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HomeMy WebLinkAboutPermit Mechanical 1983-1-6 --- . e INFORt1ATION Lll'tt 726-3753 Sq. Ftq. I.lain ~q. Ftg. Access. Sq. Ftg. Other Nel< Add Alter Rep. -Fence Demo Change/Use -Other- - i YI ~ o I IrISPECTION LIIIE. 726-3769 Job Address ) (') 9/) 0LlAll~t , , CITY UF SPRINGFIELO Cm1BIIIATION APPLICATION/PERMIT EIIERGY SOURCES: Heat ('later Heater Ranqe ValuE of Hark: Legal De5cription \/ ()~f?[() '3 \ () (r;<<i) ! . Ol<ner [n YJ1T~h}() I~~ '~ (DJlJl J llJ-/1l / Address J (. ... A C"\ '(". . Phone "'\ -r (J ,,\ > '\. L- .1",- ~,......... I . - . -'. . . /'1 rlJ/cx Construction lender Jl00hfin, 11 net ) (lidsino. \ _. () rp BuilGinQ Permit Info: Describe \~ork(Le.. Build Single Familv Residence With Attached GaraQe' .'(name) Phone (address) J Address OESIGN IEAr1 (exoires) (ohone no. Primary Structural Electrical f~echan;cal CONTRACTORS (name) (address' (1 ics. no.' (HO; res' (nhonf" no. \ Gpnp.ral PllJmb;no (!<<~~~) /, ~ J{)QI.\ ~.~~(JJ'\I~ro. J,.l:))D 11)' ~JY\L'7:t~- PLUI1BIrIG . ELECTRICAL. I MECHANICAL. Electrical ~1echan; ca 1 NO. FFF r.HARr;E NO ~~~ rHARr,F NO_ FFF rH<RGF l SQ. FT. furnace/burner to BTU's Each single fixture Residence of Relocated building (new fix. additional) S.F. Residence (1 bath) Ouplex (1 bath) each Additional bath New circuits alts. or extensions Floor furnace and vent SERVICES I Recessed wa 11 Sn~ce h@ntpr nnr! vpnt (,,00 Storm Sewer Of amps. Appliance vent seoarate Stationary evap. cooler Vent fan with sinole duct Vent system apart from heatino or A.C. Mechanical exhaust hoorl ~nd rlud. Wood stove/heater ~Jater servi ce Temporary Construction Change in existing rp,? i rtpnf'"p multifamily. comm. or lnr!ust.ri~l Sewer COMM./IND. FEEDERS Install/alter/relocate rli<;;t.rih. fppdpr<;; Of amps. TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the I ISSUANCE OF PFRlHT I () 1 DO TOTAL CHARGES TOTAL CHARGES It:, , A4 that the Electrical work be done by an. Electrical Contractor. the electrical portio.n of this permit label has been signed by an Electr;cal Supervisor and returned to the Building Division I HAVE CAREFULLY EXM1lNED the completed application for permit. and do hereby certify that all information hereon is true and correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s Board is in full force and effect as required by ORS 701.055. that if exempt t e basis for exe ion is noted hereon. and that only subcontractors and emP10Y~ in comoliance with ORS 7nl.055 wi b used on thi project. NAllE{please PrlntrY.If!rt /4't://,//h.t7ff SIG;lATURE FOr OFFIcE 11SE OW Y ,. Zone Fi re Zone Flood Plain Type/Cons t. Bedrooms Stories Units Occy Load Occy Group Sq. Ftg. Sq. Ftg. Sq. Ftg. fiain Access Other x Value Value Value x x TOTAL VALUATION BUILDING PERfHT Charges anG Surcharges Plan Ck. Comm/lnd 65%/Rldo Per Fpp ------------ Plan Ck. Res 30%/Bldo Per Fee Fence Systems Development Charqe (1.5%) PLUl1BING PERMIT Charges and Surcharges D~R1o ELECTRICAL PERr:1T Charges and Surcharges Sidewalk A/C Paving _--J.f.o~9_~-- Curb Cut . .(~ Irotal Comb. Permit 11ECHAN I CAL PERM IT Charges and Surcharges TOTAL l Co .12 L-f ~ ~ , COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100. Lane County Map Reference II 03 43 2. examole- lot 1. Block 3. 2nd Addition to Springtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. exam~le- heat/electrical ceiling/or forced ai( Qas 2. example- waterheaterjelectrical/or sotar 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 foom 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAl.! AND CONTRACTDRS 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. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. 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 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 and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION '-f'rIuA I f1, G I (){) ~ I()~OO II o/(J 6/f -- J& ,CO- ck:A - Wvf t1: -- Permit Clerk ,~~ Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature .... ~~,"M' _........' M.............;..:--<::::~.....::,~~;-.:.."':':::':':7:7..l:::....___.. _uT;~:::~~......-,-~",<-;........,.........~.c..-,-,~~--.....--_",~,,._';~"""~";"';">+ ...;-~- date