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Home My WebLink AboutPermit Building 1986-10-16 "~~lIm.J![f$I.:Jr~.~~- r.. In:,''~~~r::':J~IJf~''~''_~~_-f''''f~:::~,*,,,~~~~'':''''';''-'-~~~ Ie -9 - fe' INSPECTION LINE 726-3769 CITY OF SPRINGFielD COMBINATION APPLICATION/PERMIT '/70 Ci..~ ~;f' ,;. INFORMATION LINE 726-37 S3 ENERGY SOURCES: Heat Water Heater Range Value of Work: $8,500.00 , Sq. Ftg, Main--1O.QD Sq. Ftg. Acce... Sq. Ftg. Other on _New -XAdd-X-Alter -,-Rep. _Fence_Demo_Change/ Use _Other 00 o ...... o o -....J J~Add~.. 1278 I Street legal Description Lot 27. Block 3, Mohawk Addition Owner -Tomas Anderson Address 1278 I Street Springfield, Oregon 97477 Phone 726-8521 Building Permit Info: Describe Work (Le., Build Single Family Residence With Attached Garage) Construction Lender Cnstrl1ct ?ncl Ri'lthrnnm Arlrliti rm Deck & install new exit door Address ./ Phone DESIGN TEAM (name) (address) (lies. no.) (expires) (phone no.) Primary Structural f Electrieal Mechanical CONTRACTORS (name) (address) (lies. no.) (expires) (Dhone no.) General R.A. Rude Construction 2298 Brittanv Drive 34284 9-15-81 6RFi-q4q7 Plumbing Electrical Mechanical PLUMBING elECTRICAL MECHANICAL DUDlex (1 bath) each FEE CHARGE NO. Residence of 'q. ft. 2 New circuits, alterations or extensions SERVICES Temporary Construction w.ool Amps. CHARGE NO. FEE CHARr.E NQ F~ 1 furnace/ burner to BTU's Appliance vent separate Stationary evap. cooler Vent fan with ,,; single duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct 3.00. Each single fixture Relocated building (new fix. additional) S.F. Residence (1 bath) 15.00 1 Additional bath Water service Storm Sewer FEEDERS Wood stove/heater I Heat Pump I Air handler to 10,000 CFM I Air handler over 10,000 CFM I I I Sewer Amps. TOTAL CHARGES I 10.001 ISSUANCE OF PERMIT 10.00 TOT Al CHARGES 15. 00 . TOTAL CHARGES 1 ~ nn WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until a label has been signed by an Electrical Contractor and attached to the electrical panel. I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all 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 State of Oregan pertoining 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 that my registration with the Builder's Board is in full force and effect a s required by ORS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. ,ad.,Q/~ / ..- Basis for Builder's Board exemption: NAME (please print) R.A. RUOE r.ONSTRUr.TI ON SIGNATURE DATE /;&hd- /.&. / / / I FOR OFFICE USE ONLY Zone Fire Zon6 Flood Plain R-1 NO Typel Canst. Bedrooms <;tori~' V-N Units Clccy load Clccy Group...R.=3 <;q. Ftg. Milin c;q. Ftg. Access Sq. Ftg. Other '( Value ~(alue l/alue 8,500.00 x x TOTAL VALUATION BUILDING PERMIT 48.00 Plan Ck. Comm/lnd C"({rges and 65%1 Bldg Per Fee Surcharges 1. 92 Plan Ck. Res 30%/ Bldg Per Fee PLUMBING PERMIT Charges and 10.00 Fence Surcharges .40 Demo elECTRICAL PERMIT 15.00 Charges and Sidewalk Surcharges .60 I A/ C Pavin!! MECHANICAL PERMIT Charges and _ _ _ _ _l3--1lD Curb Cut Surcharges .52 Systems Development Charae {1.5%l 14.40 PO lO-7-Rn REC 54826 I Total Comb, Permit 89.44 89.44 TOTAL . ,,"""''''it . T-.J"'~~~ ~- ."_... _ ,...".... .....___...~~"..__ __. ..._.-...... ...... \./ " " .~ ..~"'":~r-.....,~-. '~~":,,,::.:...-. ",. ':\ COMBINA TION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. legal Description 1. example-tax lot 100, lane County Map Reference 17 03 43 2. example-Lot 1. Block 3, 2nd Addition to Springfiel~ F..t"h~o; C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air gas 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. example-1250 sq. foot house, 500 sq. foot garagE 2. example-if new project, check new-if addition, ch add, etc. ;' F. Building perinit information: 1. example-construct single family house with an at' garage 2. example-remodel existing garage into family roo ( 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 Divi (' Staff must be able to contact appropriate persons re, ..I: design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical & Electrical SchedulE A. Except where blank spaces occur in the description p of the Mechanical and Electrical Schedules, the 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 schedul have been abbreviated 2. If the item(s) to be installed are not covered on t~ ated sohedules you should consult the full schedu C. BUILDING DIVISION STAFF Will FILL OUT ALL FEES J. CHARGES ON THE SCHEDULES 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 applical the time the actual permit is issued for his signature. <- IV. Fees and Charges Plan check fees are due and payable at the time of the fi" and no plans will be processed until these fees are paid II other fees and charges are due and payable when the t+- . is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: AdditionClI Project Information: PLANS REVIEWED BY: \ \ u:<~t~ ,~ "'_"~'( :-.~ 'T ....~.--:;:-- .,~.~--::;. PERMIT VALIDATION ( CITY ( OF SPRINGFIELD City Hall Springfield. Oregon Department of Public Works OFFICIAL RECEIPT ( No. 8 5 4 912 ( Date 10 - J i 19?O . Rec'd From '7Za I2udJ (lnls:f- Address 2 zq~ f)r cttCtM_i. I 0r ~- (j ~.CC) J .qz. lV, CX). Cia I 5.CXJ tf:) I ~.CCj 6L ( ( Received For: 5P ( ( pp ~J/~ .- 4<SJo ( c ctp ( ( 4PJ ,IJ " f---{P (, / '. qeJ/J I Amount Received 'hq .4Q et:- L,) ( ( BY ( Al/HORIZED SIGNATURE SHELTON-TURNBULL PRINTERS' EUGENE, OR 87401 !5l'J51l'8 c. ( .~/ f J Permit Clerk nam" DAN Sr~ITH c,ignatureCn n/,Jr0.rtJr 7/(7 r datF' 10-8-80 '.-..~'~::~.,:,-.... "'4-::~"".'.""""'.' "..', ...,.-....,.. '.'--""""0",'__' _-;.. ~'~''''_~'h'~~''''''.~''_''''