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Home My WebLink AboutPermit Building 1981-1-13 INSPECTION LINE 726--3769 CITY Of SPRINGfiElD COMBINATION APPLICATION/PERMIT INfORMATION LINE 726-3753 1...IO.",lpHon Lo~~.a..:'~1l Mobile Home Su_bdivision_ Lot 36. Block 3 Own., ~obert Cochran. Gene & Bernar<U:liat.!: ,.. Add,... 663 WestG~nt~nnial Blvd Phon, 741-14?() Soringfield. Oragon q7477 1988.00 2$""'''8,...0 Sq. ftg. Main -r4tt- Sq. ftg. Access. _ ~ 2~~ ~ Sq. Fig. Other ::: _XNew._Add_Alter_Rep. ~ _ _Fence_Dema_Change/Ule _Other ENERGY SOURCES: Job Addr',,< 426 Srotts Glen Heat Waler Healer Ranq. Vall,/. of Work: Construction lender Building P.rmit Info: D.lcrib;-w;rji.... Build Single f,:..,~ly Reliden~ With Attached GOra:gel Sinqle (~~~nd J_:~~h~ :~~JgS &RSe Mobile Home Plumbing & Electrical service Addre" Phone DESIGN TEAM (nome) (address) (lies. no.) (expirel) (phone no.) P,;mo,. Garrett Maupi n, P.O. Box 846. Sprinqfi e 1 d 746-8514 Structural Electrical Mechanical CONTRACTORS (nome) (address) (lies. no.) (exoirel) (ohone no,) General Hiatt Brothers Construction 663 West Centennial Blvd Springfield 741-1420 PlumbinQ Electrical Mechanical PLUMBING ELECTRICAL MECHANICAL NO'I FEE CHARGE NO, FEE CHARGE NO, FEE I CHARGE Relidence of furnace/burner to Each sin~le fixture *-. ft. ~TU's Relocahld building New circuih, alterations Appliance yent (new fix. additional) or exhlnlions separate S.F. Residence Stationary evap. (1 both) SERVICES caoler I Vent fan with Duplex (1 both) each Temporary Conltruction sin!:de duct I Vent system apart from- Additional bath Amps. heating or A.C. I Mechanical exhoult Water lervice hood and duct Sewer I I Wood stove/heahlr Storm Sewer I FEEDERS I Heat Puma 1 Mobil e Home I I Air handler to Amps. 10.000 CFM ::,erVlce 115.00 I Air handler over 1 Mobile Home 10.000 CFM I Service In nn I I i ISS~ANCE OF PERMIT TOTAL CHARGES 15.00 TOTAL CHARGES 10.00 TOTAL CHARGES WHERE STATE LAW REQUIRES thai the Electrical work be done by the Electrical Contractor, tho electrical portion. of this permit shall not be valid until a label has bMn signed by an Electrical Contrador and attached to the olectrical panel. I HA VE CAREfULLY EXAMINED the campleled 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 sholl be done in accordance with the Ordinances of the City of Springfield and the Laws of the Stat. of Oregon pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building Diyision. I further cerUfy that my registration with the Builder's Board is in full force and e'ffect OJ required by ORS 701.055, that if exempt the bOlil 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. Basis for Builder's Boord exemption- 1 NAME (please print) f2.0--a6- _ Ll , 'll r ~.~ c_~ p Zon" MHS Type/Const. Bedrooms V-N Units r'!','cy Load n,..cy Group SIGNATURE~0'" ~I fOR OFFICE USE ONLY Sq. Ftg, Me;n fttr" x ~ Volu...lW. Sf! Sq, Ftg. A<ee.. --3:!'- Z({;'L... x q 'in Val.. ~ Sq. fig. Other x Value TOTAL VALUATION 199B. BEl:?.s;::8;'" Il'a 1 a wHh Mobile Systems Development Cho,oo r!.S%1 Home setup penn1 t~ I I J'/oJ OAT,I_/.3 -lj / Fire Zone Flood Plain c.torier M-! BUilDING PERMIT Charges and Surcharges 1"2'1,""0 29.80 ~ ,'1~ Plan Ck. Comm/lnd 65%/8Ida Per Fee Plan Ck. Res 30%/ Bldo Per Fee . ;. 