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Home My WebLink AboutPermit Building 1981-10-30 I INSPECTION LINE 726-3769 I Job Add,ess I legal Description I I Owner . ee~ 9 II ,--'\ t;ITY d\ SPRINGFIELD COMr:.lNATION APPLICATION/PERMIT NOTifIED INFORMATION LINE 726-.3753 1520 Olvmnic Street ENERGY SOURCES, Heat 1='1 p.(' Water Heater J:' 1 p.r Sq. Fig_ Main Jl,.5.O.(1 Sq. Fig. Acceu. Sq. Hg. Other _New_Add_Alter_Rep. _Fence_Demo_Changel Use _Other 00 ..... o ..... U1 ..... 1.hQ2.::.3D_L.L.J927 Address hh~ W rp.ntonniril SDrinofield. OR Phon. 741-1470 Range Value of Work: $5,000.00 Chv In'~eth Bv.lding Permit Info: Describe Work (i.e., Build Single Familv Residence With Attached G0100e\ Gene. Bernard ~ Russell Hiatt ~ Wavne 97477 LOildino dock a ruLjlilr:tjt.i.on_wall Construction Lender Address Phone DESIGN TEAM (name) (address) (lies. no.) (expires) (phone no.) Primary Hiritt Rrnc: 663 W. Centennial 741-1470 Structural Electrical Mechanical CONTRACTORS (name) (address) (lies. no.) (expires) {phone no.l ~"""ral Hiiltt Rrn~_ ~h1 W_ rpntpnn;~1 741-1420 PlumbinQ Electrical Mechanical PLUMBING ElECTRICAL MECHANICAL NO. FEE 1 CHARGE NO. I FEE I CHARGE NO. I I fEE J CHARGE Residence of furnace/burner to A,TU's Appliance vent separate Stationary evap. cooler Vent fon with single duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct Each sinQle fixture Relocoted building (new fix. additional) S.F. Residence (1 both) '9' ft. New circuits, alterations or extensions SERVICES Duplex (I bath) each Temporary Construction Additional bath Amps. Water service Sewer Wood stove/heater Storm Sewer FEEDERS Heat Pumr:J Air handler to 10,000 CFM Min Tnc::n rhn 1~ 00 Amps. nrvwp 11 Air handler over 10.000 CFM ISSUANCE Of PERMIT TOT At CHARGES 15. 00 TOTAL CHARGES TOT At CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of Ihis permit shall not be yalid until 0 label has been signed by on Electrical Contractor and attached to the electrical panel. I HAVE CAREFUtl Y 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 herin, and that NO OCCUPANCY will b. made of any structure without the permission of the Building Dlvlsion. I further certlfy that my registration with the Builder's Soard is in full force and effect 0 s required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who ore in compliance with ORS 701.0'/11 be used on this project. Bosis for Builder's Boord exemption ~ NAME(PI.o.ep.;n'lGEAj,E: /-!/'A 'If SIGNATURE4~A ~ DAU/"'<--:11S{j.. FOR OFFICE USE ONLY Zone M .1 Fire Zone Flood Plain Type/Canst.~~ R Bedrooms C,torie- Units 1 l')ccy load "ccy Group -.B. 2 Sq. Fig. ~ain c.q. Fig. Access Sq. Fig. Other . Value x Value x Value TOTAL VALUATION $5 _000. 00 BUilDING PERMIT Charges ond Surcharges _____.32-..00 L2R 1<;.00 _fin Plan Ck. Comm/lnd 65%/~ Per Fu Plan Ck. Res 30%/ Bldg Per Fee Systems Development Charoe (1.5%1 (,5_._00- PLUMBING PERMIT Charges and Surcharges Fanta Demo Total Comb. Permit 1l.8.8R ELECTRICAL PERMIT Charges and Surcharges Sidewalk AI C Pavina MECHANICAL PERMIT Charges and Surcharges Curb Cut TOTAL $123.88 dtl~ \ ., 1'1 COMBINATION APPlICA TION/PER.' ;C~P) I I. Applicant to furnish . A. Job Address . B. legal Description 1. examole-tax lot 100, lane County Map Reference 17 03 43 2. example-lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and constructio~ lender D. Energy Sources 1. example-heat/electrical ceiling/or forced oir gas 2. example':wo,ter heat,e.r/electrical/o[ solar.. E. Square footage or valuation, etc. 1. example-1250 sq. foot hause, 500 sq. foot garage 2. example-if new project, check new-if addition, check add, etc. F. Building permit 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. DESIGN TEAM AND 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 Mechanicol 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 abbrevi- ated schedules you should consult the full schedules C. BUILDING DIVISION STAff Will fill OUT All fEES AND CHARGES ON THE SCHEDULES ... 