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HomeMy WebLinkAboutPermit Building 1980-12-16 (2) .'"" . .--, . , ( I INSPECTION LINE 726-3769 I Job Addreu I Legol DeJ'ription I I I I <;n...i 'lg.f.ie.l d ._Oregon_---97_417 I Conltruc,inn 1,.",.1.. I Addr." CITY OF SPRINGFiElD COMBINATION APPLICATION/PERMIT . iNFORMATION LINE 726-3753 ., ENERGY SOURCES: I Sq. "g.,Main -,64-- Sq. Fig. Aceen. _ ____I SQ. fIg. Other I X New.... .Add _Alter_Rep. Fence _Demo_Change/Use 2048 Donnelly Lochaven Mobile Home Subdivision H.af WO"', H.al., ___ & Bernard Hiatt Blvd Other co o ..... ..... .... o L at 32~_BloCk 1 Own" Robert Cochran, Gene Add"" 663 West Centennial ..!.~.!'9!-~7:_~. -:--------- Vol... of wo,ll: Phone 741-1120_ 2508.00 Suilding P..m;1 I...fo: o.~~'j~ Wo;~ (i.l!.:B;;iid-~~i;" !om'!r...!l.,idenc. With AlIa,h.d G~'~9!L- _ _.~ingle_gara9~_and__1119b!1e and E1 ectri ca 1 servi ce home olumbino ........ OESIGN TEAM Primary Ga rret ("om.) {,-,rttf,.,.,i ------.. {'iCl. "0.1 (expir.,) (phone no.) Maupin, P.O. Box 846, Springfield, Oreoon 97477 746-8514 Structural Electrical Mechanical CONTRACTORS General Hi att (no"..\ ,.,ddr..,\ (lies. no.l (expires) (phone no,) BrQth~r~ Construction 663 W~~t C~ntpnn;,1 R1vn. Sorinaf~ln. Orp _741-1420 Plumbing Electrical Mechanical ,I I ;1 1 .1, .W,HhEU ~~~TE .lAWdRbEQUIRES, that the Electrical wodrk be dhando by h'he ~~ed~ico,1 Con,'rador, the electrical portion of this permit shall no' b. valid until 0 I. au. o.....n ~9ne y on E .ctrical Contrador an attac. to I e ...dflca pane. PlUMBING elECTRICAL NO. I fEE ! CHARGE NO. I Re,idence of Each ,inDle li"'1I'. .':t.ft. Relocated building New circuits, alterations (new fiA, additioftOll or extensions S.F, Reliden(.fl I II both) SERVICES Duolu (1 balh) each I Temporary Construction I Addilional bath I A.mps. I Wat.r ..,.,ic. I I Sew., I I Storm Sew., I FEEDERS I 1 Mobile Home I A.mps, I Service 15.00 1 IMobi 1 e Home I IServi ce I I I I I I I, TOT AL CHARGES 15.00 TOTAL CHARGES MECHJ~NIC"'L FEE I CHARGE NO. I I fEE - I CHARGE I I I I I I 1 110.00 I I I furnace/burne, to I\TU's Appliance yent separate Stationa,y eyap. cooler Vent fan with sinAle dud Vent system apa,t j:rom heatinA 0' A.C. Mechanical exhault hood and duct I Wood stove/heater I Heat Puma I Air handler to 10.000 CFM I Air handler aYe' , 10.000 CFM ISSUANCE OF PERMIT 10. 00 I TOTAL CHARGES "HAVE CAREFULLY EXAMINED the campleted application for permit, and do hereby certify that all information hereon is true an::l correct, and I further certify Ihat any and all work performed sholl be done in accordance with the Ordinances of the City of Springfield and the law, of the State of Oregon pertaining 10 the work described herin, and that NO OCCUPANCY will be made of any srructure without the permiuion of the B~lilding Diyision, I further ce,tlfy that my registration with the Builder's Boord is in full force and effect a s required by ORS 701.035, thot if exempt the basis for exemption is nohld heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. Bo,;, fa' .,;Id,,', Boa,d ..ompt;a.' AY'/) J NAME (please Print>_V-= 4"l_ Lv I" \ [( L t.7 C./ft- SIGNATURE ~ tlI A ft~ _ DATr! z.. jf.-fC I I FOR OFFICE USE ONLY 20n- MHS Type/ Canst. Bedrooms C,torie- V-N Units ntcy load ,." 