The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1987-9-20 Job Address ///~ , 5~ CITY Uf SPRINGFIELD CO/IBlilATlON APPLICATION/PERMIT EilERG\ SOURCES: Heat \-later Heater - errtJNl..J g/:Ji/g1-;P lHlt. I I IrISPECT lOll L1IIE 726-3769 ljL..f/ Legal Dmription 170335'9'1 0 (pr;;,CiO / , ~ _ /J ,/ I J~: Owner ~~ci/_ W(;(;C/ t:J~ Address II f h .s;, 'H r Phone ''/t(6 9.5 if I Ranqe Va1u€ of ~lorv..: JrIFORIIATlON 726-3753 Sq. Ftg, Hain ~q. r=tg. Access. Sq, Ftg. Other New Add Alter f:ep. --Fence Demo Change/Use --Other -- -- oQ -..::J G ~ \:) ~ Construction Lender Bull[:inq Permit Info: Describe I'Jork{i.e., Build Single Far:1ilv ["Iesidence 1'Jith Attached Garaa-el / &//dp1cr>J /~ / Address DeS 1 GN TEAr.1 (name) Phone (address) (1 ics. no.l (exni res) (ohone no. Primary Structural Electrical r~echani co. 1 CONTRACTORS (name) (address) 11 ir<;.. no.) (pxni rp,,) (ohonp no. ,) General Plumbina 2 , Electrical ~lechani co. 1. PLUllBIrIG ELECTRICAL MECHANICAL NO. Each single fixture FEE CHARGF rm I I Residence of SQ. FT. INew circu~ts alts. or extenslons I SERVICES I Ff=T rHAJ:lh~ NO. ~~~ rHARr,~ furnace/burner to BlUts Relocated building (new fix. additional) Floor furnace and vent S. F, Res i dence (1 bath! Duplex (1 bath) each Recessed wall Snarp hpatpr anr! vpnt Sewer ITemporary Construction Change in existing rp" i dE;'nrp multifamily, comm. or TnfllJ<;tri;1l Of amps, I cO/~r1.1l NO. FEEDERS I Install/alter/relocate distrib. feeflers Apolianee vent spoarate Stationary evao, cooler - . Vent fan with sinale duct Vent system apart from heatinQ or A.C. Mechanical exhaust hood and durt Wood stove/heater Additional bath ~!ater service Storm Sewer /ISPb I I Of amps. ISSUANCF OF PFR'IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L'\H REQUIRES that tile Electrical work be done by an Electrical Contractor. the electrical portion of this permit shall not be vali~ until the label has been signed by an Electrical Surervisor and returned to the Building Division I HAVE CAREFULLY EXMlINED the completed aprlication 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 Soringfield and the Laws of the State of Ore!Jon oertaining to the work described herein, and that rJO OCCUPArKY will be made of any structure without the permission of the Building Division, I further certify that my re9istration with the Builder's Board ;s in full force and effect as required by ORS 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 7f!L055 will be used on this project. IIAI.IE(p1ease print) CitA f'LES ~UJEU- 5IGII.~TURE~ I Fan OFFICE USE O~L~ Zone Type/Const. Units Sq. Ftg. fiain Fire Zone Bedrooms Occy Load Sq. Ftn. Access Flood Plain Stories Occy Group Sq. Ftg. Other \I? kJLJI/ om8'-2o.f)J x Value x Value x Value TOTAL VALUATlGrI PLU'~BING PERMIT Char.ges and Surcharges Plan Ck, Comm/Ind 65%/Bldo Ppr Fpp Plan Ck, Res 30%/B1 dQ Per Fe. ____j5:..~_ Fence o 7,~ Oemo Isystems Development CharQe (1.51,) BUILOING PERl'llT Charges ane Surcharges ELECTRIC~.L PERI~IT Charges and Surcharges Sidewalk ------------1 A/C Paving I Curb Cut ------------ I Total Comb. rermit I1ECHANICAL PERMIT Charges and Surcharges I TOTAL !~ .r;S- . - COMBINATION APPLICATION/PERMIT (CAP) I, App1icant to furnish A. Job Address B. Legal Description 1. examole- Tax Lot lOa. lane County Map Reference 1/ 03 43 2. example- Lot 1. Block 3. 2nd Addition to Sprlngtield Estates C. Name, etc. of owner and construction lender 0, Energy Sources 1. examole- heat/electric?' ceiling/or forced air qas 2. examole- waterheater/etectncal/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, ete, F. Building permit information: 1. example - construct single family house with an a ttached garage 2, example - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G,. Value of lVork as defined in Section 303 (a) of the Structural Specialty Code H. DES I GN TEAr., AND CONTRACTORS To avoid design or construction delays. Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A, Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate 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 schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUllOING OIVISION STAFF WIll FIll OUT All FEES AND CHARGES ON THE SCHEDULES O. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor, The general contractor is not authorized to sign the electrical label. III. Applicant to sian 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 and charges are due and payable when the permit is issued, V. FOR OFFICE USE ONLY PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPArKY: ~ PERMIT VALIDATION [ (J9J 50 1 ~/1fJ;g , ; j I . ! ~ , . . ~ . Permit Clerk cv .. Permit applicant 'exempt ~rom registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature 1 date .