HomeMy WebLinkAboutPermit Building 1982-10-20
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. CITY Uf SPRI;lGFIElO
COIIBWATlON APPUCATION/PERMIT
E!IERGY SOURCES:
Heat
Hater Heater
5600
Ranqe
INFORJ1ATION Uin.
726,3753
Sq. Ftg. 1.1ain.9E?O
~q. fta. Access.
Sq. Ftg. Other
Uel., Add Alter Rep.
-Fence Demo Change/Use
Other - -
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1 I;ISPECTIOiI UIIE.
726,37&9
Job ^ddress
1009 Hain Street
legal Description
17-03-35-41, T.L.
"A" Street
Phone
ValUE of I-lark:
4,500.00
BU11riinQ Pennit Info: Describe Work(i..e., Build Single
Family nesidence With Attached Garaqe)
Foundation only, S.U.B. truck
OwneSori.ngfield
Address 250 North
Utilitv Board
SoringfL.el.d_LOJ:,egcin
Construction lender
97477
facilities huildinq
Address
Ul:.~ I litl H.J\il
\name)
Phone
\address}
PO box 3425 Eugene, OR
(1 ics. no.}
texp; res}
(phone no.
Primary
Design Systems
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PO Box 3425 Eugene
683:-6343
Structural
Electrical
!1echan; ca 1
CONTRACTORS Iname! laddress)
General Construction Management, Design Systems
(phonp no.}
683;-6343
Plumbinq
Electrical
~lechan; ca 1
PWIIBlllG
ElECTRICAl
MECHANICAl
Each single fixture
FE" '_Cdl\BGE NO. I FEE CHARGF NO. I
Residence of furnace/burner to
SQ. FT. BTU's
FFF rI-lAPr,F
'/
NO.
Relocated bui'lding
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(l bath)
Duplex (I bath)
SERVICES
Recessed wall
Snac~ h~~tpr and vpnt
each I
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I ISSUANCE OF PFR'llT
TOTAL CHARGES TOTAl CHARGES I TOTAl CHARGES
WHEP.E STATE L\H REQUIRES that tile Electrical work be done by an .Electrical Contractor, the electrical portion of this permit
shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division
Sewer
Temporary Construction
Change in ex)sting
res 1 rJ~nr;~
mUltlfamily, comm. or
In(ivstrirll
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I App 1 i ance vent
separat~
I Stationary evap.
cooler
I Vent fan with
sinole duct
I Vent system apart
heating or A.C.
I MeChanical exhaust
hood and du~t .
I \-Iood stove/heater
from
Additional bath
Hater service
Storm Sewer
10f amps.1
ICO~1./INO. FEEDERS I
Ilnstall/alter/relocate I
distrib, feeders -
10! . amp~1
I HAVE CAREFULLY EXNlINED the completed application for permit, and do hereby certify that all infonnation hereon is true
and correct, and I further certify that any anq 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 NO OCCUPAHCY 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 emption is noted hereon. and that
only subcontractors and employees who are in compliance with OP.S 7nl.055 )11 be used on is'pra{j:ct.
UNIE(please print)--'cln'i <: L....Smi t'h SICUATU _ DATE 10-20-8:
FOr. OfFICE U1E
NA
Zone C-4
Tyoe/Const.
Bedrooms
Stories
5-N
NA
1
Units
Occy load',
Occy Group
Sq.
Ftg.
Ftn.
Ftg.
Hain
Access
Other
. x
Fire Zone NA
Flood Plain NO
B-1
Sq.
Sq.
x
Value
Value
Value
x
TOTAl V AlUA Tl Otl
4,500.00
BUILDING PERI.IIT
Cllarl)es an~
Surcharges
Pl an Ck.
32.00 65t/Blda
------------ Plan Ck.
1,28 30t/Bldo
I Fence
I Demo
I'Sidewalk
I A/C Paving
~___________: Curb Cut
Comm/l nd
Ppr Fpp
Res
Per Fee
20.80 PD
8-24-82jch
Systems Development
Charoe (1.5%) .
67.50
PlU'1BIIIG PERMIT
Charges and
Surcharges
ElECTRIU,l PERI~IT
Cha rges and
Surcharges
Total Comb. rermit
11ECHMIICAl PERMIT
Cha rges and
Surcharges
TOTAL
,
100.78
n-l
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COMB IllATION APPUCATlOII/PERHIT (CAP)
I. Applicant to furnish
A. Job Address
B. legal Description
1. examo 1 e- Tax lot 100. lane County Map Refl {Ct.
II 03 43
2. examole- lot I. Block 3, 2nd Addition to
Sprlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example. heat/electrical ceilio%r forcec
2. examole- waterheater/electrical/or s~
E. Square footage or valuation, etc. ------
1. examole- 1250 sq. foot house, 500 SQ. fooi (r;o
Z. examo}e- if new project. check:new - if de
ctleck add. etc.
F. Building permit information:
1. example - construct single family house wi far
a ttached garage
2. examole - remodel existing garage into fan
.3. examOle - convert single family residence (
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays. Build; (
Division Staff must be able to contact appropr
persons regarding design information or jab si
corrections. etc.
Abbreviated Plumbing. Mechanical. & Electrical Sch 6e.
A. Except where blank spaces Occur in the descrip
portion of the Mechanical and Electrical Sched
the applicant need fill-in only the No. Boxes
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Sche
are available at the Building Division
1. To conserve space on the permit form the s
have been abbreviated (
2. If the item(s) to be installed are not cov
the abbreviated schedules you Should consu
full schedules
C. BUIlOWG DIVISION STAFF Will Fill OUT All FEES Q.
CHARGES O~ THE SCHEDUlES
D. As noted on the CAP, the label must be deliver,
electrical contractor for signature by his ele!
supervisor. The general contractor is .not autl
to sign the electrical label. ----
Applicant to sign and date
Whenever possible, the initial application will be
a worksheet only. Where pOSSible, Building Oivisil
will prepare a type written copy and return it to 1
applicant at the time the actual permit is issued 1....
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.
II.
III.
V. FOR OFFICE USE O~lY
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CITY OF SPRINGFIELD
CllyHall
Springfield, Oregon
Department 01 Public Wor,ks (.
OFFICIAL RECEIPT
No. B 59887>>
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AUTHOAllEO SIGNATURE
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DRIGGS PRINTEJU"UTHOGRAPHlERS. EUGENE. OREGON
Permi t C1 erk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
'l'hi Q Q 1''''",,1''''''1'' 7,'"" ,,11 nwpn to snan over a Ci tv Sani tarv Sewer by
. ~pPf';,,1 AErepment nRten SeDte~ber 30. 1982.
Permit applicant exempt from registration with the Builder's Board because:
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Additional Project Information:
PLANS REVIEWED BY:
name Lorne Ple~er
signature
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date
10-20-82