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Home My WebLink AboutPermit Mechanical 1981-8-31 (3) ~.'._'- CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT C~.,~ Legal Description J 7 - /J 2 - a:? .- 3f <./ - t>~ I {) b ~~'~g c.l.tvr~.I'- '711. ~.I.lr b:;Lq3 ~ &.Phone ?Ib-L/-,~t, .~; ILl. q7l/-77 Construction Lender , INSPEC~N L1NE~ 726-3769 Job Address bd.. 93 Owner Address Address Phone DESIGN TEAM (name) (address) Primary Structural Electrical Mechanicol CONTRACTORS (name) (address) General ~~ Plumbin~ Electrical Mechanical t INFORMATION LINE 726-3753 ENERGY SOURCES: Sq. Ftg, Main Sq. Ftg. Access. Sq. Ftg. Other _New_Add_Alter_Rep. _Fence_Demo_Change/ Use _Other Heat Water Heater Range Value of Work: i(S 47 1!9- Building Permit Info: Describe Work (i.e., Build Single Family Residence With Attached Gara~e) ~/l~' .tJL ~ 14~~. F./~.1LlA,- d . --:- ,.d- ~ 1!udLJ"IL (lies. no.) (phone no.) (expires) (lies. no.) (phone no.,) (expires) PLUMBING ELECTRICAL MECHANICAL NO. FEE CHARGE NO. Residence of FEE CHARGE NO. FEE furnace/ burner to BTU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent system apart from heating or A.C. Mechanical exhaust hood and duct 'q. ft. New circuits, alterations or extensions Each single fixture Relocated building (new fix. additional) S.F. Residence (1 bath) SERVICES Duplex (1 bath) each Temporary Construction Additional bath Amps. Water service Sewer Storm Sewer FEEDERS Amps. TOT AL CHARGES TOTAL CHARGES t-J CHARGE I VL Wood stove/heater ~~ s: trO o Heat Pump Air handler to 10,000 CFM Air handler over 10,000 CFM /0, ()-O Ib. b1J WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not be valid until a label has been signed by an Electrical Contractor and attached to the electrical panel. I HA VE CAREFULLY EXAMIN'ED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further certify that ony ond 011 work performed 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 herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building ,Division. I further certlfy that my registration witl> the Builder's Board is in full force and effect a s required by O'RS 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in complionce with ORS 701.055 will be used on this project. Basis for Builder's Board exemption: ISSUANCE OF PERMIT TOTAL CHARGES NAME (please print)C L C1 fl.. .p h C e /'Yf L{ ~ '1'7 L P){ SIGNATURE e~"tR~ Y'1 FOR OFFICE USE ONLY 15. O.A--$4~ DATE (]4~5~ /qfl Zona Type/ Const Units C;q. Ftg. Main Fire Zona Bedrooms, f'lccy Load C;q. Ftg. Acces' Flood Plain Ctori..... f'lccy Group Sq. Ftg. Other BUILDING PERMIT Plan Ck. Comm/lnd Charges and 65%/ Bldg Per Fee Surcharges Plan Ck. Res 30%/ Bldg Per Fee PLUMBING PERMIT Charges and Fence Surcharges Demo ELECTRICAL PERMIT Charges and Sidewalk Surcharges A/ C Pavinll MECHANICAL PERMIT Charges and ____-1~lJ:Q Curb Cut Surcharges 16:70 -- . '( Value Valu'" Value x .. TOTAL VALUATION Systems Development Charlie (1.5%) Total Comb. Permit TOTAL II is. bo t:?~...lt" '). ... or'7" ,~ COM~'NATlON APPUCA T10N;~e ICAP) 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 ceiling/or forced air gas 2. example-water heaterjelectrical/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 family room 3. example-convert single family residence into restaurant (change of use) G. Value of work as.defined in Section 303 (0) 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 abbrevi- ated schedules you should consult the full schedules C. BUILDING DIVISION STAFF Will Fill OUT All FEES AND CHARGES ON THE SCHEDULES 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 typewritten 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: , Additional Project Information: PLANS REVIEWED BY: namf' '\ignatur.. ~. , -- . I ~;'..-- ,; ~" "..... ~".s' U~" ....:.;;.- ,_.._) .,~ . WI "" -iti:' .. .;. .~.IT VALlDATI6-is (I) , -'.