HomeMy WebLinkAboutPermit Building 1989-4-7
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'I IN~PECTION LINE
, 726-376,il'
CITY OF SPRINGFIELD
CotlBINATlON APPLICATION/PERMIT
S S. f' 1 d ErlERGYGSOURCES E' 1 t'
Aspen t., pnng le Heat as & ec nc
Lot No. 17-03-34-2-3#200 l~ater Heater Gas
Range Gas
Lotocky
Val UE of ~;;'OOO. 00 \
Builc;inq Permit Info: Describe 110rk(i.e., Build Single
Familv Residence With Attached Garaael
Build one story Social Hall with
detached cross tower, driveway, and
parking area.
(lies. no.): (exnires)
INFORrlATlON liNt
726-3753
Sq. Ftq. "lain 4 .bUU
~q. Ftg. Access. 144
Sq. Ftg. Other
LUe\~_ Add _A 1 ter _ Rep.
Fence Demo Change/Use
-Other - -
10
Job Address
704
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Legal Description Tax
Own~r Bishop Innocent Hilariom
St. Nicholas Diocesc
Address 2245 West Rice St.,
. Phone
Chicago, IL 60622
Construction lender SAME AS ABOVE
Address
DES I GN TEAr1
Phone
(address I
(name)
WEGROUP pc/Architects
John Herrick
Builders Electric
Harvey & Price
(name)
(phone no.
344-3249
687-0129
485-0922
746-1621
863 East 13th Ave.
1684 Will amette
293 Monroe
P.O. Box 1910
(address)
338 West 11th, #110
P.O. Box 1910
293 Monroe
P.O. Box 1910
Pri ma ry
Structural
Electrical
t1echani ca 1
, CONTRACTORS
(l ics. no.)
(expires)
(ohone no.)
Ga 1 eM. Roberts
Harvey & Price
Builders Electric
Harvey & Price
Genera 1
485-4253
746-1621
485-0922
746-1621
Plumbinq
Electrical
~lechanical
PLUt1BING ELECTRICAL
NO.1 I FEE CHARGE NO. I FFF
Each single fixture Residence of
'J)( total *2~ 7.5'0 ~ SQ. FT.
Relocated building New circuits alts.
0 (new fix. additional) or extensions
MECHANICAL
r.HARGF NO. I FFF r.HARGF
furnace/burner to =< 6.-=--
4 256~~34 BTlI's~ 7-Sh <7o::.:~-
O Floor furnace
and vent
IS.F. Residence
(I bath I
I Duple~ (I bath)
IAdditional bath
I Ha ter servi ce '2~(!)'/ I
1 I SERVICES 600 amp.
I
I~-t
I
I /:'-"o-of
I I
I
I
I
I I~sta~l/alter/relocate I I I 11'lood stove/heater I
dlstrlh. feeders 0
amps.I:7:?~ YS.,. &;, I ~ /7p/~ ..1
I /:n.S-cJ J -... . - I
I I I I I
I I
1~.~1
I
I
o I Recessed wall
Soace heater and vent
/I/Y?~..
1/ Appl iance vent
seoa ra te
O I Stationary evap.
cooler
V~nt fan with 1'<" -I ~J
3 slnole duct. ...-. /.
Vent system apart from I I
o heating or A.C.
Meehan ica 1 exh s,t '
11 hood and duct (~l tcheh) I r,
I
I~~c
I
I
/ /Temporary Construction
/Change in existing
residence
amps.1
I
ISSUANCF OF PFRI1IT
I HAVE CAREFULLY EXNlINED the completed ap!1lication for fJermit, 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 Springfjeld and the Laws of the State of Oregon lJertaining to the work described herein, and that rw OC.CUPAIKY wi 11 be made
of any structure without the permission of the Building Division. I further certify that my re~istration ~lith the Builder's
Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees \~ho are in compliance with OP.S 701.055 l.fill be used on this project.
