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Home My WebLink AboutPermit Electrical 1990-4-17 '\\Y Builoinq Permit Info:, Descr.be Work(i~e.. Familv nesidence With Attached GaraQe) ~~\~~J\~N~ D ~0l'J]l~,.r~~+ ,,,,"'"' I INSPECTION LINE 1726-3769 . I I I \ ownerr..f2{)rE~.k fXJuW/EJLE ~ Address J,~J() Ml.NI.JIJ.v ?1 livl' Phone !;;I/(.ot/E .oeE- 9?'ItP,!1 - (,gf-OJ"3h Job Address ";2;' / R c; Legal Description " (6A.T~ ~ LP Construction lender, Address DESIGN TEN~ (name) Phone (address) Primary Structural Electrical / / , I~echanical CONTRACTORS (address) (lies, no,) (name) Genera 1 Plumbino Electrical L.J/. !HIU/S ~/&j,,Gej If!?'!. d~Ifr5k' . ~I';:j), ~lechan; ca 1 PLUi1BING ELECTRICAL ~ I FFF rH~ ~ FFE CH~ Jill Each single fixture Residence of SQ, FT, Relocated buildin9 (new fix. additional) S.F, Residence (l bath) Duplex (1 bath) each Additional bath I ~later service jSewer Istorm Sewer New circuits alts. or extensions 12- 5'7J SERVICES I Temporary' Construction IChange in existing res j qf!.nce Imultifamily, corrm. or Industrial IOf ICOMM./IND, FEEDERS I I I I I IInstall/a1ter/relocate I I I dic;trih. fppdprc; IDf jOc> amp~1 ~ I ;~JJ I I I I I I I 1'/ ~ j.5 amps,l TOTAL CHARGES . WHERE STATE L\H REQUIRES shall not be vali1 until the' TOTAL CHARGES that the Electrical work be done by an.'Electrica1 Contractor, the electrical l1ortion of this pemit label has been signed by an Electrical SUl1ervisor 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 Oregon pertaining to the work described herein, and that UO 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 ;s 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 compliance with ORS 701.055 will be used on this project. IW1E(please printt:IArYl€<:;, L- (Y)11C:!;PfYJ SIG!lATURE a~x~/~ FOP. OFFICE US{AJIILY i( Ftg, liain Sq. Ftg. Access Sq, Ftg, Other Zone Fi re Zone Flood Plain Type/Canst. Bedrooms Uni ts Occy load Occy Group Stories BUILDING PERfllT Charges and Surcharges Plan Ck, Comm/Ind ____________~/Bldo Ppr Fee Plan Ck. lies 30%/Bldo Per Fee Fence PLU!lBING PERMIT Charges and Surcharges I,D~l!lO' 4~ UU ISldew'alk -- . A ~X.CS--I AIC Paving I Curb Cut I ELECTRICAL PERI~lT Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges . INFORliATION LINt 726-3753 Sq, Ftg. Main ~q, Ftg, Access, Sq, Ftg, Other !lew Add Alter P.ep, -Fence Demo ChangelUse Other- - ~ J (jJ ~ Build Single ....-,';:- (exoi re~) (ohone no.) .10 ,~'k "7/{'1- oR! L MECHANICAL I..EEL CHARGF furnace/burner to BTU' 5 Floor furnace and vent Recessed wall Snace hp~tpr anrl vp~ Appliance vent seoarate Stationary evap. cooler Vent fan wi th sinale duct Vent system apart from I heatina or A,C. I Mechanical exhaust hood and duct 1 ~1ood stove/heater I I I I I ,I I I I I ISSUANCf OF PFR!IlT TOTAL CHARGES DATE tj-;.f-1 iJ x Value Value Value x x TOTAL VALUATION Systems. Development Charqe [1. 5~) ". ~\ \ )(l\) I ITotal Comb. Permit 4~ ~c) I I TOTAl fit. ~ ~ 1,1 e . " ..J COMBINATION APPL1CATION/PERMIT (CAP) PERMIT VALIDATION I, Applicant to furnish A, Job Address B, Legal Description I, example- Tax Lot 100, Lane County Map Reference /I oj 43 2, example. Lot I, Block 3. 2nd Addition to sprlngtield Estates . C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heatlelectrical ceilinglor forced air aas 2. examYle- waterheater/electrlcal/or ~ 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, cneck add, etc. F. Building permit information: 1_ examele - construct single family house with an attached garage 2. examele - 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 abbreviated schedules you should consult the fu 11 schedu 1 es C. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOULES 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 Si9n 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. I. 00 ~ q- 0 1 I .o7~ , , , /I \ ~I-~ tori ":,,. ~vj ) V. FOR OFFICE USE ONLY Permit PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: I Permit appl i cant exempt from regi strati on with the Buil der' s Board Iiecause: Additional Project Information: PLANS REVIEWED BY: name signature , 'I.., . [rH"'" :,' ," !', ",,:I.'::rj"ate' , ~... 'I' '.' I L' l '.