8a 7,20 PLUMBING PERMIT Charges and Surcharges 15.00 .ou Fence ELECTRICAL PERMIT Charges and Surcharges 10.00 .'lU Demo I Sidewalk I ./e P."'". I C'ur-b ~ut I Total Comb. Permit 76." 81.36 185' 18.50 MECHANICAL PERMIT Charges and Surcharges EXI;:jrl'/"'V'q, 1:. :J-. 76.~ TOTAL 81.:m -", '",~ -'.' - - . ,"", ..." . ~ .~. t...~,~~ . "*'"'.... -:..,.~~=.'!>. ; (.,.~ ' 't-.: ~ l , _ -.... p~""~i-~' "". '. <J: 'i" _ COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example.tax lot 100, Lone County Mop Reference 17 03 43 2, example-Lot 1. Block 3, 2nd Addition to Springfield, F"nl~. C. Name, etc. of owner and construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced oir gos 2. example-water heater/electrical/or solar E. Square footage or valuation, etc. 1. exomple-1250 sq. foot house, 500 sq, foot goroge 2. example-if new project, check new-if addition, che add, etc. F. Building permit information: 1. example-construct single family house with an attc garage ( Rec'd 2. example-remodel existing garage into family roan . . 3. example~convert single family residence into restaurant (change of use) G, Volue 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 Divis ( Staff must be able to contact appropriate persons reg design information or job site corrections, etc. II, Abbreviated Plumbing, Mechanical & Electrical Schedule, A. Except where blank spaces occur in the description pc of the Mechanical and Electrical Schedules, the applic need fill-in only the No, Boxes adjacent to the approF item(s) to be installed B, Full Plumbing, Mechanicol, ond Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedule hove been abbreviated 2, If the item(s) to be instolled are not covered on th. ated schedules you should consult the full schedul, C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A CHARGES ON THE SCHEDULES III. Applicont to sign and date ( , Whenever possible, the initial application will be used a: worksheet only, Where possible, Building Division Staff, prepare a typewritten copy and return it to the applican ( the time the actual permit is issued for his signature. IV. Fees ond Charges Pion check fees are due and poyable otthe time of the c llie and no plans will be processed until these fees are paid. ' other fees and charges ore due and payable when the P:-:..... is issued. ("" CITY OF SPRINGFIELD (l ( City Hall Springfield. Oregon Department of Public Works OFFICIAL RECEIPT CI ( No, B 55581n J- /8 19rfO ' From/If'()cJzCll~/7 miwrl-hnt.f, n Address ;J. 0 & V / ()P/l ,~ " ~~g,U' CC j)4'~((J CI Received For: (J Dote (' & , I cJ(j.Oo , q(~ - / ,\-; (JO .1&0 10,O(j , r.;O 1,c;JO /f. ,4n 19" ,(I ( pp (I 470 (' ..0.0 I (I ( 4% f!OA f/if'LrJ ('1~ suJ (I ( (I Amount Received $' ?fa .LL' 14 (J~d(v ( (, ~"I A,UTHOR1ZEO SIG",A,TUIU: s..nTO...Tu.....U~~ ~"'''TE''S " ~lJQ~"[ 0.. 87"01 .....'. (, I. ( V. FOR OFFICE USE ONLY Permit Cler~ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 5 foot wide setback sidewalk to be installed with City standard curbcut. . - ._~ . - ".'.0 Additional Project Informotion: PLANS REVIEWED BY: name Lorro 01 "l9('~ si9nature/~ 'I I' I 0~-. " date 12-11-80 HlSPECTIOII L1IIE 726-3769 Job Address Legal Description / n +- Construction lender Address Dt.~ll.irl TtAj-l Primary C.....,~-.._,l -- -_._- i Electr~c.~l I I ..=-:-~::.~~. i ::..