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HomeMy WebLinkAboutPermit Demolition 1981-6-29 I . ".. ", . ;- \ ""'.~"'t.!IlEw';'~~!,W'~.~'~!i'Il-'~~;':!d-'I..\.[l'U,U~~I(-'L.aJ.~I'"l!!l~.. II . \ , -1 ~_.. .... ' ' '- , ._~'" ......,.'1".... ...,'. I INSPECTION LINE 726-3769 I Job Address Itegal Description I CITY OF SPRINGfiElD COMBINATION APPLICATION/PERMIT INFORMATION LINE 726-3753 170m:'" n21\00 ENERGY SOURCES: Sq. Fig. Main ;>0 I 0 Heat ~AS Sq. Fig. Accen. Water Heater elect Sq. Ftg. Other Ranqe _New_Add_Alter_Rep. 1 Value of Work: \_FenCe_DOmO_ChangefUI. _Other 81. 088.00 Building Permit Info: Describe Work (i.e" Build Single Phone 7,d';_ ,7,0 Family Residence With Attached Goraae\ Addren940 SOUTh .4 ~rrl St- Springfield, Oregon 97477 Construction Lender PeonIes Bank DEMO existing store structures and OJ :J ..c E) 4157 Main Street Own" Sherman Ruttencutter Address Phone co.,,~trt1ct she:ll only fOT new Nel~onts. Tire Warehouse DESIGN TEAM (name) (address) (lies. no.) (expires) (phone no.) Structural ~ J~' ~~ W~ 7?(,-nsn Primary Georve (;riffin 2&1\(, Mannr nriv~ Electrical Mechanical CONTRACTORS (nome) (address) (lics. no.) {excirell {,)hone no'\ Twin Rivers 44 Or~~on StT~et. Creswell 2040 W. Broadwav 345'''' .,dd-l &32 G..neral Metal Clad 8ldrs. Plumbing f.R,_1d1d Electrical J.I~Tn"y Dpnc:ol;n SR t:; wP<:.t (t.mf' ~nT\; ':::J 1 R 1 ,~A ~1_110t: I Mechanical .1 I I PLUMBING ELECTRICAL MECHANICAL NO. FEE CHARGE NO. I FEE CHARGE NO. FEE CHARGE Duplex (1 bath) each 1 Temporary Construction 1"1 nil furnace 1 burner to A.TU's Appliance vent seporate Stationary evap. cooler Vent fan with single duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct : ~ Each sin~le fixture Relocated building (new fix. additional) S.F. Residence (1 both) 25.0 Residence of sq. ft. New circuits, alterations or extensions SERVICES Additional both Amps. Water service Sewer Wood stove.lheater Storm Sewer FEEDERS Heat Pum"l Air handler to 10,000 CFM Air hondler oyer 10,000 CFM Amps. ISSUANCE Of PERMIT TOTAL CHARGES 25.00 TOTAL CHARGES 10.00 TOTAL CHARGES WHERE STATE lAW REQUIRES that the Eledrical 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 .Iectrical panel. I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further certlfy that any and all work performed sholl b. 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 bit made of any structure without the permission of the Building Division: I further certlfy that my registration with the Builder's Board is in full fQt"ce and effect as required by ORS 701.0.5', that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be uUld on this project. Basis for Builder's Board exemption. NAME (please print) M.., ~ e f /7 t:/'o P/ SIGNATURE,9~......,..../ vt1 ~4 OATE t:t. -.;:7 P-I7 . fOR OFfiCE USE ONLY , BUILDING PERMIT Charges and Surcharges SHELL ONLY I ADDITIONAL Units Sq. fig. Main 5R7'" x 13 &0 Value &1,0&&.00 n.cy Load c_. fig. Access x Value ""'~'"Y Group Sq. ftg. Other x Value PERMITS ROD FOR INTERIOR TOTAL VALUATION 81.088.00 Zone C4 fire Zone flood Plain Type/Const.~ Bedrooms c'ori~. PLUMBING PERMIT Charges and Surcharges 251. 