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Home My WebLink AboutPermit Building 1982-7-13 ~ '.. o COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description I. examole- Tax Lot 100, Lane County Map Ref II U3 43 2. examole- lot 1. Block 3, 2nd Addition to ~prlngtield [states C. Name, etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or force 2. examole- waterheater/electrlcal/or s~ E. Square footage or valuation, etc. - I. examoleo 1250 sq. foot house, 500 sq. foc 2. exa~ple- if new project. check:new - if a C/leek add. etc. F Building permit information: k 1. example - construct single family house ~ attached garage 2. examole - remodel existing garage into fa 3. examole - convert single family residence restaurant (change of use) ... _: .: "'"''' ~,' " "n"" " """, '"' ,., . Structural Specialty Code H. DESIGN TEM1 AND CONTRACTORS To avoid design or construction delays, Build Division Staff must be able to contact approp persons regarding design information or job s corrections, etc. II. Abbreviated Plumbing, Mechanical. & Electrical 5c A. Except where blank spaces Occur in the descri portion of.the Mechanical and Electrical 5che the applicant need fill-in only the No. Boxes to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical 5ch are available at the Building Division 1. To conserve space on the permit form the have been abbreviated 2. If the item(s) to be installed are not co the abbreviated schedules'you should cons full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEE CHARGES ON THE SCHEDULES O. As noted on the CAP, the label must be delivere electrical contractor for signature by his elec supervisor. The general contractor is.not auth to sign the electrical label. --- III. Applicant to sign and date Whenever possible, the initial application will be a worksheet only. Where possible, Building Divisio will prepare a type written copy and return it to t applicant at the time the actual permit is issued f signature. IV. Fees and Charges Plan check fees are due and payable at the time of application. and no plans will be processed until t fees are paid. All other fees and charges are due payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE 1. Need siqned improvement aqreement for I ~ 2. All conditions outlined in site plan n as modi fi ed & noted ( Permit applicant exempt from registratior Additional Project Information: PLANS REVIEWED 8Y: CIUJ)F SPRINGFIIELD .. City Hall Springfield, Oregon Department 01 Public Work" OFFICIAL RECEIPT NO.8 Date '" \;~1f39 / (nc Rec'd Fro ~ '~,J\ ~ r\ \ ,,('(lJ) Address~l\ ~~ V~lmniQ~o , ~{.'\O~~ - , .. ~ ( 59420 (I (, ( c Received For. U~(\~ \j '1S?J '-.~~mn (I r.-)'(l?J 00 l5.~~ rt'{)() CLl ' 4lfn- 0 cC) ~n4~~ _~q 2iJ - I.SZ []J)/(l~~ \01o? t ~.Q n~o 7' ' t K oJ Amoun ~ceived ~ -zto '~ '~~ . --- - , _J I , . ... __ CITY OF SPRINGFIELD i. I , I "';> ('" ,.() 00 r-x (I lt0/a ( \\\0 ~ (I Gl 40Jn (I (, ~, I u ( ~.. CilyHall Sprlnglleld, Oregon Department 01 Public Work,; (. OFFICIAL RECEIPT . No.8 59421 ~ \:1lg<69 I · , . (I ~ ~ C')('\"\ \. ~ ""G.h ',(I '~ \Q\o1\ ~[UiwiqQL ?;Qnw:\ ( <I Date ~i' ( Received For. (.. , <I (r jfu~ tI '/ , c!) 'rft.IB I (. (\ MI'\.&J W . ~..l1\LX\ ,_~ l l'i'Q.1.L') -'3~,lU Ii .f; t ( --~ .Amount Received -4 f)~)--T. ll~o _rt-. (bJ;;J:n f AllTl'IOpDSlGNATURE \- ( !L ~ . ~ BRIGGS f'RINTERS/LITHOGRAf'H!:RS.I:UGENE. C'RII!:GON .. name L~~ ?-~~ signature ~ /~< '!l'......... , ~ -". da te 7-/3'-g ";e ....- .~.._.._. ..- -..;. .-' '~.--=::::::::: .:::::'''::':"_': :=::=::.:"C'::':-:::--::-:',':.':.~";_'" . :;::i:":'::~~~~"::::.. ....~_~ ... .....~r.:.-.:.~-=.. "~~"_ ..~_-'-'~ ....__~ ......~.. .._~...:: . jIlISPECTIQ;1 LIIIE. 