I'M" (p ,.." pd't) ~ k: .A1. ,Az, he... 105 e "-'-l :".<--c_s lO'''''!RE_ ~-Ac~ DOTE.9"J'- f7
FOP. OFFICE USE ONLY
Zone.c.~......&'l-s-c:::~Type/Const. 5=-/#;:::. Units S<1. Ftq. rlain 41::;-~ x Value -q;o,r~~~
Fire Zone Bedrooms Occy Load ?3i35 Sq. FtlJ. Access x Value'"
Flood Plain Stories I Occy Group,A 2-/ Sq. Ftg. Other.5/~ W~ Value Y~p--t:/'
<!Jif~~/;Y#"C P#-~ 0'..I"-~ ~~ ~~ - TOTAL VALUATION3;r,~~
~~ Te:> ~h" ~oar: c.....r./.........~r/~ ~ 1~7S~€'7 /~~y /
BUILDING PERNIT - c;.- E' .L" I Pliin Ck. Comm/lnd -'" ~.r ISystems Development I ,_ .r- .,,-~
Charges and ---_.c2_":?~'Z~_ 65%/Bldq Per Fee ?4'"5"C?7:2 Charqe 0.57;) /5~,?
Surcharges U? /c.L Plan .Ck. Res 1-:iJ .1/.... "'IL-. . LfI.
l...; . rP L 30%/B1dg Per Fee 1~~.4f:- r~ #h'..b-........ &!5'
---2;i~- ::::' ~'~I ;~;'
---'22...:2~-' Sidewalk
7. 88 I A/CPaving I --:23$. e::>C> .ITotal .Comb. Permit I /B(::2. B:3
____Y~Eq__~I~'bCPt ~~_ I TOTAL 7,.176:;,'tP
z~ 9'8 <::. r""'-- ~~
r . ...._
PLUf1BING PERMIT
Charges and
Surcharges
ELECTRICJl.L PErmIT
Cha rges and
Surcharges
r1ECHANICAl PERMIT
Charges and
Surcharges
-..~ -~
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COMB1NATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I. Applicant to furni~h
A. Job Address'
B. Legal Description fjt;~
'. . 1. 'examp 1 e:- Tax Lot 100, Lane County Map Reference
17 03 43 .'
2. example- Lot Ii Block 3i 2rid Addition to
Springfield Estates .
C. Name, etc of owner and construction lender
D. Energy Sources
1.. example- heat/electrical ceiling/or forced air gas
2. example- waterheater/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,
check add, etc. '
F. Building permit information: .
1. example - construct single family house with an
attached garage .
2. example.- remodel existing garage into family room'
3. examPfe- convert single family residence into
restaurant (chang~ of use) ,
.G. Value of work as defined inSectiori 303 (a1_of the
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or con~truction delays, 'Building
Division Staff must be able to cont~ct appropriate
persons regarding design information or job site .'
corrections, etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in ihe desc~iption
portion'of the Mechanical and Electrical' Schedules,
the appficant need fill.:.in only the No. Boxes adjacent
to the appropriate item(s) to be installed .
B. . Full Plumbing, Mechanical, and Electri'cal Schedules
.. 'are available at the Building Division
_,', ,I. To conserve space .'on the permit form the schedules
have been abbreviated .
2. If th~ item( s) to be ins ta 11 ed a re not covered on
the abbreviated schedules you should consult the
full schedules
C. BUILDING DIVISION STAFF WILL'FelL,OUT ALL FEES AND
CHARGES ON THE SCHEDULES .
D. As noted on. the CAP, the label must be delivered to the
electrical. co~tractor for signature by his electrical
supervisor. The general contractor is.not authorized
to sign t~e efectrical label. -
III. Applicant to.sign and date
Whenever possible, the initial application will be used as
A worksheet only. Where possible, Building Division Staff
will prepare a type .written copy and return it to the
applicant at 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
application, and no plans will be processed until these
fees are paid. All other fees a~d charges are due and
paya~lJ~ ~Ihen:~hepermi.t is issue'd.-' '. ..'
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Vi 'FOR OFFICE USE ONLY
Permit Clerk.
PROJEGT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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.Perm~t applicant.exemp~ frplI! regist~a'tion with the.Builderts'-,Bo'ard'becaJ'se:'~
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Add i.t i.ona 1 Project Informat i:on:
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