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HomeMy WebLinkAboutPermit Electrical 1990-4-6 - IIilSPECTlON LINE 726-3769 . CITY OF SPRINGFIELO COMBINATION APPLICATION/PERMIT EIIERGY SOURCES: Heat I~ater Heater .' INFORllATlON LINE 726-3753 SQ. Ftg. I,'ain ~q. Ftg. Access. SQ. Ftg. Other Hew Add Alter Rep. -Fence Demo Change/Use ---:-Other- - =B ::5 - ~ -::J Job Address. 2800 Gatewav Blvu Sorirjofif>lri Legal Description \f]{) ::\Q{~()() tJ-:J..3CD Ran!1e Valu, of I'/ork: Owner' General, Growth'.of California . . .u,.,. ~-#. _ .::::~~~-'i:W)~~ ,~~' I Buihiinq Permit Info: Describe Work( Le.. Famn'/ nesidence Hi th Attached (jaraQe) Build Single Extend power & Emoorium Slab. telephone conduits under Address DESIGN lEAI1 (name) Phone (address' flies. no.) (exoires) {ohone no. I Primary Structural Electrical t1echani ca 1 CONTRACTORS (namel (address\ (1 ics.no. 1 (exoiresl (ohane no. \ Genera 1 Plumbino Electrical L. R. Brabham. Inr. In-~ WP~t Q ~tr~~t ~nIingfield. OR 97477 7~7-6h3A #20-87e exp 10/01/90 ~1echanical PLUI,IBI NG ELECTRICAL MECHANICAL No FFF r"~ yo F' , J:IJARliE.-'l(l :TI- J:IJARliE. SQ. FT. furnace/burner to BTlI's Each Single fixture Residence of Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence 11 'bath) , Duplex (1 bath; each Additional bath SERVICES Recessed wall So~cP hp~tpr ~nrl vpnt Storm Sewer amps. Appliance vent seoarate Stationary evap. cooler Vent fan with sinale duct Vent system apart from heatinq or A.C. Mechanical exhaust hood and dur.t Wood stove/heater Sewer Temporary Construction Change in existing rps.i Q~nq' multifamily, camm. or TnrllJc:.t.rial Water service " Of COMI1./IND. FEEDERS Install/alter/relocate r1ic:trih_ fpprlprc;. Of amps. TOTAL CHARGES ~iERE STATE L~W REQUIRES shall not be valiJ until the I SSUANCF OF PFRtII T TOTAL CHARGES I, TOTAL CHARGES that tile Electrical work be done by an. Electrical Contractor. the electrical portion of this pemit label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED 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 performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Drec,:lOn pertaining to the work described herein, and that UO OCCUPArlCY will be made of any structure without the permission of the Buildina Division. I further certify thnt my re!1istration ",/ith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in complia~ce with ORS 7nl.055 will be used on this project. S IGIIATU~ 1~ 4. C\M..'"1;:- IWIE(please print) Tim I nnt7 DATE 1'li/q(J Zone Fi re Zone Flood Plain Type/Con,t. Bedrooms Stories Units Occy Load Dcc.v Group FOr. OFFICE USE DIlLY S<1. Ftg. f1ain Sq. Ft!J. Access Sq. Ftg. Other '--J x Value Value Value x x TOTAL VALUATION BUILDING PERfllT Charges and Surcharges Plan Ck. Comm/lnd ____________ .,ill/Bldo P.er Fee Plan Ck, Res 30%/Bldo Per Fee Fence Systems Development Charqe (1.5~) , PLUI~BING PERMIT Cha rges and $urcha rges D~mo' ELECTRICAL PERIHT Cha rges and Surcharges jl MECHAN I CAL PERMIT Charges and Surcharges ~..:0.Q___ 'Sidewalk I. k.~ A/C Pavin9 Curb Cut Total Comb. rermit TOTAL 16{8. G:3 '. COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A: Job Address B. Legal Description 1. example- Tax Lot 100. Lane County ~lap Reference 17 oj 43 2. ~xam~le- Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. exalT!Ple- heat/electrical ceiling/or forced air qas 2. exa~le- waterheater/electrlcal/or solar E. Square footage or valuation, etc. 1. examDle- 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 garoge 2. exam~le - 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 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. I f the item( s) to be ins ta 11 ed a re 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 O. 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 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 OSE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION " -. .. . /6 7' ~~ \ -)'-0 -qO Pennit Clerk d~ . Permit applicant exempt from registration with the Builder's Board because:' Additional Project Infonnation: PLANS REVIEWED BY: name signature date