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HomeMy WebLinkAboutPermit Fence 1982-7-1 . ~ .~ l' CITY OF SPRINGFIELD COI1BIIIATlOfl APPLICATION/PERMIT . I INSPECTION LINE. 726-3769 Job Addr~ t04/ 0 ~'){), IloJ:rl Legal Dmription \In 3 3Lo 32..:(::(OCfn\ o~'x\~LD~ ~\_Ltr')~ Y(\l"\s,. Address M ((J s-"JN./ to --!:t\ ' ~ -Phone constr~~~rd J - ~ ,lb-O(9() INFORI1ATlON L1N' 726-3753 Sq. Ftg. I.lain ~q. Ftg. Access. Sq, Ftg, Other r~ew Add Alter Rep. Ranqe ~nce_Demo_change/Use Valu, of4r(j(y) ,00 , _Other Buildina Pe+'mit Info-: Describe \~ork(Le., Build Single FamilY Residence With Attached Garaae' ts(\(\ lL. '- ~O 1\ ml r 1J EIIERGY SOURCES: Heat Hater Heater ~ Q) ~ I~ -0 Address DESIGN HAl,' {name} Phone {addressl (1 iC5. no.' (exo;res) (ohane" no. Primary Structural Electrical Meehan; ca 1 CONTRACTO~ (namel Genera 1 (UJ..1 ') IliA {addr~ss , (1;1"'.5. no.' ~ (exlJirpc;) (I')hnne no. Plumbina ~ Electrical ~1echan; ca 1 PLUI1BItIG ELECTRICAL MECHANICAL NO, FEF r.HARr,F Nn FFF fHARhF NO. FFF fHARG[ SQ, FT, furnace/burner to BTlI' 5 Each single fixture Residence of Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (] bath) Duplex (1 bath) each SERVICES Recessed wall Snac~ hpatpr ann vpnt Storm Sewer Of amps. Appliance vent seoaratp Stationary evap. cooler Vent fan with sinole duct Vent system apart from heatinq or A.C. Mechanical exhaust hnnd and duct Sewer Temporary Construction Change in existing rp~jdf'nr::p multifamily, comm. or lndustrial Additional bath ~Iater servi ce COMI'!. II NO, FEEDERS Install/alter/relocate rli<;trih, fppdpr<; Wood stove/heater Of amps. TOTAL CHARGES TOTAL CHARGES WHERE STATE L.\I~ REQUIRES that tile Electrical work be done by an shall not be valiJ until the label has been signed by an Electrical I SSUANC, OF PFR!IIT TOTAL CHARGES Electrical Contractor, the electrical portion of this per~it Supervisor and returned to the Building Division I HAVE CAREFULLY EXN11NED 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 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 perta i n i ng to the work descri bed herei n, and tha t rw 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 ORS 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. I~AI'IE(please print)~k IA U nUL:, /7{E\,f SIGIlATURE_~~ n~ FO~ OFFICE USE DilLY I) DATE 7-1-~J- x Value Value Value Zone Fire Zone Flood Plain Type/Canst. Bedrooms Stories Units Occy Load Occy Group Sq. Ftg. f1ain Sq. Ftg. Access Sq, Ftg, Other x x TOTAL VALUATIOIi BUILDING PERI,IIT Charges and Surcharges Plan Ck. Comm/lnd ____________ 65%/Rldo J:pr Fpp Plan Ck. Res 30%/Bl do Per Fee ____________1 Fence Demo Systems Development Charqe (1. 5%) PLUI1BIIlG PERMIT Charges and Surcha rges / [5, O() ELECTRICP,L PERI~IT Cha rges and Surcharges Sidewalk A/C Paving Total Comb. rermit TOTAL /0'.06 11ECHANICAL PERMIT Charges and Surcharges Curb Cut . . ,> COMBINATION APPLICATION/PERMIT (CAP) t. Applicant to furnish A. Job Address B. Legal Description \ 1. example- Tax lot 100, Lane County Map Reference 1/ uj 43 2. example- Lot 1. Block 3. 2nd Addition to Sprlngtield Estates. . C. Name. etc. of owner and construction lender D. Energy Sources 1. exam~le- heat/electrical ceiling/or forced air qas 2. example- waterheater/electrlCaJ/or solar E. Square footage or valuation, etc. - 1. examele- 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. examEle - 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 AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be ab1e 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 an 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 ~ivision 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 I' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION ",\ Permit Cl erk ~ Permit applicant exempt from r~gistration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature '.-.;......-.... _...h,.~..._...,....::::t:J;'1;;.'.::::-~':::::...._.._..........,.=:;::,t:..-;::~.-o:~""~~":_...\...........",_...,;..:.;"-0-."'.............:.:.... ,:;,-._'-.::-:............... date ........................- ,J