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HomeMy WebLinkAboutPermit Electrical 1988-10-14 I INSPECTION lINE 726-3769 CITY Uf SPRINGFIELD COMBINATION APPLICATION/PERMIT ~ I . , I (1/1.. rjllERGY SOURCES: -, q~ H.4R.I.t>//If f<tJtJD 7&/7--2./C ~Heat legal Oescription 7/fy / n 7' 2!IJO. Ilater Heater Ran~e ~t1'/"s., /74?7,-;r:::J. Val~E of NorK: Owner' Tlll1A./ d- "USAN 11:: LIMr.J..I . Add ,/, I ,,/ h _.j!uil<iinQ Pennit Info: Describe NorK(Le.. ress ...,.07-./ 1\/6 t f.(~JIIE<I P onr.:5,'(;/?t;. r.hmil v ~esidence Nith Attached Garaoe I - . 1"- ,,- - j;"rA CF'Ne . c~(" 97W2.- : , " Construction Lender . . INFOR/IATlON LINt 726-3753 Sq. Ftg. I.tain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. Fence_Demo _Change/Use _Dther 00 0() o Build Single -SJ (;J ,"""". ~F Job Address Address Ut~lliN TEAf1 (name) Phone (address) flies.no.1 Cexniresl Primary I ~{~ . 1(;1 Structura 1 Electrical Mechanical CONTRACTORS (namel (address 1 (lieS.M.l (pxnirps) (ohnnp nn.) General Plumbina Electrical \^I~f'PJp..v t;;./e.c.. 'if;)(') 1..1..1, l~ 3<l :J f3 :s .:2..o-~9e-- , 1='1='1=' r':fARG.E. _NO_ &81 -.:2/0<.../ ~lechan;cal PlUI.IBING ELECTRICAL MECHANICAL NO. FEE rHARr,F Nn Each single fixture Residence of ~(")OO SQ. FT. '..EEL ..cJJAIlllE. :: Relocated building (new fix. additional) New circuits alts. or extensions 1:)'C9'Y' /YJOre- SERVICES ;:;jl 31~ ;1~~: furnace/burner to BTU. s " 'I Floor furnace and vent S.F. Residence (j bat.h 1 Duplex (1 bath) each Additional bath Recessed wall ~nMrp hpJUpr nnrl vpnt ~Int~r .~erviCI=! ITemporary Construction Change in existing . rp~ j (j~rtl"p multifamily, camm. or Tnr1'Ic,trinl Storm Sewer Of COMl.1./IND. FEEDERS amps. Appliance vent "f1naratp Stationary evap. cooler -.. Vent fan with sinole dur:t Vent system apart from I heat;na or A.C. Mechanical exhaust hond and durt Wood stove/heater Sewer \"~.c1 I Install/alter/relocate dic:.trih. fpprlprc;. 10f I I I amps. I SSUANCE OF PFR!1lT TOTAL CHARGES . WHERE STATE L.\ll REQUIRES shall not be vali~ until the TOTAL CHARGES TOTAL CHARGES that the Electrical work be done by an"Electrical Contractor, the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division 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 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 OCCUPAr,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 exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in cornplian~e with ORS 701.055 will be used on this project. 1lAf.IE(please print) @lklflJ'{) ~.c;..u.~Ar-\l SIGIIATURE ~LO~)'~.lJ."L OATE /o/;~/rt FO~ OFFICE USE OIll Y Zone Tvpe/Const. Units Sq. Ftg. riain Fire Zone Bedrooms Occy load Sq. Ft9. Access Flood Plain Stories Dccy Group Sq. Ftg. Other x x Value Value Value x TOTAL V AlUA TI ON BUILDING PERI-tIT Charges and Surcharges Plan CK. Corrm/lnd 65t/Bldo P~r Fpe ------------ Plan Ck. Res - 30%181 do Per Fee Systems. Development Char~e tl.5~) . D~o . I I I Plm~BING PERMIT Charges arid......- Surcharges. -' Fence <. ELECTRICAL PER!~IT Charges and .. \ Surcharges 1",\ MECHANICAL PERMIT Charges and Surcharges bo . cYD l'sidewalK -------3~~-ol A/C Paving I Curb Cut I Irotal Comb. Permit I I TOTAL ~ '3.00 I .~ ; ! i ! 1 .1 .1 .j l , 1 .~ :, : '. ~, 'J ; ., .j . I, :. :~ I ,. j .} 1 , . f ,! I~ , j i Ii !: . .. . . 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 11 oj 4J . 2. examele- Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ceilina/or forced air qas 2. examole- waterheater/electrica(Jor 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 pennit information: 1. example - construct single family house with an attached garage 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. OESIGN 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 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. 1 I l. Appl icant to sign and ail fed - 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. 1~7 j)t() j( _ ~ /YJ V. FOR OFFICE USE ONLY' 0(./ Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ~ Permi t appl i cant exempt from regi'strati on with the Buil der I s Board because: Additional Project Information: '. PlANS REVIEWED BY: . name signature date