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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 - - ~ i=--- 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