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Home My WebLink AboutPermit Building 1981-5-14 .,~~:_:" J.,::~,,,,',:,(~:::,":~:'i!C_!!'lt...e.r;';~,';~;!,~J:~! .,).,'c":"~,~":,:..~.,,,..__,,,,..:,' I ..,.i" ,"., uj.!'1 .'", ".....~;""~" "''''.,~ ...;........ ..: " '. ,- - 'Ddir/in~T4-='~ '...,,>=~-_..--~- -'"~''' INSPECTION LINE 726003769 CITY Of SPRINGFIELD COM8lNAnON APPLICAIION/PERMIT INFORMATION LINE 726-3753 Own., ErnesJ.J:loJJ.Oway Add.... 4864 Da i sy Street Springfield, Oregon 97477 $21,500.00 Sq. Fig. Main 1 j44 Sq. Fig. Access. Sq. Fig. Other )LNew_Add_Alter_Rep. _ _Fence_Demo_Chonga/ Use _Other 00 .... o W N 00 legal Description 325 Scotts Glenn Drive Lot 69, Block 5, Lochaven ENERGY SOURCES: "aa._ElectJJl Water Heater -E-l ect- Ranga ~lect V.;llue of Work: Job Addreu Phan. 726- 3890 Building Permit Info: Describe Work (i.e.. B'Jild Single Famil-r Residence With Attached Geraae) Conitruction lender Double Wide Mobile Home SetuD Only Address Phone DESIGN TEAM (nome) (address) (lies. no.) (expires) (phone no.) Primory Structurol Electrical Mechanicol CONTRACTORS (name) (address) (lies. no.) (expires) (phone no.) Plumbinq .~ralrl Trialo~ ,~'os 575 SoutR-A-S,tr~et Owner Owner 02953500 747-4008 Gener,:,1 Electricol Mechanical PlUMi3ING NO, FEE CHARGE I NO. Eoch single fixture Relocoted building (new fix. additional) S.F. Residence (1 both) Duplex (1 both) ea;h Additional bath Water service 1 1 Sewer 118' ,20.0t 20.0C 1 Storm Sewer I Plb I 1 Conn MH 15.0C 15.0t elECTRICAL MECHANICAL FEE . CHARGE NO. I FEE I CHARGE MH Connection MH Pedistal I 10.00, 10.0~ . 10.0C 10.00: furnace/burner to A.TU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent system apart from heati....g or A.C. Mechanical exhaust hood and duct Residence of sq. ft. New circuits, alterations or extensions SERVICES Temporary Construction Amps. Wood stove/heater FEEDERS Heat Pump Air handler to 10.000 CFM Air handler aver 10,000 CFM Amps. , ISSUANCE OF PERMIT TOT At CHARGES 35.00 TOTAL CHARGES 20.00 TOTAL CHARGES WHERE STATE LAW REQUIRES tha' the Electrical work be done by the Eledrical Contractor, the electrical portion of this permit shall not be valid until Q label has b..n signed by an Electrical Contractor and attached to ,ho electrical panel. I HA VE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I furthe, certify that any and all work. performed shall be done in accordance with the Ord:nances of the City of Springfield and the laws of the State of O,egon pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I further certify tnat my registration with the Builder's Board is in full force and effect a s required by ORS 701.0.55, that if exempt the basis for exemption is noted heron. and that only subcontractors and employees who ore in compliance with ORS 701.055 will be used on this project. II NAME (please print) Basis for Builder's Board exemption: _.." R~ //G',V/.6:(, ;j(1LL(y~/d.(A SIGNATURE Aa1.Lii~,-jfj.'i<-u.'<Lt:f / " I FOR OFFICE USE ONLY DATE S-/4-6'/ Zona f'It1:> Fire Zone Flood Plain Type! Canst Bedrooms C.torie~ 1 Sq. Fig. Main 0;:,. Fig. Acce!' Sq. Ftg. Other . Value Value Value 1 , Llnih t'~cy Load Occy Group . TOTAL VALUATION BUilDING PERMIT Charges and Surcharges 40 0 )Plan n. Comm/lnd . 