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Home My WebLink AboutPermit Building 1988-8-1 (71c)/,pFF97'?~ ~ ' ~ CtTY UF SPRINGFIELD ~ ' ----COMBINATION APPLICATION/PERMIT EliERGY SOURCES: Heat Hater Heater' Range ValuE of Work: ijOo.....- Phone BUiiGino Permit Info: Oescr,be Work(i.e., ~b- ~/~ _Familv I'tesidence Hith Attached Garaoel "(;> ~~~ ~ I . . I INSPECTION LINE 726-3769 Job Address '71 ~"2... LA-~.-<7__--V L=J::> ; Legal Description /:?-e>7-";?")-2-:" _~'<cr~ / Owner ~CZ:;;:~ K?<'<::..r5~ - / : ~"" <S"P'~)) ,&'ft" / Address Construction lender Address DESIGN TEA/1 (name) Phone (address) Primary Structural Electrical Mechanical CONTRACTORS (name I General 1/ W/-l"c-'R (address) Plumbino Electrical Hechanical PLUIIB HIG NO. FFF r.Hi\RGE Nn Each single fixture Residence of Relocated building (new fix. additional) New circuits alts. or extensions S.F. Residence (] bath) Duplex (1 bath) each SERVICES INFORlIATlDN LINt 726-3753 Sq. Ftq. '.tain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Demo Change/Use Other- - ~ ~ V) ~ \ I I Build Single ,7'~~ ,.c:c,/? ~ ,- COp/, ?/?'.7='/77 (lies. no.) (exoi res) (ohane no.) o O"{ , I \ \ (l;r.~. nn.) (pxo;rp~) (ohonp nn. <t:'"' ~ ~ ELECTRICAL MECHANICAL ~~~ f~~ Nn. I ~n' fl-lJ1R.GE.. SQ. FT. furnace/burner to BTU's Floor furnace and vent Recessed wall So~r.P hp~tpr ~nrl vpnt Additional bath I Temporary Construction ~Ia ter service I Change in existing res. i fte.ncp Sewer I multifamily. COll1Tl. or TndlJc;tr;",l Storm Sewer I Of amps, I I C0I1fl.flND. FEEDERS ~ I I Install/alter/relocate dic;trih. fppdprc; ~r\, I IOf amps. ~I I ((\V\jl I \..,../ I I Appliance vent seoar",tp Stationary evap. cooler Vent fan with sinole duct I Vent system apart heatino or A.C. I Mechanical exhaust hood ",nd dlJr.t. l \-load stove/heater from 1lAf.1E(p1ease print) !{ oee- ~ 4.. p(i.u I'H" SIGIIATURE~' - ?L I<',.t DATE Q../..SS FOr. OFF I CE USE ollL Y--' . - Zone /'DR Type/Const. <'-~; Units Sq. Ftg. f1ain , Value Fire Zone Bedrooms Occy Load Sq. Ft~, Access </8"1' x Value .y~"""..,-" Flood Plain Stories Occy Group #7-/ Sq. Ftg. Other , Value BUILDING PERHIT Charges anC: Surcharges ~ PLm~BING PERMIT Charges and.......... . Surcharges Plan Ck. ___Le_~___ 65%/Rldo ~ Plan Ck. ,...- ..,./?> 30%/Blde Fence Conmfl nd ppr Fpp R'es Per Fee Dl/flIO ELECTRICAL PERI~IT Charges and Surcharges 'Sidewalk A/C Paving ___________J Curb Cut I MECHANICAL PERMIT Charges and Surcharges TOTAL VALUATION re:>,::.? , R"-/-.!!'!Iir /' 52 - Systems Development h, (P Char~e (]'5~) , I I I I I I I Total Comb. Permit /6...50 TOTAL /7- =-'=' ./ . " . \ . , COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION 1. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 1/ 03 43 2. exa~le- Lot 1. Block 3, 2nd Addition to spr,ngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceiling/or forced air Qas 2. examole- waterheaterjelectrical/or solar E. Square footage or valuation, etc. - I. 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. exam~le - 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 fu 11 schedu I es C. BUILDING DIVISION STAFF WILL FILL OOT 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 signa ture. 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. FDR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: , , .:>:....,_.., .' I PLANS REVIEWED BY: name / -L?7?' HE' ?CCZ; 6r ~ -'~ signature /" ~~~~ ~~ -/ /' - date &.-/~ . .