~ .~ ~-. \ .. . " h .' . Permit eler"" ~ate INSPEC~N LINE .. 726-3769 . , , CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT ENERGY SOURCES: .,.,_..... , , INFORMATION LINE 726-3753 Job Addres; be?. q 3 ~ Idt~ f!.1:: Legol Description /7 - /) 2- 3 =? - 31../ - tJlJ / I) b ~lCVI'",t.i}'k f~ ~ ~ e,fllJlP.-1.-C-e.- '711. Bl..P-~ - .6.~ q 3 ~tcd~ U.:hone 7LII:;-'I33' .f41~, IJA Cf7L/.77 P;~/) --. Construction Lender Owner Heat Water Heater Range Value of Work: 1151 7 bJJ... Sq. Ftg. Main Sq. Ftg. Access. Sq. Ftg. Other _New_Add_Alter_Rep. _Fence_Demo_Change/ Use _Other Address Phone Building Permit Info: Describe Work (i.e., Build Single Family Residence With Attached Garape) Jy~ A..).H)'u-d- ~ {)L~.LL /4 eLL 1-~LfA.,- };~ ~J{ Address DESIGN TEAM (name) (address) (Iics. no,) (expires) (phone no.) Primary' Structural Electrical Mechanical CONTRACTORS (name) (address) (Iics. no.) (expires) (phone no.) General ~-' PlumbinR - Electrical Mechanical PLUMBING ELECTRICAL MECHANICAL NO. FEE CHARGE NO. FEE CHARGE NO. FEE CHARG' .,> Residence of furnace/burner to STU's Appliance vent separate Stationary evap. cooler Vent fan with single duct Vent system aport from heating or A.C. Mechanical exhaust hood and duct Each single fixture Relocated building (new fix. additional) S.F. Residence (1 both) ~q. ft. New circuits, alterations or extensions SERVICES Duplex (1 both) each Temporary Construction Additional bath Amps. Water service Sewer V'" I Wood stove/heater '~t~ s: trtJ' Storm Sewer FEEDERS Heat Pump Air handler to 10,000 CFM Air handler over 10,000 CFM Amps. I , ISSUANCE OF PERMIT It), tJ-o /6-' H TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by the Electrical Contractor, the electrical portion of this permit shall not' be: valid. until a label has been signed by an Electrical Contractor and attached to the electrical panel. I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that 011 information hereon is true and correct, and I further certify that any and 011 work performed 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 herin, and that NO OCCUPANCY will be made of any structure without the permission of the Building ,Division. I further certlfy that my registration with- the Builder's Board is in full force and eiffect a s required by oks 701.055, that if exempt the basis for exemption is noted heron, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. Basis for Builder's Board exemption: NAME (please print) r: to I<..p 11 C (" "......, tf Q 1:(9 Lev SIGNATURE -e4/1~ Y'1 FOR OFFICE USE ONLY 6~k -" u DATE ~ 3J! fClL 'i ~ Zone Type/ Const. Units Fire Zone Bedroom' Occy Load Flood Plain <;tori",' Occy Group , .\ BUILDING PERMIT Plan Ck. Comm/lnd Charges and 65%/ Bldg Per Fee Surcharges Plan Ck. Res 30%/ Bldg Per Fee PLUMBING PERMIT Charges and Fence Surcharges Demo ELECTRICAL PERMIT Charges and Sidewalk Surcharges AI C Pavina MECHANICAL PERMIT t, Charges and 1.5"~ Curb Cut Surcharges ------- -- ,bv ~ ~ .,........ -, - ....,- . .-.,._..,.~ n_' - " ..Iti..;......... 1.'1.4 ........ <;q. Ftg. Main <;q. Ftg. Access <;q. Ftg. Other " Value Valup Value x x TOTAL VALUATION Systems Development Charae (1.5%) Total Comb. Permit TOTAL l a II /5. bO ~.. . '.,. __.t:~ ____ - - .. - _ ___ ~~....-a .-. COMBINA liON APPLlCA liON/PEt (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-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 gas 2. example-water heater/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 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 abbrevi- ated sohedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES 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 typewritten 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: Additi.onClI Project Information: PLANS REVIEWED BY: name <;ig naturf' .PERMIT V ALIDA liON / Permit Clerlr .-late