726- 37 69 Job Address 3294 Legal De$cription Owne r CITY Of SPRIIIGFIELD CDrlBI:IATlOM APPLICATlOM/PERMIT EilERGY SOURCES: Heat Hater Heater Ran~e ValuE of Hark: $182.985.00 , Buih:ino Permit Info: Describe Work(Le., Phone747-42t9Familv Residence Hith ~.ttached Garaae) .. Main Street Map 17-02-31-31, 4600 Tax Lots 4500 Address Le~ S~hwab Tire r.pntprs P.O. Box 667 Prinevil1e. OR 97754 Construction lender Address DES I GII nAil (name) Phone (address) lit INFORltATION UNt 726-3753 Sq. Ftg. l'lain ~q. Ftg. Access. Sq. Ftg. Other flew Add Alter Rep. --Fence Demo Change/Use Other- - 00 N o W o w Build Single Construct Alignment Center, Tire Warehou! Car & Truck service canopies & remodel Remodel Existing Building (l;es. no. \ (exo;res) " (ohane no. \ Primm McConnack Consulting Eng., 63925 Quail hayden Rd. ,Bend OR 389-0864 Structural Electrical Wa rner Engi neeri ng, 895 Country Cl ub Road. Euqene OR liechanical Roqers En9ineerinq G.P.. 78A Centennial LD.. Euqene OR CONTRACTORS (name) (addr~ss) - (li~~_ no.) MO. I ~IEach single fixture I Relocated building : (new fix. additional) Is.F. Residence II bath) IDuplex (1 bath) each IAdditional bath 300 I Hater service 10/100.F I Sewer Storm Sewerl01l00LF Stnrm Spwpr Trtn I I I I Genera 1 Plumbina Flpct,rir:"l - --. -- ~'echani ca 1 940 1 'ill...! I Res i dence of SQ. FT. INew circu~ts alts. X or extens lOns2 0 r mar e ISERVICES I ITempOrary Construction IChange in existing rp$}ppncp Imultifamily. COrml. or lnrluc;;triil.l 1 IOf 225 ICOru~./IND. FEEDERS I Install/alter/relocate rlic;;trih_ fpprlprc;; 2 IDf PLUI1B lNG ELECTRICAL 484-0620 484-0227 (phone no. (exp;rp,,) MECHAMICAL '" . rl-1olRG..C NO. . '" 'rHARli[ FfF rHI\Rr,F 1 furnace/burner to )"r;>r 1 00 OO~TU' s . 7.50 5.00 60.00 30:00 101l.00 In,nn 225 15.0C. Floor furnace and vent 3 Recessed wall llloil.ce heil.tpr ~nrl vpnt 6.0018.00 amps. I I I I 135.00 I Appliance vent seoar~tp Stationary evap. r:onlpr Vent - fan with sinole duct Vent system apart from I heating or A"C Mechanical e~haust I hood and dud_ I I I I I I I I I I 12.00 12.00 I. 10.00 39.50 Wood stove/heater amps. ?5.nl sn.nn Gas piping Air Piping ISSUANCE OF PFR!IIT TOTAL CHARGES TOTAL CHARGES 100.00 TOTAL CHARGES WHERE STATE L\Ii REQUIRES that the Electrical work be done by an 'Electrical Contractor. the electrical portion of this pernit shall no~ be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division ~ I HAVE CAREFUllY EXMllNEO the completed app 1 i cati on for permi t. and do hereby certify tha tall informa t i on hereon is true and correct. and I further certify that any and all work oerformed 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 herein, and that NO OCCUPA[{CY will be made of any structure without the permission of the Building Division. I further certify 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 exemption is noted hereon, and that only subcontractors and employees who are in comoliance with OP.S 701.055 will be used on this project. IjAIIE(please prinYc::::;.n. >U. t. "-- ~C\L.::l SIf.IIATURE FOP. OFFICE USE OljLY So. Ftg. 11air4.4lliLA 1; anf11eDld" Wrt rphn'USe 81.312.00 Sq. Ftg. AccessTrlick canalW Value 8_,80!l.00 Sq. Ftg. OtherAuto CanaDY x Value 28.256.80 Existing Bldg. RemodelroTAL VALUATION 45,443.20 P~ving & ~i+p Tm~r~vpmept~ lQ_171_nn Systems Oevelopment 1-82 985 00 ~9'h-3~ Charoe (1.5~) ~:8,/ ' . Pd. 7-6-82 1/59380 I \ l \ v Zone r.-4 Tyoe/Cons t. Units Fire Zone Bedrooms Occy Load Flood Plain No Stories 1 Dccy Group BOILDIIIG PERfllT Charges anc Surcharges PLD'1BIMG PER!iIT Cha rges and Surcharges ELECTRICAL PER!~IT Charges and Surcharges I1ECHAfl I CAL PERMIT Charges and Surcharges B-2 Plan Ck. Corom/Ind 383.00 65t/Bldo PH Fee ------------ Plan Ck. Res 15.32 30t/Blda Per Fee 200.00 Feoce $ lB. 00 ------------ 8.00 Demo ___lDD40ll..____ Sidewalk 4.00 I A/C Paving 39.50 I Curb Cut ----1~58----- OATE 7/;3)f:). I Cre~it !or I' cv II:;:n . c.c: over~ayment of plan -35.10 92.00 12.00 Total Comb. Permit 873.40 TOTAL $3583.08