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Home My WebLink AboutPermit Mechanical 1988-8-1 Job Address to CJ c;- 6 AJ, 19 !Ju.,: K&ph !;;ho..ur CITY Of SPRINGfIELD . INfDR/IATIDN UN" CDIIBHIATIDN APPLICATION/PERMIT, 726-3753 EIIERGV SOURCES: Sq, ftq. 1,Iain Heat ~q. Ftg. Access. Water Heater Sq. Ftg. Other Ilew Add A Iter Rep, --Fence Demo Change/Use Other- - Range ValuE of Hork: I INSPECTION LINE 726-3769 vIYWu 10n~ E, r::?zOrUL.Jt<-<-..Phone lr/h ~Zb.. ~/C) j 57f0 Construction Lender ~ ~ ,.ni2- Address /3;;2 BUilciinQ Permit Info: Describe Worklioe.. Family ~esidence Hith ,I'I.ttached Ga-raqe) ~ :iJc ~ ~ U Build Single ~ B ~ E;""' ~ Legal Description ~ Owner Address Ut~lliN TtAt'l (name) Phone (address) (1 ics. no.) (exni res) (ohone no.l Primary Electrical c,~'"} ",1.,/,\/\ Structural - Mechanical CONTRACTORS (namel (addrpc;c;) (l ice;, no,) (pxnirps) (ohnnp no,) General Plumbina ~~ 1\ .A"6 Electrical ~lechani ca 1 ~ PLUIIBING ELECTRICAL MECHANICAL NO, FEE r.HARr,F NO ~~~ r~ARr,~ NO, ~~~ r~AQr,~ Each single fixture Residence of So' FT, furnace/burner to BTU's Relocated building (new fix. additional) S.F. Residence (1 bath] Duplex (1 bath) each New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wall Sn~r~ np~tpr ~nrl vpnt Storm Sewer Of amps.1 I Appliance vent seoaratp I Stationary evap. cooler I Vent fan with sinole duct I Vent system apart heatino or A.C. I Mechanical exhaust hood and duct from Additional bath Sewer Temporary Construction Change in existing rpsJ df.nC':P multifamily, comm. Or Tnduc;.trial \<Jater servi ce ?~ COMM,/INO, FEEDERS Install/alter/relocate dic;.trib. fpprlprs 10f I I I Wood stove/heater amps. 0/-fIMdl-lciA / s d{) , b((' 7S ISSUANCE OF PFRmT TOTAL CHARGES WHERE STATE L'W REQUIRES shall not be valiJ until the I TOTAl CHARGES I TOTAL CHARGES that the Electrical work be done by an .Electrical Contrac.tor. the electrical portion of this pernit label has been signed by an Electrical Supervisor 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 Derformed shall be done in accordance with the Ordinances of the City of Spri ngfi e 1 d and the laws of the Sta te of Oregon pertai n i ng to the work descri bed herei n. and that 1m OCCUPArKY 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 as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project. Zone Fire Zone Flood Plain Tvpe/Const, Bedrooms Stories WI LLJ 19M:> SIGN^TURi3.fftJ~ FOr. OFFICE USE mIL v Sq, Ftg, Ilain Sq. Ftn. Access Sq, Ftg, Other OATE f~h% NAI'IE(please print) (JOILJN (E Units Occy Load Occy Group x Va1ue Value Value x x TOTAL VALUATION BUILOING PERMIT Charges and Surcharges , Plan Ck, Comm/lnd ____________...Q2!/Bldo Per Fpp Plan Ck. R'es 30%/Bl do Per Fee Fence 'Systems Development Cha rpe (1. 5%) , PLUIIBING PERMIT Charges and~.."'" Surcharges . 06mo ELECTRICAL PERIHT Cha rges and Surcharges .Sldewalk MECHANICAL PERMIT Charges and 'a Surcharges VI AlC Paving 15.00 I Curb Cut --------7-~1 Total Comb. Permit I I TOTAL j 15-7~ I . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference II uj 43 2. exam~le- Lot 1. Block 3, 2nd Addition to ~pringt;eld Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilin~/or forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - 1. examole- 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. examole - construct single family house with an attached garage 2. examole - remodel existing garage into family room 3. examole - 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, OESIGN TEAM ANO 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, BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP. the label must be- del ;vered 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. \WC6~~ ~,.-\\- V, FOR OFFICE USE ONLY Permit Clerk ~ PROJECT CONDITIONS TO BE SATISFIEO BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: '. .... . PLANS REVIEWED BY: name signature date . .