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HomeMy WebLinkAboutPermit Mechanical 1982-6-8 . I INSPECTION LINE, 726-3769 CITY Uf SPRINGFIELD COMBIIIATlON APPLICATION/PERMIT . I NFORlIATI ON liNt 726-3753 Sq, Ftg, I"ain ~'1. Ftg. Access. Sq, Ftg, Other I~ew Add A Iter P.ep, -Fence Demo Change/Use Other- - ~ J 3 Job Address 3825 International Court EIIERGY SO~Rfeh Heat !-later Heater Range Valu' of Hork: Legal Description Lots 5 & 6, Commer.cial Park Subdivision Nils Holt 401 East 10th Phone Builriino Permit Info: Deser,be Work(i~e.. Build Single Familv nesidence With Attached Garaae' Owner Address Euqene. Oreqon Construction Lender 97401 686-8282 Revised mechanical plans bv Harvev & PriG' ComOllnl/ " r"r:,,; w.d .1ulle...l.. 1 qR? Address DE,lliN TEAll (name) Phone (address) flies. no.) (exoiresl (ohane no.) Primary Structura 1 Electrical Mechanical CONTRACTORS (name) (address) (lic;s. no.) (expires) (phone no. ) Genera 1 Plumbino Electrical flechanical Larry L. Grimes. Harvev & Price. 2015 Nuqqet Wav. Euqene. OR 746-1621 PLUIIBING ELECTRICAL MECHANICAL NO, FEE CHARGE Nn ~~~ r~~ NO ~~L ..tllARG[ SQ, FT, furnace/burner to BTU's Each single fixture Residence of Relocated building (new fix, additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (] bath! Duplex (1 bath) each Additional bath SERVICES Recessed wall ~o~rp hp~tpr ~nrl vpnt Sewer Temporary Construction Change in existing res. i de.nee multifamily, COI\1T1. or lnrluc;triiil 6 App 1 i ance vent c;eoariite Stationary evap. cooler Vent fan with s.inole duct Vent system apart from heatinq or A.C. Mechanical exhaust hood find due t 3.00 18.0C! ~Iater service Storm Sewer I I _I 1 I I ISSUANCF OF PFRI1lT 10.0(; TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES 88. OC: WHERE STATE LW REQUI RES tha t the E1 ectri ca 1 work be done by an.'El eetri ea 1 Contractor. the e 1 ectri ca 1 port i on of thi s permi t shall not be valij until the label has been signed by an Electrical Supervisor and returned to the Building Division Of amps. CDMI,\. IIND. FEEDERS I Install/alter/relocate. n;c;;tr;n. fppdprc; 10f -I 1 I Wood stove/heater amps. .....5.... HVAC Uni t< '..JlO.. .1O..Jl.[; <; !-IPt:l t Pllmnc: , nn in nn 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 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 fm OCCUPAllCY 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 compliance with OP.S 7D1.055 will be used on this project. <IJ G.;>(p erkAs. (0 ; bj (/ X'"" /' / IlAI-lE(please print) <.:3>~ <:;'Y\A.A rf 1~ SIGIIATURE ~c;/ff' FQP. OFFJGF USE miL Y Sq, Ftg, 11ain REVISED MEC~ANICAL ~~fWS ONLY Sq. Ft~. Access Sq, Ft9, Other DATE ~M2.- Zone (;-4 Fire Zone NA Type/Canst. ~-lhour Bedrooms NA Stories 1 Units Occy Load Occy Group 94 B-2 x Value Value Flood Plain x TOTAL VALUATION BUILDING PERfl1T Plan Ck, Comm/lnd Shstems Development Charges and ------------ 65t/Blrln Ppr ~p~ C aroe (1. 5~) Surcharges Plan Ck, Res 11ECHANICAL PER. 91.52 30%/Bldo Per Fee PLU'1BING PERMIT Fence :REDIT FOR PRIOR 56.50 Charges and ------------ Surcharges D~mo 'ER. FEE OWED 33.75 ELECTRICAL PERI~IT I'Sidewalk .(% State S.C, 1.27 Charges and ------------ I A/e Paving Surcharges Total Comb. rermit 11ECHANICAL PERMIT 88.00 1 Curb Cut 135.02 Charges and Surcharges n---1':'92---- I TOTAL , . COMBINATION APPLICATION/PERMIT (CAP) I, Applicant to furnish A, Job Address B, Legal Description 1. example- Tax lot 100, lane County Map Reference '17 03 43 2, example- Lot I, Block 3, 2nd Addition to spnngtield Estates' C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air Qas 2. 'eX31r!P1e- waterheater/electncalior ~ E. Square footage or valuation, etc. 1, examole- 1250 sq, foot house, 500 sq, foot garage 2. examole- if new project. check:new - if addition, check add, etc, F. Building permit information: 1. exam~le - construct single family house with an a ttached garage 2. example - remodel existing garage into family room 3. exam~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, 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, Mechahical, 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 0, 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, --- Ill, 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 DCCUPANCY: . PERMIT VALIDATION (2J..G +1-5~ l~/ '--'YN-ck ' 410 3~,l5 ),d1 Permit Cl erk CUIoLcL Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: . nanQDW_Cf/j P~J ^ , ----..- - -~..,.-.....; . '-' " - :~::~~:,l;km~~~:i\l'~" ~~~~,