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Home My WebLink AboutPermit Building 1981-5-22 R.,/'-~H/<::'''' A INSPECTION LINE 726.3769 . . INFORMATION LINE 726-3753 CITY OF SPRINGfiELD COMBINATION -.\PPLlCATlON/PERMIT ~ \) ~' " /5d ". /<:V~ PC'l'<~ /dO:>MA./h S:r. L.gal D.m;p';an 11-" 3- ~ !'~'1/, r;.,.fl1?' ",,;c , )t" L:. , f'oKt"CR4 .,. Job Address ~~~ T'b ..,S'~ Ow no, 5PRhll6.r/cL.&> Add"" ~ <:,c> N A OT/~T""" :5r. Con$frudion Lender Address DESIGN TEAM (nome) Primary ~SJ6.N -5~~ I' Structural Electrical Mechanical CONTRACTORS (nome) Gon"ai VAN~'-'~~C:~;. Pl,mbina {jaHN4::5.:: ;::>~,,:~.. <I,,',kel 07Y V/elV &ecr. Mechanical PLUMBING ,I NO, II I FEE )?"A,;pn Sq. Ftg. Main g~ Sq. Fig. Access. Sq. Fig. Other _New _Add.)S.Alter .:-..Rep. I_Fence_oemoXChOngel Use (B~. 06__, _O'h." Building Permit Info: Describe Work (i.e., Build Single Familv Residence With AIt<'Jchf!d Gara,.,el ENERGY SOURCES: Heat Water Heater AI,/I, Ranqe~'A Value of Work: Phano 7"/,(- ~"/ -,,"/ ,"'R~L ~~e ~ ~F'>v~' Phone (address) . (expires) (phone no.) (lie$. no.) PoP R:lx Z,41 ;$5" .E~C'N~ , ~)y'o3' ~S5-~3'1~ fJ.. ~~ (OXD;"')'~ (Dhan. no.! (address) (lies. no.) 5/~ 't:" MA./N ,<j 7: 5~"r;-a::>. ~c:;;o #~c..:...,.,.J?t:>, ~G,y~ . , 7 '17-098'9 ~8"-1<9< ELECTRICAL MECHANICAL FEE CHARGE I I I Each sinQlc fixture Relocatod building . (new fix. additional) S,F. Residence (I both) CHARGE NO. ~"ol Ix I Sq: ft. New circuits, alterations or e,densions""C'R"MCV II:!F /S.- I I I I I I I I I I' I TOTAL CHARGES I WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contrachn, the eloctrical portion of this permit sholl not be vC1lid until 0 label hos been signed by an Electrical Contractor and attached to the electrical 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 thot any and 011 work performed sholl be done in accordonce 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 structure without the permission of the Building Division. I further certlfy that my registration with the Builder's Board is in.full force and e:ffect 05 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. ~ Dualex (1 barh) each Additianol bath Water service Sewer Storm Sewer ,):<>1> Basis for Builder's Board exemption: NAME (please print) ~~ ~11tI "" 20ne c-<( Fire Zone IJ..4. Flood Plain-IYG:> Typel Canst. Bedrooms ~torie. -x. . /Y jJ,A 2. BUilDING PERMIT Chargos and Surcharges 'i!24. ...0 "3_"3~ 5,<>0 PLUMBING PERMIT Charges and Surcharges .<"" ELEORICAL PERMIT Charges and Sur...!'arges ~t:::',"'C> 1.6C MECHANICAL PERMIT Charges and Surcharges I .--------1 CHARGE NO. FEE Residence of furnace/burner to :1TU's Appliance vent separate Stotionary evop. cooler SERVICES Temporary Construction Vent fan with single duct Vent system aport from heating or A.C. Mechanical exhaust hood and duct / :z~C> Amps. --:2.~ Wood stove/heater FEEDERS Heat Puma Air handler to 10.000 CFM Amps. Air handler over 10,000 CFM ISSUANCE OF PERMIT TOTAL CHARGES ~..l> TOT AL CHARGES SIGNATURE DATE~ ~t:{ , I Value /S::?_~. 'U "I Value Value I TOTAL VAlUATION~'~..o! FOR OFFICE USE ONLY Units I""lccy Load ~~ Occy Group_B..2 J;g<l x <;:". ftg. Main Sq. ftg. Access Sq. Ftg. Other x Plan Ck. Comm/lnd 65%1 BldCl Per Fee Plan Ck. Res 30%1 Bide Per Fee s'/. 6<> Systems Development Charae f1 ,5%) Fence -~ Demo I Total Comb. Permit /3'1.16 Sidewalk I AI C Pavina I I I I TOTAL tt(BB. ~ Curb Cut , 'COMBINATION APPLICATION/PER. (CAP) I. Applicant'Ja furnish A. Jab Address B. legal Description L example.tax lat 100, Lane Caunty Map Reference 17 03 43 2. example.Lat L Black 3, 2nd Additian ta Springfield Estates C. Nome, etc:. of owner and construction lender O. Energy Sources 1. example-heat/electrical ceiling/or force-d air gas 2. example~woter heater I electrical/or solor E. Square footage or valuation, etc. 1. example.1250 sq. faat hause. 