HomeMy WebLinkAboutPermit Mechanical 1980-10-9
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INSPECTION LINE
726-3769
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CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
INFORMATION LINE
726-3753
Job Addreu
1092 Pleasant Street
TL 6000, Map 17 03 26 41
legal Oe5cription
OW"" Guv Maves
Add"" 1832 North 11 th
Sprinqfield, Oreqon
Construction lender
Addreu
DESIGN TEAM
(nome)
Paul Olson Construction
(addreu)
2951 Hayden Bridge Rd
6-81
Primary
Structural
Electrical
Mechanical
CONTRACTORS
(nome)
Paul Olson Construction
(addren)
2951 Havden Bridqe Rd 23623
6-81
726-8502
General
Plumbinq
Electrical
Mechanical
PLUMBING
NO.
Each 5in!:!le fixture
Relocatod building
(new fix. additional)
S.F. Re5ldence
(1 both)
Duplex (l both) each
Additional both
Water 50rvice
Sewer
Storm Sewer
TOTAL CHARGES
Street
97477
746-7793
ENERGY SfVRCES:
Heat I eCt
Wafer Heater
Range
Value of Work:
Sq. Ftg. Main
Sq. Ftg. Accen.
Sq. f'g. Oth" -520
_New_Add_Alter_Rep.
_Fonce_Demo_Chango/ U5e
_Other
'1
CXl
o
o
'"
CXl
..,.
fEE
CHARGE
Phone
phone
FEE
CHARGE NO.
I
I 2
I
I
I
i
Amps.
15,000.00
Building Permit Info: Deu,jbe Work (i.e., Build Single
Family Re5idence With Attached Goro/:le)
Residential Addition; woodstove
(tiel. no.)
(phone no.)
5.00
I
I
I
I
I
I
10.00 I
15.00 I
WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit sholl not be valid until a
label- has been signed by on Electrical Contractor and attached to th. electrical panel.
I HAVE CAREFULLY EXAMINED the campleted application for permit, and do hereby certHy that all information hereon il true and carroct, and I further
certify that any and 011 work perfortnGd 5hall be done in accordance with the OrdinanC05 of the City of Springfield and the LoW5 of the State of Orogon
pertaining to tho work de5cribed herin, and that NO OCCUPANCY will be- made of any structure without the perminion of the Building Divilion. 1 further
Ollrtlfy that my rogi5tration with the Builder's Boord i5 in full force and effect a s required by ORS 701.055, that if exempt the basis far exemption is noted
heron, and that only 5ubcontractan and employees who are in compliance with ORS 701.055 wi! used on thi5 project.
Ba5i5 for Builder's Board exemption'
Re5idence of
(expire5)
23623
726-8502
(liu. no.)
(.,hone no,)
Cexoire5)
ELECTRICAL
MECHANICAL
fEE
CHARGE NO.
5q. ft.
New circuits, alteration5
or exten5ion5
15.0C
furnace/burne-r to
A.TU'5
Appliance vent
5eparato
Stationary evap.
cooler
Yent fan with
5ingle duct
Vent 5Y5tem apart from
heating or A.C.
Mechanieal exhau5t
hood and duct
SERVICES
Temporary Construction
FEEDERS
Amps.
I TOTAL CHARGES
"PAUL t'JL<;O I
NAME (plea5e print) " AJ
"IGNATU
FOR OFfiCE USE ONLY
K-l
Type/Con5t
Bedrooms
C.tori~"
Zon~
Fire Zone
Flood Plain -li(l
BUILDING PERMIT
Charge5 and
Surcharges
PLUMBING PERMIT
Charges and
Surcharge5
ELECTRICAL PERMIT
Charges and
Surcharges
MECHANICAL PERMIT
Charg05 and
Surchargo5
V-N
IInits
""'ccy Load
("'\ccy Group
1
72.00
Plan Ck. Comm/lnd
65%1 Bldq Per Fee
Plan Ck. Re5
30%/Bld!:l Per Fee
2.88
Fence
Demo
15.00
.60
Sidewalk
AIC Pavina
____ 15.00
.60
Curb Cut
1
Wood 5tovo/heoter
Heat Pump
Air handler to
10.000 CfM
Air handler over
10.000 CFM
ISSUANCE OF PERMIT
15.00 , TOTAL CHARGES
u:;;d, " ,
"'--
DATE &A/r"o
K-j
Sq. Ftg. Main
Sq. Ftg. AccOl'
Sq. Ftg. Other
Value
Yalue
l:>,OOlJ.OO-
x
o.w
x ~ts ,ts:J Value
TOTAL V ALUA TION
SY5tem5 Development
Charoe 1l.5%l
21.60 PO 80-09-30
RECEIPT 54759
Tolal Comb. Permit
TOTAL
106.08
1
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COMBINA nON APPlICA TION/PERMIT (CAP)
I. Applicant to furnish i ..
A. Job Address
B. Lega I Oescri ption
1. example-tax lot 100, Lone County Mop Refc---
2. example-Lot 1. Block 3, 2nd Addition to Spri r.
c. Name, ett. of owner and construction'lender
D. Energy Sources
1. example.heat/electrical ceiling/or forced air f
2. example.water heater/electrical/or solar
E. Square footage or valuation, etc.
1, example-1250 sq, foot house, 500 sq. foot gc i.he
2. examJ.?le.if new project, check ~-if additiol
odd. etc.
F. Building permit information:
1. example-construct single family house with al I'ta
garage
2, example-remodel existing garage into family
3, example-convert single family residence into (
restaurant (change of use)
G. Value of work os defined in Section 303 (0) of thE
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS C'
To avoid design or construction delays, Building 0
Staff must be able to contact appropriate persons
design information or job site corrections, etc. (
"
PERMIT VALIDATION
~ "
-.
CITY
OF
SPRINGFIELD
(
II, Abbreviated Plumbing, Mechanical & Electrical Schedl
A. Except where blahk spaces occur it'! the description
of the Mechanical and Electrical Schedules, the app
need fill-in only the No. Boxes adiacent to the appr
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 schedu
have been abbreviated
2. If the item(s) to be installed are not covered on th
ated schedule; you should consult the full schedui.
C. BUILDING DIVISION STAFF WILL Fill OUT All FEES".
CHARGES ON THE SCHEDULES
~:m
City Hall
Springfield, Oregon
Department of Public Works
OFFICIAL RECEIPT
No. B 5 4 8 46
19 y;O
Dote f O.L.? ,
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Received For: .. ,. - "1 -
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","UTHOR1ZED SIGN....TURE "-,"'8 {
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111. Applicant to sign and date
Whenever possible, the initial application will be used O!
worksheet only. Where possible, Building Division Staff \I
prepare 0 typewritten copy and return it to the applicant
.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 OF .
and no plans will be processed until these fees are paid. :J:ii
other fees and charges are due and payable when the permit
is issued.
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V. FOR' OFFICE USE ONLY
Permit Cler~
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additional Project Information:
PLANS REVIEWED BY,
nom"" .
DAN SMITH
<'gnature DrLn /~m 1 j~~.fl1 /J!p
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dato
10-1-80