~_;'.:---: . . CITY OF SPRINGFIELD CD/iBlilATION APPLICATION/PERMIT ---.. ... E!IERGY S9URCES: . " Heat Electr~c 4'26 Scotts Glen Lochaven Subdivision t.la ter Hea ter Ranqe 3Co (name) =-;'.~::ir.r: Hiatt Bros, h I()d~, Owner Gene & Bernard Hiatt & Robert Address 663 W. Centennia'tocnran Pj'1l't-l4201 Springfield I I I Ge"'le"i!l I "*'"r;,,; Penselin Electric ! .~:-,---,. ~!.!..':-'3:~~ ~=C~ ~:~.: :~~:~~~ .1:':' . r~ARr;E ,~elocd~2d building j (new fix. additional) , I S - p , . t". ,.es 1 dence '1 t-ath) IOup,ex '(1 bath) each Additional bath ~!ater service SeloJer I Storm Sewer IWIE(please print) Zone Fi re Zone Flood Plain BU I LO HlG PERI'IlT Charges anc Surcharges PLur,lBING PERI'IIT Charges and Surcharges ELECTRICAL PERI:IT Charges and Surcharges 11ECHANICAL PEPI11T Charges and Surcharges :~ Val u2 ~f ~6'O . INFORlIATION UII, 726-3753 Sq, Ftq. 1'la;n ~q. ftg. Access. So. Ftg, Other Ilel< Add A lter ~ep, --Fence Demo Change/Use -Other - - '~ ......... - - IUJ ~ Builc;;na Permit lnfa: Describe l~ork.( Le., Family l1esidence 1./ith Attached (iflracre) Mobile home set up with lexniresl Build Single I I I I (ohone no. \ improvements Phone (address) (1 ics. no.) l I I I I I I I TOTAL CHARGES I TOTAL CHARGES WHERE SiATE L,11~ REQUIRES that tile Electrical work be done by an Electrical shall not be valiJ until the label has been signed by an Electrical Supervisor ~~:"C:>551 . j i::.. _ ~~. I Springfie1a Springfield 20-48C ::l:::T::t:C':.L nn I : r:.:.::~:,::= ReS1cence ':7 SQ. FT. INew circu~t~ alts. or extensl0ns I SERV ICES I Temporary Construction Change in existing rp<;;ri!:'nrP multifamily, camm. or Jnc1l1<;.tl"'ial amps.1 I Install/alter/relocate I rli<;trih. fppdpr<; Of CDI,Y,1. /I NO, FEEOERS Of amps. (~:\'Jir~<;i I ronnnp ;10. \ 741-1420 741-1186 :'IECr.';il I CAl ::1. ; ! furnace/burner to I BiU's I Floor furnl1ce and vent I Recessed \...a 11 ~n~rp hp~tpr ~nrl vpnt I II='~T ! r:.1~:::-r.~ . I I I I I I I Appl iance vent s_en~ ra tl=' Stationary evap. cooler Vent fan wi th sinale duct. Vent system apart from heatino or A.C. Mechanical exhaust hood <lnd rlllet I Hood stove/heater I I SSUANCF OF PFRtll T I TOTAL CHARGES Contractor, the electrical portion of this permit and returned to the Building Division [)p " VI w ~ \LI L a</k... Tyoe/Const. Bedrooms Stories Units Occy Load Occy Gt'OUP / IQ' CO I Plan Ck, _____-::J....:... ~___ fi5'.UB1r1.cr Plan Ck. 30%1131 do /5 06 Fence --n-n~-~2rl O~~~_. ___n./l2.QQ_ Sidewalk . <.j () A/C Paving I Curb Cut I I '1 ~ (omb. rermit .-'1 . ,TOTAL I COlTiTl/lnd PJ.r Fpp Res Per Fr:e r In OATE/I- 6 ~Yo x Value Value Value I HAVE CAREFULLY EXN1H1ED the completed application for I)ermit, and do hereby certify that all information hereon is true and correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Soringfie1d and the laws of the State of Oregon oertaining to the \....ork described herein. and that 1m OCCUPAlICY will be made of any struct~re without the permission of the Building Division. I further certify 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 exemotion is noted hereon, and that only subcontractors and employees who are in compliance with O~S 701.055 will be used on this project. SIG;I^TURE~/{)./ ~ ~ FOr. .OFFICE USE DilLY Sq. Ftg. riain Sq. Ftg. Access Sq, Ft9, Other x x TOTAL VALUATION Syste~s Devefopment Cha roe (1. 