HomeMy WebLinkAboutPermit Building 1981-3-9
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CnY OF SPRINGfiELD
COMBINATION APPLICATION/PERMIT
~--
MAR . ~ ~91
INSPECTION LINE
72603769
INFORMATION LINE
726-3753
Legal Description
420 Riverview Drive
17-03-34-14- TL 5700
ENERGY SOURCES:
Hea'
Water Heater
Range
I Val~e of Work:
Owner
\f,,,'.nAllp C\mi th
420 Riverview Drive
Springfield, Oregon
3596.40
Sq. ftg. Main
Sq. ftg. Accen.
Sq. Ftg. Other
_New_Add_Alter_Rep.
_Fence_Demo_Chonge/ Use
_Other
lUtl.
ex>
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Job Addren
Addren
DESIGN TEAM
(name)
746-5973 Building Permit Info: Describe Work (i.e., Build Single
Phone Family Residence With Attached Garaqel
97477 ~r"("lnc:p nnrrh ~nrl m~ke Dark of
living room
Phone
(addren) (lies. no.) (expires) (phone no.)
Address
Construction lender
Primary
'":''' .....?....
Structural
Electrical
Mechanical
CONTRACTORS
(nome)
(address)
(lics. no.)
(expired
Cohan. no,)
Gllnllrol
owner
Plumbinq
Electrical
Mechanical
PLUMBING
ElECTRICAL
MECHANICAL
NO,
FEE
CHARGE NO.
FEE CHARGE NO,
FEE
CHARGE
/
Each sinQ;le fixture
Relocated building
(nllw fix. additional)
S.F. Residence
(1 bath)
1
~,. ft.
N.w circuits, olterations
or .xtensions
to.OO 10.00
furnace' burn.r to
ATU's
Appliance v.nt
separotll
Stationary ....ap.
cooler
Vent fan with
single duct
Vent syllem aport from
heoting or A.C.
Mechanical .xhoull
hood and duct
R.sidence of
SERVICES
Duplex (1 both) .ach
T.mporary Construction
Additional bath
Amps.
Water ser.,ice
Sewer
Wood sto...e/heoter
Storm Sewer
FEEDERS
Heat Pump
Air handler to
10.000 CFM
Air handl.r o....r
10,000 CFM
Amps.
ISSUANCE OF PERMIT
TOTAL CHARGES
TOTAL CHARGES
10.0C TOTAL CHARGES
WHERE STATE LAW REQUIRES that the EI.ctrical work b. done by th. EI.ctrical Contractor, the electrical portion of this permit shall not b. valid until a
label has bMn signed by an Electrical Contractor and attach.d to the el.ctricol panel.
I HAVE CAREFULLY EXAMINED the completed application for permit, and do h.r.by certify that 011 information her.on is true and correct, and I further
c.rtify that any and a\l work performed shall be don. in accordance with the Ordinances of the City of Springfield and the Lows of the Slate of Or.gon
pertaining to the work d.scribed herin, and that NO OCCUPANCY will b.. made of any structure without the permission of the Building .Oi...ision. I further
certlfy that my registration with the Builder's Board is in full force and effect as r.quired 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 proj.ct.
NAME (pl.ase print)
Basis for Build.r's Board ex.mption'
l/el:',y~/k
cSAI; a
CIGNATURI:
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d~.;,/L
IV.
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DATE V ,vI
FOR OFFICE USE ONLY
Zone R-l
Fire Zone
Flood Plain
'ryp./Conlf. V-~
&edrooms
~tori.~
Units
Occy Load -1.fl
"'~cy Group
?
c;". Ftg. Main
Sq. Ftg. Accen
Sq. Fig. Other
lOR
BUilDING PERMIT
Charges and
Surcharges
28.00
loll::
Plan Ck. Comm/lnd
65%/ Blda Per Fee
Plan Ck. Res
30%/ Bldg Per Fee
8.40 PD
x 33.30 '(olu. 3SQfi 40
Value _
Value
TOTAL VALUATION
J Systems De....lapment
Chara. fl.S%)
2-25-8
x
PLUMBING PERMIT
Charges and
Surcharges
Fence
Demo
Total Comb. Permit
39.52
ELECTRICAL PERMIT
Charges and
Surcharges
10.00
.'1U
Sid.walk
Alc Pavintl
EP Label Fee
.20
\:/;1
~ftl~
65 .,
MECHANICAL PERMIT
Charges and
Surcharges
.r.-
39.72
Curb Cut
TOTAL
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