HomeMy WebLinkAboutPermit Fence 1989-11-13
Owner Ftc:h..trc:. I~ 0>01 I. no'
Address 311.2 u\(~J~.!:rtrit? l Phone
S/J~ / q--,r-!-77
v rJ.JL' '.
. CITY Uf SPRINGflE~D . INfDRlIATlON LlOt
COMBINATION APPLICATION/PERMIT ' 726-3753
ENERGY SOURCES, Sq, Ftg, Hal n
Heat ~q, Ftg, Access,
Nater Heater Sq, Ftg, Other
--1~ Add Alter Pep,
Range 0"ence_Demo_Change/Use
Valu, ~hWor.t1"V\, ,00 _Other
'7tJ:7-J.?>11 ,'Jf UJ
Builoino Permit Info, Descr be Work(i,e,. Build Single
Familv nesidence With Att,~,h~d G~raoe\
'j
] INSPECTION ~INE
726-3769
Job Address 31M Indu..:)-/-R..;AL-
Legal Dmrlption II {);( .5 f) 3 4-
{}<jt'oo
-
-
~
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Address
DESIGN TEAl1
{name}
Phone
(address\
I
~,1~J~
Caxniresl
(ohone no.
Construction l;nder
Primary
Structural
Electrical
Mechanical
CONTRACTORS (namel
General ~on ~Cl' [1"
Plumbino
(address'
PO fJ()~ .10, ~'HL
(li~<;.. nos'
4-11 (,,(,
(excires)
}!)'/3 '/80
(D~QnP no.\
I cf(" . '? :3;L <f-
Electrical
~1echani ca 1
PLUIIBIrIG
ELECTRICAL
MECHANICAL
SQ, FT.
eee ~.r.e No
eee
r"6JUiE.
ND, FFe 'rHARr,F NO
Each single fixture
Residence of
furnace/burner to
BTU's
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(J bathl
Duplex (1 bath) each
Additional bath
SERVICES
Recessed wall
SD~C~ hp~tpr ~nrl vpnt
Storm Sewer
Of
amps.
Appliance vent
s_~D~r~te
Stationary evap.
cooler
Vent fan with
sinC'le duct
Vent system apart from
heatinq or A.C.
Mechanical exhaust
hnnrl and duct
1
Sewer
Temporary Construction
Change in existing
rp.s i d{!.ncp
multifamily, COnIn. or
Industrial
~Iater servi ce
COfIII./1 ND, FEEDERS
Install/alter/relocate
distrib. feeders
Wood stove/heater
Of
amps.
TOTAL CHARGES
WHERE STATE L'W REQUIRES
shall not be vali1 until the
I SSUANCE OF PERllIT
TOTAL CHARGES I TOTAL CHARGES
that tile Electrical work be done by an,'Electrical Contractor, the electrical portion of this
label has been signed by an Electrical Supervisor and returned to the Building Division
pemit
I HAVE CAREFUllY EXM1INED the completed aprlication for permit. and do hereby certify that all information hereon is true 1
and correct. and 1 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 IlO OCCUPAUCY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s
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 701.055 will be used on this project.
IWIE(please print) K'" ...... 1'7 /tI flrJ/2./2 0
Zone Type/Canst. Units
Fire Zone Bedrooms Occy load
Flood Plain Stories Occy Group
SIr,rIATURE ~
Far. orFICE USE OiIL Y
Sq, Ftg, f1ain
Sq. FtlJ. Access
Sq, Ftg, Other
,~4~
.
DATE/le-I.J ~tf'J
x
Value
Value".'
Value
x
x
TOTAL VA~UATlOtl
BUILDING PERIIIT
Charges an~
Surcharges
Plan Ck, Comm/Ind
65X/Alda Per Fee
------------'"""PTan Ck. R'es
30X/BldQ Per Fee
Fence
.Systems Development
Charoe (1. 5~ ' ' '.,
.;'
PLUIIBING PERMIT
Charges and
Surcharges
f5,D6
ELECTRICAL PERIHT
Charges and
Surcharges
DlJlI10
'Sidewalk
AIC Paving
Tota' Comb, Permit
MECHANICAL PERMIT
Charges and
Surcharges
Curb Cut
TOTAL 5, {)O
5,00
.
.
.
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I. Applicant to furnish~
A, Job Address
B. Legal Oescription
1. example. Tax Lot 100, lane County Map Reference
11 oj 43
2, example- Lot I, Block 3, 2nd Addition to
Springfield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources "
J. . examele- heat/electrical ceilinQ/.or forced air qas
2. example- waterheater/electrical/or solar
E. Squar.e footage or valuation, etc.
I, example- 1250 sq, foot house, 500 sq, foot garage
2. 'lexample- if new project, checknew - if addition,
. cneck add. etc.
F, Building pennit information:
1. examele - construct single family house with an
attached garage
2. exam~le - 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. 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, 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
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, ---
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
signa ture.
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.
;i\
\'/
~
~16ry
\
V, FOR OFFICE USE ONLY
Permit Clerk
~
.
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
I'
PLANS REVIEWED BY:
name
signature
date