The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 1986-5-14 ~I IrISPECTION LWE 726-376g . . - CITY UF SPRINGflElO' COMBINATION APPLICATIDN/PERMIT I EUERGY SOURCES: Sr",...e-r (M"$e"",,: Heat l~ater Heater Ranqe .~(lSj INFORllATION LINe 726-3753 Sq. Ftg. I"ain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Denx. Change/Use Other- - ~ i I~ 0\ ~ \\J & Job Address 5'5(1 M a/II legal Description C. /1'1 ..( 517,,' ",,?'.. e I '" 7- z!> i.lorrJ. .srlt SI',."" +Phone .J'c,j,,, Fr'f 7;z.tf,-36S4- Construction lender ValUE of Work: ~ -,,00. Owner Address BuildinQ Permit Info: Describe Work(i~e.. Build Single Familv Residence With Attached Garaael E /?t!r.,'1 Cc"se,.v",/',nr t::leclr;cn/ /11 "'ISH "l"~ Address U<SlGN TEAI~ (name) Phone (address) (lies. no.) (exoires) (ohane no. I Primary Structural Electrical ~ Me E 11"/A~<"I'S /~dI~ ""I;'w /(Ivl'''' 'O"III~ <;;",-f 325; E~o".,. "12- 3-'fZ _ 7Z.ID .7 Mechanical CONTRACTORS (name) ( address ) (lies. no.) (pl(n~' (nnnnp nn l_ General Plumbino Electrical L K'.8 ,.,pI/Adl?1 I~ - D Wl".;f ~ "<;-tue1- I',y.,.""f/el/ IftZ 747~;;~'1e , ) '-techa"; ca 1 PlUllB I NG ELECTRICAL MECHANI CAl rlO. . OfF r"1J.IlliL JlO......I. IReSidence of SQ. FT. I New circu!ts alts. or extenSlons ISERVICES I ITempOrary Construction IChange in existing rps- j rlynrp Imultifamily, comm. or Tnrlu...td;tl >cLJJ:l:!AB.IiE fin >>> r"~ Each single fixture furnace/burner to BTU's Relocated building (new fix. additional) Floor furnace and vent S.F. Residence (1 bath' I Duplex (1 bath) IAdditional bath Iwater service I Sewer 1 Storm Sewer I I I I I I Recessed wall ~~ace heatpr ~nrl vpnt :.~L ~ I each TOTAL CHARGES TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali1 until the label has been signed by an EJectrical Supervisor and returned to the Building Division I I I ISSUANCf nF PFRltlT I TOTAL CHARGES App 1 i ance vent ~poarat.p Stationary evap. cooler Vent fan with 5inole duct 1 Vent system apart heatino or A.C. I'Mechanical exhaust hnnd and dUl"'t I ~lood stove/heater I I 1 from 10f ICDffi1,/IND. FEEDERS IInstall/alter/relocate I rli...trih fpprlpr... 10f Z IR~.d..t"~ /-l{..h I 1 amps.1 amps. I I I 1 I 1 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 oerformed 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 no OCCUPAI~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 ons 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 b~ used on this project. IlAf.lE(please print) SIGrl^TURE FO~ OFFICE USE miL Y So. Ftg. riain Sq. Ftg. Access Sq. Ftg. Other DATE Zone Fire Zone Flood Plain Tvpe/Const. Bedrooms Stories Units Occy Load Occy Group x x Value Value Value x TDT^l VALUATIOII BUILDING PERmT Charges and Surcharges Plan Ck, Comm/Ind 65%/Rldo P~r Fpp ------------""P"ian Ck.Res 30t/Bldo Per Fee Fence Systems Development Charoe tl.5~) , PlUIlBING PERMIT Charges~ and Surcharges OURIO I I I hota' I I TOTAL Comb. Permi t ELECTRICAL PERr~1T Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges )Ji> P"'t!. ------------ .Sldewalk I A/C Paving 1 Curb Cut I N~ F4!e. . . r COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. legal Oescription I. example- Tax lot 100. lane County Map Reference '11 U3 43 2. example- Lot I. Block 3. 2nd Addition to Spr,ngtield Estates .C. Name. etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ceilinqlor forced air Qas 2. examoJe- waterheater/electrlcal/or SOlar E. Square footage or valuation. etc. ------ I, example- 1250 sq. foot house. SOO sq, foot garage Z. example- if new project, check new.- if addition. cneck add, etc. F. Building pennit information: ". 1. example - construct single family house with an attached garage Z. examole - 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. 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 8. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbrevidted 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. 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 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 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 signature date ,.