65%1 Bid" Per Fee Plan Ck. Res 30%/ Bldq Per Fee Syslems Development CharC'e Cl.S%) 322.50 PLUMBING PERMIT Charges and Surcharges 35.00 1.40 ~u.uu Fence 30.00 PO 5-13-8l REC#56484 ,p label Fee Demo I Total Comb. Permit .20 115.20 ELECTRICAL PERMIT Charges and Surcharges Sidewalk .80 AIC Pavino 6.00 MECHANICAL PERMIT Charges and Surcharges Curb Cut 11.80 437.70 TOTAL ,.1'.:--:'L:::;';..,':: ,::::.::~~_,~,llk.,.t!I!;~"!)#!.\l~'~ ~:,-'~'C:'!;"';~~'~""'-!"'~!:'""t:"o .!)...;,t. ..=" '",..:' _i ,. ,,:Jf w'"""",1 .-:~~"'''''''';.t~':'':<''>;::, III. Applicant to sign ond date 1- Whenever possible. the initial application.will h... ,,~.......I _~- ...: - - - - - - I . - - - . - - . - . - - - . - - worksheet only. Where possible, Buildi~g OWNER'S ELECTRICAL LABEL prepare a typewritten copy ond return ,t t BUILDING the time the oclual permit is issued for his BUILDING DIVISION-City of Springfield-346 MAIN 51, IV Fees and Charges 726-3753 (Bus.), 726-3769 {lnspediofts} . ATlAC TO ELECTRICAL PANEL Plan check fees are due and payable ot th and no plans will be processed until these other fees and charges ore due and payo~ is issued. COMBINATION APPLICATION/PERMIT (CAP) I. Applicont to furnish A. Job Address B. Legal Description 1. example.tax lot 100, Lane County Map Referen, 2. example.Lot 1. Block 3, 2nd Addition to Springfit C. Nome, etc. of owner and construction lender D. Energy Sources ' 1. example-heot/electricol ceiling/or forced oir go, 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. . 1. exomple-1250 sq. foot house, 500 sq. foot garo~ 2. example-if new project, check new-if addition, c add, etc. F. Building permit information: 1. example-construct single family house with an a garage 2. example-remodel existing garage into family ro 3. example.convert single family residence into restaurant (change of use) G. Volue of work os defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Oil Staff must be able to contact appropriate persons r design information or job site corrections, etc. II. Abbrevioted Plumbing, Mechanical & Electrical Schedu A. Except where blank spaces occur in the description of the Mechanicol ond Electricol Schedules, the apF need fill.in only the No. Boxes odjocent to the app' item(s) to be installed B. Full Plumbing, Mechanical, ond Electrical Schedule, are available at the Building Division \ 1. To conserve space on the permit form the schedl have been abbreviated 2. If the item(s) to be instolled are not covered on ' oted schedules you should consult the full sched C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES CHARGES ON THE SCHEDULES < CITY OF SPRI N'GF'I Ei-D----~ City Hall Springfield, Oregon Department 01 Public Works OFFiCIAL RECEIPT /" '> F N~ B 565b3 Date 5-/5 1981 Rec'd FromF:ynt:.st-APvPvlu 1+-'l.1.ftUJ~ Address 48&,4 Do. /51/ St.-cS;J"p,j { / I ik. ( fh, Received For: (r{'~ .f)/,.l) <;"'/ iJ-. ?/mho , 40/0 Glee -1"10 ( J..1/-1 ( 4(~.a9 35:0}> j,4f! dD.~ O. ESe> to. Of! //.8,9 G,c;:l.O ( / In\ S/rn (If' LLJ h:1J ( #"()2..J8B ( - -.:p//. zo Amaunt Received '-;.37, - ~IL (at .~ ~ ( AUTHOAIZlED $IONATUAE 'HUTO...TUIll......LL ~"'HTIIII' _ 11,1011:..11:. 0111 .UG1 ( ...",. \ " ( ( N~ 0218 B Signature of Building owned' d b f "'41' connoding olo"'lea' ;n. i1o?,c! (Must be provi e e ore energl _ ~ T C{ _ ~ b 1IIeE:i. ~ I 4. !a. {^< -J-/ll ,$U ~ .',-r 1', /I\IJJI)'J ~ I (M.mng~~"o ) (Pleese prin, t1 (OW, ner's N me) q I ...,......... C:::::.