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HomeMy WebLinkAboutPermit Building 1981-4-1 /" (~ a. "/ J,.., ..:__.tl.L!~,",~l!..~~~~~~:I!~~:~J.i.t:."l~)jiJ~~ " . -'" "1 " " " .,. "'., " ..,..,' .~=._.~~......~~- ",'." ~,'. ',.. '.' ..... ~~.JJ~. '. ,,_>O....,'-'ft~~::--.-.:...,'~..j,L.J:f.JS:.T[ . ... ,..--., .... >- ~,- -- "'. .---. "~'~""""'[' .~....-~,. ";." "._ .~\.-.- h'- ..,....,..,>~,,!!L_,..~~._,..,:.r ,-,.."".c.. .'... .". i INSPECTION LINE 726-3769 CITY Of SPRINGfiELD COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 Job Add"" 5892 Main Street Suite 7 legal De.";p"o, Lot 12, Buda Mesa ENERGY SOURCES: H.a' Flprt f-IeaUump- Water Heoter -f-l eG-: Ran~e Valuo of Work: 28,780.00 Sq. Ftg. Main Sq. Ftg_ Access. Sq. fIg. Other _New_Add_Alter_Rep, _fence_Demo_Change' Use _Other Complete Lease So Building Permit Info: Describe Work (Le., Build Single Familv Residence With Attached GoroQe) 44fi Owner Or. (':1 ;u"'1r W Rnj:lorllQ,V' 1717 Centennial Blvd Springfield, Oreqon 97477 Phone 746-9552 co .... <=> N Cl CO Address Comolete Me~ical le2<~ ~pacQ Address 1.t, N~tinn~l Mohawk Branch R2n~ Construction lender Phone DESIGN TEAM (nome) (address) (lies. no,) (expires) Ii (phone no.) ~l )~'17 ~~ Primary Structural Electrical Mechanical CONTRACTORS (name) (address) (lies. no.) (expires) (phone no.) Plumbing Darrell Wilson. 1717 Centennial Rlvrl Beeson Plumbinq 3-Wav Flp~tri~ Chase Co ~s:l4 Q_ll_s:ll 771>_n<;70 General Electrical Mechanical 1031 10-81 726-1981 PLUMBING ElECTRICAL MECHANICAL No.1 7 FEE CHARGE NO. FEE CHARGE NO. FEE CHARGE Duplex (1 bath) each Temporary Construction 2 furnace/burner to II.TU's Appliance vent separate Stationary eYap. cooler Vent fcln with single duct Vent system apart from heatirg or A.C. Mechanical exhaust hood and duct 3.0016.00 Residence of Each single fixture Relocated building (new fix. additional) S.F. Residence (l both) <;nn ,<; nn 1q. ft, New circuits, alterations or extensions SERVICES Additional both Amps. Water service Sewer Woad stove/heater 1 Amps. 200 l!i nn HeatPumpJl7 ;alr'Qo:::IrlJJ ;C'C'II::.rl ",;+Or, A;, ha,dl.. to J' ob # 810175 Permits 10.000 CFM Air handler over 10.000 CFM Storm Sewer FEEDERS ISSUANCE OF PERMIT 1n nn 16.00 TOTAL CHARGES 35.00 TOTAL CHARGES 15. 00 I TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be dOM by the Electrical Contractor, the eledrical portion of this permil shall not b. yalld until a label has boen signed by an Electrical Conlractor and attached to the eledrical panel. I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and corred, and I further certify that any and 011 work performed sholl 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 modo of any structure without the permission of the Building Division. I further cortrfy that my registration with the Builder's Board is in full force and effect a s required by ORS 701.055, that if exempt the basis fa, exemption is noted heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will be used on this project.. Basis for Builder's Board exemption' <IGNATURE~d~ FOR OFFICE USE ONLY DATE'C!tY-!l ( NAME (pleoie print)-+ . " NO Type/Canst. Bedroom' c:.to,ie' V_N Units 1 0:1. Ftg. Main Sq. Ftg. Access Sq. Fig. Other 996 x 2R - QO_Value ?s:l.7Rn Zone R P Fire Zone Flood Plain f'\ccy Load f'\ccy Group~-~ Value Value TOTAL VALUATION x 28.780 BUILDING PERMIT Charges and Surcharges 124.00 '---':-96-- Plan Ck. Comm/lnd 65%/SldQ Per Fee Plan Ck. Res 30%/ Bld!