00 10.04 25.00 Plan n. Comm/lnd 6.5%/ Blda Per fee Plan C\!:. Res 30%1 Bldq Per Fee 163.15 Systems Development Chcrae n.5%' 1216.33 fence ELECTRICAL PERMIT Charges and Surcharges 1. 00 10.00 Demo Total Comb. Permit Sidewalk (,.30 ^" AIC Povinn MECHANICAL PERMIT Charges and Surcharges Curb Cut TOTAL 1683.22 III. Applicant to sign and date Whenever possible, the initial application will be used as worksheet only. Where passible, Building Division Staff.,. ( prepare a typewritten copy and return it to the applicant . -. the time the actual permit is issued for his signature. ~ . IV. Fees and Chorges Plan check fees are due and payable at the time of the application, 'and no plans will be processed until these fees are poid. All other fees and charges are due and payable when the permit is issued. ,. ,", I '/ ~~~:'c;.:~~":~r~:;'~"'j""~,';~"'<' " . /. ~i}~\;~'A.:W.:'::'.~~~!;~~~~jl\!"'~;;',l"ti)'!... COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example-tax lot 100, Lane County Map Reference 2, example-Lot 1. Block 3, 2nd Addition to Springfield 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-I 250 sq. foot house, 500 sq. foot gorage . ~ ,2. example-if new project, check new~if addition, ehec add, etc. . F. Building permit information: 1. example-construct single family house with an otta garage '2. example-remodel existing garage into family room 3. example-convert single family residence into restaurant (change of use) G. Value of work os defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS ' . To avoid design or construction delays, Building Divisi Staff must be able to contact appropriate persons rege design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical'Schedules A. Except where blank spaces occur in the description po ~ of the Mechanical ond Electrical Schedules, the applicl I need fill-in only the No. Boxes adjacent to the approp Ie item(s) to be installed B. Full Plumbing, Mechonical, 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 not covered on the ated schedules you should consult the full schedule C C.' BUILDING DIVISION STAFF WILL FILL OUT ALL FEES At CHARGES ON THE SCHEDULES V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . \ \ -' , . I., " ._LL ,..,.., PERMIT VALIDATION c CITY OF SPRINGFIELD City Hall Springfield. Oregan Department af Public Works OFFICIAL RECEIPT I (I ( ( . \. rn No. B 56814,1 Dote '-\.A.U\ Cl , N-' \ 1 cR \ ( Rec'd From ~~ ~ \\~~C\ . \(\~ ~5 . CI Addres~ .\).~~ 4\9.\ ('\~5)\\\~~~ _ N,.hp", -'I Received "For: \....A ). \'\L) n ')51 0 ~ \ . \~)\().o"t' \.\)~~I:{) ~~.(f) Le" - \ ,00 \3-~ S\ n \n 00 ~) - 41> \ln~ ,\S .---. lo ,&:> .'(1 ., \ ~l1n. ~'?J ( (/ - ,- (' \. (I -- ..~~~~ .~. CI ( (I (' Amount Received \, lo<z;j. Q 2-. (\ Xc (I eeL 'N:>.. \ - . \,r!~.~, ( S"l~TO".TU"'NIU~~ ~"""Tl"'l . lUGlNl, 0" 17.01 .1111.. \.. ~I (I (I Permit Cler~ ~.: i' , , .. ,.: 1. ,., nnc OERMIT IS APPRO"ED FOR cnMcTollrnON OF nit' "I~!'-IHNG SWEll ("~'- v. An'ilTTTnNAI ~ . PERMITS AND' INSPECTIONS ARE REQUIRED FOR COMPLETION OF THE INTERIOR OF THE BUILDING I' 'PRIOR TO OCCUPANCY. .. Additional Project Information: PLANS REVIEWED BY: nomeL"~I~t: t" ~.:-:~~ signaturl'" , .'. ". . <. . v ';:i"-'. 'I 'I ."~ .' ~ '.' I.: 'r. :, I I .. I ..r" . ,. .'-',". .-... '.1' . : ~at~ JUNE 29,19fn'