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HomeMy WebLinkAboutPermit Electrical 1985-3-29 Val~€ of Hork: -,1$ 1500 BuilciinQ Penn'it Info: Describe \~ork(i-.e.. Familv nesidence With Attached Garaae) f), ~/}tA'/), ?j...., rP~", o <:9.00 ~' ., 4t, I IrISPECTlON LINE 726-3769 Job Address ~ 5 S El )j~o...vI Legal Description [i A-ttM ~ I CITY UF SPRINGFIELD COMBINATION APPLICATION/PERMIT E!lERGY SOURCES: Heat Hater Heater Range Owner w~~I~. Ljli.( /LfJn~, [Jd.<6 ~,Wl/ Phone Address Construction Lender Address Dc>!li" [EAIi Phone (address) (name) (lies. no.) Primary Structura 1 Electrical Mechanical CONTRACTORS {name} (address) (1 ics., 1"10,,) Genera 1 Plumbino ~ INfORlIATlON ll~c 726-3753 So. Ftg. 1.Iain ~q. Ftg. Access. So. Ftg. Other New Add Alter ~ep. --Fence Demo Change/Use Other - -- ~ 00 ~ () In ~ Bui ld Single (exnires1 I {ohane no.} (p1(t"Jir'Pc,' (ol1nl'lp ru"l \ (~ee- mAU 'f,,'./e. \~ '- Electrical k'L;;rI i~o ,~ 84if. S '?'is-i'-)r JplI{) ::t''?:J 6(" '5/{JO . , - ~1echan;cal PLUIIBING , r"'IRliE ..Jj(L ELECTRICAL ..J!Q..,. ff, fHARGF Each single fixture ...I!O..-! I Res i dence of . SQ. FT. INew circuits alts. or extensions I SERVICES I ", Relocated building (new fix. additional) S.F. Residence (] bath) I Duplex II bath) IAdditional bath 1~later service I Sewer I Storm Sewer each MECHANICAL ,cc rlJARliE furnace/burner to BTU's Floor furnace and vent Recessed wall Sn~rp hp~tpr ~nrl ~~nt ITempOrary Construction I IChange in existing I rec;,idencp Imult({amilY, corrrn. or I lnduo;.trial 10f amps.l I ICO~1./IND. FEEDERS I I Install/alter/relocate I rlic:tr-ih fpprlprc: 10f ~ amp~ I f~.DO I I I 4c/D I .(,0 I I I SSUANCf OF PFR!1lT TOTAL CHARGES TOTAL CHARGES I~.&O ,I TOTAL CHARGES WHERE STATE L\li REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical rortion of this permit shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFUllY EXM1INED the completed aprlication for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work oerformed 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 flQ OCCUPAI~CY 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-t the basis for exemption is noted hereon. and that only subcontractors and employees,who.are in comoliance with ORS 701.055 Wi~l ~sed o~ this project. IlAIlE(please print(J:);;vib~P. ~ JIJ SIf,IIATURE ./ ~ fO~ OrflCEUSE DIU,., Sq. Ftg. t1ain Sq. Ft9. Access Sq. Ftg. Other Zone Fire Zone Flood Plain Tvoe/Const. Bedrooms Stories Units Occy Load Occy Group BUILOING PERNIT Charges and Surcharges , Plan Ck. Conm/lnd 65%/Rldo Ppr Fpp ------------"'"Pian Ck. R'es 30%lBlda Per ,ee Fence PLU'~BlNG PERMIT Charges and Surcharges D~mo ELECTRICAL PERI~IT Cha rges and Surcharges __L9!.QQ___J Sidewalk , 1.00 I AIC Paving I Curb Cut I 11ECHANICAL PERMIT Charges and Surcharges Appliance vent c;eoa r:a tp Stationary evap. cooler Vent fan with sinole duct Vent system apart from I heatino or A.C. Mechanical exhaust hood and durt I Hood stove/heater I I I DA~d-27-rf x Value Value Value ,x x TOTAL VALUATION Systems Development CharQe (1.5~) I I I ITotal Comb. rermit I I TOTAL ....-..... J $. (00 r . , COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. legal Description I. example- Tax Lot 100. Lane County Map Reference 1/ U3 43 2. exa~le- Lot I. Block 3, 2nd Addition to Spflngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examEle. heat/electrical ceiling/or forced air Qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. ------ I. examole- 1250 sq. foot house, 500 sq. foot garage 2. examp.le- if new project, check-new . if addition, check. add, etc. F. Building permit information: 1. exam~le - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. examole - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (al of the Structural Specialty Code H. DESIGN TEN1 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. BUILOING 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. --- Ill. 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. ~ 9 (jV V. FOR OFFICE USE ONLY Permit Clerk ~ 1 P~JEC~ CONDITI~S ~O BE ~ATISFIED BEFORE OCCUPANCY~ ~~~ :JJAI>- - ~!u:.o LO joe. 0 ' f.~zY 1..u--6 .l'1'X 5LL~. .L - r!J~ ~) '-~.o -..0 . ~ ~j;~ ~ ff!.d~;'; - J:i"!:::rJ..- ~ 8~J ...~:t.._~, ~~ ot~. Permit applicant exempt f~omt?egistration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date