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Home My WebLink AboutPermit Demolition 1981-6-29 (2) INSPECTION LINE 72~769 . CITY OF SPRINGFIELD COMBINA TlON:APPLlCA TlON! PERMIT . INFORMATION LINE 726-3753 ~ .:( ..- I ENERGY SOURCES: Heat (;AS 1 Water Heater elect Ran!:le Value of Wark: Sq. Ftg. Main ~o I 0 Sq. Ftg. Accen. Sq.. Ftg. Other _New_Add_Alter_Rep. _Fence_Demo_Change! Use _Other OJ - J .r: t5 Job Add,... 4157 Main Street Legal Description 17n?~2~2 02f.nn OW"., Sherman Ruttencutter 81,088.00 Building Permit Info: Describe Work \i.e., Build Single Familv Residence With Attached Garaae) Address940 SmITh 4~T'r1 .c::."t Phone 7A"_ ,'),t) Springfield, Oregon 97477 Construction Lender PeonIes Bank DEMO existing store structures and Address Phone COT'strnct shell onl v for new Nel son t s Tire Warehouse DESIGN TEAM (name) (address) (lics. no.) (expires) (phone no.) CONTRACTORS (address) ~ J~ .d;<{ V~ (Iics. no.) Y (expires) 7?/\- 225(' Primary Georue.Griffin 2866 Manor Orive Structural Electrical Mechanical (name) (phone no.~ Plumbina Twin Rivers 44 Orepon Street. Cre~we]l 204n W. Broadwav :\4521' :\44-1 ill /\R:\-ldld Gener(ll Metal Clad Bldrs. Electrical Ht)nT'Y Ponct)li'J"l hQ~ Woc. ('pntt)nn; ~1 Rl,~r1 ~A1_11Q~ Mechanical PLUMBING elECTRICAL MECHANICAL NO. ~ FEE I CHARGE NO. I FEE I CHARGE NO. FEE CHARGE. Duplex (1 bath) each Temporary Construction "n nil furnace/burner to ~TU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent system apart from heatinSl or A.C. Mechanical exhaust hood and duct Each single fixture Relocated building (new fix. additional) S.F. Residence (1 bath) 25.0 Residence of s9. ft. New circuits, alterations or extensions SERVICES Additional bath Amps. Water service Sewer Wood stove/heater Storm Sewer FEEDERS Heat Pump Air handler to 10.000 CFM Air handler over 10.000 CFM Amps. ISSUANCE OF PERMIT r TOTAL CHARGES I 25.00 TOTAL CHARGES 10.00 TOTAL CHARGES WHERE STATE LAW REQUIRES that th. Electrical work be don. by th. Eledrieal Contractor, the .Iectrical portion of this permit shall not ba valid until a label has been Ngned by an Electrical Contractor and attached to th. .Iectrieal panel. I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall 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 b. made of any structVre without the permission of Ihe Building Division. I further certify that my registration with the Builder's Board is in full force ond effect a s required by ORS 701.055, 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 used on this project. Basis for Builder's Board exemption: NAME (please print)..J!,.,Af'tE.r /7 .-:: /'0 p-/ SIGNATURE;2r.. .-:' FOR OFFICE USE ONLY ~~ OATE .c. -,,? 9-17 . , Zon~ r.4 Fire Zone Flood Plain Type/Const.--YN ~drooms C;.torie~ Units occy Load n ""y Group Sq. Ftg. Main 0::..... Ftg. Access Sq. Ftg. Other 5R7/\ x 1 " R,O_Value Rln88.00 x Value x Value TOTAL VALUATION 81.088.00 SHELL ONLY ADDITIONAL PERMITS ROD FOR IN' ERIOR BUILDING PERMIT Charges and Surcharges 251. 00 10.04 25.00 Plan Ck. Comm! Ind 65%/Sld!:l Per Fee Plan Ck. Res 30%/Bldq Per Fee 163,15 Systems Development Charae f1.5%\ 1216.33 PLUMBING PERMIT Charges and Surcharges Fence ELECTRICAL PERMIT Charges and Surcharges 1. 00 ._...1!L.00___ Demo Total Comb. Permit Sidewalk /\.:\11 .n AI C Pavino MECHANICAL PERMIT Chorges and Surcharges Curb Cut TOTAL 1683.22 1-' I .~ .... ; ~ -, .P~RMlt VALIDATION .:1 .. . .... - OB. "J- _c. aD. Legal Description 1. example-tax lot 1 Dei. Lane County Map Reference 17 03 43 2. example-Lot 1. Block 3, 2nd Addition to Springfield. Estates Name, etc. of owner and construction lende", t ~. Energy Sources 1. examcle.heat/electrical ceiling/or forced air go"s 2. example-water'h"eater!eledrieal/or 501ar. _. E. Square footage or valuation,. etc. -. r. ., ." . ._ 1. example-1250'sq. foot ho'use, 500 sq: foOt'gaiage'. 2. examole.if new project, check new-if addition: 'cheek add. etc. F. .Building permit information: 1.o'"example.consfruc;t single family house with an attached", go rage 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-qvoid design or construction delays, Building Division .... 'Staff must be able to contact appropriate persons regarding. . c;fe_sign information or job site corrections, etc. .', .~. ~ -......... -:t!. . i'::,-", L. -q;;- , "," .. .c... .. - - , : ' .--------- , ,'. II. Abbreviated Plumbing, Mechanical & Electrical Schedules A. Except where blank spaces occur in the description portion , of the Mechanical and Electrical Schedules, the applicant 'need fill~in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing. Mechanical. and Electrical Schedules are available at the Building ~ivision 1. To conserve space on the permit form the schedules hove been abbreviated 2. I~ the item(s) to be installed are not covered on the abbrevi- ated schedules you' should consult the full schedules C. BUILDING DIVISION STAFF WILL 'FIlL OUT ALL FEES AND" CHARGES ON THE SCHEDULES I,.' III. Applicant to sign ond date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare 0 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 are paid. All '. other fees and charges ore due and payable when the permit is issued. V. FOR OFFICE USE' ONLY ~ Permit Cler~ -,' t'''' , PROJECT CONDITIONS TO BE' SATISFIED. BEFORE OCCUPANCY, .,. Y,- ~;'. THIA PFRMIT TC: APPROVFn FOR CO~STllliCTio~"oF T'lf RlITt "TJiG SHEll mol" v _ ADDITIONAL 1 \ ".'.....- --"\. ' . PERMITS ANDIINSPECTIONS ARE REQUI~D:FOR COMPLETION OF THE INTERIOR OF THE BUILDING ~. . 0' .~~ - ~ \, ~...' , PRIOR TO OCCUPANCY. --- .- , , .' ,. .'~., .~ , ' , "~ !;.>.:....-~-, \....\ l: Addi~if?n~1 Project Information: " '. . " ,-,1,1. . ~ " PLANS REVIEWED BY: I, nam"" c;ignatur"" "'atf" JUNE ao:1'6;r".;';' . ,