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HomeMy WebLinkAboutPermit Plumbing 1988-5-11 INFORllATION LINt:. 726-3753 Sq. Ftg. r.1a i n ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. Range --Fence Demo Change/Use Val UE of Hork~ b1) D Other---- Buildinq Permit Info: Descrlbe Work(i'.e., Build Single Family Residence With Attached Garaqe) -:f-W/lri:;lun:... 'rL ///lrletC/1;r;}J'Ld 4J/!v ~--<~,. / !J 6 _~.._._---;.T_ - .--. "",~ 't LI,NSPECTION LINE 726-37(-;') . Job Address 537 IJ}. CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT ENERGY SOURCES: Heat l~ater Heater jTempOrary Construction IChange in existing residence Imu1tifami1y, comm. or Industrial 10f amps~ ICOMM./IND. FEEDERS I /Install/alter/relocate I distrib. feeders IOf amp~1 I I I I 1 I I I TOTAL CHARGES / ':;-:oPbl TOTAL CHARGES TOTAL CHARGES WHERE STATE L!\\~ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion'of this permit shall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division Legal Description 17-C~'':l?-Y'''31 c:> $""2'--?-> I' ownerUk Fuif l~ Add;:.9~ lf1q- O~ . c~ende~;'P- Vtltp.. ~) Phone Address DES I GN TEAt~ (name) Phone (address) Primary Structural Electrical , Mechanical CONTRACTORS ~~ (name) ~ ___ r (address) bA- If flr,J-fl it/j/11 ~ {L11/tJ-- (1u4v}y~ General P1umbinq Electrical ~lechanical PLUt1BI NG ELECTRICAL NO. ' FEE CHARGE NO. '2 Each single fixture ~u~fir' ~/ A!b'A~ 'Relocated building (new fix. additional) Residence of 7,.9> I$~ SQ. FT. New circuits a1ts. or extensions IS.F. Residence (1 bath) IDuPlex (1 bath) IAdditiona1 bath IHater service I Sewer each I SERVICES I Storm Sewer ~ ~ ,~ (1 ics. no.) (exDires) (Dhone no.) j "}'-\ , '1/ ~/\ " (lies. no.) ~- ~ ~xDires) (ohone no. ) ( t f 1- ;;).K t/ / ) ~ ~ MECHANICAL FFF rHARGF NO. FFF rHARGF t furnace/burner to BTlI's Floor fu rnace and vent I I I I I I I I I. I I I Recessed wall Soace heater and vent I App 1 i ance vent seoarate I Stationary evap. cooler I Vent fan wi th sinale duct I Vent system apart from I heating or A.C. I Mechanical exhaust I hood and duct 11'lood stove/heater I I I I I I I ISSUANCE OF PFRr11T I HAVE CAREFULLY EXAt1INED the completed application for permit, and do hereby certify that all information hereon is'true --1 and correct, and I further certify that any and all work Derformed 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 OCCUPAriCY 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 701.055 wi1 be used on this project. rW1E(p1ease print) J)+(! IM}--l d ~ P L!!-, SIGNATURE FOR OFFICE USE DATES-I/ -at( /" Zone <:: L:.. Fire Zone Flood Plain TYDe/Const. ~~~~nits Bedrooms Occy Load Stories / Occy Group .21- 2 Sq. Ftg. t1a in /y?e::s fA Sq. Ftg. Access Sq. Ftg. Other x x x Value -::::::z~~ Value Value o {{ -;;J.fc -~f . ~~~~~~~Ga~~R~1IT ____3':3:~~_ ~~~~B~~~ ~~~~~~ ~ I. (~ lJ3!lJ Surcharges ') / ./ Plan Ck. Res ' . fa 3' ,30%/B1 dq Per Fee PLU11BING PERMIT / ~- I Fence I ~~~~~:~g=~d 5' ----.{L2~~7?1 D6mo I ELECTRICJl,L PERrHT ISidewa1 k I Cha,rges and ----------__ Surc~arg,~~ ' . _ ' ' ,j-~/c Pavin,go I t1ECHANICAL PERMIT ~ "',1 Curb Cut . I Charges and ____________ Surcharges I I TOTAL VALUATION Systems Development Charge (1.51,) , //:4. I I I I Tpta.l Comb,. Permi t, ' I TOTAL .,~~ f/'9. 88.1 . ~ ""' k.'~ w.~- -' COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Oescription 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 ceiling/or forced air qas 2. example- waterheater/electricalior 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 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 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 schedul 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 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: ---.::::::::: t> ~ , , .r" r .. PERMIT VALIDATION ~, . \. : ..... ( I tfq ( " ((oX? t? "/ . "'- Permit Clerk r~' Permit applicant exempt from registration with the Builder's Boar~ because: Additional Project Information: PLANS REVIEWED BY: name -L&>~&E.'7t c-~~ signature "".J"~'" ~ I~-ar::::> , ~ '~ da te ,.:)'- =< --8"8 I