HomeMy WebLinkAboutPermit Building 1980-7-31
JUL 1 0 1SBa
"lOTlFIED -.
.
H m~~morl L1IIE
II -7
Job Address Ie;! Shady Loop
Legal Description 8, Shady Lane
Owner Vahala Const.ruction
-._.
Address 988 North 63rd Street
Spfld, OR
97477
Construction lender
Address
Ul:.~llirl TEArl
(name)
Primary
Madsen Design
Structural
Electrica 1
!1echan; ca 1
COtlTRACTORS \ name}
Vahala Construction
Genera 1
Plumbina
8eeson
3-Way
Plumbin9
Electric
Electrical
f.lechanical
PLUIIBIIIG
-1!!' . FF' r:HI1!U~1=' '10
Each single fixture X
IRelocated building I
(new fix. additional)
X S.F. Residence 125.00
f1 bath}
Duplex (l bath) each I
1 Additional bath 110.00 I
-- I-
~!ater service
Sewer
Storm Sewer
ValuE of I'lar\<:
29,161. 00
Buil:t.iinQ Permit Info: Describe \'Jork(i'.e..
Family P-esidence IHth A.tlached (iaraae)
CITY OF SPRlilGFIELD
COIIB IIIATI ON APPLI CA T JON/PERM I T
1st Add
I
I
I
---1
I
I
I
Sinqle
Family Residence;
Fireplace
att Gar
E!lERGY cljIUlfll t
Heat C
Hater Heater t lect
tlect
Ranqe
Phone
746-7719
Phone
(address l
t 1 ics. no. J
(address)
f~~1
726-375~ nr~ I
Sq. Ftg. '.Iain ] 057
:q. ,tg. Access'4ll4 ~
Sq. Ftg. Other C)
-1le"_Add_Alter _~ep. g;
__Fence__Demo__Change/Use un
_Other
Build Single I
I
(exo;resJ
(ohane no.,
(lir~_ no.\ (pxo;res)
746-7719
988 N 63rd
(nhnne nn, )
27990 4-5-81
ELECTRICAL
'"'
1 ru"lRGL. NO
~5. 00 I
I
I
I I
1-+
I 3
I
I 1
I
I
I
I
Residence of
1057
SQ. FT.
INew circu~ts alts.
or extenSlons
SERVICES
Temporary Construction
Change in existing
fp",.i d~nrp
multifamily, COnlTl. or
Inrltlc;,tr;al
Of
amps.
r ...---
COI~I'1. II NO. FEEDERS
Install/alter/relocate
r1ic;trih, fpprler"
I HAVE CAREFUllY EXM1INED the completed aprl;cation for ~erm;t, 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 Soringfield and the laws of the State of Oregon pertaining to the work described herein, and that He OCCUPAr~CY will be made
of any structure without the permission of the Building Division. I furt ertify that my registration with the Builder's
Ooard is in full force and effect as required by ons 701.055. that if exe pt t basis for exemntion is noted hereon, and that
~~::(::::::t::~::~s andv::~~:e:~::~~eu::;~:l~:~:~ with :~:'II::~R055 ':"11 b {e~n (~~\~~e)ct. D~TJ:3I- 9tJ
FO,~ OFFICE USE GilLY
S~. Ftg. Ila';n 057
-
Sq. Ftg. Access 484
Sq. Ftg. Other
TOTAL CHMGES
WHERE STATE L~W REQUIRES
shall not be valiJ until the
Zone R-1
Fi re Zone II I
Flood Plain NO
Tyoe/Const.
Bedrooms
Stories
V-N
3
1
1
Units
Occy Load
Occy Group
R-3
MECHANICAL
I
I furnace/burner to
BTU's
Floor furnace
and vent
'~
I
Recessed wa 11
~n~<p hp~tpr ~nrl vpnt
Appliance vent
seDa ra tp
Stationary evap.
cooler
I Vent fan with
sinale duct
Vent system apart
heatina or A.C.