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 typewritten copy and return it to the applicant at the t,ime the actu,al permit is issued for his signature. , ,I IV. fees and Charges . , Plan check fees are due and payable at the tiine of the application, a~~_~o' plans will be processed until these fees are paid. All . <:>ther fee~ and charges are due and payable when the permit . }s is/sued. . ,.'.' , i.I' ,''',+,01' ./ V.'-2FOR:OffICE USE ONLY ,....,..,. .::-.~ \"~-- PROJECT CONDITIONS TO BE SATISfiED BEfORE OCCUPANCY: '.' \)J.()(,-l::l\' ~.--"- -~ ~~~~ Additional Project Information: PLANS REVIEWED BY: name signature - Udll .;)1II1...1I ..<> " . ~E~MIT VALIDATION . Permit CierI- / _;'r,..~ ~~ r _/ ~I , . .~- -.<<'-:: ""- ".,o,t.- 0 . 7 't. ----::=.:~'~/' , ~- ..;-""-- ~~\\\ ~\\\~:o date 10 2!'-91 '1"'1 , J ...1 \ f .....~;~:b.~I.JI.l\I";..i<;:;;J,;;,;~.~.~J;;,_".;J.j . ~ --~, . ,I~,' - - . ....,-,,,,,,;.,., ". "OlIFf;:!) ..,"'. ...... ~ .... ~-- INFORMATION LINE 726-3753 INSPECTION LINE 726-3769 CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT legal Description ENERGY SOURCES: Heat ~l pr Water Heater ~ 1 Ar Ran!:!e Value of Work: $5,000.00 Gene_ Bernilrd II. RI/~~pll Hiilt,t ~ Wilvnp rhv 10"'.;>Jtt . BUilding Permit Info: Describe Work (i.e., Build Single Phone 741-1420 Family Residence With Attached Garo!:!e) ::I <;~JL.olY.mR. i r 1 hO.~o C; t. r:eat T I 1927 Sq. Ftg. Main --il.,.5.OD Sq. Ftg. Accen. Sq. I"'t9. Other _Ne....._Add_Alter_Rep. _Fence_Demo_Chonge/ Us. _Other 00 ..... o ...... t11 ...... Job Address O.....ner Address hh1 w. rpntp""i~l Sorinqfield, OR 97477 LQadinp dnrk ilod partjjjDn willl 1. ~ " Construction lender .~ Address Phone , . DESIGN TEAM (name) (oddren) (lies. no.) (expires) (phone no.) Primary Hi rltt Rrnc: 663 W. Centennial 741-14?n Structural Electrical Mechanical CONTRACTORS (name) (addren) (Iics. no.) (expires) (phone no,) General Hiiltt Rrn~. hh1 w. rpntpnni~l 741-1420 PlumbinQ Electrical Mechanical PLUMBING ELECTRICAL MECHANICAL NO. I FEE 1 CHARGE NO. I FEE I CHARGE NO. I FEE I CHARGE f'J Residence of furnace/burner to ':l..TU's Appliance vent separate Stationary .vap. cooler Vent fan .....ith single duct Vent system apart from heatin~ or A.C. Mechanical exhaust hood and duct Each sin!:!le fixture Relocated building (ne..... fix. additional) S.F. Residence (I both) s~. ft. Ne..... circuitl, alterationl or extenlions SERVICES DUD/ex (1 bath) each Temporary Construction Additional both Ampl. Wate' service Se.....er Wood stove/h.ater Storm Se......r FEEDERS H.at Pump;) Air handl.r to 10.000 CFM Air hondl.r over 10.000 CFM Min Tnc:n rhl] nrvwp 11 , l; nn Amos. ISSUANCE OF PERMIT TOTAL CHARGES 15. no TOTALCHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the EI.ctrical work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until a label has been signed by an Electrical Cant,actor and attached to the electricol panel. I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further ~ertify that any and aU .....ork performed sholl be done in accordance .....ith the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the .....ork described herin, and that NO OCCUPANCY .....iII be- mode of any structure .....ithout the perminion of the Building Division. I further ! certify that my registration .....ith the Builder's Board il in full force and .nfect a s required by ORS 701.055, that if exempt the balh for exemption is noted t h.ron, and that only subcontractors and employees .....ho are in compliance with ORS 7012:055 .11 be used on this project. 