500 sq. faot garage 2. example-if new project, check new-if addition, check add, etc. F. Building permit information: 1. examplp.-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 af wark as defined in Sectian 303 (a) af the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction delays, Building Div:sion 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) ta be installed B. Full Plumbing, Mechanical, and Electrical Schedules ore 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 yau shauld cansult the full schedules C: BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND, CHARGES ON THE SCHEDULES III. Applicant ta 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. 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. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: · PERMIT VALIDATION <;. Permit CierI- ?r-AN$ ,p~~,~ ~ /N",p~c::.rA::>h'''' ,e~4>L.V,ptSC> ;=;;;0 N VA':::: , _J- A~l!LL/gNA"- 5 Y~rE""'. z- FtR~ ~ N""A~ HcCc.UR~1'::> < Additional Project Information: PLANS REVIEWED BY, / . ~c;:-=..;-~ n~me..1.-&>RNe;- r ~,.~ c;ignatur-:- -JI--:::l.I.S/ ""ate .t5o 1'-011'1<::'.., /i INSPECTION LINE 726-3769 . .. . :'..,.,.~~'.~ ,- i-CITY OF SPRINGfiELD COMBINA n"ml APPLICATION I PERMIT . INfORMATION LINE 726-3753 I \A) " () ~ " fa;::("'6R4't 15 0 ~. /<)/-, ;';-""5'<~ Job Addum ~A/yC;e To 1&0 s;- )\-4,4./ /Y 5/: l.gol c.",;p';o~j lot:? J.?: ~- 'II f- O,R r '" r ,'::L. ~"')'~~ Own" ~ PR/..(/<:".FA~'-.D Addn!Si '< ,0. N A Ur/wry :5r. COlntrudion Lender Addren DESIGN TEAM (nome) Primary T~~k';N ....5crcs~~l"..<:., ENERGY SOURCES: Heot Waler Heater -1L ~J. RanQIl ~A.. Voloe of Work: gft'l'"f Sq. Fig. Moin Sq. FIg. Acceu. Sq. Fig. Other __New._ _Add ~Alter_Rep. .. _Fence_.__DemoXChonge/Uu~ ____.Olher - /~CJo.-I~_r. .:.>0 ( B /c:::c-o. Buildin'g Permit Info: Describe WOII (i.e., Build Single Fnmilv Re,idp,n~'" With Attoc~_,:j Garone; Phon. 74'4-~" .)/ -- -- - - ~-'JC'o.=L ~ c?F:F/..::"",'5 // - ;~C><J.:s. c: Phone (address) (expires) (phone no.) (lies. no.) ,;,.;:.;> ~;,,< .3'1_;;;~ ;.;;...=~_-~-:S , '7' ., YO 3' ~8?-&:3~:: Structural Electrical Mechanical CONTRACTORS (name) G.n.,o' V,4I1"';;~';,""Z? Plumbing (J ~H"I ~.J-<: ~57.. ?'-~, Electrical ~/71l~ Y:lEY/ ~~r. Mechanical PLUMBING (address) (lies. no.) (expire~) {a hone no_1 5/:J~MA/N .-;7: ~~ #.-'fNW.y" ''=;'l:} ~~~Ll:>, 7'17- 09Si<7 ';:;X?-/:Z9:J. , ,:':..,;;' (;~,.y,,~ ELECTRICAL I FEE 1 CHARGE NO. CHARGe MECHANICAL FEE CHA.RGE I NO. i lS:dOI I I X I I I / !'.IO. I Each sinqle fixturo R.lacatad building (new fix. additional) S.F, Residence (1 bath) DUDlex (1 balh) each Additional bath Water senica S......er Storm Sewer TOTAL CHARGES I I I I I I S-:~l> I FEE furnace;burner to I1TU's Appliance vent separate Stationary evcp. cooler Vent fan with sinqle duct Yent system apert from heotinq or A.C. Mechanical exhaust hood and duct Resid.nce of so: ft. New circuits, altera/ians or extensions "2J>j<;::>",..,Q/l ~ /5. <><> SERVICES Temporary Construction Amps. """2~ ::s:-O= Wood stove/heater FEEDERS Heat PumD Air handler to 10.000 CFM Air handler over 10,000 CFM Amps. TOTAL CHARGES 1I~"" ISSUANCE OF PERMIT I TOT At CHARGES WHERE STATE lAW REQUIRES that the Electrical work be done by the Electrical Cantrador, the .Iedrical portion of this permit :ohall not be vCllid until a label has been signed by an Electrical Contractar and attached ta the electrical panel. I HAVE CA.REFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I furth.r certify that any and all work performed sholr be done in accordance with the Ordinances of the City of Springfield and the Laws of the Stat. of Oregon pertaining to the work dOlcribed herin, and that NO OCCUPANCY will be mode of any structure without the permission of the Building Civilian. I further certify that my registration with the Builder's Board is in .full force and e<ffeet os required by ORS 701.05.5, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.0.5.5 will be used on this proiect. Basis for B",i1der's Boord exemption. NAME (please print) ~~ .A ~ c.