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HomeMy WebLinkAboutPermit Miscellaneous 1980-11-3 ..'-" rOo""', . ',' . .' , .' INSPECTION LINE 726-3769 NorlFi~" 1/-J-86 ~INfORMATlON LINE 726-3753 ~6,f)f)f).tJS CITY OF SPRINGFiElD COMBINAJlON APPLlCAJlON/pERMIT r F .1ohn Deve 1 oDment Coml1anyon ..-- ""'B.;ilding"P~f;jt 'in'f~; -~crjb. wo;"- (i.... Build Singl. Addr.ss ?2.2..3.-fJ~ ~~7Ql npll AVPnl1j:i Phon. 2..83.::.5.J65 family Ilelid.nc. Wilh AUach.d GarQ":lI.l Vancouver, Washington (503) Slab. ceilina. H.V .A.C.. electrical, - - - - - -. Dlumbina - Children's Store 'obAdd,... 5499 Main Street ......----.-- L'9al D''',;pt;an 17 02 33 4 Tax Lot 600 Owner Conltruction Lender Address DESIGN TEAM (name) QirhArn ~hm~nn ~ A"nr;~T~~ ~~ ,W 11,th Ave ~Prlvprtnn, np (,5Qll-Z22d2?1 Primary Str\lduf'al EJectriazl Mechanical (NEll.GY SOURCES: H.at _Elect "N'U.f Heolef _ E 1 ec t I Sq. fig. Main Sq. Fig. Accen. Sq. Fig. Olher _New__Add _Alter_Rep. ...fenc. ____ Demo_Chongel Use 00 o ..... o .0 N ~9!.....:=:=:::---=-- Yo I... of WOfll: 12.000.00 __Olh.r Phon", (address) (ohone no.) flies. noJ {expiresl CONTRACTORS (nome) (oddreu) (liu. no.l (cxoiresl (phone no.) G\Onerlll C.E. John Construction 7223 NE Hazel Dell , Vanc. ,WA 223-01 JOHN C 347LF 283-5563 PlumbinQ Schmidt Plumbing 7500-C NE 16th Avenue,Vanc.,WA 694-8535 Electricol 3-Wav Electric 4739 Main Street. SDrinqfield, OR 746-9743 hchonical Durbin Heatinq P.O. Box 1042, Eugene, OR 343-1412 PLUMBING NO. I FEE I CHARGE NO. I 5.00 15.001 I I I I 3 Each sinqlc fixture Relocated building (new fix. odditiano1) S.F. Ruidence (1 bath) Duplex (1 both) eoch Additianol bath Water service Sewer Storm Sewer ElECTRICAL MECHANICAL I FEE I CHARGE NO. FEE CHARGE Residence of furnoce/burner to ~TU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent system aport from heoting or A.C. Mechanical exhaust hood llnd duct 3.00 ~1. ft. New circuits, a/terotians or extensions SERVICES Temporary Construction 1 Amps. Wood stavel heoter FEEDERS Heat Puma Air hondler to 10.000 CFM Air handler over 10.000 CfM 1 15.00 Amgs. 200 1 3 ton HVAC 6.00 ISSUANCE OF PERMIT 10.00 15.00 TOTAL CHARGES 19.00 TOTAL CHARGES 15 _ on TOTAL CHARGES 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 Electricgl Contrgctor and attached to Ih. .I.drical panet. I HAVE CAREFUUY EXAMINED the completed application for permit, and do hereby certify that 011 infOrmation hereon is true and corred, and I further certify that any and 011 work performed sholl be done in occordonC'e with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to t"e work described herin. ond thot NO OCCUPANCY will be mode of ony 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 ORS 701.055, that if exempt the bosis for exemption is noted heron, and that only subcontroctors ond employees who ore in complionce with ORS 701.055 will be used on this project. Basis for Builder's Boord exemption' rO..'ll Ai.;j/;J NAME (please print) f:=J. t::!...J.l Zon" C-4 Typel Const. Bedrooms "_ <:torir-" V-N 1 fire Zone Flood Plain NO ~ BUILDING PERMIT Chofges and Surcharges 60.00 '.'1U PLUMBING PERMIT Charges and Surcharges .15.00 .60 15.00 .60 19.00 -------- .76. ELECTRICAL PERMIT . Charges and ~ufchafges MECHANICAL PERMIT Charges and SUf(harges SIGNATURE../1// J FOR OfFICE USE ONLY w~~ /6-~-'i<- DATE Units 'Jcc:y Lood .....cc:y Group 1 x Value Value Value , 1- \ i Sq. Ftg. Main Sq. Ftg. Accen Sq. ftg. Other x B-2 _ x TOTAL VALUATION 1? . 