The URL can be used to link to this page

Home My WebLink AboutPermit Building 1981-3-12 'i~ ~,._ :;.~~."~'~'1':'~~~m~~:~:::"=,,,,,,,~,,,,,''''''"';"~1---''' ._'~;;-.r- -"; ...~.~'~.~ .'~"-._'r____'-; 'i6*\.~'c~~~f,,::::~,K:;~~(';'~~~~\~~~:~';7!.;~,~:f~'':''G,;''i,,!,~,,~~: ,: '_., ,;:"" .',' ,'_:~ ;;, 11",1..1.1. . II.:..!Il I I. [~"J.u...(:::."~lll.e. 1.1., II ,JIIII .....l...II. 1.__' 'III... ."lo,I;',. '.'. III.' IlIe.IIU."" "" .-.. .' .-.-....... ~ '1:".... '.. , ~~ -'--_....~~,.. "."~ I INSPECTION LINE ..w.' 726-3769 . "..~. I Job Addr.n Itegal Description 4350 Main Street - Suite A TL 2300. Mao 17 02 1? 11 CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT ';.' . . "~~. ENERGY S'f"e!'Ct Heat Woter Heaterl::. I ect INFORMATION LINE 726-3753 Owner Hiatt. Hiatt & Cochran 663 West Centennial Sorinafield. Oreaon 11, 500 Sq. F'g. Main Sq. Ftg. Accen. Sq. Ftg. Other _X_New_Add_Alter_Rep. _Fonco_Demo_Chonge' Use _X_Other .LLUU Ranqe Volue of Work: co .... C> .... N C> 'Address Phone 741-1420 Building Permit Info: Describe Work (i.e., B:.Jild Single . Family Residence With Attached Garaqe) 97477 c;~ nrlwich-Shon, Lease Space - See Job #792971 Address DESIGN TEAM P.. Springfield Phone Construction lender (nome) (address) (lies. no.) (expires) (phone no.) Primary A. ~J.- ,~ Structural Electrical Mechanical CONTRACTORS (nome) Hiatt Brothers Investments Springfield Twin Rivers Plumbing Eugene Penselin Electric Sorinqfield Harvey & Price Sorinafield (address) (lies. no.) (expires) (phone no,) plumbinq 20-96 20-48C 741-1420 683-1414 General Electrical 7111_11ill; 746-1621 Mechanical PLUMBING ELECTRICAL MECHANICAL Duplex (1 both) each Temporary Construction 2 litmelb'(j~.' .~, ___,____ _Bll s Appliance vent separate Stationoryevap. cooler Vent fan with single duct Vent system aport from heating or A.C. Mechanical exhaust hood and duct I FEE ~.OO : CHARGE NO, FEE CHARGE - NO. , FEE CHARGE NO, Residence of 2 12.00 11 Each sin!:llo fixture Relocated building (new fix. additional) S.F. Residence (1 bath) 5....0.0, 55..JlO._ ~q. ft. Now circuits, olterotions or extensions SERVICES ::.00 6.00 Additional bath Amp.. 15(1 'I; nn Water senice 1 Sewer 10.00 Wood stovel healer Storm Sewer FEEDERS Heat Pump Air 'handler to 10.000 CFM Air .handler over 10.000 CFM Amps. ISSUANCE OF PERMIT 10.00 TOTAL CHARGES 65.00 rOTALCHARGES 25.00 TOTAL CHARGES ?R nn WHERE STATE LAW REQUIRES that the Electrical work be done by the EI.drical Contrador, the eledrical portion of this permit shall not b. valid until a label has been sign.d by on EI.ctrical Contrador and attached to the electrical pan.1. I HA VE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further certify that any and 011 work performed shall b. done in accordance with the Ordinances of the City of Springfield and the lows of the Stat. of Oregon pertaining to the work described herin, and that NO OCCUPANCY will b. made of any structure without the permission of the Building Division. I further certlfy that my regiSlTation with the Build.r's Boord is in full force and eff.ct os requir.d by ORS 701.055, that if exempt the basis for ex.mption is not.d heron, and that only subcontractors and employ.es who ore in compliance with ORS 701.055 will be used on thi.' project. NAME (please print) OE,v/Vi 5 6- ;"0 (/ 1-=-/( ---y. . . r (. II ~ ~ SIGNATURE ~~ , ~.?J'L '7 _ /"'J-..fJj; 1ATE ? ~ Basis for Builder's Boord exemption- ], FOR OFFICE USE ONLY I~U Type/Canst. Bedrooms ~torier #-N 1 Units 1 Leilse ,n) B-2 So Sq. Ftg. Main Sq. Ftg. Access Sq. Ftg. Oth.'. 