HomeMy WebLinkAboutPermit Building 1980-11-21
.':"."'~~~;;;"~~'~,j"':J:.:~.;;~J,,,-,,.!..~~~,';,,,.~.~.lfe;Em.'t~~"""'~
/'
~~~~~%;~~:,:,1",:t-~-;;"'~
J
./
I
-------
"'... ,.,-'~--:-"_- - -:'V"L:;J...." ~.......~.--..........-..'"""--<-
INSPECTION LINE
726-3769
CITY OF SPRINGFiElD
COMBINA T10N APPLICATION / PERMIT
INFORMATION LINE
726-3753
Owner
Ed's Investments
8,857.08
i Sq, Ftg. Main :LSl6
Sq, Ftg, Access, -w4
Sq, Ftg, Other
_New __Add__Alter _Rep.
__ _Fence_ _Demo_Change/ Use
_Other
00
o
f-'
f-'
Q\
Q\
Job Address
6324 - 6326 Aster Street
ENERGY SOURCES:
Heat E l..ec...t-CH-
Water Heater E l_es:: t_ '
Range 1= 1 prr,
Value of Wark,
Legal De,criptian Lot 7, Cliffside r.lanor
Address 6790 Main Street
Springfield, oregon
Phone 746- 2011
97477
Building Permit Info: Describe Work (i.e" Build Single
Family Residence With Attached Garage)
Construction Lender Far West Federal Savings
FOUNDATION FOR ZERO LOT LINE DUPLEX
ONLY!!! !
Address 96 E. Broadway, Eugene
Phone 686-1151
DESIGN TEAM
(name)
(address)
(lies. no,)
(expires)
(phone no.)
Primary
Structural
Electrical
Mechanical
CONTRACTORS
(name)
(address)
(lies. no,)
(expires)
(phone no.)
General
Fd's Tnvp.c;t1lleI1ts
hJqn M~in strp.p.t_ Springfield
1/:;;:;;
R-14-Rl
~nll
Plumbing
Electrical
Mechanica I
PLUMBING
ELECTRICAL
MECHANICAL
NO, FEE I CHARGE NO.
Each sinqle fixture I
Relocoted building I
(new fix. additional)
S.F. Residence I
(1 bath)
Duplex (1 bath) each I
Additional bath I
Water service I
Sewer I
Storm Sewer I
Residence of
FEE i CHARGE NO,
I
furnace I burner to
BTU's
Appliance vent
separate
Stationary evap.
cooler
Vent fan with
single duct
Vent system apart from
heating or A.C.
I Mechanical exhaust
hood and duct
FEE i CHARGE
I
I
sq, ft.
New circuits, alterations
or extensions
SERVICES
Temporary Construction
Amps.
Wood stove/heater
FEEDERS
Heat Pump
I Air handler to
10,000 CFM
Air handler over
10,000 CFM
Amps.
ISSUANCE OF PERMIT
TOT AL CHARGES
I TOTAL CHARGES
TOT AL CHARGES
WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until a
label has been signed by an Electrical Contractor and attached to the electrical panel.
I HAVE CAREFULLY EXAMINro the completed applicatian for permit, 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 Springfield and the Laws of the State af Oregon
pertaining to the work described herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I further
certify that my registration with the Builder's Board is in full force and effect a s required 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 project.
Basis for Builder's Board exemption:
NAME (please print) ~d ~ ~_ ([!--
SOGNATURE -!i'..a _~~<'?:
FOR OFFICE USE ONLY ~
DATEI t -.JI-AO_
'J
Zon..
Fire Zone
Flood Plain
RA
Type/ Const. V - ~
Bedrooms
C:tories
Units
f"lccy Load
Occy Graup
C;q. Ftg. Main
~q, Ftg, Access
Sq, Ftg. Other
l..o.~
Value -1L,-s:l ~ 7 ().8--
Value
Value
TOTAL VALUATION
x
x
BUILDING PERMIT
Charges and
Surcharges
Plan Ck. Comm/lnd
_______ 48-,-OQ~~%/Bldg Per Fee
1. 92/ Plan Ck. Res
30%/ Bldg Per Fee
I Fence
I Demo
I
Systems Development
Charae (1.5%)
PLUMBING PERMIT
Charges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
Curb Cut
I Total Comb. Permit
I
I
I
I TOTAL
49.92
ELECTRICAL PERMIT
Charges and
Surcharges
Sidewalk
I A/ C Pavina
/"
, ./
'-" iOlD""~' -.., ~'"~-"-"~"~"1fC" " ' '~~~~l~ .!/i.!;.~~~"""", :i!i'1~i;,~<~
~~:~'!,:~~.*';"~~/~I";~_"-:"""'~'~~"""~~~t.~~ .,.:....-:'~.~~@~~~~~~_~..._.,~~'.. '''' '._ _ . :....c."!hy'<.-"_ __"~~,""O'_.~"';V),' dO'........ _ _",.-: ',..~~.. .,,,...,_....... .
