HomeMy WebLinkAboutPermit Building 1980-10-6
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:'ll:! ,',(!dreSS 5650 Da i S1 Street
1,t"";JI :e~criptionTL 300, 400, 401 r.1.R. 17 02 33 IJ,
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. . NOTiFIED
. CITY OF SPRINGFIELD
'CQ/1BItIATION APPLICATION/PERMIT
E!IERGY SOURCES:
Heat
Hater Heater
AUG
~ '1~80
-
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..
RanCle
Va1u€0~tr-Hor"'0' 00
L...:J,lJ'J .
-t'tlFOIUlATlON liNt
726-3753
Sq. F tg. f.la i n
~q. Ftg. Access.
Sq. Ftg. Other
~ew Add Alter ~ep.
Fence_Demo _Change/ Use
Other
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Olson & Parker Investments
995 West 5th Avenue
Eugene, Oregon 97401
Buih;ino Permit Info: Describe ;.jorK(i..e., Build Single
Family nesidence With Attached Garaqe)
co
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o
U"1
0'
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Phone
con~truction Lender
Construct streets. sewers. and
drainage for ~1opile Home P.lI.1)
storm
Phone
(address)
71 Centennial Loop
<
(lics. no.)
(exoires)
(phone no. \
4,<35-11.64^
....JJ reS S
S~)j(,;l iD";:,
:;rir.~ary
(name)
Olson & Thompson Inc
7123
S~ructural
~lectrical
:~echanica I
CC::iR~.cTORS
(address)
(1 ics. no.)
(expires)
(phone no. )
\name)
r,~neral
?1 u;;lbina
~lectrical
"l'I:;hanical
PLUf1B IrIG
ELECTRICAL
MECHANICAL
',,). i
FEE I CHARGE NO.
I'"FF r.HARGFNO. I
I ~FF 'fHARr,F
SQ. FT.
furnace/burner to
BTlI's
Each single fixture,
Residence of
IRelocated building
I (new fix. additional)
I
I S.F, Residence
1(1 hath)
!Duplex (1 bath) each
,
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wall
Soace heater and vent
3357; Sewer 10.00/100 l.F. 390.0(
127rJStorm SewerlO.00/10lLF. 130.0e
Of
amps.
Appliance vent
seoa ra te
Stationary evap.
cooler
Vent fan with
sinale duct
Vent system apart from
heatina or A.C.
Mechanical exhaust
hood i1nd duc:t
Wood stove/heater
Indditional bath
.
!',:dter service
Temporary Construction
Change in existing
residence
multifamily, comm. or
Industrial
COMM./IND. FEEDERS
Install/alter/relocate
~;~trih. fp~~~r~
Of
amps.
ISSUANCE OF PFRMIT
. ,
'~;.:L CHJl.RGES 520.0( TOTAL CHARGES
.
niiEr.E STATE L.iH REQUIRES that the Electrical work be done by an
~"111 not be valiJ until the label has been signed by an Electrical
TOTAL CHARGES
Electrical Contractor, the electrical portion of this permit
Supervisor and returned to the Building Division
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1 HAVE CAREFULLY EXNlINED the completed application for permit, and do hereby certify that all information hereon is true
.:.tl correct. and I further certify that any and all \~ork oerformed shall be done in accordance with the Ordinances of the City
-. Sarlngfield and the Laws of the State of Oregon pertaining to the work described herein, and that ~O OCCUPA"CY will be made
~: ,Iny.strllcture without the permission of the Building Division. I further certify that my registration ~lith the Builder's
,;~rd IS In full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
(~IY subcontractors and employees who are in compliance with OP.S 701.055 ~li11 be used on this project.
Flooo Plain
..
;'{tJ
Units
Occy Load
Occy Group
S IGil^TURE
FO~ OFFICE USE OilLY
So. Ftg. /1a i n
Sq. Ftg. Access
Sq. Ftg. Other
OJl.TE
I
..
';~;'~(olease print)
: :~'! TmSTfJUD
r'r~ lone 111
Tyoe/Const.