-I.( }/'.4 ' Type/ Canst. "'Z". /':/ Bedrooms I..{. A Zone Fire ZOnG Flood Ploin ,/./0 c::.tarie, L~ BUILDING PERMIT Charges ond S",rcharges ~' ..,'" ____=-C{,__ -;. ~. _:;..,~A .....:::"" PLUMBING PERMIT Charges and S",rcharges .::;'<>0 -', ,:Zc, ELECTRICAL PERMIT Charges ond S",r"!-larg.s ?fc,'~"" .'~ ...... , .... MECHANICAL PERMIT Charges and Surcharges CATEt? /f./l..~ , I SIGNATURE FOR OFFICE USE ONLY IJnifs f"lccy Load _~ Oeey Group B . :: ,<?/s;<./ x Value _ Ii::;. -=:e>. .. . Sq. FIg. Main Sq. Ftg. Aceen Sq. Ftg, Other x Value x Yalue TOTAL VALUATION_/~'~ ..., Plan Ck. Camm/lnd 65~ol Bldq Per Fee Plan Ck. Res 30%/Sldo Per Fe. <) ,-/, ':e> Systems Development Chor~~ (1.5%1 Fence Demo 13<'/./6 Total Comb. Permit Sidewaik AI C Povino Curb Cut 1$($8. % TOTAL III. Applicant to sign and dote Whenever possible, the initiol application will be used os worksheet only. Where possible, Building Division Staff w prepare a typewritten copy and return it to the applicant the time the actual permit is issued for his signature. +- IV. Fees and Charges Plan check fees ore 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. COMBI NA nON . APPLICATION/PERMIT (CAP) I. Applicant'JO furnish A. Job Address B. legal Description 1. example-tox lot 100, lane County Map Referenc 2. example.Lot 1. Block 3, 2nd Addition to Springfie' C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air qas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. - L examale.1250 sq. foot house, 500 sq. fool garage 2. example-if new project, check -n;;,-if addition, chI odd, etc. F. Building permit information: 1. examplp-construct single family house with an aU garage 2. example-remodel existing garoge into family roar 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 ovoid design or construction delays, Building Div:s Stoff must be able to contact appropriate persons reg design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedule, A. Except where blank spaces occur in the description pc of the Mechanical and Electrical Schedules, the applic need fill.in only the No. Boxes'adjacent to the approF 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 schedule have been abbreviated 2. If the item(s) to be installed ore not covered on the ated schedules you should consult the full schedule C: BUILDING DIVISION STAFF Will Fill OUT All FEES M CHARGES ON THE SCHEDULES V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .' - ."" · PERMIT VALIDATION , " CITY OF SPRINGFIELD City Hall Springfield, O~egon Department of Public Works OFFICIAL RECEIPT c ( (' ~.Jrl M~NO. B :) 7 3 3 2( ( Date "- ,.,-, '~- ( Rec'd From t ( fJ~"\'\'-f\) Address ( ~~ PA-:V- ( \ Received For: = 5 ,f!:kJ ( ~\) " '-.~,O{) r-I7 ~ .:JOe ( q) )/Y) e b /.. ("d)' (~~ Ef+ It?) ...,. ,. 'e C' (.1 ^fV'> (' Amount Received l~ U-J ~f!0-^- / --:i.UTHOIfl'!"lO SIGNATURE SH[LTON.TU"N.ULL ~"'''T[''S . [UC[Nl[, 0" 17"0' <: " \, (~I UI".S .C,. (I " Permit CierI- : ,?;;,./4~!r . ?=.,h'N,~ ,,:,' /N"'P~c::.T""'/\f'5 1e<<;4><-v.,?<ED ~.= h/VA<:::. J- A';/)I r/~N..:::. '5 YS T<t;:J\A , Z. fi R ~ ,?~, "...",'-,.....-=- .,.~....(~~~~,;"::.;..~"t-.~ Additional Project Information: PLANS REVIEWED BY: / "-c:"",- -~ nome L-P/l;~c,; ... ..............,. C:r r"J "ignature , _n.i '"'1-?t-!SI date