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HomeMy WebLinkAboutPermit Mechanical 1980-10-9 _1.1";;+':'""" '~'-;:.[_ ..."":.~ 1l!'~'"!=~ INSPECTION LINE 726-3769 '~'J''''' ':-.~"t!...~ 1_~1 ":""--~''-'''''~'~':''''':'''''C''' ,~, I -'-.~;,>:ir~~~~:..t.._,~.~!..~.~..-.;;J.! 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 I ~..~.. ;-~'l~"";:'..,. ~. ~.:S:~ ._"";fJ. . ::',-'jt;~..-...",__~. ,,_--"~'i*,"-.~ ."'~~1lia-,:J;~;""!IWJj..".,.,~,';;i~~!!>,~::,,_'~;""',\i.,!;!}' 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.? , -P. \ C\r-.,(),^ (\'I'lS+;CI..".,tM' , Rec'd From ,{L \.j , - . ("), 0,.1 s:;,-)'--i n .--n. \ i~\jdoV\ 1:'Jv.<t'-'-':I , T'! Addre~s", _,4 -,-, --. __ ~- r.:<.Id BVIM~pf'p('lClqp,LJ Received For: .. ,. - "1 - pv<=...,"j (,lI\tn \ p., ':, I A I "' f) ...fA' J q~~ E.(e.dri~/J ( "/'7,-, 14edlol/l,;o 1 ~CJr~, ( ( ( 72.y9 2 {.i/,,{; .0....:.- ( ( 15 "!2 ,4>.? JS,oP ,It;D ( , .bl , Am~unt ,-~ '( --,'", 06~, ' Received .:;. I O~..L. ~'- ~ ~~~ ( ","UTHOR1ZED SIGN....TURE "-,"'8 { '''....a...LL ..""Hf;"'" ~UGIt..It. 010 "7"0' \ S"I;LTO'" ~ ( 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. \ "' --, t CI 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 I I dato 10-1-80