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HomeMy WebLinkAboutPermit Electrical 1989-8-9 - Dw,a~ ~.~~JcB1l'?(t?#b-P' B-:5~~ 'I INSPECTi~N T;'.NE" .. ,0. , CITY OF SPRINGFIEl,D ' . ' (NFORMATION UNt 726-176'f. -' COMBINATION APPLICATION/PERMIT 726-3753 Job A~ress I (p 5D Cen+en~;;) ~~~~GY SOURCES:''''' ;~:.> ~~~: ~~~:ss. ';B Legaj Description \ r) () 3ri-S?J4 t\-5100 Hater Heater Sqi{e~tgAd~th!~ter Rep. 0 / - Range Fence~emo_Change/Use . - , ValuE.3 ~rk: ~ Other ~ ow'nd\(\\\U: (\l~ ~(\l\(lclffi~f\t~ . ,0) ,00f)~ .~ -,. S' Addressv'\.? ':J...{~.. (r~' y ~^~n.-\.- phan""'.oS BU110.WO P~~llt Info: De.scrlbe Work(1.e., BU11d Single II f'I ?;,:Q~~~Q \~~-'q~4X?-> r~\\ \FJrl~tH'~At*~~d~i\QmC\rtJ' Construction Le~r J ~ \)~~ <1\)\'0\()\".X1 Q__; (address) (lics: no.) (e~i~) , (phone no. I S<=\ ~D\)4M-,€u.~ \O~;/\~l{) Address DESIGN TEAM (namel Primary ~~\\~~~. J- \\~ r\~ u n~ Structural ' Phone Electrical Mechanical CONTRACTORS- (name) Genera 1 l~~ (\.. 9_\< j . Plumbino ~ '~ ) (address) (lies. no.) (expires) (ohone no. ) , " Electrical . ~lechani~al ~ \'G~~ ~~ \t)l\~ PLUt1B I NG \j ELECTRICAL , I CHARGF NO. MECHANICAL NO. FEE CHARGE NO, FE!: 'FF!: . CHARGF SQ. FT. I furnace/burner to ~ .BTU's ,?~p///9/r- t1 oar furnace - and vent Each single fixture Residence of ( Relocated building (new fix. additional) /1Iew cir~u~ts alts. , or extehslons a. .6'-;r? ,/J-;I.d~~ I" SERVICES Recessed wall Soace heater and vent S.F. Residence (1 bath) Duplex (1 bath) each Additional bath Storm Sewer Of amps. Appliance vent separate Stationary evap. cooler Vent fan with sinole duct Vent system apart from heatino or A.C. Mechanical exhaust hood and duct Wopd stove/heater ~later servi ce Temparary Canstructian Change in existing residence multifamily, camm. or Industrial '~- Sewer COMM./IND. FEEDERS Install/alter/relocate distrib. feeders' Of amps. I SSUANCF OF PFRt1IT. TOTAL CHARGES TOTAL CHARGES ';:?-;;;;?-SO TOTAL CHARGES ~/"?' ,/;s:. ~ , WHERE STATE L'\\~ REQUIRES that the Electrical work be done by an-:Electrical Contractor, the electrical portion af this permit sha,ll. no,t be vali'l.until the label has ~een signed by an E]ectric~l 'Supervisor and returned to. th.: Building Division ~ ~ ~ '.~~. . ,., '.. . I". \, _ I HAVE CAREFULLY EXmlINED the completed application for permit, and do hereby certify that all information hereon is true and corr.ect, and I further certify that any and all work performed.shall be done in accordance with the Ordinances of the City of' Spri'ng'fi e fd"<irid the Laws of' 'the state' of Oregon oertai'ning to the, work descri bed herei n, and tha'tNO OCCUPAHC'y. will be made of any structure without the permission of the Building Division. I further certify that my registratian ~Iith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt,the .basis tor exemptian,is noted hereon, 'and that only subtontractors and employees who are in compliance with,OR~ 7nl.05~ will be used on ~his ~roject: BU'ILDING PER~1IT Charges and Surcharges :\6 ?J<rl~1/fl1 f171 SIGN^TUR~J-0f~J ./;lAC:; I FOR OFFICE USE or~Uf I I Type/Const.::3~S?/3'Units Sq. F~. t1ain ' .x Value Bedrooms ' Occy Loa~ Yo Sq. Ft~. Access x Value Stories I Occy Group ??-2 Sq. Ftg. Other~/~P" x Value -;::;.c:;,vc.