\...~ ,~~~ ~r^4-fS F1Vl ....",,-", . r" (Addre" of Premise~ Served) " V. FOR OFFICE USE ONLY PROJECT CONDITiONS TO BE SATISFIED BEF Description of Work: Servlce(s\ 'WV\.V\. F..der(s) Additional Circuit' f'~O$b.\ - n"W\~~~. _Temporary Service (Requites a separate label) . __ - -" - ~ . I . a ency to conned and energ.ze the Permission is hereb! granted to on H~I~C~~~S t'1~~~~s :CCOMPANIED BY A RED APPROVAL eledrical 5ystam deSIgnated hereon W NOTICE AffiXED BY AN ELECTRICAL Il<SPECTOR. VAT'" lOB N'" INSPECTED BY Additional Project Informotion: --- ---'-'~-- ---- .___ _.____ n_ II 1 TOM SHEIRBON SignatuJim .JfuJJ1 ~/f1p 5-14-81 PLANS REVIEWED BY, name__"__ date r INSPECTION LINE 726-.3769 ,i CITY Of SPRINGfiElD COMBINATION APPLlCAflON/PERMIf . INFOAMAJlON LINE 726-.J7SJ '-(< i Sq. Fig. .....oin I Sq. fig_ Aceon. Sq. fig. O,h.r j _New _Add _Alter _Rep. ~. Demo_Chang.iU,. _Other ./ Building ~ermil Info: Describe Work ii.ll.. Build Singl. Fc:'mily Re';~~"~,:, w;lh ~':~ C}-:"':''1!.1 00 OCJ, o (0 V '~d Job Addren 3d ~ ~C,C!ti I) 6. (!J.n ENERGY SOUlKES: I Legal Oescription (HeL loCI .eUCs dCC"J/Cfi ('n I O_n.' 'r \l:n 0 f11- 'l '\n\ \[)( '- j(t I Add.... \~ ~ _"\0("~(',lG (\'p~on. I ~tw-J <N (Qr7Q', - I Construction l~J..) . I Addre" I DESIGN TEAM I Primo'y I Structural Heat Wal., Heal.r Ro"qe _ Value of Work: C{)0CO Phone ./ . ( \ f\ 1\ \\rTl .r:::-, -1 01-0'( Q qQ '--.J\\J!.d -' (\ (no""". . (odd,,,n) (lin. no.). (expire,) (phone no.) Electricol Mechonicol General CONT!lACTORS ( U-t "-.-:5\\0 (nome) (address) C1ies. no.) {expiresl (phone no.) , Ii '''---. Plumbino electri<<ll ~'.!.r Mechoni<<ll PLUM lUNG ELECTRICAL MECHANICAL I FEE 'CHARGE I I " I I, I NO. I fE!: I CHA.RGE , NO. I I I I I I p:;:: CHARGE NO, SE!lVICES furnoce/hurner !o ~TU', Appliance vent separate Stationory evap. cooler Vent fan .....ith single duct Vent system aport from heatinq or A.C. Mechonical exhaust hood Qnd d~Cf Residence of foch sinql. filrture R"loca,ed building ~new fiJl,. additional) S.F. Relid.n~e (1 barh) 1C~: ft. New circuits. alterations or extension I Ouolu {1 bothl eo,h I I I I I I /J //;1/ I II /I Temporary Construction Additional bOlh AmpI. Water lervice I I I , I I I r I TOTAL CHARGES I WHERE STATE LAW REOUIRES that the Electrical work b. don. by the Elertricol Cantrauo', the et.ctrical partioll of this permit shall not b. valid until a lobel ho, been ,igned by on Electrical Contractor ana attached to Ih. eledricol panel. Sewer Wood stove/healer -/ /I />7 y /-----;- I I Air handler onr I 10.000 CFM ....- /!/d .' I '/ Stor.m Se......r FEEDERS Heat Puma Air handler to 10.000 CFM AmpI. ~ TOT At CHARGES ISSUANCE "OFflPERMIT I TOT At CHARGES Balis for Builder', Board e,umptionl NAME (pl.o.. p,ln.) B':c: 1/ E./ ( E(, f/;)}. I. {kvMt I HAVE CAREFUtt Y EXAMINED the completed application for permit, and do h.ereby certify that all information hereon il true and correct, and I furth., certify thof any and QII 'Work performed ,hall be don. in ocwrdonce with ,he Ordinance, of the City of Springfield cnd the laws of the Stat. of Oregon p.rtoining to th. .....ork dltlCribed herin. and that NO OCCUPANCY will b. mod. of any s!rudur. without the p.rminion of the Building Divilion. I furth.r certify thot my registration with the Builde"s Soord is in full for.:. and .,ff.ct a I required by ORS 701.0.55. that if u_~mpt the basi, for exemption is noted.' h.ron, ond Ihat only Ilolbc:ontraclon Qnd employ.., who ore in compliance with ORS 701.05.5 will be used on this project. /> ~ i.' 1, ~IGNATUR.e ..