HomeMy WebLinkAboutPermit Electrical 1981-11-4
INFORMATION LINE
726-3753
Sq. Ftg. Main ::>~'U eX1St.
Sq. Ftg. Acceu.
Sq. ftg. Other.
_New_Ad~_Alter_Rep.
_Fence_Demo_Change/ Use
....:...Oth.,-.l:omplph> inter
Plumbina. Electrical. Mechanical & InterJo.'
for Shell bui 1t under, Job #810416. 6-29-81
I
'. ".., '. . . . ". // - ../1
~~;~,-,,::.:;,..:;~.~.c.i:"""_':'."II':""'; .. "!'I'ilL IlllL "'.. ''/'1'''' " '.'1' ,~.~-.~.~. ~ I", "I ""'_'I",
__~ _ .. _R___~J.- ~".""""'''''~j''"~_'''~J~~-O;'''_~'''~~_'' .,
.'
INSPECTION LINE
72~3769
CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
Job Add,... 4157 Main Street
l.gaIO."dp'lan 17-0?-1?-12...__LL26QO
ENERGY SOURCES:
H.al Ga~ FA Ilnit
Water Heater ~ 1 p.,.. t
Range
Value of Work: '
Htr
Own., Sherman RlJttpnr.lJtt.pr
Add,.., 940 S. 43rd Strppt
'r~;n~field. OR 974L7
Construction lender Pf3nnl j:l, R::.nk
. ~~71fi. (In
JOO: /4b-14jl Building Permit Info: DelCribe Work (i,e., Build Single
Hm Phone 74n-1?:~n Family Residence 'With Attached Goraae)
Addreu
Phone
DESIGN TEAM
(address)
(expires)
(lies. no.)
(name)
Primary
Gporop I. Gri ffi n
~~
~~
V/~
?Rhh Mannr nr;vp
Structural
"
"
Electrical
Tf3n ~"np.r fnr ~p.nrgp. ~riff,n
"
Mechanical
CONTRACTORS
(name)
(addreu)
,.
(expires)
(lies. na.)
G.n.,a; Mptal r.larl Rlrlr~
Plumb;na Twin Rivers Plbq
44 Orpgnn ~t. Crp~well 3452~
2040 W. Broadwav
hRS W, r.pntpnn;al Rlvrl
Electrical Henrv Pense 1 in
Mechanical
PLUMBING
ELECTRICAL
MECHANICAL
NO.
FEE CHARGE NO. FEE
I
I furnace / burner to
I~TU's
I Appliance vent
separate
I Statianary .'fap.
cooler
I Vent fan with
single dud
I Vent system apart from
heating or A.C.
Mechanical exhaust
hood and duct
1 Each single fixture
Relocated building
(new fix. additionol)
S.F. Residence
(I bath)
Residence of
CHARGE NO.
12
15.0C
2
1
5.00 '9, ft.
New circuits, olterotians
X or extensions 2 or mOl e
SERVICES
Duplex (1 both) each
Temporary Construction
Additional bath
Amps.
Water service
Sewer
Wood slove/heater
Storm Sewer
FEEDERS
Heat Pump
Air handler to
10,000 CFM
NOliE: 5 plumbin9 fixturES
were charged to the firs1
perjmi t.
2
Amp., 100
1O.0C20.00
Air handler over
10.000 CFM
1
Gas Pioino
ISSUANCE OF PERMIT
TOT Al CHARGES
5. 00 TOTAL CHARGES
35. on TOTAL CHARGES
co
.....
o
-l'>
.....
0\
or
(phono no.)
726-2250
"
(phone na.)
344-1832
fiR3-1414
741-1186
FEE CHARGE
s:a8 19.50
3.00 h.OO
4.50
I
I 2.00
I
I
HI nn
4?,nn
WHERE STATE lAW REQUIRES tho' the Electrical work b. done by Ih, Electrical Contractor, the .lectrical 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 HA ve CAREFULLY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and carrect, and I further
certify that any and all work performed shall be dane in accordance with the Ordinances of the City of Springfield and the Laws of the State af Oregon
pertaining to the wark described herin, and that NO OCCUPANCY will be made of any structure without the permissian af the Building Divilion. I further
certrfy that my registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemptian is noted
heron, and that only subcontractors and emplayees who are in complianCII with ORS 701.055 will be used an this project.
Ba.'. fa' BuHd.,', Baa,d .x.mptlan' . .' /7~ ;:Ji;'-"'- .
NAME (pl.a,. pdnl~ ~:-A"';~-1/ If!:r r.fiz,' {-'.,/r r.E/,7SIGNATUP,~~--IA.r??#??((/../A~.f, ~ATE//- ~-d?/
FOR OFFICE USE ONLY
Sq. Fig. ~Qin --C..orIJ.ol ~te ; 'lter~V' Value
Sq, FtgSM~ WDO. x' 80 Valu. ---2..40.0...00-
Sq. Fig. ooliJore ?o?n x Rn_vatu. ?31fi 00
nnly.JRl . nRR nf' .. .roTAl ~ALUATlON '1$4736 on
. . Systems Develapment I
W Rn Cho,.. (1.5%) 7.l-..O~
I I
I I
I
I
I
lone
r II
Type/Const.~
Bedrooms
l:,torie.:' 1.
