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HomeMy WebLinkAboutPermit Mechanical 1987-12-8 ~. ~. ~1;;"- .,> 11'NSPECTlON tINE 726- 37 69 , Job Address ~2C ~/e-/y,Iy/A~ ;;c. 'vD. Legal Description 17"(J3~~-3'0~zc>c> IfAML/Ar /-/J/PDL tF X~L Owner ~PR/h~rr~P nB<./c;' )c~t:: 5 Address ::)=:z S-/'77 //J -5"r 7J.~~e?? 7-,-~ ~P~. ~7f'#/4 L~~ Construction Lender CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT EHERGY SOURCES: Heat \~ater Heater Range ValuE of I'lark: INFORf1ATION LINt: I 726-3753 Sq. Ftg. r.lain ~q. Ftg. Access. Sq. Ftg. Other Ne\~ Add Alter Rep. --Fence Demo Change/Use --Other-- -- % 'dJ ~ \tV 'vJ Buildinq Permit 'Info: Descr' be Wark(i.e., Build Single Family nesidence With Attached Garaqe) ///-57//<4 CXHAV57'~Z?? ~~ . , 4~J/.E / A:/~~ 7~"'/ 21.8" Address DESIGN TEAr'1 (name) Phone (address) (lies. no.) (exDires) (Dhone no.) Primary Electrical Mechanica17.1So!?/?'A'<~h;1~/~ 2~3 '5$ /5"?!:z~r CONTRACTORS (name) / (address) (lics. no.) ~~, !~~ __ \'\1""'"- Structural (exoires) n~-9/"9"" (Dhone no.) General P1umbinq C (181 If) Electrical ~'echanic'a1 ?.M/?"# ~...r~ r~r~.c, Z~g' -5!f!. /:>$.5"7: 7:?~- 9/9'/ . , PLur,1B I NG ELECTRICAL MECHANICAL NO. FEE CHARGE NO, Each single fixture Residence of FFF rHARhF~ NO. FFF rHARhF SQ. FT ~ furnace/burner to BTU's Relocated building (new fix. additional) New circuits alts4 or extensions Fl oor furnace and vent ...~ .'~j~ ~ S.F. Residence (] bath) Duplex (1 bath) each SERVICES Recessed wall Sqace heat~r and v~nt '.~~. 'j,' ~ .1,':;)', '~ f!J Sewer Temporary Construction Change in existing residence multifamily, comm. or Industrial 10f amps. ' COMM./IND. FEEDERS Install/alter/relocate distrib. feeders 10f amp~ a~7: ~/'-{,/'7'?/r d& .~/;>.?~~~ h~ ,~?r . ~5j/?,,~ ,2)/$ j,~ , / Appliance vent seDarate Stationary evao. cooler. , Vent, fan with sino1e duct Vent system, apart from heating or A.C. Mechanical exhaust hood and duct Wood stove/heater '/. Additional bath ~Iater servi ce Storm Sewer I SSUANCE OF PFRtlIT TOTAL CHARGES 'TOTAL CHARGES . ' WHERE STATE L~W REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be va1i1 until the label has been signed by an Electrical Supervisor and returned to the Building Division TOTAL CHARGES M/H. /_5:~ I HAVE CAREFULLY EXNlINED the completed app1 i cation; for permit, ar)d do hereby certify that all informati on hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that NO OCCUPANCY 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 exemp ~he basis m tion is noted hereon, and that only subcontractors and employees 0 are in compliance with ORS 7n.l.055 w 1 be used ' t rW1E(please print) JM ,A J .......".,: "LDATr/'Z -IB-BI Zone Fire Zone Flood Plain Type/Const; Bedrooms Stories Units Occy Load Occy Group Sq., Ftg. t1ain Sq. Ftg. Access Sq. Ftg. Other !(\) Plan Ck. Comm!Ind c., '2 .,:::- 65%/Bl do Per Fee C.J_ 7........ Plan Ck. Res 30%/B1dq Per Fee x Value Value Value x x TOTAL VALUATION BUILDING PER~1IT Charges and Surcharges Systems Development Cha rge (1. 5%) f PLuP4BING PERMIT Charges and Surcha rges Fence ELECTRICfl.L PERrHT Charges and Surcharges I tc1EhtHANICAL PERMIT arges and Surcharges lp Dt;mo _ ___ __ ___ __-' Sidewalk I A/C Pavi ng ~ _ _ Lfi: _e:.~_ _I Curb Cut ~7~ , IT~tal Comb. Permit 1 I TOTAL 1S:7~ 1/. S"CJ .., Gtr'........ ~/I~ r;;:.f,:t. <,' 'C:O':~''T:~'':-'''' 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 17 03 43 2. example- lot 1. Block 3. 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air qas 2. example- waterheater/electrical/or solar 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 f~mily 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 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 fu 11 schedu 1 es 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 signa ture. 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 ItJ0r(~ 12- f--81 U Permit Clerk PROJECT (ONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder',s Board because: Additional Project Information: PLANS REVIEWED BY: ~ nameY__nN&:" .>>~~Signature~__ .~ date /-Z-&" 27