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HomeMy WebLinkAboutPermit Building 1980-12-11 (2) . . ~ ' ~..:" ~. \. 'of;~'... '1:;''1:'' \.... .\....,..... -~." .,~"'" ,', " '"'''';'''', .:.:.;'.t~ .....f .iJ;':;.~~.;-..... ...;,o,:,\...,4:.j.;,.;.;:....:eI,..~,.);ti.;.;v1 ,....... ,-, I'" .'\l<' ~.# '\~~':l:....,.".;;~.,o'-::t~ ....\.1. 1't"". -, ." ,., ~ ,". .' '"., - .f.' ...-.- (. .-, J .u.,~. '" ; :..,. . : ...._. '; ': 'I t.,; . '.:... :,. .; ..~ ~'': ':" ','f . ' . cln OF S'RINGfIELD COMIUNATlON ""'l!CATlON/PERMIT INFCIRMATION LINE 726-.:1753 I INSPECTION LINE 726-3769 I Job Addre" I 'f0'f 20.94 DgJllleUy_. legol Oe..,'otio. _, o,chaven .Mobile .Home Subd i v j 5 i on ... _I nt14...J310cL4 Ow.e, Robert Cochra, Gene &Berna.r:d_~iaJ;J_ ENERGY SOURCES: . I Sq. Ftg. Moin H.ol Sq. FIg. Access. 'Nt'J"-' Heo,..' __._~~ -,-". .----~_I S.C}' FIg. Other lo~ _.-._ ~~____'_ ___ I ^ New ~_ Add .._Alter _Rep. 'Yal_ of ....;~~:.... .hnce _Oem,)_Chonge/Use , ., 4598.00 ..O,h" '" o ..... ..... W, \0 Add,... 66J WPS t rpntp'mi ~ 1 Spri ngfield,_0~egon_-97_477 8u.ldi~ -PIt,m" I"fo: o.w,b; W~;k- (i.e.. Build Single' .fom~1 R.,id.'He Wi,h "ltoth.d.....9..~9!1 Double garage, mobile home plumbing & -- --...- Electrical ~~rvic~ '''no 7_41::.1420_. Construction lend., Add,e" Phone DESIGN TEAM (nome1 (oddr.nl Primary Garret Maupin. ~ 0 Box R46, Springfipl~ Structural Electrical Mechanical t:t]NT~~~T0RS l"ome\ laddreu1 l:iia.tt R...nih'''^< fl)nstrllrtion 1i1i1 WP<t fpntpnni.l 1l1"d, Spril1gfiel,l 741-1420 I I WHERE STATE LAW REQUIRES thot the Electricol work" done by the Electrical Contractor, ~h. electrical portion of this permit I~all not b. valid until a I' I label hos been signed by an Electrical Contractor and olta'ch.d to the electrical panel. G.n.r~1 Plumbina I I I I 'I I I I I I I I I 1 I Electrical Mechanical PLUMBING ELECTRICAL NO.1 I I I FEE CHARGE NO. Residence of Each sinqle fixture Relocated building (new fix. additional) S.F. Residence (1 bath) 1Q. ft. New circuits, alterations or extensions SERVICES Duplex (I bath) each Temporary Construction Additional bath Amps. Water service Sewer Storm Sewer FEEDERS Mobil e Home Service Amps. TOTAL CHARGES I I I I 15.001 TOTAL CHARGES Ilies. no.) (exoiresl (phone no.) _741i-R5l4 (lies. no.l (phone no.l (expires) MECH.t,NICAL FEE CHARGE NO, FEE CHARGE furnace/burner to I I\TU's Appliance .....nl I seporate Stationary evop. cooler Vent fan with sinQle duct Vent system aport from heatinQ or A.C. Mechanical exhaust hood and duct Wood stove/heater Heat Puma Air handler to 10.000 CFM Air handler over 10,000 CFM 10.00 ISSUANCE OF PERMIT 10.00 TOTAL CHARGES I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that 011 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 Stato of Orogon pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Bdlding .Division. 1 further certlfy 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 exemption is noted h.ron, and that ~nly subcontractors and employee, who ore in compliance with ORS 101.055 will be used on this proj.ct. Basis for Builder's Board exemption- "''' ~.1 ( Y / c i) L l'"- SIGNATURE ~ ~ fOR OffiCE USE ONLY NAME (pl.as. printl p~ ITIn,) V-N Sq. Fig. Main Sq. Fig. Access Sq. Ftg. Other Type/Canst. Bedrooms C-tori"'" Utiits n....., Load l"'lccy Group M_ 1 Zon" Fire Zone Flood Plain BUILDING PERMIT Charges and Surcharges plan n. Comm/lnd 65%/ BldQ P.r Fee Plan Ck. Res 30%/ BldQ Per Fe. 9.60 32.00 1.28 PLUMBING PERMIT Charge, and Surcharge, 15.00 .60 10.00 .40 Fence D.ma ELECTRICAL PERMIT Charge, and Surcharges 158' 15.80 Sidewalk A/C Povina MECHANICAL PERMIT Charges and Surcharges Curb Cut 1 10.00 1<./ .J/~ "ATE~/-1~1.. 