=l Per Fee 80 60 PD 3-23 t~y.tem. Developme,' . - tho roe {l,5%1 ' REC 56128 , 411...10.... PLUMBING PERMIT Charges and Surcharges 35.00 l.'1U Fence Demo Total Comb. Permit 197.60 MECHANICAL PERMIT Charges and Surcharges 16.00 I -----:64--1 Curb Cut I I ___L__ I I I LOTAL 629.30 ELECTRICAL PERMIT Charges and Surcharges 15.00 .bu Sidewalk I AI C PavinQ ,.. :~:,";,:":::~_'.:,,,.:=~...,_,__ .;~~JJr:~;~,....:,:~_;;.:1!2:,:.._.:," .odlJ !lIH ,.~l'~!.~:.!"", , ,/ . ' ..../, ..,..7 \\'IiI..L!~.:~._t.~ J.I~~~k~l~tk.::JJ}IP III. Applicantta sign and date Whenever possible, the initiol application will be used r worksheet only. Where possible, Building Division Staf, ')., .- pre, p~r.~.a typewritten copy and return it to the applieo ~. the time the actual permit is issued for his signature. "- I Fees cuid Cha;g~s .' " ('" ,t, Plan check fees are due and payable at the time af thel-:-~_ , . . . . ' and na plans will be processed until these fees are paid. All ather fees and charges are due and payable when the permit is issued. COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Jab Address B. Legal Description 1. example-tax lat 100, Lane County Map Refere, 2. example-Lot 1. Block 3, 2nd Addition ta Springf f~ C. Name, etc. of ~wner and construction lender ' D. Energy Sources 1. example-heat/electrical ceiling/or forced air gc 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foat house, 500 sq. faat gara " 2. example.if new project, check new-if addition,. c." add, etc. F. Building permit information: 1. example-construct single family house with an c garage 2. example-remodel existing garage into family rc 3. example-convert single family residence into restaurant (change of use) G. Value of work as defined in Sectian 303 (a) af the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Di. Staff must be able to contact appropriate persons r design information or job site corrections, etc. II. -Abbreviated Plumbing, Mechanical & Electrical'Schedu A. Except where blank spaces occur in the description . af the Mechanical and Electrical Schedules, the apF need fill-in only the No. Baxes adiacentto the appr item{s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedule: are available at the Building Division 1. To conserve space on the permit form the sched, have been abbreviated 2. If the item(s) to be installed are not covered on t . . ated schedules you should consult the full sched, C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES CHARGES ON THE SCHEDULES w. V. FOR OFFICE USE ONLY PERMIT VALIDATION CITY OF SPRINGFIELD ( ( City Hall Springfield, Oregon Department af Public Wark. OFFICIAL RECEIPT (] No. B S 619 8 ( Date 4 -I 19 ^' /' Rec'd Fram (I ,cn(i I{f7 / ()r-'/~l)tf:i 1.d. I' - Address n 11 (' PilT/Ilil'! / (}(J ( ( Received For: ( h\--) 17 ~-1- ()O LIOII) 4,0J(~i P~) ,- S\~J (j (~ (" J LIDI,) I C!(; cr -P I I~DO (~, ~\C'I!J ') , fo( i ( rnp 1/r;00 L\CI(-, II-l\ 'f . SDC:~ [t. ;:7) i " D . C ( .C ( ( ( ~ ( ( (Jr' I r,,}L. /' ::.:z,(-' Amaunt Received (f _-L_ {?I'? ( AI/THO..IZIED 51GHATUlllIE .M.UON.TU.N.ULl....NT.... lEuOlEN._ O. IUO' ",,,,'l " \.,' Permit Clery PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: STTF llLVTFl.j "'In f'T~f' m'pnDTMF~IT f'nJM ~ ll.nllTOCn '>aU- , - Additianal Project Infarmatian: t THIS PERHIT FOR Cor~PLETION OF A LEAse SPAr.F FOP A nnr.rnRS nFf'Trl' THE BUILDING SHELL'IS JOB # 801107 PLANS REVIEWED BY: name LORNE PLEGER signature ~{IYn ~ l-l-yp(y,r ....ate 3-31-81 :J