5~,) 352.,:::6 4J8.50 .. . t . ] ~j " ~ . , . 1 ! , ; , ; ~ ~ '. 'i ,. J J l . ; I ! ~ ~ ~ . ij i bt-_, .- . I COMBINATION APPLICATION/PERIIIT (CAP) I. Applicant to furnish A. B, C. O. Job Address legal Description 1. exawole- Tax lot 100. Lane County Map Reference II U3 "3 2. examole- Lot 1, Block 3. 2nd Addition to ~pr1Jlgrield Estates ~ame. etc. of owner and construction lender Energy Sources 1. examole- heat/electrical ceilin%r force, 2. eXG~Jle- waterheater/electrlcal/or s~ c- Square footage or valuation, etc. - 1. examole- 1250 sq. foot house. 500 SQ. fOQ' 2. exa:;loie- if new oroject. checknew - if al checr. add. ete. ' 3~~jJjn9 oenMit inior~Jt;on: ='=-:.,,: - -:;-,:;::-:::: singie family ric:Jse~-: d~~l!cJ1ed gar~~e ~.::~~:~ = ~~~~~~; ~~;.~~~n~c;~~~g~e~~~~;.;:: (r j ~ ~ ~ ! E. .~~:~~~~~~ ::~~;.:e ~~ ~se: . . - - .~._: :: .~r~ ~5 :~;T~e~ 1n St~~cturai SDeci~lty Code ::::: :;~; ~::".:";.: ;.~;: C:::T~;;;:i;jRS S~ction 303 (a) o' III. : .i'.~:: :::31;r: J~ .:.:~:s:~~uctic:1 deiays~ 3:Ji1~' :fvlsiQr. ~:~~f ~:JSt a€ 301e ~o cantac: aopropr :~~$=~S re:=rcin; ~~5i9r. Tnfo~~tion or j~b S' correC:l0ns. etc. ::'::'"?'::~:-=': :;;:-7:l:::.';~ :-'-=':!;cnical. 3. Elec:~~:~l ~:: : ~~c~~: x~e~e ~i~;,~ ~~~ces occur in :h~ cescr;: ::~::=~ :f :~~ ~~,:~~~jcai and Electrical Sc~e~ ::-:e .::~~::=.:-:: ~~~~ :'~n-in onlv the :iO. ~c:xe5 :: :r.e ~~~r~~rj~te ~:em(51 to be install~d ~- ~ull Pju~~lns. ~ec~anical: Jnd Electrical SChE ;~~ :~!1:~~:: ~: :~~ SUlloin: ~ivi$icn . ~: c:~ser~~ scace ~:1 the~permit 7ar~ :he ~ nave o==n ~bbreviatcd 2~ If :he l:er.:(s) c:o be instai1ed are not :::m ~he aooreviated $cn~oules YOU should cons~ ,'Ill} scnecu j es ~ C. BUILDr:;G D!VISI0i~ STAFF WILL FILL OUT ALL FEE~ CHARGES 0:1 THE SCHEDULES D. As noted on the CAP. the label must be deliver electrical contractor for signature by his ele suoervisor. The general contractor is not aut to sian the electrical label. - Applicant~to sign and date Whenever possible. the initial application will be a workSheet ooiy. Where possible. Building Oivisi will preoare a type written copy and return it to applicant at the time the actual permit is issued signdture. Fees and Charges Plan check fees are due and payable at the time of applicJtion. and no plans will be processed until fees are paid. All other fees and charges are due payable when the permit is issued. IV. V, FOR OFFICE USE ONLY PERMIT VALIDATION CITY OF SPRINGFIELD ( City HolI Springfield. Oregon Deportment of Public Works OFFICIAL RECEIPT No, B 1960 I Rec'd From H-( oft "'f C .Dr A aij) I I :2 w' " r\ ..".J-, Address 1,;/;:: ,j l-L..-,_C :;cre j i .' ; (.0 - r , " (S. Received F::r: i//"i( '--t'-X :..';' f!,{;;"JU S;1,'7'ttS . '-J -~ (, o ::::=1<1') ~'.J..:... \....' L- () i '-/{).OO \,.., r"'Y\-'^- ft'J IS-. ()O (::r: 'Ie, , /'7 () , Iv , fJ.L/ If). 00 {~ , Lf7~ (/0 c:::; f) C J ,~5:J.. 5"0 'r' c' ". Amount Received 4/ Y 50 ~~~-" -< \J ,. ~ AUTHORIZED 5IGNAnllU: S..CLTO............ULL ....'...I.S" (uGU.., 0" ...0' ( '. PROJ~CT CONDITIONS TO BE SATISFIED BEFORE OCCUP,a.rlCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Infor~ation: ~ PLANS REVIEWED BY: name signa ture date cIc", o \: (l ;1 " r, I \" ; ; l , ; . r' U . (~ ' II I (I 0 :J mmj ~ 1 ~ ~ ~ I ~ j ~ ~ :! -.."., c. I