'cy Group cO'l Value Value Value TOTAL VALUA'rION . ".ou c~UIl.UU Fire Zone Flood Plain M-l Sq. Ftg. M.::Jin C:q. Ftg. Acces- Sq. Ftg; Other . ?SnR nn .:10 Plan Ck. Comm/lnd 65%/Sld!1 Per Fee Plan Ck. Res 30%/ Bld~ Per Fee Sy,tems Deyelopment Chame fl.5,,"l IPaid with Mobill IHome Setup perm t~ I BUILDING PERMIT Charges and Surcharges 24.00 7.20 PLUMBING PERMIT Charge, and Surcharges 15.00 ..JJ Fence Demo Total Cnmb pftrmit 74.96 ELECTRICAL PERMIT Charges and Surcharge; 10.00 68' 6.80 I I TOTAl. I I jl 74.96 MECHANICAL PERMIT Charge. and Surcharges Sidewalk I Air P_.'"" I Cur~ ;~~--~ ._-------1 1 10.00 .'IU '. . .... I. Applicant ta furnish A. Jab Address B. Legal Description. .. 1. example-tax lot 1 00, lon~- Co~~ty Mop Refer;nce i 7 03 . .. 2.. example-Lot LBlock 3,.2nd.Addition to Springfield Eslatf ..r C. Name, etc. of owner and'c~nstruction ie~der'. . .... D. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example.water heater/electrical/or solar E. Square footage or valuo"tion, etc. - 1. example.1250 sq. foot house, 500 sq. foot garage ~. example-if new project, check ,ne.w-if addition, check. ( . "add, etc. '. 1,,- ...... ...~. . F. Building permit information: .. 1. example-construct single family house 'with' an a,ttoch, . (. garage 2. example-remodel existing 9C1rage into familfroom 3. example-convert single family residence into restaurant (change of use) G. Value of work as defined in Sectian 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS. To avoid design or construction delays, 'Builaing Divisil Staff must be able to contact appropriate persons rege design information or job site corrections, etc. ". ""l ~, .:' .. PERMIT VALIDATION .:,... -,'-- .~~ ~~. .. -4. t.: -~"~~''::, t~- .~ COMBINA TION APPLICATION/PERMIT .(CAP) . '. ~'~f:;'" -~.~., : ,.~ ',. ~ . . '-' . '. .. Dote. CITY' . OF SPRING':"" City Hall E l 0 o Springfield 0 epartment af'p r~gOn OFF I C , A l RUb/Ie Work. EeE/PT No. B 5538'~ 'l' ( -, ( II. .Abbreviated Plumbing, Mechanical & Electrical Schedule, A, Except where blank spaces occur in the description pI I h Irt of the Me.chanical and Electrical Schedu es, t e appli ~ need fill.in only the No. Boxes adjacent to the appro 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 sched, have been abbreviated 2. If the item(s) to be installed are not covered 0;' ated schedules you should consult the full schec C. BUILDING DIVISION STAFF WilL FILL OUT ALL FEE' CHARGES ON THE SCHEDULES ,.' '. CI (.1 / ( ( III. Applicant to sign and date Whenever possible, the initial application will be us' I" worksheet only. Where possibl.e, Building DivisiC?n S' \.~ 8'1" prepare a typewritten copy and return it to the app ,-::-r'.' the time the actual permit is issued'for his signatun ..;. \..."" IV. Fees and Charges ! Plan check fees are due and payable at the time oJ-. 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. (~I = ( Amount ( ( <: '''l~'~''''UII''~Ul~::,~''':Z:lt"O S'G"''''T'tJ,,~ '(liS. (UQ'U'I. all .'.0' ...".. . C _. \'< ,.. V. FOR OFFICE USE ONLY Permit Clerk ~ .\..\ )- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 5 foot wide setback sidewalk to be installed with Cit '.. ., . .:--.-i , -, ,:ro,_. ........... ~ ...;', " \~Ii.i;'i.~ ,.?.!,,;,...; " ..~ ~ .;.. .Y~";:~ ..- "~- .J'". ,-. ~.: 1 Additional Project Information: '. ..-,............;. PLANS REVIEWED .BY, ,.~ :/~.'~ 1""~ . Lorne Pleger nome . ,. signature date 12-11-80 ,,' ... .".~.' ~ ~ .. .-......