120n x ......9.......5LVolu. x Valu. x Value TOTAL VALUATION 11.500,00 [;-'1 Zone Fir. Zone Floo~ Plain ':>ccy Load '1ccy Group 11 ,~UU. UU "t.. BUILDING PERMIT Charges and Surcharg.s ", 60.00 -----2~lTO- Pion Ck. Camm/lnd 65%1 BldQ Per Fe. Pion Ck. Res 30%1 Bldq Per Fee 39.00 PD 2 24 l~y"em. O..el.pme"' - - dharqe (1.5%) 172,50 PLUMBING PERMIT Charges and Surcharges 65.00 L.bU Fence D.mo Totol Comb. Permit 185.12 ELECTRICAL. PERMIT Charges ana Surcharg.s 25.00 l.UU Sidewalk .1.. AI C PavinQ MECHANICAL PERMIT Charg.s and Surcharges , . 28.00 :,-::--:::'=_-:T:-12- '..~.J Curb Cut I T~T~.l. .,..... :... _.1. 357.62 i ~~':'" -It;, . ,~~( .,;;::iFt~~!.-'.-'~'~'0\~~:~~~":~~~~:~~~~-?~:~~':' .~ ~:':'::-~:;!'-~~~:~~.."". .~~s,f;~-:~;:~:;~~~- ~.~:~/..:~:~~'~>:~_:.':.~~~ : ",:<~, -~~: ....,~~~f~11,a~:~::t '~',J!f!J.'1'...~<,;.;._,.". .,;;...1 '.....:'.....<~ 'to ......G~ ,."'.'<"....i1-l'~':.p."-.. . )'."..","A. .:':'''~'':-''''''~'~''~'.'''.':..,,,~j..,. ~ . .,--";.../.,::....:~.,~X~_&,~.... 00.:. .'~ ,;...:.....-:~....~.,. ~i!r;;::.t.: ::;m'~.~.";OA-'-,"d$,,.....~;:~o/~j., ' ':. ,,~.....-,~ . '. ~.~.;.:.~~~"::'.....~_.;.... .-..........-~.. ...~_~~~1'.:n...."'-:!,"'.'n.~_..':"L~. ,. '...-. .~~ ~~""""":'...~o-."'~,-._.....l=""'1'...~.J"Ii'~ , , COMBINATION APPLICATION/PERMIT (CAP) I.,~pplicant to furnish .:A.' Job Address B, legal Description ,1. example-tox lat 100, Lane Caunty Map Reference 17 2, example,lat I, Black 3, 2nd Addition to Springfield E, C. Name, ete, of owner and construction lender D, ' Energy Sources 1. exampleAheat/electrical ceiling/or forced air qas 2. example-water heater/electrical/or solar ~:.' E. Square footage or valuation;" etc. ..,..,. I. example,1250 sq. fool 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 attach, 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'avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regard design information or job site corrections, etc. II, Abbreviated Plumbing. Mechanical & Electrical Schedules A. Except where blank spaces occur in the description portie af the Mechanical and Electrical Schedules, the applicant need fill-in only the No, Boxes adjacent to the appropria1 ,item(s) to be installed B, Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1, To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the ab , ,. 'ated schedules you should consult the full schedules C, BUILDING DIVISION STAFF Will FILL OUT All FEES AND CHARGES ON THE SCHEDULES Ill. Applicant to sign and 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. l IV. Fees and Charges i-~' 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 payable. when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: -, .j" :: ...r;,". "n' .j', .. ,J. , ... ,.~. .' Additional Project. Information: .':,: "'.,:'l.'.-' ". PLANS REVrEWED BY: PERMIT VALIDATION (. CITY OF SPRINGFIELD ( City Hall Springfield, Oregan Department af Public Warks OFFICIAL RECEIPT No. B 5 S 0 2 8 I,' ('\ 1--", 19 r-, Fram \~\ \(1, tt' Dill6 Address \ (~('~ Cc I\. \J r~\'\ ~(\ \i \l\ \ f~ . ~, I , Dote ( Rec'd \'~i\ " . \ \. ,\ ( " \ Received Far: ( I: X'-~ (,'~.K'\ - - (j V\X\\u ~ (; 0 0'1- ( lcO~ ,!,) .L\D (nC~ ()O .0r-),'\ - Cl coO -- 0J~::" CO #;f, I ,({) ~ /')0 GO ,--... C'j, I , / :?- \ T'l ,":-:D L\0,,) ( ( c C'\\D,(f'~H ( c r \" 1,)(,\['/ i\ c:" - - /7j /1, ( ( f'~y\1 ) . \d~ \:.,\~. \~\ \f\~) , ( Amount Received ( ~.,' AU"rl-lORIZED SIGNATURE -Z: (: -, 5..nTO".TU'''.SUU ~1Il'NTI;IIl'" IEUGE"IE, Olll .,..0, '58'5".8 ( Permit CierI- J' 1.-.:;,:: ......m . . ~ ".;" ~ .'H '.f.:;" ~ :-. : ..;:~T.~~. . " . A-. I ~~~~":.r. " ~"'" , . ".,l /"';'" .. . ",'.~,;. ' . ,. .~. . J .,-,. ...;.. ~--, ,',::..: DAN SMITH. nam'" signatu';1JrLn Amth ): ' ., ~.: ....\.:. ~~~_~"_L..~'._'_..' ,.'n 1.1'.'. .~'A' ;.....1\,. 3-11-81 dat~' '-'"'-,,:-.. ~ ,