Mechanical exhaust
hood and duct
I Hood stove/heater
l. 00 9.00
from
x 24.20
x 7.40
Value
Value
25,579.40
3,581.60
,
Value
TOT^L VALUATION ~~ ,lbl. 00
BUILDING PERI.UT 127.00 I Plan Ck. ConmfInd IShstems Development 437.40
Charges anc 65%/Bldn Per ~ee C aroe (1.5~)
Surcharges ------------, Plan Ck. fes 1i-30-R~
5.08 30%fBldo Per Fee 38.10 PO
PLUI1BING PERI~IT _____.35..00 I Fence I 1
Charges and
Surcharges , ao Dflmo I
ELECTRICAL PERr:1T 25.00 Side"alk 56. 63' 5.65 I
Charges and ------------
Surcharges 1. 00 A/C Paving Total Comb. rermit I 236.37
11ECHAN I CAL PERI~IT 23.50 Curb Cut lll' h 1.80 I I
Charges and 673.77
Surcharges -------~94--- I I TOTAL
.
61-
40 -
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. examole- Tax Lot 100. lane County Map ReI
II oj 43 (
2. examole- Lot 1. Block 3. 2nd Addition to -
Sprlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources ~
1. examole. heat/electrical cei1;nQ/or force .
2. exa~Dle- waterheater/electrlcal/or sorar-
E. Square footage or valuation, etc. -
1. examole- 1250 sq. foot house, 500 SQ. foo' (~t
2. examole- if new project. check-nfw - if at
check add. etc.
F. Building pemit information:
1. example - construct single family house wi ~rl
attached garage
2. examole - remodel existing garage into faIT
3. examole - convert single family residence
restaurant (change of use) (
G. Value of work as defined in Section 303 (a) of
Structural Specialty Code
H. DES I G:I TEA:.! ArlO CONTRACTORS
To avoid design or construction delays, Buildil (
Division Staff must be able to contact appropr'
persons regarding design information or job sit
corrections. etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Sche ~~
A. Except where blank spaces occur in the descript \
portion of the Mechanical and Electrical Schedu
the applicant need fill-in only the No. Boxes a
to the appropriate item(s) to be installed ~
B. Full Plumbing, l'lechanical. and Electrical Schedl ..
are available at the Building Division
1. To conserve space on the permit form the sct
have been abbreviated
2. If the item{s) to be installed are not cover ~r
the abbreviated SChedules you should consult
full SChedules
C. BUILOIiIG DIVISION STAFF WILL FILL OUT ALL FEES A ('
CHARGES 0;1 THE SCHEDULES
D. As noted on the CAP, the label must be delivered
electrical contractor for signature by his elect
supervisor. The general contractor is not autho
to sign the electrical label. -
Applicant to sign and date
Whenever possible, the initial application will be u;
a worksheet only. Where possible, Building Division
will prepare a type written copy and return it to thE
applicant at the time the actual permit is issued for
Signature.
IV. Fees and Charges
Plan check fees are due and payable at the time of th (
application. and no plans will be processed until the
fees are paid. All other fees and charges are due an~'
payable when the permit is issued.
!II.
V. FOR OFFICE USE ONLY
.
~.
(ITV OF SPRINGFIELD
City Hall
Springfield. Oregon
Department of Public Works
OFFICIAL RECEIPT
No. B 5 41 7 8 n
Dale 1- ~l 19r:<{) . .
( ) - I~ n /) '" (0" c...,-p, I
Rec'd From ~~. -. --J. ~T,
Address Cj q q ~() (o3r rL 'I _ (J
Received F::-e;p (ZI DO .
LA7\ 5.08
pp J 36.00
10/0 J 4n
6(,f~-1~t~() ~~~~
V \J~ldJ . \I41J
tP I Azb6 2~ 00
4,v/D .' .00
I 2~ .c:jO
- ,q4-
!'1,4~
'\'-31 _ (/0
(0):].)( ce
Qf ,.,
Io,UTHO"'Zl!.D SIGNI\TUIltl!. (
~"Ii:L1D".T ~...uu ~"'''TIi:.S . EUGENI Oil '7.0' 5""" \..
Cf~'
..... _r. ..___.._
q:30C2UhV -
,'.' .\
iii
PERMIT VALIDATION
L-t P 6/)'
-rin
SJ )/Cc I
t A~Q '~Ge~v~d.
c~
Permit Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
STREET TREES REQUIRED AT 30 FEET ON CENTER
,
j
Permit applicant exempt from registration with the Builder's Board because:
Additi ona 1 Project Informati on:
PLANS REVIEWED BY:
name
DAN SMITH
Signature_tOtL..... ~
da te 7-3-80
.
..
(J
n
(~
.<e
.11
.
(
(
c
(
(
1
I
,
.
J