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HomeMy WebLinkAboutPermit Building 1981-2-10 I INSPECTION LINE 726-3769 Legal Delcription 5892 Main Street Lot 12, Buda Mesa CITY Of SPRINGFIELD COMBINATION APPLICATION/PERMIT I ENERGY SO'r'fe'Ct Heat Water Heater El P.c:t Range -NJ' Value of Work: Owner Dr. Clark Roeder 1717 Centennial Blvd 235,000 INFORMATION LINE 726-.37.53 I ~<>A- Sq. Fig. Main u-'>Uu Sq. Ftg. Accen. X" FIg. Other _Hew_Add_Alter_Rep. _Fence_Demo_Change! Us. _Other 00 o ..... ..... o ...... Job AddrflU Address Phone 746-9552 - - Building Permit Into: Describe Work (i.e., Build Single Family ~es,idence With A:tt~,~.h.eEU:~.I?~~g!)__ Shell OnlYior_r-tedical Building Sprinqfield, Oregon 974]L_ Canstruclion Lender Addren Phone DESIGN TEAM (nome) (address) (lies, no.) _____(!~pirel) (phone no.) Primary Kip M. Amend. ~A 1?21-llon~lrl Strppt, FK Jacobson. P.O. Box #5088. Euaene C:;lIitp R. Eugene ----... ,---Ii \ ~ ~\~ (expires) '''t 9-11-81 687-0226 485-3480 Structural Electrical Mechanical CONTRACTORS (name) (address) (ljes. no.) 584 (phone no.\ General Darrell M. Wilson 726-0579 Plumbinq Electrical Mechanical PLUMBING ELECTRICAL MECHANICAL NO, I FEE I CHARGE NO. j FEE I CHARGE NO. I I FEE I CHARGE Each lingle fixture Relocated building (new fix. additional) S.f. Residence (I bath) .,~. ft. furnace/burner to R,TU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent ,y,tem apart from heating or A'.C. Mechanical exhaust hood and duct INA Re,idence of New circuih, alleration, or extensions SERVICES Duplex (l both) each Addition~~ath Temporary Con,truction Amps. NA Water service Sewer Wood stove/heater Storm Sewer FEEDERS Heat Pump Air handler to 10.000 CFM Amps. Air handler over 10,000 CFM ISSUANCE OF PERMIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by Ihe Electrical Contractor, the electrical portion of thi, permit shall not b. valid until a label has been signed by an Electrical Contractor and attached to Ih. electrical panel. I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon i, true and correct, and I further certify that any and all work performed ,hall be done in accordance with the Ordinances of the City of Springfield and the Lows of the State of Oregon pertaining to the work delCrihed herin, and that NO OCCUPANCY will he made of any lfructure without the perminion of the Building Division. I furth.r certlfy that my registration with the Builder's Board i, in full force and effect as required by QRS 701.035, that if exempt the hasi, for exemption is noted heron, and that only suhcontraaors and employees who ore in compliance with ORS 701.055 will he used on 1his project. Basis for Builder's Board exemption: "GNATURE A )IJAA-Lilj1~'/1 fOR OFFICE USE ONLY L'/ DATE ,)-/ () - 0 NAME (please print) BUILDING PERMIT Charges and Surcharg8l SHELL 489.50 ----19. S6 1 ONL Y!!!!!!! Unih nccy load Occy Group R-? Sq. Ftg. Moin Sq. Ftg. Access Sq. FIg_ Other 8808 Value 215.000.00 Value -3tT;0OO-;-Oo- Value TOTAL VALUATION 21i5 .000. OIL- . 20n" KUl, . Fire 20ne Flood Plain K-':: NA NU 1:0 Kt-' Type/ Canst. Bedroom' C,tarie" V-N Plan Ck. Comm/lnd 65%1 BId!=! Per Fee Plan Ck. Res 30%/ Bldq Per Fee 317.85 PO SYllems Development Charae 0.5%) 3,975.00 PLUMBING PERMIT Charges and Surcharges NA Fence Demo TOlal Comb. Permit 509.08 ELEORICAL PERMIT Charges and Surcharges 11:\ Sidewalk I AI C Pavina MECHANICAL PERMIT Charges and Surcharges NA Curb Cut TOTAL 4,484.08 ,'. -...:_~ ... ,- -',' ",'.-) ~~~~. " .,(~. " "I '............ c____. .... ..- ~ 1';~Il;t';"_ t ....J.. ,.... ......... .. ~-..... 1(' ~ ._.....~._~...... . 'c. .-.-...... ____.... C.......'WC.~ I.....de. 0. e.-w-- . 1. ..o'"el..h~'/.fK'ricor ceilin(l/or forced air gas 2. o.omple-woler heolerieleclrlcol/or ~ E. Square fOOl age or valuolion, etc. 1. exomple-12S0 sq. foot house, 500 sq. foot garagE 2. exomple.if new project, check new-if addition, ch add, etc. F. Building permit information: 1. ,examcle-construct single family house with an '0;1 , garage 2. example-remodel existing garage into family rool 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 ovoid design or construction delays, Building Divh Staff must be able to contact appropriate persons re9 design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical'& Electrical Schedule, A. Except where blank spaces occur in the description pc of the Mechanical and Electrical Schedules, the applic need fill-in only the No. Boxes adjacent to the approF 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 schedule have been abbreviated 2. If the item(s) to be installed are nol covered on the ated schedules you should consult the full schedule e. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES At CHARGES ON THE SCHEDULES 111. Applicant to sign and date Whenever possible, the initial application will be used as worksheel only. Where possible, Building Division Staff yo prepare a typewritten copy and return it to the applicant 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 01 and no plans will be processed until these fees are paid. . other fees and charges are due and payable when the p' is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: '",- . i-..---~ '&W.-. :'.J' ~ " <r . ;~ : J~ (" City Hall Springfield, Oregon Department of Public Works r' OFFICIAL RECEIPT r Q ~O. B 55783(" Date rr.- - \ '._..' .19 '\ , , \ ""I''''~[)II II 'lL/An Rec'd From ,-\),1 r " ,I ,). 'J), tluj' ' '. 1/11' I !~ ')r' I ,~, ," (' V'-;' I) ! " Address !., C.t' j tTi'! 1..._..>' ~ < \'1 ,of' Received Eor: t..\<6 y ."2J() .- r "'<-l.-J ,'. qU/h [q .S9 ( - <' ~ AI (~,. { t:-'J . UJ ( .:: , '- c' .... ~ ( \:.., { Received 441A ,07;, r J---- (. -'4~~-= Amount ~ " rg/ -('I ~ -- UTHO'U1ED S,Q/IIIATUilUl ..,u'. r r . SMIU.TO,,'TUIt..1 L ....'..TC.S ' EuoeNIl. O. 17.0' '- " " \, t ll= Permit Cler~ THIS PERMIT FOR SHELL ONLY!!!! THERE ARE NO PLUMBHIG QRELECTRI CA"l, OR MECHANICAL PERl1ITS FOR TilE BUILDIiIG., S6MI! PLUMBING PERMITS HERE ISSUED FOR SEl'IE1 Additional Prcject Information: ONLY, OUTSIDE THE BUILDING S.D.C. WILL BE REQUIRED ALL LEASESPACES AS SUBMITTED. PERrtITS PRIOR TO JANUARY 1, 1981 ARE FOR OUTSIDE WORK.. PLANS REVIEWED BY: "emf" DAN StUTH /aAyf;:7/~ 2-4-81 :ignaturo ~ate