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Home My WebLink AboutPermit Demolition 1981-6-29 (3) I INSPECTION LINE 726-3769 I Job Address I legal Description I I Own.. Sherman Ruttencutter I Addres~g40 ~nl1i"'h A"t",,'\ ~... I I I Addren I DESIGN TEAM. I Primary . CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT . INFORMATION LINE 726-3753 17n?~?~? n?I>nn ENERGY SOURCES, Heat (;A...c; Water Heater elect Range Value of Work: Sq. Fig. Main :;'0 I 0 Sq. Fig. Access. Sq. Ftg. Other _New_Add_Alter_Rep, _Fence_Demo_Chonge! Use _Other d1~ain Street Phone 7A"_ ,("~n 81. 088.00 Building Permit Info: Describe Work (i.e., Build Single Family Residence With Attached Garoge) Springfield, Oregon 97477 Construction lender PeonIes Bank DEMO existing store structures and Phone eOnllTtlct ..hell Tire Warehouse on1v for new Nelson 's (nome) (addreu) (lies. no.) (expires) I (phone no.) r,,,,,..a.. r,tif.fip 2866 Manor Driv.. ~~ ,~ ~ 726-2250 Structural Electrical Mechanical CONTRACTORS (name) (oddreu) (I in. no.) (expires) (phone no.l PlumbinA M"~a1 Clad B1drs. 'l'tdIL.R.i v...... ~enry Pll'R~~~~~ 44 Oreion Street. Creswell ?ndjl 1'1- Rroadwav 34526 344-1832 683-1414 General Electrical -SOl: Wo.et Centrn..nt U1"A 7&1_11111> Mechanical PLUMBING ElECTRICAL MECHANICAL I NO, I FEE CHARGE NO. FEE CHARGE NO. FEE CHARGE Duplex (1 bath) each 1 Temporary Construction 1n.n I furnace/burner to ATU'. Appliance vent .eparat. Stationary _yap. cooler Vent fon with single duct Vent system apart from heotin!;l or A,C. Mechanical exhaust hood and duct i Each sinj:lle fixture Relocated building (new fix. additional) S,F. Rluidence (1 both) 25.0 Residence of <<l.ft. New circuih, alterations or extensions SERVICES Additional both Amps. Wat.r service Sewer Wood "ave/heater Storm Sewer FEEDERS Heat Pump Air handler to 10,000 CfM Air hondler o....r 10.000 CFM Amps. ISSUANCE OF PERMIT TOTAL CHARGES 25.00 TOT At CHARGES 10.00 , TOTAL CHARGES WHERE STATE LAW REQUlIlES that the Electrical work be done by the Electrical Contracto"r, ,the electrical portion of Ihis permil shall not be "valid until a label has been signed by. an Electrical .contr~d~r and altached 10 the ~Iectrical panel. I HA VE CAREFULLY EXAMINED the ~mpleted application far permit, and do hereby certify that all information her~on is true and correct, ond I further certify that any and all 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 made of any strudure without the permission of the Building Division. I further cernfy 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 ~sis for 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- NAME (please print) d , ~O /oJ .r /7 .r:. /0 P:I 'IGNATURE~/.----/ / ddI tC. ,?""-F;/ OATE - FOR OFFICE USE ONLY , Zone fA Fire .i.~'~.-'''l' Flood Plain Type/Canst. ledrooms VN Units l"'\ccy Load nccy Group 5876 x 13.80 Volue ~,088.00 ,-,.-. '" ." x Value x Value TOTAL VALUATION ;. C:tori-* Sq. Ftg. Main Sq. Ftg. Access Sq. Fig. Other ADDITIONAL PERMITS ROD FOR INTERIOR 81,088.00 SHELL ONLY 10_nd Plan n. Comm/lnd 65%1 Bide Per Fee Plan Ck. Res 30%1 Bldg Per Fee 1 63.,. 16 Systems Development CharQe 0.5%) 1216.33 BUilDING PERMIT Charges and Surcharges _ _Jill..illL__ PLUMBING PERMIT Charges and Surcharges .':l.,' . :-,'.-.25.00 Fenc:e . . ,....r., .'. :.;:f(,.,;\~, ~~".1~~' 1 nn Demo ...,." "Tc;t~I-'CQ:m~."i7ermit :,....... ."1 ELECTRICAL PERMIT Charges and Surcharges 1n nn Sidewalk F.. ~n ,n Ale Pavina MECHANICAL PERMIT Charg~~ and ' Surcharg~s ---'------4-- , ~( Curb Cut " . 't~} TOTAL . I, .1683. 2~\: I 'l','.' COMBINATION APPLICATION/PER. (CAP) I. Applicont to furnish A. Job Address B. Legol Description 1. example-tox lat 100, Lane County Map Reference 17 03 43 2. exomple-Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced oir gas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foot house, 500 sq. foot garage 2. example-if new project, check new-if addition, check add, etc. F. Building permit information: 1. example-construct single family house with an attached garage 2. example-remodel existing gorage 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 avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electricol Schedules A. Except where blank spaces occur in the description portion of the Mechanicol and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanicol, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules hove been abbreviated 2. If 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 .PERMIT VALIDATION 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 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 are paid. All other fees and charges are due and poyable when the permit is issued. V. FOR OFFICE USE ONLY Permit Cler~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: T~Te:: D.DMTT Te:: &PDDOlfED FOR CONSTRIICTT0M 0. TUr:: ~1.1Tt_t;)HIG SHELL ON!" v. AOOTTTONAI PERMITS AND INSPECTIONS ARE REQUIRED FOR COMPLETION OF THE INTERIOR OF THE BUILDING PRIOR TO OCCUPANCY. AdditionClI Project Informotion: PLANS REVIEWED BY: name i 11"I~t: "", ..._-'"' signatur.... .l JUNE 29,1981 alp