Units
t"'\tcy load 96
. Occy Group ---B?
Fire Zone
Flood Plain no
'NOTE:' Pri or.'Ilu.1'fuq..Pprmit
BUILDING PERMIT
Charges and
Surcharges
w.a.sis,sl,pn fnr ~n",l'
Plan Ck. Comm/lnd
_____-.J~'O'O 65%/Blda Per Fee
Plan Ck. Res
1.?R 30%/Bld~ Per Fee
PLUMBING PERMIT
Charges and
Surcharges
'\ nn Fence
I Total Comb. Permit
. ?n Demo
elECTRICAL PERMIT
Charges and
Surcharges
I
I
I
.-'- TOTAL
1: ~ nn Sidewalk
1 . an Alc Pavina
MECHANICAL PERMIT
Charges and
Surcharges
_____-1f." 00_ Cu,b CuI
1. ~R
118.56
..___~~.1.n..AJl__ .
. --. . . ~...
, . '. '. . '. .. ,., . . . '. .4
_L":-_.~,:,;L.-l,~:,~ ~ ~.II.~~~A,I;'Ii',l":",,.Il"I&!..-."~ '~"i..u..&.II-I. , : ,loll.. ,1lI1 "III j II. ~! ~~I _
. ( CITY OF SPRINGFIELD
- City Hall
Springfield. Oregan
. Department of Public Work.
OFFICIAL'RECEIPT
III. Applicant to sign and dote
Whenever possible, the initial application will be used as a
worksheet only. Where possible, Building Division Stoff 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 ore paid. All
other fees and charges are due and payable when the permit
iS~!S5ued.
:~~:,,~____:~ 1 ,._
COMBINA nON APP\ICA nON/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example-tax lot 100, Lane County Map Reference
2. example-Lot I. 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 QQS
2. example-water h~ater / electrical/or solar
E. Square footage or valuation, erc.
1. example.1250 sq. foot house, 500 sq. foot garage
2. example~if new project, check new-if addition, chec
odd, etc.
F. Building permit information:
1. example-construct single fomily house with an attol
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 ovoid design or construction delays, Building Divisic
Stoff must be a ble to contact appropriate persons rega
. design information or job site corrections, ete:
II. Abbreviated Plumbing, Mechanical & Electrical Schedules
(
A. Except where blank spaces occur in the description por
of the Mechanical and Electrical Schedules, the applica
need fill.in only the No. Boxes adjacent to the appropr
item(s) to be installed
B, Full Plumbirlg, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedules p
hove been abbreviated \,
2. If the item(s) to be installed are not covered on the'
ated schedules you should consult the full schedules .'
C. BUILDING DIVISION STAFF WILL FILL OUT All FEES AN (
CHARGES ON THE SCHEDULES j-, .
V, FOR OFFICE USE ONLY
;
1,.--
PROJECT CONDITIONS TQ BE. SATISFiED BEFORE OCCUPANCY:
Additional Project Information,
." l~!'11
.-
I
(O~
No. B
'7'-'9
" J' I
v, . (I
(
'.
/t- f- 19 fri.
Rec'd From Jtt..Vt./wl.AAr\. ~W-ltJ.i N Ji:t:zL 'I
Address q4/) S. d.'"\/1A '5T
Dote
(
-I
Received For:
( -;~ ,lJ~-f':
'Pill ~/'" IIPJvY)IIt
, t/-b1/J
91..u.. _ ':MJutll.J;
It if7a
_ ~'-' ...iV-"N'~
~~ (--~A
~L:~-
P
-iiI ~
..f.),
I ,;) ~
q
...-: t)()
. :111
(
~
,1
\.
1<€',.t7a
J.4b
;.f;;. .()'()
I r...Q
(I
7/. Or../-
:ZO. ff)
(1
Amount Received
Ut.-
q
11,2/ /).iflj
~.J0 .
( I - AUTHOltIZ[D SIGNATUltE
'. SHELTQN-TUII".ULL ~III"TEIIll - EUGENI:, QII "",,0'
(i
11111.1 (
(I
;,1..:
.'.
.'_ I
. . ~
/-; "'.
Permit Clery
Thp n,.;q.ina]-/J.l~n~ !l. nPY'fl1it~ wpt:e...fur thp ~tr".c..tu.r"l ~heJlR.
r,:::lie:. t..LQ.Pmc: nn 1 v
TJ1esLpJanc; ~.pt)nnit(: Ar'P f'...o.r.-Ihp rnm~lptinn nf thp. inb:~r;or in('"llltiing nnE..--
- .~
,. 'j.'-
ollJmh;n~)(t!lrp nnt-'oy_er.ed...initi.i.lllv ~nrl p]prt.rir"l "nrl....mecl>~nir"l ~u~tpm~
PLANS REVIEWED BY,
name
Loroe Pl e.ger
Signature~~
~4U->
p>
I
date 9-28-81