Loading...
HomeMy WebLinkAboutPermit Building 1988-9-21 CITY Uf SPRINGFIElD . INFORlIATlON LINe COMBINATION APPlICATION/PERMIT 726-3753 EIIERGY SOURCES: Sq, Ftg, '.Iain Meat ~q, Ftg. Access, Water Meater Sq, Ftg, Other -1lew _AddXA Iter -Yep, Range _ Fence Demo Change/Use ValuE of Work!~ t7flJ. Other- - Buildinq Permit In'fo: Describe Worl<(Le.. Build Single Family Residence With Attached Garace) /Ia-:h,~ P; /ltJ/11/llJclJ (J ~M'~ ?#~R~".,..c7'. I I I I I I -::27_56 TOTAL CMARGES :::?::<?-SC> 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 Surervisor and returned to the Building Division t. . ~' /&/- J. I INSPECTION LINE 726-3769 Job Address /1)0 r,( Legal Description 17.0'3.7?__ I) - t r owner~ M.-I.d-lk Address II) 0 k 02~a ~ Phone Construction lender Address Ue~ IliN I eAI1 Phone (address) (name) nics. no.) Primary Structura 1 Electrical Mechanical CONTRACTORS,,", ~ (name) General f Y; /' vl, lad::") J - J~ f1i~<;,. no.l Plumbina v Electrical t1/1..6 ~1echan;cal PLur.mING ELECTRICAL NO. HF r,HARhF NO ~~c ru~ Nn :3 Each single fixture Residence of ;1,fb 2<-5.:> SQ, FT. Relocated building (new fix. additional) ~ New circuits alts. ,.... or extensions '7 L>~ ~",AE: SERVICES ??-S" I I I I I S.F. Residence (1 bath) Duplex (1 bath) each Additional bath Iremporary Construction I'Change in existing rp,," i d_pnrp Imultifamily. camm. or Indu<;.trial IOf ICO~1,/IND, FEEDERS I Install/alter/relocate di,trih fppdpr~ Of amp~1 ~Ia ter serv; ce Sewer Storm Sewer amps. ~ TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be vali1 until the DC) gj ~ ~ .......... ~ (exo;res1 (ohane no.' 0).''...1, '. rn~) (pxoirpc;.) rohnnp nn \ 68""1-c?!'L/I MECHANICAL ~t"t" r....11R.G..E. furnace/burner to BTU's Floor furnace and vent Recessed wa 11 Sn~rp hp~tpr ~nrl vpnt Appliance vent c;.poaratp Stationary evap. cooler Vent fan wi th c;.inole duct Vent system apart from I heatino or A.C. Mechanical exhaust hood rind rllJrt Wood stove/heater ISSUANCf nF PFRlIIT 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 rw OCCUPAr~CY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Buil~er'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 compliance with ORS 7~1.055 will be used on this project. SIGNATURE FOP. OFFICE USE DilLY Sq. Ftg. tiain x ValuE' Sq, Ftg, Access x Value Sq, Ftg, Other~A?::>"~(,x . Value /<':"~.~ , /2-3 '5'] TOTAL VALUATION 7( (7'2 a (I -crl syste. ms Development A/ "" - D vl- '" all Charqe (1.5~) , /Y,H- '. IIAI'lE(please print) Zone c.~ Fire Zone Flood Plain Type/Canst, ~:-/.k' Bedrooms Units Occy Load Occy Group 11-2 I Stories BUILDING PERHIT Charges and Surcharges ~ Plan Ck, ___./j~_<2f:_...illIBlda c'"' Plan Ck, ,/ D .53 30%JBlda ____~::~E_ Fence /./3 ____~__:::-:..~_Sidew~lk /./"3 (f) ComnlI nd Ppr FpF> Res Per Fee ':;r PLUI~BING PERMIT Charges and.......- r;; I Surcha rges I ELECTRICAL PERI\l1; Charges and '1 Surcharges \ MECHANICAL PERMIT I Charges and Surcharges i A/C Paving I Curb Cut I De:lno DATE I ITota, I I TOTAL Comb. Permit I /&;;5.:2 '7 .--1 - .. . '. .c 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 II U3 43 2, example- Lot 1, Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources _ 1. examele- heat/e1'ectrical ceilinq/or forced air Qas 2. exa~le- waterheater/electr;cal/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. 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 TEM4 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 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 and date Whenever possible, the initial application will b~ 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 Permit Cl erk ~ ->- PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: , Additional Project Information: " '.' PLANS REVIEWED BY: . name ~3~ 7L~?-t=T" signatur -:-0 da te '9-::? r B'S