HomeMy WebLinkAboutPermit Building 1980-8-21
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I INSPECTION LINE
726-3769
I Job Address
CITY OF SPRINGFiElD
COM&INA TION APPllCA TIONI 'liMIT
INFORMATION LINE
726-.3753
I Sq. FIg. Main ~Oil."
ENERGY 'I~U'if.f~c~ Sq, Ftg. Aceen.' AOA
H.c:.' Elect Sq. fig. Other
Wofe. Heal.'
Rempe ;Rl Pc"t _XNew_Add_Alter_Rep.
.---1 Val;;:f8~~~'00 _~t~::_O.ma_Chang./U"
I Building Permit Info: Describe Work (i.e., Build Single
747-5968 Family Residence With Attached Goraqe)
746-2018
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legal Description
823 01~pic Street
Lot 9, YO~gsto~e
Owne,
William E, Moore
889 Aspen Street
phone
Addreu
Sorinafield.
Orp:aon
Office
9747.7
Sinqle Familv Residence: att oar
Con\truction Lender
Address
Phone
DESIGN TEAM
(name)
(address)
(Iics. no.)
(expires)
(phone no.)
Primary
Stan Steele
3445 Chevy Chase Eugene
Structural
Electrical
Mechanical
CONTRACTORS
(name)
(address)
(Iics. no.)
(expires)
(phone no.)
PlumbinR
W.B. Contracror~
Negotiable Plumbing
Arc Electric
General
Electrical
Mechanical
Comfort Flow Heating
PLUMBING
ELECTRICAL
MECHANICAL
No.1
I
I
FEE
CHARGE NO.
FEE
CHARGE NO.
FEE
CHARGE
Temporary Construction
3
furnace/burner to
100.,.000_BTU',
Appliance vent
separate
Stationary evap.
cooler
Vent fan with
single duct
Vent system aport from
heating or A.C.
Mechanical exhaust
hood and duct
6.00
Each single fixture
Relocated building
(new fix. additional)
S.F. Residence
(I bath)
x
Residence of
1 n.a.n ~q. ft.
New circuits, alterations
or extensions
25.00 1
Duplex (l bath) each
25.001
I
SERVICES
'0.00
x
3.00
9.00.
1
Additional both
10.00
Amps.
Water service
1
4.50
Sewer
Wood stovel heater
Storm Sewer
FEEDERS
Heat Pump
Air handler to
10_000 CFM
Air handler over
10.000 CFM
Amps.
ISSUANCE OF PERMIT
10.00
29.50
TOT At CHARGES
35.00 TOTAL CHARGES
25. 00 TOTAL CHARGES
WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not b. valid until a
label has be.n signed by an Electrical Contractor and altached to the electrical panel.
I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is tr~e and correct, and I further
certify that any and all work performed sholl be done in accordance with the Ordinances of the City of Springfield and the Lows of the Stote of Oregon
pertaining to the work described herin. and thot NO OCCUPANCY will be mode of any structure without the permission of the Building Division. I further
certify that my registrotion with- the Builder's Board is in full force ond effect as required by ORS 701.055. that if exempt the bosh for exemption is noted
heron. ond that only subcontrocton and employees who ore in compliance with ORS 701.055 will be used on this project.
Basis for Builder's Boord exemption:
NAME (please print)
WILLIAM E. MOORE
<IGNATURE?lta~, 9A~
FOR OFFICE USE ONLY
DATE ~~"fi e
Zon-
R-1
Fire Zon.
Flood Plain
NO
Typel Canst
Bedrooms
C:;"oriAo
V-N
3
1
IInits'
":cy Load
""'ccy Group
R-<
"q. Ftg. M~in
Sq. Ftg. Access
Sq. Ftg. Other
1040
4B4
x -2.Q 1"
x CL_r;O
'faJue --29-,2211 nn
Value .t1 - c;QB.....O.O.-
Volue
33,822,00
TOTAL VALUATION
BUilDING PERMIT 139.00 Plan Ck. Camm/lnd
Chorges and 65%1 Bldq Per Fee
Surcharges 5.56 Plan Ck. Res
30%1 Bldq Per Fee
PLUMBING PERMIT
Chorg", ond 1S,OO Fence
Surcharges 1.00
Demo
elECTRICAL PERMIT 3~.C()~ 74.64
Charges and Sidewalk
Surcharges . .10 ~8
(. .' Alc Po ViM
MECHANICAL PERMIT -z.q ~O 18'
Charges and Curb Cut
Surcharges ---------
( 18
Systems Development
Choroe (1.5%\
507.33
41. 70 PO 8-7-80
IiliLlf :>4L:>U
Total Comb. Permit
256.90
7.46
11. 80
764.23
TOTAL
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B, legal Description
1. example-tax lot 100, lane County Mop Ref.
2, exomple,lot 1. Block 3, 2nd Addition to Spri'
C. Name, etc, of owner and construction lender
D. Energy Sources
1. example-heat/electrical ceiling/or forced ai
2. example~water heat,er/electrical/or solar
E. Square footage or valuation, etc.
1. example,1250 sq, foot house, 500 sq, foot 9
2. example-if new project, check new-if additi
add, etc.
F. Building permit information:
1. example-construct single family house with
garage
2. example.remodel existing garage into fam
3. example-convert single family residence in.
restaurant (change of use)
G, Value of work as defined in Section 303 {a} 01
Structural Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Buildi
Stoff must be able to contact oppropriote per
design information or job site corrections, etc.
PERMIT V ALIDA liON
net
.
CITY OF SPRINGFIELD
City Hall
SprIngfield, Oregan
Department of Public Work.
OFFICIAL RECEIPT
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II. Abbreviated Plumbing, Mechanical & Electrical S
A. Except where blank spaces occur in the descr
of the Mechonicol and Electrical Schedules, tl
need fill.in only the No, Boxes adjacent to th
item(s) to be installed
B, Full Plumbing, Mechanical, and Electrical Scf
are available at the Building ~ivision
1. To conserve space on the permit form the
have been abbreviated ClC\ .,\
2. If the item(s} to be installed ore no,\cbvef
, - . .ated schedules you should consult the ful
C, BUilDING DIVISION STAFF Will FilL OUT A
CHARGES ON THE SCHEDULES
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Applicant to sign and dote
Whenever possible, the initial application willi
worksheet only. Where possible, Building Divis
prepare a typewritten copy and return it to the
the time the actual permit is issued for his sign
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IV, Fees and Charges J-
Plan check fees are due and payable at the time ot the appucQIn,...,
and no plans will be processed until these fees are paid. All
other fees and charges ore due and payable when the permit
is issued.
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V, FOR OFFICE USE ONLY
Permit Cler~
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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Additional Project Informotion,
nam....
:Ji\.'i Si'!ITH
'ignat~r'-~_;J{) /~
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PLANS REVIEWED BY,
[ -= CJ,p..)
CXYv-.-7,;A<; PS .late
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0-21-00
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