--~ I 4mC\. V TOTAL VALUATION Plan Ck. CommjInd \QQ n.,. W 13~n..sstems Development <--~ 65%/Bldo Per Fee () 0 ,Y\\ 0 r'1 ~'rqe (1.5%), . 7~O- Plan Ck. Res " 30%/Bldq Per Fee DATE f(-;;' d .'t /" , NAME(please print) Zone C~R Fire Zone Flood Plain ---~~~-~- I~. /S- PLU/~BING PERMIT Charges and Surcharges Fence Dt1mo ELECTRICAL PERfHT Charges and Sur.cha.rge~ MECHANICAL PERMIT Charges and Surcharges ~ - _.~.~, 'Si'de.w~il k - - --.....-=-- -,-~~-:::.-- ____/.:b~_:~~_ Curb Cut ~/)' TOTAL .g36.5';3 ,. - .~ ~_-,~,c:~-l ,Cio251 ' ... ? - ......~ A/C Paving Total Camb. Permit ~ 7~ ~~ /~'=-?>A"!~-C~ O/V?Yt:... ~~~ ,~ ' "'- ~ -~ --~ A, ,I, , //'~~~~~~~ / , I --6'~- ~/T-~75 '-0, COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lqt 1. Block 3, 2nd Additian to ' Springfield Estates C. Name, etc. of awner and construction lender D. Energy Sources t 1. ',example- heat/electrical ceilingjor forced a~ir qas 2. example- waterheater/electrical/or solar E. Square faotage ar valuation, etc. 1. example- 1250 sq. foot house, 500 sq. faot garage 2. example- if new project, check-new- if addition, check add, etc. F. Building permit infarmatian: 1. example - canstruct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into. restaurant (change af use) G. Value af work as defined in Section 303 (a) af the Structural Specialty Code I H. DESIGN TEAM AND CONTRACTORS To. avoid design ar constructian delays, Building Divisian Staff must be able to contact appropriate persans regarding design information or job site corre~tians, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the descriptian partian of the Mechanical and Electrical Schedules, the applicant need fill-in anly the No. Baxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To canserve space on the permit form the schedules have been abbreviated 2. If the item{s) to be installed are nat cover.ed on the abbreviated schedules you shauld consult'- ui'e full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted an the CAP, the label must be delivered to the electrical contractar far signature by his electrical supervisor. The general cantractor is,not authori'zed to sign tlie electrical label. ,- , II 1. App 1 i cant to. sign and date Whenever passible, the initial application will be used as a'worksheet only. Where, possible" Building Division Staff wi'll prepa re ,a type wrHteD, copy' and return it to. the applicant, at the time the actual permit is'~issued far hls' signature., ,",' " , IV. Fees and Charges :', ,",: 'I,!,I."', P,lan check fees are due/and payable"at',thel,time af the', ~pplication, and no. plans ~ill be processeg uptil these , fees 'are pa i d.' All other fees' and 'charges, are I due and ' payable when the permi.t is, issued. I: - , , V. FOR OF~ICE USE ONLY PROJECT CONDHIClNS TO BE SATISITIED BEFORE OCCUPANCY: " ._ .-. I , I ?i~c-~/:y~~ ,,3:~ ~~~~-e';_ ~7>~ , ~, . ....~ ." PERMIT VALIDATION ~q '\,\~U \\) \ ~~. ) 1(\(0 V. \?-\~d. Pe~it c:erk (o/fljiu _/)r==-I/.-. '" ,~_~~-e::-_::/ a V.?5~.Y. ;Z>~~/~0 , Permit, ?'ppl i cant e~empt from regi strati pn with ,th~ Buil der I s Board because: Additional Project Informqtion: , . -- I , PLANS REVIEWED BY: I I , name I-b&/TC ~ --- ,,' " " ~#_"\ ..=.)..~..::. ;.". r-t~erT, ~;gnature~, .~~,..~....date . , . '/ ' r " " , , , I ~-?-b- t' .