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HomeMy WebLinkAboutPermit Fence 1979-10-8 I INSPECTION LINE 726-3769 . CITY UF SPRI NGF I ELD .. COMBINATION APPLICATION/PERMIT EilERGY SOURCES: Heat Hater Heater Range '.Valu, of Work: T',C\bl:>.~ Bul1riina Permit Info: Familv Residence With INFORlIATiOH LINt 726-3753 Sq. Ftg. 1.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. . ~Fence_Oemo_Change/Use _Other I ~ ,fP I Job Address ("fn"-l G-vu.V\Ht_i'lo..Lt... Legal Description ~ \~LOQJ\ ,- Owner 10M ~ Lc>o........o.. S~e.\<r'\cH:."'- Address Cl,.n V'i\f'... a....s. ~,c:.'c 721,~h<l!""2 q Descr.be Work(i,e., Build Single Attached Garaae) Construction Lender . ""'0"'- ~ , 1=~Y\c.r.. G,' n....ou.V\ri ~ Ie .3' 0...'-'0 \A ~d. \,.,. ""'" +- Address DE~jGN TEAH (!lame I ~,,\~ Phone t address 1 .....: .flies.no.) (exoires) (ohane no.) Primary Structural Electrical Mechanical CONTRACTORS (name I (addrpc;s) nie's. no.) (PXr:li rpsl (ohonp no Genera 1 s~\c Plumbina Electrical . . ~ . ~lechanical PLUt.1S I NG . ELECTRICAL 'rl" . MECHANICAL NO. FFF rHARr,F Nn Each single fixture Residence of SQ. FT. furnace/burner to STU's IRelocated building (new fix. additional) S.F. Residence (] bath) Duplex (1 bath) each IAdditional bath Iwater" service I Sewer .1 Storm Sewer I I I I New circuits alts. or extensions Floor furnace and vent SERVICES I I I Recessed wall ~~~rp hp~t~r ~"rl wpnt I l I I I I 10f COMM./IND. FEEDERS Install/alter/relocate rl;~trih fpArlpr~ amps. Appliance vent ~~oa ra t~ Stationary evap. c:ooler Vent fan with' !;.inalE~ duct Vent system apart from heatina or A.C. I Mechanical exhaust hand ~nd dud. Temporary Construction IChange in existirg rp') i dYJlre Imultifamily, camm. or , Induc;trial Wood stove/heater Of amps. .,. TOTAL CHARGES WHERE STATE LAW REQUIRES shall not be vali~ until the I I I TOTAL CHARGES that the Electrical work be done by an label has been signed by an. Electrical ISSUANCF OF PFRillT TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division 'I I HAVE CAREFULLY EXAMINED the completed application for ~ermit. 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 Sari n9f; e 1 d and the Laws of the S ta te of Oregon pe rta i n i n9 to the work descri bed here in, and tha t rm OCCUPAHCY wil 1 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 cornoliance with ORS 701.055 will be used on this project. Zone Fire Zone Flood PhTn Tvoe/Cons t. Bedrooms Stories "''''l.' ,,,.\-\"''''" '_~SIr,1IATUr-- ~ ~ .....Q\.V ~'O..... FOr. OFFICE USE O"LY So. Ftg. 11aln Sq. Ftg. Access Sq. Ftg. Other ., rW.IE(please print) Tn Ll LA OATE lo":'R- 7q Units Occy Load Occy Group x Value" Value Value x x TOTAL VALUATION BUILDING PERfllT Charges anC: Surcharges ~ ~ -::::-) . Plan Ck. conmlIndl ~~0~__-____ 65%/Bldo Psr Fpe . Plan Ck. Res . - ------------, :;:"',"tJ IIO~) .Sidewal k ------------ I A/C Pavi ng Curb Cut Systems Development Cha roe {l. 5~) PLUI~SING PERMIT Charges and Surcharges ~ _ .J..- . .':.fJt;-;:'.;- . .~--' . - . ELECTRICAL PERI~IT Cha rges and Surcharges MECHANrCAL PERMIT Charges and Surcharges : .Cot ....;... . .:....... .r Total Comb. Permit '..:. .. ...,:....:::, '~.- --.......'Wl;.._,-"._.--.'"",., -.. . ,.. : , . I,OT"L . .'. . ...,... . . . \\).(5:) , I " . ,,~.~ . COMBINATION APPLICATION/PERMIT (CAP) I. Appl icant to furnish A. Job Address .-' .:.B. Legal Oescription 1. example- Tax Lot 100, Lane County Map Reference 17 03 4J 2. examole- Lot 1. Block 3, 2nd Addition to. Sprlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ce;l;nq/or forced air Qas 2. examole- waterneater/electr1caJ!or solar E. Square footage or valuation, etc. - 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check-nfw - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. examJDle - remodel existing garage into family room 3. examole - 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 ANO 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 DI'IISION 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 USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: '. I PERMIT VALIDATION . . . :ITY OF SPRINGFIELD City Hall Springfield. Oregan Department of Public Works OFFICIAL RECEIPT ,. No. B 517t. ., ~K'-t-J. PJ 19 'lC\ I From \("')('(\ ~'(\ l;) \ I\t\('I ress \C)\()U ~~0_~tO ".~ ived For: ~tr~ ..:fJu.6\1-5 I(),CO aunt Received \,( ) 00 l't~ ,.-. Ml\fL> ~H~~r;o SIGNATURt!: l .....lTO...'u.....u~~ ....'..'....5 . ..1.10....... 0" .7.01 ..."., "- . ~..o ~ 0 _ _ _ .0 _. .. _ 0 ~ _ . . .._ . _ . Pennit Cl erk ".,,~ I Pennit applicant exempt from registration with the Builder's Board because: Additional Project Infonnation: PLANS REVIEWED BY: .. name ---'signature -...... 'date' ". .J