000 00 Plan Ck. Comm/lnd 65%/BldCl Per Fee Pion Ck. Res 30%1 Bid.. Pl"r Fee --. -_._--~----- 39.00 PD 10-27. Grlt.m, D".lapm.nt i:Warae (J .5%1 Ktl, :l:lUOO fence Demo Total Comb. Permit Sidewolk A..'r:. P':''':~3 . Curb Cut ~13.36 __1___.._----- I TOTAL City Hall Springfield, Oregan Department of Public Works (" OFFICIAL RECEIPT No. B S 51 00 ( it" Dote 11- il?' 199D ' . Rec'd From C P') , Inl1 () '0JJ){!)/),o. ( (11. dd -7iL?;J IJE HAW/OEfl! A ress , , "\ '" C(JI c:c::. ( i '.."- . --:: .~ :......, \ \ I .~_._l--:::: "-^-" I i ,- ::X->--'" ( VIvVI ,~v \I ---- J?",- 'l\ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. legal Description 1. example.tax 101 100, Lone County Mop Refere' 2. example.Lat 1. Block 3, 2nd Addition to Springf C. Nemer etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air gc 2. example-water h~ater/electrical/or solar . E. Square footage or voluatio!'1 etc. 1. example. 1250 sq. foot house, 500 sq. foot gara! 2. example-if new project, check new-if addition, c add, etc. F.. Building permit inform~tion: :1. example~construct single family'hous'e with an 0 garage 2. example-remodel existing garage into family rOI 3. example-conyert single family residence into restaurant (change of use) G. Value of work os defined in Section 303 (0) of the . Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Divi Staff must be able to contact appropriat.e p~rsons re design information or job site corrections, etc. .' II. Abbreviated Plumbing, Mechanical & ElectricalSchedul, A. Except where blank spaces occur in the description p of the Mechanical and Electrical Schedules, the appli need fill-in only the No. Boxes adjacent to the appro, ilem(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit fo'rm the schedulE have been abbreviated 2. If the item(s) to be installed are not covered on thE oted schedules you should consult the full schedul, C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AI CHARGES ON THE SCHEDULES PERMIT V ALIDA liON p CITY OF SPRINGFIELD ( Received For: B(.J 6.0/' \f' . (cD. cu 1_,~O 1500 ("'() jC"j . on In(~ !Cl.00 , ':0 c pp ( ~Olt) C(P <f i\OI/\ I" ~\P ( LtC! 16 (b, _..__1 " 1 ( .C c c' (I c- (I (' ,~ \ \'::z..._,d~) Amount Received :..L C4J ....,,ht10"'ZE:D $lGNATUIIIE: '..tllTa"'.Tu.....Ull ~,,,..Ttl"S . tlUGtl..ll. all ,.,.01 ,. III. Applicant tD sign and dote Whenever possible, the initial application will be used os C' . worksheet only. Where possible, Building Division Stoff " 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 ore due and payable at the time of the aF!- .. and no plans will.be processed u~til these fees ore paid. AII' other fees and charges are due and payable when the permit is issued. (I .e."" V. FOR OFFICE USE ONLY Permit CierI- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 1. 1 Additional Project Information: - PLANS REVIEWED 'BY: . /7! ( - I/., .. 'ignatu~~l !f? ~ote DAN SMITH 10-31-80 nof"!l.-:" .(1 ( .,.... (I