HomeMy WebLinkAboutPermit Electrical 1988-10-18
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Add J Phone/n BU11alnQ Pennit Info: Descrlbe \~ork.(l.e., Build Single
ress ';<1 <1-1 G. 15th Aw... <06(,-7101., Familv nesidence I~ith Attached Garre)
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Address Phone
UI:.~lliN TE.Ar~ (name) (addre..",) (lics. no.)
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I INSPECTION LINE
726-3769
.
CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
E!lERGY SOURCES:
Heat
Hater Heater
Range
Valut of Hork:
~.
Job Address
Mo.">1 St. :Lm,;>rOVQ/WOo-:t~
~...... .D/2. Cjl<l-o~
Cons~ruction Lender
Primary
Mechanical
-CONTRACTORS
(name)
(address)
nice;.. no.'
Genera 1
Plumbina
Electrical CJ..e...v GL; &Ie.c..fi,'<-.,Xw:..
I I
"'echan; ca 1
f.'o. PO)( J:J..Mo S ~<t:11--.
'173(J<!
10'67<;"
PlUI1BING
ELECTRICAL
NO.1
Each single fixture
INFORlIATION LIN' II
726-3753
Sq. Ftg. l'lain .
~q. Ftg. Access.
Sq. Ftg. Other
Ilew Add A Iter Rep.
--Fence Demo Change/Use
Other- -
fexo;res)
00
~
F
,I
(ohane nO.l
,....", iIi"' ,
;1.- '1- g 9 399-7focf/
MECHANICAL
I FEE r.HARr,F NO I t J:'~~ I rl::lAR.G..E.. ~1O I _I_j:~j:" I ru~
Residence of furnace/burner to
SQ. FT. BTU's
Relocated building
(new fix. additional)
New circuits alts.
or extensions
S.F. Residence
(1 bath)
Duplex (1 bath) each
Additional bath
II SERVICES
IOOA
"'" 50
:l,;). - .lIf7,-
Temporary Construction
Change in existing
rpo;ietrJH"'e
mUltifamily, camm. or
InrllJc;.tr;",l
IOf
/1 ICOMI'I./lND. FEEDERS
[Install/alter/relocate
dic;.trih_ fpprlprc:
IOf amp~1
[
[ 59" .s<v<~
u
I
Water service
I
I
[
/5,-llb5.-
I 1
1
I
.;Jo.'l-
Sewer
Storm Sewer
amps.
1,,10(1)
[
I
I
r... I~
-. :..1 \ .....-
1
1
I
.fI, 1./-33" 13
\ ,J"}.
'-'\~ J
Floor furnace
and vent
Recessed wall
Sn",rp np""tpr ",nrl vpnt
Appliance vent
sena ra te
Stationary evap.
cooler
Vent fan with
s;nolp rluct
Vent sys tern apa rt from I
heatinq or A.C.
Mechanical exhaust
hoorl "no duct
Wood stove/heater
ISSUANCf OF PFRIIlT
I HAVE CAREFULLY EXAMINED the completed application 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 flD OCCUPAUCY 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 ons 701.055, that if exempt the basis for exemption is noted hereon. and that
only subcontractors and employees who are in compliance with ORS 7nl.055 will be used on this project.
IW.IE(please print) lXlnre-t.\ G~
SIGIIATURE (~
FOr. OfFICE USE DIllY
Sq. Ftg. liain
Sq. Ftn. Access
Sq. Ftg. Other
\ (I/JJ\
Zone
Fire Zone
Flood Plain
Tvpe/Const.
Bedrooms
Stories
Units
Occy Load
Occ.Y Group
BUILDING PER~1lT
Charges and
Surcharges
Plan Ck. Comm/Ind
____________ 65%/Rldo Pj'r F~~
Plan Ck. Res
30%/Bldo Per Fee
Plur~BING PERMIT
Charges and.......
Surcharges
Fence
Demo
ELECTRICAL PERfllT
Cha rges and vI
Surcharges
4 ( 2..90 [sidewalk
- ----:s~~ ~3-1 AIC Paving
I Curb Cut
I
,.
MECHANICAL PERMIT
Charges and
SurCharges
DATE IO-/~-gg
x
x
Value
Value
Value
x
TOTAL VALUATION
Systems Development
Charqe (1.5~) '.
I
I
Total Comb. Permit
I
\f33, . \~J
I
I TOTAL
."
,
COMBINATION APPlICATION/PERMIT (CAP).
1. Applicant to furnish
A. Job Address
B. legal Oescription
1. examole- Tax Lot 100, Lane County Map Reference
II 03 43
2. ~xample- lot I. Block 3, 2nd Addition to
Sprlngtield Estates
C. Name, etc. of owner and construction 'lender
D. Energy Sources
1. examole- heat/electrical ceilinQ/or forced air Qas
2. examPle- waterheater/electrlcal/or solar
E. Square rootage or valuation. etc. - .
I. examDle- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check-new - if addition,
cneck. add, etc.
]. Building pennit information:
1. example - construct'single family house with an
attached gar.age
2. example - remodel existing garage into family room
3. exa~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 regar,ding 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
full schedules
C. BUILDING 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. ---
. III.. .Applicant to sign iinddate
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 penmit is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
,,'\
)
.
PERMIT VALIDATION
...
i'?/& c( q {
~"r
\O~J ,
e~
.
Permi t Cl erk
.
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
/
".
PLANS REVIEWED BY:
" name
signature
~
date