Loading...
HomeMy WebLinkAboutPermit Electrical 1983-3-21 1 INSPECTION LINE, 726-3769 . . Phone7~_~~) INfORllATION liNt 726-3753 Sq. Ftq. f.lain ~q. Ftg. Access. Sq, ft9, Other New Add Alter Pep, Range .. \~ Ofetnhecer_oemO_Change/Use Value of Hark: N Bullciina Permit Info; Oescnbe \1ork(1.e.. Build Single Family ~esidence With Attached Garaae) ~ (fl Job Address ~5.s S, 'r!' Sf , I Legal Oescription Vf7C J~'~f?=\l~~()F}2fX)1 I -- Owner /... ~S; Address ::;L ')" S ' :3 F' .{' / C), Construction lender hi 0 /0 r S '-'9' Sf W !oO 'o<l Address UI:.~lurl 11:.Ar~ (name) \~. \()[~ ( ) Phone (addressl (lies. no.) (exoires) (ohone no. J Primary Structural PYe.~neq E: / e do r 9/ n /() ~c1c:r rnt1A'> t;(;J. -~-I I<<:!... 9-30-'l.? 7<fl-d't7: nectrical Meehan; ca 1 CONTRACTORS (name) (address I (l iC'.". no. (exo; rps) (phone no.) Genera 1 Plumbina Electrical ~1echan; ca 1 PLUIIBI NG ELECTRICAL MECHANICAL SQ, fT. furnace/burner to BTU's fff CHARO, I NO, I ,ff CHARGE NO ~~~ rHAR~F NO. Each single fixture Residence of I Relocated building (new fix. additional) lS.F. Residence (1 bath) IDuplex (1 bath) each IAdditional bath ~Iater service New circuits a1ts. or extensions I~,OO 1';,00 I C{rrj 0 I Floor furnace and vent ISERVICES I Recessed wall Sn~rp hp~tpr ~nrl vpnt 100 I.Go I I I I I I amps, ~,O() I tj10 I I I I I I ~ \ -~ () amps. Appliance vent seDaratE' Stationary evap. coo1er Vent fan with sinole duct Vent system apart from I heatinq or A.C. Mechanical exhaust hood ilnd durt Sewer ITempOrary Construction Change in existing rf':'j..l<!ence multifamily, COIJ1J1. or Industriill Storm Sewer Of COMM,/IND, fEEDERS Install/alter/relocate dic;trib. fepders IOf I I I Wood stove/heater 1<;'.(}lJ , (,,() ISSUANCE OF PfR'IIT TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valiJ until the TOTAL CHARGES TOTAL CHARGES that tile Electrical work be done by an -Electrical Contractor, the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXN1INED 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 OCCUPAtKY 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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701~~11 be used on th~prOject. IWIE(please print) /:::bPAL b I~ bicat=./JEL srr,a^TlR~J.-d I? ~ DATE..2/2/)83, fOn OFfICE USE 'OaLY Zone Fire Zone Flood Plain Tyee/Canst, Bedrooms Stories Units Occy Load Occy Group Sq. Ftg. t1ain Sq. Ft9. Access Sq, Ftg, Other x Value Value Value x x TOTAL VALUATION BUILOING PER/lIT Charges and Surcharges Plan Ck. Comm/Ind 65X/Slda Ppr Fpe ------------ Plan Ck, Res 30%/Bldo Per Fee Fence Systems Development Charqe (1.5%) PLUI1BING PERMIT Charges and SurCharges Demo ELECTRICAL PERI~IT Charges and Surcharges .2&C)O - l. ~U 'Sidewalk I A/C Paving Curb Cut Total Comb. Permit 11ECHANICAL PERMIT Charges and Surcharges I TOTAL ~\,'2-0 " rt j . COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A. Job Address B. legal Description 1. ~xample- Tax lot 100. Lane County Map Reference Ii 03 43 2. example- Lot 1. Block 3, 2nd Addition to springtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. ------ 1. example- 1250 sq. foot house, 500 sq. foot garage 2. exam~le- 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 room 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 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, BUILOING 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 CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permi t . f PERMIT VALIDATION / I i --' lrzOloOO -o-tl'-E8 u &csl\~~ Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature 1- date __ , ,- _ .--,.-__~_"_ . ~ ""h""'~""",,",-,--"': _~,,""~',""."-:~"'"'_' ~ .. . 255 SOUTH "A" STREET .L:iI:iIlI.LS "\I,, H.LflOS sse; 2'5 <) 5- ):j' S j-