HomeMy WebLinkAboutPermit Building 1990-7-9
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Job Address 4015 Main' St.. Sorinqfield. OR 97478
Legal Description see attrached
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. CIlY UF SPRINGFIE~D
COMBIIIATION APPLICATION, PERMIT
EIIERGY SOURCES:
Heat
l~ater Heater
Range
Valu<r~ry:)() ()[)
OR Phone741_02".,BUiltiinQ P~r111it Info: Describe \~ork(;.e..
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INFORftATION liNt
726-3753
Sq. Ftg. "lain
~q. Ftg. Access.
Sq. Ftg. Other
Ilew Add A 1ter Rep.
-Fence Demo Change/Use
Other - -
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j INSPECT 1011 Utic
, 726- 37 69
Address
Larry D. & Miriam L. Jones
93701 Marcola Rd. Marcola.
Build Single
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Owner
Construction Lender
Key Bank/Eugene
Eugene. OR 97440
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Phone
(address l
!lies. no.)
(exoires) A
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fohone no. i
Address 975 Oak St.
DESIGN TEAM (name)
Primary
Structural
Electrical
Mechanical
CONTRACTORS
(name)
(address)
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no.)_
Genera 1
John Vahala
PlumbinQ
-
Electrical
PLUllB I NG
ELECTRICAL
,..Q~ '7G1n
':H" rl-l+ furnace/burner to
BTU's
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MECHANICAL
~techanical
Marshall Oil
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FFF
l":HARGF
Nn
F'FF '.!.HARG..E..
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Each single fixture
Residence of
SQ. FT.
Relocated building .
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
11 bath)
Duplex (1 bath) each
Additional bath
SERVICES
Recessed wall
~n~rp hp~tpr Anrl vpnt
Storm Sewer
Of
amps.
'2.. ; ~=-;. / 7i:,.,w;z::> ~ a_-t
Appliance.'vent
seo.arate
Stationary evap.
cooler
I Vent fan with -:;? 7_-
sinole duct ./ ~~
Vent system apart from
heatina or A.C.
Mechanical exhaust
hood and duct
Sewer
Temporary Construction
Change in existing
res j qe.nce
multifamily, camm. or
Tnc1ustrial
Water service
COMH./IND. FEEDERS
Install/alter/relocate
distrib. feeners
Wood stove/heater
Of
amps.
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ISSUANCE OF PFRIIIT
TOTAL CHARGES ~H /~ -'> TOTAL CHARGES
WHERE STATE l.\\~ REQUIRES that tile Electrical work be done by an
shall not be valid until the label has been signed by an Electrical
~ TOTAL CHARGES /S':""'"
'Electrical Contractor, the electrical portion of this permit
Supervisor and returned to the Building Division
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 herein, and that UO OCCUPAHCY w"ill 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 t e basis for exemption is noted hereon. and that
only subcontractors and employees who are in compliance with OP.S 7nl.055 will used on this project.
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Units
Occy Load
Occy Group
SIGII^TURE ~t>. ~
FO~ OFFICE USE miL Y / I {/
Sq. Ftg. liain V x . Value
~ Sq. Ftg. Access x Value.
}3-2- Sq. Ftg. Other.:?~C'L 2./-,"0'9 Value
(o-l-qtfO :t\'h 5l:) TOm VALUATION
Conrn/!. nd n \ CQ,2 Syste. ms Development '
P~r Foe 'I C-"'- ~ CharQe (1.5~)
Res
Per Fee
DATE.2Ji19D
/
llAf.IE(please print)
Zone L::: ~.
Fire Zone
Flood Plain
Tvoe/Const. 5-YY
Bedrooms
Stories.
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BUILDING PERflIT
Charges and
Surcharges
,I Plan Ck.
__ ~:/~;?3:?___ 65%1Bldo
~ -= Plan Ck.
~.:;>-;:;>. 30%/BldQ
___J.2?.~___ Fence
-7> Demo
'Sidewalk
PLUt1BING PERMIT
Charges and
Surcharges
ELECTRICAL PERlm
Charges and
Surcharges
AIC Paving
_ u _15::. ~u Curb Cut
-75
Total Comb. Permit
MECHANICAL PERMIT
Charges and
Surcharges
TOTAL
IY7-Y=3'
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Co;.iBIIlAlION APPLICATION/PERMIT (CAP).
I. Applicant tol furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, lane Co~nty Map' Reference
17 03 43
2. example. Lot I. Block 3, 2nd Addition to
spr,ngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. exam~le- heat/electrical ceilinq/or 'forced air Qas
2. examyle- waterheater/electrlcal/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,
checl< add, etc.
F. Building ,pennit information:
1. example - construct single family house with an
attached 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. OESIGN TEAM ANO 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, & 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 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 abbreviated schedules you should consult the
full schedules
C. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEOULES
D. As noted on the CAP, the1abel must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is.not authorized
to sign the electrical label. ---
III. 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 type written copy and return it to the
applicant at the time the actual penmit 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
payable when ,the permit is issued. I
PERMIT VALIDATION
V. FOR OFFICE USE ONLY
Permit Clerk
1,ICf 40
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project. Information:
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PLANS REVIEWED BY:
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L~7?~ Ac:;:::;~ signature ~.-::.~_-I'/ -c::.. ~-'-"" date
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name