Bedrooms
Stories
x Value
x Value
x Value
TOTAL VALUATION255 . "l(),). O"}
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{.,....r-::~\ ...nd
',t.,;r'(,..", r1i~ \
STREETS AND SEWERS ONLY
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,
I 520.00
. [------~O.30--
! D~mo
I Plan Ck. CommlInd
65%/B1do Per Fee
Plan Ck. Res
30%/Bldo Per Fee
Systems Development
~~~ro~ (1.5%)
:";ilOI~IG PERl.llT
.:",lr";f!S tln~
. .;r'C~."r;e.\
337.68
Fence
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eIt.....~I:.~ ",.,d
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:l:()lOI.l..llI;;:,4 "(ll~!! T
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"'iP1t~~*'IO'\
A/C Paving94, 576
Curb Cut
277 .00
Plan Check FEE
Tota 1 cJrl,~ ~ rermit
137.68
817.30
11,155048
, [I
Sidewalk
--
. TOTAL
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':': ':.~"'i~'~ ~~: ~.~i .
1. ,Applicant .to furnish
A. Job Address
B. Legal Description
1. examp 1 e- Tax Lot 100, Lane Count. .....'
17 03 43 t
2. example- Lot 1. Block 3, 2nd Add'
Springfield Estates
C. Name, etc. of owner and construction
D. Energy Sources (
1. examo1e- heat/electrical ceilin~
2. examole- waterheater/electrical/l
E. Square footage or valuation, etc. . '
1. examo 1 e- 1250 sq. foot house, SOl g.
2. example- if new project, check-rle
check add, etc.
F. Building permit information:
1. example - construct single famil) fus
a ttached garage
2. examole - remodel existing garage.
3. examole - convert single family r
restaurant (change of ~se} ('
G. . Value of work as defined in Section 3 '",
Structural Specialty Code
H. DES I GN TEAr-l Aim CONTRACTORS
To avoid design or construction delay Su
Division Staff must be able to contac "
persons regarding design information
corrections; etc.
II. Abbreviated Plumbing, Mechanical, & Elect (}
A. Except I.:here blank spaces occur in th
portion of the Mechanical and Electri,-
the applicant need fill-in only the N.
to the appropriate item(s) to be insti. (d
B. ,Full Plumbing, ~lechanical, and E1ectr "
, are available at the Building Divisioi
1. To conserve space on the permit fc
have been abbreviated ~
2. If the item(s) to be installed arE (.. Amount Received
the abbreviated schedules you shol
fu 11 schedu 1 es
C. BUILDING DIVISION STAFF WILL FILL OUT
CHARGES ON THE SCHEDULES _
D. As noted on the CAP, the label must be
electrical contractor for signature by
supervisor. The general contractor is ~.
to sign the electrical label. ,
Applicant to sign and date ,j....:...
Whenever po~sible, the i~itial application will be ~sed 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 permit is issued for his
signature. . ,
IV. Fees, and Charges
Plan check fees ~re 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;
...._...
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, COMBINATION APPLICATION/PERMIT '(CAP}
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V. FOR OFFICE USE ONLY
City Hall
Springfield. Oregon
Department of Public Works'
OFFICIAL RECEIPT
No. B 54808(.
Date J 0 - G, 19~n .
Rec'd From 01 &QYl' '- Orl.V kIJ y
Add'." ~ 5\3 3 K0-dq,,~
.
CITY OFS'P'RINGfIELD
~
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Received For:
PLQ.n'. C-ru cl2YW )
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<--P(1.J() !3 3j, 0~
, p~~ - 52{) ,DO --.
20.~O
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C- ,.' BY.
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- /AUTHORIZED SIGNATURE
S~E\.TON.TUANELI.L PRINTERS '. EUGENE. OR 97.01
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Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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. ADDITIONAL PLANS AND PERMITS ARE REQUIRED FOR WATER AND ELECTRICAL SYSTEMS, COMMON SPACE
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I~1PROVE~1ENTS, LANDSCAPING, IRRIGATION, FENCING, SIGNS, ETC. ALL IMPROVEMENTS MUST BE IN~
STALLED AND APPROVED PRIOR TO OCCUPANCY .OF ANY MOBILE HOME UNIT
Permit applicant exempt from registration with the Builder's Board because:
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Additional Project Information:
j
,
,PLANS REVIEWED BY:
name
LORNE \:J. PLEGER
.' signature
~~~~
, ~
,) date
2.26.80