1 I'. Balis for Builder's Board exemptiom NAME (pl.a.. p,;nt) G 1: Aj,E: 1-1,' A..if SIGNATURE 4~ A "7/~ OAlf /t? -:.lrlS{-(_ FOR OFFICE USE ONLY Zone M .1 Fire Zone Flood Plain Type/Conlt.~/- 1 I-IR It.edroom' C;tori.- 1 Units Occy load ("kcy Group _ R 2 Sq. Ftg. Main "q. Ftg. Accen Sq. Ftg. Other "alue x Value x Val",e TOTAL VALUATION $5.000.00 BUilDING PERMIT Charges and Surcharges _____..32. nn 1.28 15.nn . fill Plan Ck. Comm/lnd 65%/ BldQ Per Fee Plan Ck. Rei 30%/ SldCl Per Fee SYltems Development Charoe (1.5%l 75.nn PLUMBING PERMIT Charges and Surcharges Fence Demo Total Comb. Permit 48_RR ElECTRICAL PERMIT Charge I and S",rcharges Sid......alk I AI C Pavino I Curb Cut ---------1 I TOTAL $123.88 MECHANICAL PERMIT Chorges and Surcharges .1.. II..,_.U.,L \ / , '--+ IllIll1 .. JII..J:....I'IIlIIl!!H:lil ,..'- --" ./r....;,._.... " ~ . 'J- ,-"- .-:. .-. ....-,... ,...a ~ -=-- COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant ta furnish A. Job Address B, legal Description 1. example-tax lot 100, lane County Map Reference 1.703 43 2. example-lot 1. Block 3, 2nd Addition to Springfield I (' C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example-water heater/electrical/or solar E. Square footage or valu~tion, etc. - 1. example-1250 sq. foot house, 500 sq. foot garage 2. example-if new project, check new-if addition, cheel ( add, etc. F. Building permit information: 1. example-construct single family house with an attac Rec'd garage C 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) af the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS ( To avoid design or construction delays, Building Divisio .- Staff must be able to contact appropriate persons regal design information or job site corrections, etc. I CITY OF SPRINGFIELD ( ( City Han Springfield. Oregan Department of pubnc Works OFFICIAL RECEIPT I~ n '<.n No. B Date l.) Qt. . I....J. /19 <;(\ From ~i(Jjc~-_ ~)J\_dS. I Address (!J0~ c..."'::>. CQ.(,JD.fUvi) 57555( C ( Received For: /' d~\J\f1 LF)-J ~~)O - \ VC:1) - _. rY1f'--- CH .t.;;~ { . erC/ tS 0'" .00 1 '-If'').OO ( II. Abbreviated Plumbing, Mechanical & Electrical Schedules A. Except where blank spaces occur in the description port of the Mechanical and Electrical Schedules, the applical need fill-in only the No. Boxes adjacent to the appropri 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. cavered on the c ated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL Fill OUT All FEES ANI CHARGES ON THE SCHEDULES (' ( C il (~ II III. Applicant to sign and date Whenever possible, the initial application will be used as c worksheet only. Where possible, Building Division Staff wi C. prepare a typewritten copy and return it to the applicant c the time the actual permit is issued for his signature. IV. Fees and Charges Plan check fees are due and payable at the time af the apl and no plans will be processed until these fees are paid. AI- other fees and charges are due and payable when the permit is issued. ..' , 10r(J.o~ cg\lJ:J D~ w II Amount Received ~r (.. ~.. AUTHORIZED StGNATUIU: ,.",., ( .: 'HUTOH.TU"H'U~~ ...."Ol..... . I[UQI[HIl, 0.. ".0' f V. FOR OFFICE USE ONLY Permit Cler~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: AdditionQI Project Information: name---D"n t;miiP signature da'~d~-;d \. - date 10-29-81 PLANS REVIEWED BY: