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HomeMy WebLinkAboutPermit Building 1981-6-29 (4) INSPECTION LINE 716-3769 fI Job Addrl!U ,2.43 '-5 i)6RI/Dc:!' h':Jol Demiotion ~ -'2..::; ....,.., f' :-~ OW"," k'onA J,~ ("'fe.lF/rlcL .2 LI~r-:; D,-..2/lM), Addr.u ConHructio" lend.r Add,." Of SIGN TEAM (nomei Primory SGt:...F StrucTurol Electricol .v.echo"icol (nome) CONTR-'.CTORS G,"".' \ 1Ae:.-:t. - ;:;:';:;)14-6<1'; 5<iFCF CITY OF SPRINGFielD . COM81NA nCN APPlICA flON I PERMlf~ INFORMATION LINE 7'26-37SJ iSq'~~It~ ~. :;oal:r Heater B~~r: I ~:: Ftg: Oth.r . - '" Ronqe _ , _N.w ~Add .)C:Alt.r _Ritp. (). I Volu. of War.: 7'1S'2. ~ _._fence_Demo_Chang.iU,. ~ J _45A -,~ _O,h.. N Pho", '-::211/ A(}>7 Buildtng Perm;llnfo: OeiCrib. Work ii.o., Build Sing I. I ....n. T'f -L.' ") Fomi!.. Re,idl!"c~ With Attl1ched Gora.!!:.1 "U' IJop ~~ J\~M. ,&TN-R~ .yI I b(~tE ~..t# dE?"IV~ -~4'l .,~~ ~~G I ENERGY SOURCES; ?~O =< . Phon. j j j , i j 1 I . (addr.,,) (licl. nO.) (expir.,) (phon. no.1 , " , _.c:-.--:.-~ €MJPiLo>V€er:' 0yC. ~/:::>IE'-t.. c:::."....,sr. I ~ (oddrllss) flics. no.) (..?ir.l) (phOM no.1 Plvmbinq EleclticClI L: - ...:.. ~ .~-'- r Mec"onical -?cl?':'F , PLUMalNG .' ~.'. ELECTRICAL MECHANICAL R.lider". of F:;: CHARGE NO, I FEE !CHARGE furnoc.(burner !o 'j BTU', I IJ.- Applianc. vent --' - .';l--' I.parale Stationary e...ap. ~oier / V.nt fan wilh ~.-, ,ingl. duct Vent IYlt.m apart from heatinq or A.e. M.chonical exhault hood ond duct Wood ,to...e/heat.r Heat Puma Air handler to 10000 CFM Air handl.r o".r 1 0.000 CF M i ! ISSUANCE OFl'PfRMIT lIP. Cl:> - IS-:- TOTAL CHARQES /3 - Eocn ,;"qle filltur. R.locored building ("ltW fill. odditio"oll S.F. ~Illidltnc. (1 bOlh) FEE t CHARGE I NO. I !~-~- I ,e I , ~~: ft. New circuih. alt.ralionl or eJl\t.nlions NO. I ~I I I i Duolu (1 bOlhl I'och Addilio"ol bOTh Water ,It' "ice I I I I I I r- Sewer Sh:lr,," Se_er SERVICES T.mparary Conltruction AmOI. FHCERS Ampl. TOT AL CHARGES ItfP. -I TOTAL CHARGES WHERE STATE LAW REOUIRES thot Ih. EI.ctrical work b. dene by th. El.rtricol Contractor. the .Iectrical portiofl of this p.rmit ,hall not b. yalid until a 1ab.1 ha, been li9".d by on Electricol Contractor ond attached to th. el.ctricol pan.l. I HAVE CAREFULLY EXA.....INED the compl.ted opplicCltion fCl, permit. ond do her. by certify that all inFormotion her.on i, trve and correct, and I further certiFy thot ony ond 011 ","ork performed ,hall bo don. in occ.ordanctl with Ihe OrdinonclU of th. City of Springfi.ld and th. low I of the .Stot. of Oregon pertaining to ,h. worlr: descrio.d herin. ond that NO OCCUPANCY will b. mode of any I'ructur. without th. permiuion of th. Building Di...ilion. I further certify that my regilrtation witn the 8uilder'1 ~Qrd is in full farat ond m.ct 01 required by ORS 701.033, lhat if u..mpl'th. balil for ...mption i, noted" h.,on. and Ihot only ,ubcantracton and omplay.., who Clr. in compliance with ORS 701.055 will b. used on 1hi, praj.ct. BOli. far Build.r's Board eJl\emption: NAME (pleCls. print) ~~V\ ~ H r C~ \ \<\--,,\ iI<. ~ I Type/ Conll._ "1Z:- AI Bedroom. 'itori.- Zone fir. Zone Flood Plain I ,- '1'1. ..rr> ~------- 1.7~ /0.- .. 'fO /<): d'O .~e. .___6~:O fj7. BUilDING PERMIT Charg., Clnd Surcha,g.1 PLUMBING PERMIT Charg'" and Surcharg.. elECTRICAL Pf~MIT Charge, a"d Surchargll. MECHANICAL PERMIT Charge. ond S",,,"or9.1 ,.-l '1GNATUR' ~~(~ \0...~~ FOR OFFICE USE ONLY 'q,Ftg,Mo;"~ '-;Z"-l~./~€~ C:q; ff9'~- et..~ x II:>. Sq. Ftg. 011'1., .II: i . DATE (,.,';;'1-55 \ I I ~1/2...,si bCfO.. _0 ! i 7~';>~::> ~ { ~alue Valu. VCllu. Unih I""Iccy load Oecy Group _:K!' - :s . TOTAL VALUATION Plan Ck. Comm/'nd 6S~:'/Bldo: Per Fell Plan Ck. Ite. 30~:.1 atdq Per Fee 1"2 ::;>~ 1"-"'~"'7t> /' ~:P.. ~ Syslem. De....lopm.nt Choroe /1..5%1 /Y-. Fence ~s: :zS Oemo Totol Comb. P...rmit Sidewolk ..1\ tin..;".. "'T' .~ <G>" '-,.iLJ ...-,--'",c.."= ,,' _ -"""U' ~~ TOTAL,1i:-n ...t,..... .c:; ...~... ~~l.7~f""' ... . '/a-;;;,i../",- Curb Cut ,.',;.._,........... . .. ,v~. _"!'.. ~...,..,. ,.~~;:,,""". <:':~:;~~'i'"..... ~~!...-..::~.:,' .1::......"':~::... .'....~b;.~,:t.~...!\~- . COMBINATION APPlICATlON,'PERMIT .P) I. Applicaru. ta furnish A. Jab Address B. legal Description 1. examDle.tax lot 100. lane County Map Reference. 2. exam ole-lot I. Block 3, 2nd Additian to Springfiel c. Na.me, ele. of owner and construction lender D. Energy Sources 1. examole.heat/electrical ceilinQ/or forced air (Iris 2. cxamole.warer hearer; electrical/or solor E. Square footage or valuarion, etc. I. exomole.1250 sq, foot house, 500 sq, foot garage 2. examDle-if new project, check ri'eW-if addition, chf odd. etc. F. Building permit information: 1. exomolp..construct single family house with on ott. garage 2. examole-remodel existing gorogl!:- into faniily roar 3. exo:nple.convert single family residence into rCSlauront (change of use) G, Value or work as defined in Section 303 (a) of Ihe Structural Specialty Cede H, DESIGN TEAM AND CONTRACTORS To ovoid design or construc!ion deleys, Building Divi$. Stoff musr be able fa contect oppropriate persons reg . design informcrion or job site c.orrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedule! A. Except where blcnk spaces occur in the description pc of the Mechanical and Electrical Schedules. the opplic need fill.in only the No. Boxes adiocent to the cpprol= . item(s) ro be installed. ___ .. -S.' Full Plumoinq. Mechanical. and f:i:!,;t,(cal Schedules . 'are available at the Buildinq Div;'ii',JIi 1. To conserve space on the pen,..it form the schedule hove been abbreviated 2. If the item(s) to be installed ore not covered on the ored scheaules you should consult the fuil schedule C. BUILDING DIVISION STAFF WilL FilL OUT ALL FEES At CHARGES ON THE SCHEDULES III. Applicant to sign ana dole Whenever possible. the initiol application will be used as worksheet only. Where possible. Building Division Staff v. prepare a typewritten copy and return it to the applicant the lime the actual permit is issued for his signaturE. Fees and Charges ~. Plan check fees are due and payable ot the time of the 01 )CI' .. ~ and no pions will be processed until these fees are paid. ,l- ather fees and chorges are due and payable when the permit is issued. IV. V. FOR OFFICE USE ONLY .-- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additional Project Information: PLANS REVIEWED BY, name LoR~ ({~~ signature -...... .. ~MIT VALIDATION 17 03 43 CITY OF SPRINGFIELD ( City Hail . Springfield, Oregon Department 01 Public Works OFF I C I A l R E C E I PT ( ( No. B 5 6 8 2 9 '/-1- 19ft Rec'd From QonoJ.ct te~land Address ;2 LI.3 '5 (J,0 Y'" Nyj,,-, ( Dale ( .-' ~( , \ Receiv~d For: ( I- y),'f) L/L-I 00 Lje, J. 7& ( Ie) , ,,'" I)~' 10, Or) ft~ LjC .i.fi) '70 I fJ/J -. -- _. . . -c----/S--. {)O ____1._ ( L/C;~, ,(00 ( fYl.A'7 I~.CO (: I. ~;;;. ( '. r' . ~ ?;::) . ,=i, B c2hJJ.cJC (l ~dU-- Amount Received (' '. ~I ..~".. AUTIoIOA1Zl:D SIG~...rUlU: ...CLTO...TU.......LL ~",..T"".. ru'n"c. 010 .'_0' ".. ( . ).' :. Permit Cieri-' . ,.-....., '_"A;-___.._........~._~_._,. ~ , I I. I I -lotI"" C-;3'o-B /