-:/.JJ-..-r..<-c...-,Wr,.-( jLii~~ , DATE f,,:;;?-?/ FOR OFFICE USE ONLY Zone Ail H- ~ Fire Zone Flood plain - Typel Conlt. .:::;r -I S.droom, ,\11--1 Sq. Ftg. Moin Sq; Ftg. Accllu Sq. fig. Other . '.'olue Clari.. ! IJnih "'Cty Load nccy Group :JI: Value )( Value . TOTAL VALUATION ,:;; Son, a::> Sysleml Development Choroe f I ,.5~1 I Tolol Comb. P~'mit I I TOTAL Cl'/. 9~ 111. Applicant to sign ond dote Whenever possible. the initial application will be used Q: worksneet only. Where possible, Building Division Staff . prepare 0 typewritten copy and return it to the appliean the time the actual permit is issued for his signoturt.. t-,... IV. Fees and Charges Plan check fees are 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 ore due and payable when the permit is issued. COMBINATION APPLlCATlONIRMIT (CAP) I. Applican:. to lurnish A. Job Address B. Legol Description 1. examole.tax lot 100, lone County Map Referenc! 2. exomole-Lot I. Block 3. 2nd Addition to Springfiel C. Name. ele. of owner and construction lender D. Energy Sources 1. e)(omole-heat/electricol ceiling/or forced air gas 2. cxomol~-wafer heater: electrical/or solar E. Square footage or valuation, etc. 1. examole.1250 sq. 1001 house, 500 sq, loot garage 2. exomole.if new project. check ~.if addition. chI add, etc. F. Building permit information: 1. exomolp..conslruct single family house with an ott garage 2. exomole.remodel existing 90r09& into family rool 3. .exa~ple.convert single family residence into rcsrauront (change of use) G. Value of work as defined in Section 303 (0) 01 the Structurol Specialty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction delays, Building Divh Stoff must be aole to contact appropriate persons.re~ design informolion or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical Schedule A. Except where blonk spaces occur in the description p' of the Mechanical and Electrical Schedules, the appli, need fill.in only the No~ Boxes adjacent to the approl item{s) to be installed B. full Plumbing. Mechanical. and Electrical Schedules ore available at the Building Division . 1. To conserve space on the permit form the scnedul, have been abbreviated 2. If the item(s) to be installed are not covered on thl aled schedules you should consult Ihe lull schedul, C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULES v. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Additionol Project Information: PLANS REVIEWED BY, nam""' ...ignolurp. . ~ PERMIT VALIDATION ,r CITY OF SPRINGFIELD City Hall Springfield, Oregan Department of Public Works OFFICIAL RECEIPT -' ( ~ ,\U\ No. B Dale~l\.'GJL 19~1 Rec'd F{~ ~lt), ~~~\\~J\YHr\ Address ttfSlot Do J. 0~ ~ ( 56767 '- <eo Received For: ( ( ( \'~K\ r\1~ ,GO ( AOt=, Cj (I') . ... ~ - ( (. ( (,' ,ob Cfln Received ,~ , (~ Amount ( ~....I ( A,UTMOlt.ZI:O SIGNATURE ( '"I[LTO"'TU"N'U~L ~"'''T'U.' . [UGIE..':. 001 .,.0. ,.."., '" ( :, Permit CierI- r ~ ----- " I' I I I j ilL/? ~ote C;; -/y -- y/ , ..........- ,