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Home My WebLink AboutPermit Mechanical 1987-10-11 - -.... ~ INSPECTION LINE 1726-3769 CITY OF SPRINGFIELD COtIBIIIATION APPLICATION/PERMIT c; 7<1)7 Ranqe \) r--.- _I ValuE of \lark Ocr 'v{)q 1/ I,~O CJ BUllc,lno .Pennlt Info Descrlbe ~Jork(, e . BU11d Slngle Phone 7<1'-6 t/ J ~ Farlll y l1es 1 dence lh th Attached Ga raae ) A~fJOl~ ~~ ~J6v () l__ d Ji-A ~n_'-' INFORlIATION LHIE 726-3753 Sa Ftq flaln :q t"tg Access 5q Ft9 Other New Add Alter nep -Fence _Demo_Change/Use ~Other N. ;2/~ f;r E'IERGY SOURCES Heat '~a ter Hea ter Job Address //L/o legal De~cr1ptlon Owner' 1<.", J l<.ej Addre55 J I 'f () N 0o.flc-J ()IL Jfs:".0v>^ 1 J ..; 2-1 St :;; f Address OESIGN TEAI1 (name) Phone (address) ~ :>- CI'-. Q "- \Xl Constructl;n Lender (llCS no) (eX01res) (ohone no ) Pnmary Structural Electncal ~'-I). (.,&j{ / '1echamcal CONTRACTORS (name) (address) (11cs no) (pXOlres\ (ohonp nn Genera 1 I PlumblnQ Electncal - CrU.J A <1., - -,'1 '1 ~', /tlechamcal PLUllBING ELECTRICAL MECHANICAL NO , FEF 'CHAR(';F Nn I ~~~ 'rI-lARr,~ NO '~~~ 'rHARr,1=" I Each slngle f1xture Res1dence of 1 ~ 00 IS 0 D SQ FT furnace/burner to BTU's IRelocated bUlld1ng (new flX addltlonal) Is F Pesldence (] bath I IDuPlex (1 bath) each IAddltlonal bath I ~Iater serV1ce Sewer New clrCU1ts alts or extens10ns Floor furnace and vent SERVICES Recessed wall So~~p hp~tpr ~nrl vpnt :,/10 I I 7c; ITempOrary Constructlon IChange In eX1stlng rp" 1 rlpn~e Imu1tlfam1ly, corrm or TnrllJ"trl~l 10f amps I I COl111 IIND FEEDERS I IInstall/alter/relocate I rll"tnh fppdpr" 10f amps I I I I Apollance vent seoarate Stat10nary evap cooler Vent fan wlth slnole duct Vent syste~ apart from heatlna or A C Mechan1cal exhaust hood a nd duct \Jood stove/heater Storm Sewer "I _ 7) ISSUANCE OF PFR'IIT TOTAL CHARGES WHERE STATE L'W REQUIRES shall not be vallj untl1 the 1'; 7\ TOTAL CHARGES that tile Electncal work be done by an label has been slgned by an Electr1cal TOTAL CHARGES Electr1cal Contractor, the electrlcal portlon of thlS permlt Supervlsor and returned to the BU1ld1ng Olv1s1on I HAVE CAREFULLY EXMlINED t'le completed apnl1cat1on for I)ermlt, and do hereby cert1fy that all 1nfonnatlOn hereon 1S true and correct, and I further cert1fy that any and all work Derformed shall be done ln accordance wlth the Ord1nances of the Clty of Spnngf1eld and the Laws of the State of Oregon oerta1nlng to the work descnbed hereln, and that 1m OCCUPAr~CY w1ll be made of any structure w1thout the perm1SSlon of the BU1ldlng D1V1S1on I further cert1fy that my reqlstrat10n w1th the BUllder's Board 1S 1n full force and effect as requlred by ORS 701 055. that 1f exempt the baS1S for exemptlon 1S noted hereon, and that only subcontractors and employees who are 1n comollance w1th OPS 7nl 055 w1ll be used on th1S project IIAIIE(please pnnt) ')Ao"l se.vb ofr/ SIr,rIATURF ~ l?--. ~ Fon OFFICE USE DilLY DATE (O-f[ -r7 Zone Tyoe/Const Umts So Ftg f1a1n F1re Zone Bedrooms Occy Load Sq Ft9 Access Flood Pla1n Stones Occy Group Sq Ft9 Other BUILDING PERil IT PI an Ck Conm/l nd Charges and ------------ 65%1Bldo P~r F~p Surcharges Plan Ck Res 30%/Bldo Per Fee PLUI1BING PERMIT I Fence Charges and ------------ I D6mo Surcha rges ELECTRIUL PERI'IT I Sidewalk Charges and ------------ I A/C Pav1ng Surcharges MECHANICAL PERMIT __I_S_Q9____ Curb Cut Charges and 10 Surcharges .7<; x x Value Val ue Value x TOTAL VALUATION Systems Development Cha rqe (l 5~) Total Comb Permlt iTOTAL ) S" IS .