Loading...
HomeMy WebLinkAboutPermit Mechanical 1983-10-17 . . II:1SPECTIOr/ LlIIE 726-3769 CITY Of S?RlijGFIEliJ COIIBI;IATlON APPLlCATIOr//PERMIT ElIERGY SOURCES: Heat !'/ater Heater Ranqe Job Address jyoq s. Sf. 'A' Legal Description Owner 1!in<",e'o H:J(,fnu.Yturt ilJ ~t- l)L ValuE: of I-lark: r::.L ;q()q ~ ~DIJ () Construction ~~ lIIfORllATlON U:'t 726-3753 Sq. Ftg. Hal" ~q. Ftg. Access. Sq. Ftg. Other r~e\<i Add Alter Rep. --Fence Demo Change/Use Other- - I' .1 8J J I~ I,J,' VJ7lnr, BU1!c;ina Permit Info: Oeser be ~Jorl<li,.e" Build Single Familv l1es;dence lHth .A.ttached Garaqe) (u;\ l t-,w\lhrn,\'UiQ \ \ ni +- U ITempOrary Construction IChange in existing fl?s.i ~e-nre ' Imultifamily, camm. or lnrlustrial IOf amps.l ICOMM./IND. FEEDERS I IInstall/alter/relocate I rli,tr;n. fppdpr, 10f amps.1 I I I ISSUANCE OF PFRrllT I TOTAL CHARGES I TOTAL CHARGES 10.00 that the Electrical work be done by an 'Electrical Contractor. the electrical portion of this pe~it label has been signed by an Electrical Supervisor and returned to the Building Division Address Phone Address DI:.:::dlir{ TEAl' Phone (address) (lies. no.) (name) Primary Structural Electrical Mechani ca 1 CONTRACTORS (name) (addn's" 1 11 in,. no.l General Plumbino Electrical "'echanical PLUI1B 1IIG ELECTRICAL 110. FFF [HARGF Nn ~F~ rHARGF NO. Each single fixture Residence of SQ. FT. Relocated building (new fix. additional) S.F. Residence (] bath) 10uplex (1 bath) each IAdditional bath IHater service I Sewer INew circuits alts. or extensions . I SERVICES I Storm Sewer TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be vali1 until the {exoires} (chone no. (pxni rpc;,) (ohanp nn.) MECHANICAL FH rHARGr: furnace/burner to 'lIH niliL BTU' s 1000 Floor furnace and vent I l I I I I I I I I Recessed wall Snarp hpatpr anrl vpnt I App 1 i ance vent c;,eoarate I Stationary evap. cooler I' Vent fan with sinole duct I Vent system apart from I heatina or A.C. I Mechanical exhaust ' hoorl and duct j ~1ood stove/heater I I I I HAVE CAREFUllY EXA!1WED the completed aprlication for permit, and do hereby certify that all infonnation hereqn 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 Spri ng fi e ld and the la\-/s of the Sta te of Oregon perta i n i ng to the work descri bed herei n, and that UC OCCUPAIlCY 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 s required by ORS 701.055, that if. exempt the basis for exemption is noted hereon, and that only subcontractors,and emplo e who are i~~~C~~ OP.S 7Q1.D55, will be used on this project. 1IA11E(please print) ,y _~5A~Aj_ SIG,IATURE.t DATE X /&// ~ f3 , ;7" ......-FO~ OfFICE USE o;lLY Zone Type/canst- / Units Sq. Ftg. Hain x Value Fire Zone Bedrooms Occy load Sq. Ftg. Access x Value Flood Plain Stories Occy Group Sq. Ftg. Other x Value TOTAL VALUATION BUILOlNG PERI-llT Plan Ck. COIlm/! nd Charges an~ ------------ 65VR 1 do Ppr Fpp Surcharges Plan Ck. Res 30%/Bl do Per Fee PLU'~BING PERMIT I Fence Cha rges and ------------ Surcharges Demo ELECTRIUL PERr~IT Sidewalk Cha rges and ------------ Surcharges AIC Paving rlECHANICAL PERMIT __u_tQ.._QS;L I Curb Cut Charges and Surcharges C-JO I Systems Development Charoe (1.51) , Total Comb, rermit I I TOTAL 10.10 .I . COMBINATION APPLICATION/PE~1IT (CAP) a I. Applicant to furnish A. Job Address B. Legal Description 1. examole- Tax lot 100. Lane County Map Reference 11 03 43 2. examole- lot 1. Block 3. 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ceilinq/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. examole- if new project. checklnew - if addition, cneck add. etc. F. .Building permit information: 1. examole - construct Single family house with an attached gar~ge 2. example - 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. DESIGN TEM4 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. 11. 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. BUILDIlIG OIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The genera1 contractor is.not authorized to sign the electrical label. --- III. Applicant to sign and date Whenever possibJe, the initial application will be used as a worksheet only. Where possible, Bui1ding 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: . PERMIT VALIDATION -~. ~DY Permit Clerk It UltS'l / (! 1-..- Permit applicant exempt from registration with the Builder's Board because: Additional Project Information:. PLANS REVIEWED BY: name signature 1 date I