",
f'-..r::~.. .... " ~.'r',,-~ '--:": ""'~.' ..
-.' ._.'-:"'-:':'--:--'-'~-- .--...::.-.-.
COMBINA TION APPLICATION/PERMIT (CAP)
1
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example-tax lot 100, Lane County Map Ref. n'c.
2. example-Lot 1. Block 3, 2nd Addition to Spril ,,'
C. Name, etc. of owner and construction lender
D. Energy Sources (
1. example-heat/electrical ceiling/or forced air
2. examplecw.'ater heater/electrical/or solar
E. Square footage or valuation, etc. , , '. ,
1. example-1250 sq. foot house, 500 sq. foot gal 'e
2. example-if new project, check new-if addition
add, etc.
F. Building permit information:
1. example-construct single family house with an
garage
2. example-remodel existing garage into family r ,
3. example-convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (0) of the
Structural Specialty Code (
-i{O~5IGN TEAM A~eNTRACTORScS:I bhlH
To avoid design or construction delays, Building Di'
Staff must be able to contact appropriate persons n ~rc:.
design information or job site corrections, etc.
'.
II. Abbreviated'Plumbing, Mechanical & Electrical Schedul
A. Except where blank spaces occur in the description F
of the Mechanical and Electrical Schedules, the appli
need fill-in only the No. Boxes adjacent to the appro
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 schedule
have been abbreviated
2. If the item(s) to be installed are not covered on the
ated schedules you 'should consult the full schedule
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AI'
CHARqES ON THE SCHEDULES
III. Applicant to sign and date
Whenever possible, the initial application will be used as,
worksheet only. Where possible, Building Division Staff wi
prepare a typewritten copy and return it to the applicant (
the time the actual permit is issued for his signature.
PERMIT V ALIDA liON
CiTY OF SPRIN'GFIElD
City Hall
Springfield, Oregon
t of Public Works
Departmen
OFFICIAL RECEIPT r: I f) 4 ~
~O B ~OL v
.
\ \ - f0 \ ~,19 ~C
:::: From ffl.[)~,,)(\JJfI-
la, r, /1"/\ \: .rot\ J, :0-
Address _' .~
,-
,
('
...
,(
,(
Received For:
tio,
"
o 4(0CP (
\: D\r" 1s- 4Q-, (crL (
,. .~ Lt<6 uO (
c:.X'1Ltr} / 9, 1 C{ Z-
' \J L cl > (
(~t:- ~.\,I
(1
(,
0Jg___~jS~
Amount Received
~...,. -(
TURl'laUI..L PRINTERS EUGENE OR q ~
SHEI..TON-
if
(
at
(
'"
I,.
IV. Fees and Charges 1-
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 and charges are due and payable when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
C:'T?~~T ~~::~ 5 ?~Q'}!:'~r _r...r~ :: 9 r:: C:J C~~:TI:~
Additional Project Information:
SERa LOT LINE DUPLEX - FOUNDATION ONLY
Permit CierI<-
r
'-' \..1
-.....1 (-".... ~'>
,_/J -..I'.J...
'\ '.
. j'C')'jl~'0i"b::r
Cor.J;.iON WALL TO BE INSPECTED AT TIlE TIME OF CONSTRUCTION
NO INSPECTION AFTER FOU~~DATION UNTIL SURVEY APPROVED BY CITY ENGINEER
PLANS REVIEWED BY:
name
DAN S~lITH
,/J j'
1 //';' A~ rA.,~- ,W .
/L.....+' ~.;o"-,. ( ;-v /' ,/ J:- c;;... -- , ~
signatur",
-:late
11 1') ,,/'\