~ ' ~ COMBINATION APPLICATION/PERMIT (CAP) Appllcant to furnlsh A Job Address B legal Descrlptlon 1 example: Tax Lot 100. Lane County Map Reference II 03 43 2 example- Lot I Block 3, 2nd Add1t1on to Sprlngtleld Estates C Name, etc of owner and constructlon lender D Energy Sources 1 example- heatlelectrlcal cel1,~q/or forced alr Qas 2 exa~le- waterheater/electrlcal/or solar E Square footage or valuatlon. etc 1 example- 1250 sq foot house. 500 sq foot garage 2 example~ If new proJect. check new - ,f addltlon, check add, etc F BUlldlng permlt lnformatlon 1 example - construct slngle famlly house wlth an attached garage 2 example - remodel eXlstlng garage lnto famlly room 3 example - convert slngle famlly resldence lnto restaurant (change of use) G Value of work as def1ned 1n Sect10n 303 (a) of the Structural Speclalty Code H DESIGN TEAM AND CONTRACTORS To avo1d des1gn or construct1on delays, BU1ld1ng 01v1s1on Staff must be able to contact appropr1ate persons regardlng des1gn 1nformat1on or Job s1te correct1ons, etc II Abbrev1ated Plumb1ng, Mechan1cal, & Electr1cal Schedules A Except where blank spaces occur 1n the descr1pt1on portlon of the Mechan1cal and Electrlcal Schedules. the appl1cant need f1ll-1n only the No Boxes adjacent to the appropr1ate 1tem{s} to be 1nstalled B Full Plumb1ng, Mechan1cal, and Electrlcal Schedules are ava1lable at the BU1ld1ng 01v1s1on 1 To conserve space on the perm1t form the schedules have been abbrev1ated 2 If the 1tem{s} to be lnstalled are not covered on the abbrev1ated schedules you should consult the fu 11 schedu 1 es C BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES o As noted on the CAP, the label must be del1vered to the electr1cal contractor for s1gnature by h1S electr1cal superv1sor The general contractor 1S not authorlzed to Slgn the electncal label - III Appl1cant to s1gn and date Whenever poss1ble. the ln1t1al appl1cat1on w1ll be used as a worksheet only Where poss1ble. BUlld1ng 01v1s1on Staff w1ll prepare a type wr1tten copy and return 1t to the appl1cant at the t1me the actual perm1t 1S 1ssued for h1S slgnature IV Fees and Charges Plan check fees are due and payable at the t1me of the appllcat1on, and no plans w1ll be processed unt1l these fees are pa1d All other fees and charges are due and payable when the perm1t 1S 1ssued V FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY <.; PERMIT VALIDATION ~ ~ ~V \)~ {/ \ Permlt Cl erk ~(Y Permlt appllcant exempt from reglstratlon wlth the BUllder's Board because Addltlonal Project Informatlon PLANS REVIEWED BY name slgnature . date '''' " " " "-'f -..:1' .I f.U!!1 PLQl PLAN .1........,....., \ . 'r I' 1 I " 'Ilt . " ei ,,' . .""..1. .~.t " ~.;;.,....""-~ {..s.: ',. +4 ':JI~ \ EB ,*- I ' ,,- .... , -w_ ~ ......1 ..........- , ~,.,. " ~~ ......" ~~~-----.;..' ..... .., ~ ~_ ,...,.. 1;.;M~"~,~" . i .. ~ ~.'" ...;....i~~:~ l. . "..... I~. .,~ r.......... 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