expires) (phone no.) 747-8823 7117-8823 Primory ~min P;lI7 " '1 Structural A"+.o.m" n D:l'7 Electrical ^ 1 ~""~ e1 0",,+' . \ ,~ ., ..l Mechanical Rnn Pi pr,...p " CONTRACTORS (nome) (oddress) (lies. no.) (expires) ~. '(phone no.) 4115-4a9 J42 wn General M,lI .... Pr'lj:ll!.rt..1 PC: .( Ma r~ha 11 Sm1 th' Plumbing Electrical ..!t ~ 1'....+ ~ 1 ~,..~ '.1 Mechanical rin~ '[;...0"",.0 , " PLUMBING ELECT1U~AL " MECHAN ICAl NO. I FEE I CHARGE NO. I FEE l CHARGE NO, " I' FEE " CHARGE Duplex (l bath) eoch , Temporary Construction' 2 ffnnc~~o~er to BTU's ~ Appli~nce ,vent ,~ separote Stotionary evop. cooler Vent fan with . single duct Vent system apart from ' heatlrig or A.C.' Mechonical exhoust ho'od a'nd du'ct 6.00 " Residence of 1 I ':1 Q Each si~Rle fixture Relocated building (new fix. additional) . S.P ~ Residence (J bath) I; nn Ill; nn 2 ~Q, ft. New circuits, alterations or extensions 15.0C ,. SERVICES .,3.006..00 ", Additional bath Amps. Woter service I I.' Se~~r 1 Storm Sewer ,.. " , " Wood stove/heoter 10.00 " FEEDERS ,," '\ .\. > .' Heat P~mp , Air h~ridler to 10,000 CFM of . Air handler over 10.000 CfM ' Amps. "., '\ ,r~' ;,., ',' f>\{li .....' II 'I I TOTAL CHARGES t, 55.00 TOTAL CHARGES I. WHERE STATE LAW REQUIRES that the Eledrical work be done by the Eledrical Contrador, the eledrical portion of. this permit shall not be va~d until a " label, has been signed by an Electrical Contrador and attached to the eledricClI panel. .'... '" _'..'. .~.._...",,:;-:.:... ',!!,..:-'{,.:~o.~~.-:-""~:'""'-':,::--~ .~ I I HAVE CAR~FUlLY.EX1~~~!?....th!'.ncomple!e.!Lapphcalton\for..permll. ond do' hereby certify that 'all-'nfor~ation hereon IS true and. carrect, ond I further ". -" ~~certify t~at ony and 011 work performed shall be done in accordance with the Ordinonces of th~ City of Springfield and the Laws of the State of Oregon pertoining to the work described herin, a'nd that'NO OCCUPANCY will be modo of ony structure without the permission of the Building ,Division. I further c::ertlfy'that my registrotion with the Builder's Board is in full force ond ~ect 0 s required by ORS 701.055, that if exempt the basis for exemption i. noted heron, and that only subcontr~ctors and employees who are in complionce with ORS 701,055 will be used on this project, ., ',!,,' ISSUANCE OF PERMIT 10',00 22.00 15.00 TOTAL CHARGES ~~~ '. " Basis for Builder's Boord exemption:. NAME (please print) c.IGNATURS: FOR OFFICE USE ONLY ')ATE , Units Occy load "'ccy Group 1 l!l BZ Sq. 'Fig. Main Sq. Ftg. AC~I' Sq. Fig. Other 1725.75 xtf.}'4~::64" Volue Value Value $8.000.00 ap\<: Zone r- . fire Zone Flood .!Ioin 'ry~e/Const.~' Bedrooms C;torie. x TOTAL VALUATION' :liB.OUO.OO BUILDING PERMIT Charges and Surchorges '. plan Ck. Comm/lnd. 65%/ BldR Per Fee Pion Ck. ROI " 30%/SldQ Per Fee ~n Systems Development Charae {, .5%l - -- ---$.44..-0(1 .. .\ ~~~~~I~:n;,~~~I'~~\lI:'!i"" .,1. 'n.,'t~:.>:".'.t ~I~f'. Surch~rges "~'.".l"""~ :-,''1" ELECTRICAl,PERMIT '1.' Charges-ond ...- .~ .~-, Surcharges I MECHANICAL' PERMIT", Charges and I";;", ,.<:.: ~ Surcharges 1 '" '':";.~::ei~'r-~::;'' 1 7~ tl;1; nn " .' Fence.. A ",-' . J"';' ". ...~. ., ,.... '...tC..>. ? ?n Demo " ".jK' j)?l~>,'~':~;' . .Total Comb. Permit ,;~&-.::~~..!~.\~, ;, !.' ' 'j(} :1:-;: ".,~, ' ... -t-t1e:- nn Sidewalk ....- , .I>n A/ c: Pavina: ,- .' :.:.J-~'. ... . . d:?'?'..o' n ._-,-~--~ . ago Curb 'Cut " .',: ",i'.'; '.f;.;"." t ...-;---.';':': .,I:a....~.~J';.o.:., ~. ",; '",.-:;,'.? T.'?!~l , . :!:., ,I'i' , . .t.17n.~~~~t~\~~~~~ !;;:~j .'" '. .,~... 0" -. _ _ . COMBINATION APPLICATION/PEa (CAP) I. Applicant to furnish A. Jab Address B. Legal Description ,. example-tax lat 100, Lane Caunty Map Reference 17 03 43 2. example.Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. ,. example-1250 sq. foot house, 500 sq. foot garage 2. example-if new project, check new.if addition, check add, eic. F. Building permit information: 1. example-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 OivisiQn 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 abbrevi- ated schedules you shauld consult the full schedules C, BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES III. 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 typewritten 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 the permit is issued. V_ FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY: a name -Dan_Smith signature . PERMIT VALIDATION J:.5105t ~. 4Y.Cb '-I9b I.lip PrJ 55.00 L/9o 2,2.0 --YJ IS tn Lf10 roO IYV{J 2.2.en '-1'10 . ~<6 plcw c.L a~,lD() 110,DY cL - , Permit Clerk {!, /I O/A ~ ./ date .5:.lJ=Q?