484 . . 9.50 '{alue "olue ---A5.9B..1JD- x '{olu. TOTAL VAlUA'''ON '1:>Ytl. UU I IPaid with MObilJ IHome Setup Permit: I I I I Systems De.....lopm.nt Charo. 11.5%\ Total Comb. Permit 94.68 TOTAL 94.68 !' ;. ,> " . " p .,.....~.,.- ~-.. ~.".. . "'ti":. . -.- ~::";', '_ :r_ COMBINATION APPLICATION/PERMIT (CAP),,;;, ,}t, PERMIT YALlDATION' ,-". I. Applicant to furnish 'f'-' ..., .~ -.~I~.;.-_~ . ~ ;'.c~. ~ _' - - .. . ~ ~.... !!t' .' . A. Job Address ....;,....' .r t .~_;~ r '" .l'~ ,.' -..... ':.....~ , ""~"f:.-..... B. legal Description .': _:. ,,;,,t!..~.:'" ...ti '\.;-,- ""...~. .),;:~' \. ~!___.:.. i .~<t>f' .. 1. example-tax lot 100. Lane County Map Reference 17'.03 43 '.-. ',' , ' .. 2. example-Lot 1. Block 3. 2~;J.~~~!tio~,toSR'ingli;_ -' (I T Y , 0 F ' S P R IN G F IEl D C. Nome, etc. of owner and construction lender I D. Energy Sources 1. example-heat/electrical ceilinq.' or forced oir ga~ 2. example-water heaterielectri~al:'or solar E. Square footage or valuation, etc. - 1. example.1250 sq. foot house. 500 sq, foot gara~ 2. example-if new proiect, check ne'!.Y-if\..apdl_tl?,r1' cI :1'". odd, etc. . . 4.. F. Building permit information: 1. example.construCt single family house with an a (._, Rec'd garage . 7" 2. example-remodel existing'gorag'e i!:lto family rOt ~. 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 Div (n Staff must be able to contact appropriate persons rE design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedul ( A. Except where blank spaces occur in the description r of the Mechanical and Electrical Schedules, the appl need fill-in only the No. Boxes adjacent ta the apprc (at item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1 1. To conserve space on the permit form-the schedu \. have been abbreviated 2. ~ If the item(s} to be installed are not covered on d ated schedules you should consult the full schedu ( C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES I CHARGES ON THE SCHEDULES '. '<, I ";>:." ~ .:. .1. . t ~~"\ r Date-'/2 ~}5 19)5Al!....B_..5538Q~ " From4-\.(n1t r fJV1~! ' r Address ~O {.CXQY:\-kl[U1UD~ City Hall Springfield. Oregon Department of Public Works , OFFICIAL RECEIPT !I!I!I"'. (: ~ Ii. (' , . - ( ( ( ( -. ( C ( \) ( Received For: R.p , 57 DC) - ~)h I. Z<n W ,\) ,!c:),(r) vr--" / /) / /) ry ~/.D ID'{;x If'y-> +7 PI,1 J.-- Y, ( rY'J ~;r)) r cc- 1F5 . <? [J I III. Applicant to sign and date Whenever possible, the initial application will be used c worksheet only. Where possible, Building Division Staff prepare a typewritten copy and return it to the applicar ~ the ~ime the actual permit is issued for his signature. IV. Fees and Charges Plan check fees are due and payable at the time of the, and no plans will be processed until these fees are paid, other fees and charges are due and payable when the permit is issued. Amount Receive~l Lr ,(ov dL-- ~I Jli' ~~"j, - THORIZIi:D SIGN...TURI: $H.~TON.TUIU..U ~ ~~I..T.~!1 . 'lUG.N.. O~ !I..Ql (0" V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 5 foot wide s_etbilc~ sidewalk to'~ installed with ritv ~bndilrd cllrhrllT ',.' "'.' ~, , I " Additional Project Information: ,....,., " PLANS REVIEWED BY: nam~ Lorne Pleger ",ignatur,.. 7~~:-' ; , "ate 12 .11.80 ',:j,