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HomeMy WebLinkAboutPermit Building 1980-09-12ECTION LII.IE 37 69 CTTY OF SPRINGFIETD- COMBI NATION APPL ICATION/PERMIT 726-37 Structura I E'l ectr i ca l I'lechanical Genera I PI cal 'tc Job Address liater Heater Ranqe EIIERGY SOURCES Hea t 3z l-egal Description 102' 0wn Yalue of l.lorkfr or< Sq. Ftg. Access.-- Sq. Fto. 0ther__ l{eur Add Al ter P.eo. -FeiEl Demo chanqeTuse Other - Ftq. I'la Addres s PhoneS Buileinq Pernrit Info: Describe llork(' Farni 1y Res idence l,li th Attached Garaqe A e., Build Single Construction Lender -{\l na p , Addre s s Phone I QC E oaJ t ,\) DES i GN TEAI{name (address lics. no.exDI res (phone no. Primary n CHARGF NO FFF l.HARGF Each single fixture furnace/burner to BTU' s Rel ocated bui I dinq (new fix. additional ) New circuits alts or extensions S . F. P.es i dence(l bath)SERVI CES I Floor furnace and vent Recessed wal I Soace heat-er and vFnt Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra te [,later service ge in existing dence C han res i Stationary evao, coo l er Sewer multifamily, I ndus tri a I comrn. or Vent fan with sinole duct Storm Sewer 0f Vent systern apart from heatino or A.C. cor.lr.,r. / rND. FEEDERS Mechanical exhaust hood and duct- I n sta I I /a I ter/ rel ocate di stri b. feeders l'Jood stove/heater .amp s.0f ]SSUANCF OF PFRtlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES l,lHERE STATE LAI'I REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitshal'l not be valil until the label has been signed by an Electrical Supervisor and returned to the Building Divisio4 on oertaining to the work described herein, and that NC 0CCUPANCY will be maDivision. I further certify that my registration urith the Builder's llAl'lE(please pri S I GIJA Dermi t rfo rmed 0reo the B ty de g 0 ect I HAVE CAREFULLY EXAHINED the completed application for , and do hereb.y certify that all information hereon is trueand correct, and I further certify that any and all work pe shall be done in accordance with the Ordinances of the Ciof Springfield and the Laws of the State ofof any structure without the permission of uildin Board is in full force and effect as required by ORS 7 1.055, that if exempt the basis for exemption is noted thatonly subcontractors and employees who are .in comcliance with 0l?S 701.055 vrill be used on this Val ue TOTAL VALUATIO x(n Ftq. l'lain Group Sq . Ftg. 0ther Acces sFtg I ue-Fire Zone Bedrooms 0ccy Load x Val ue Cons t Uni ts Flood Plain Stories. Zone Tyoe/ Plan Ck. Conrn/Ind 55%/81do Per Fee 1e VE 5q" opmentternsBUILDING PERNIT Charges and Surcharges Fe e Plan Ck. Res 30%/BI dq Per FencePLUI4BING PERMIT Charges and Su rcha rges Dgmo I SidewalkELECTRICAL PERI1IT Charges and Surcharges A/C Pavi ng Tota'l Comb. lermi t Curb CutI,IECHANICAL PERMIT Charges and Su rc ha rge s toDTOTAL PLUI1B I NG ELECTR I CAL MECHAN I CAL 1 anF Residence of sQ. FT. I COMBINATION APPLICATiON/PERMIT (CAP) Applicant to furnishA. Job AddressB. Legal Description I. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition to Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources r forced air gas sol ar PERMIT VALIDATION I 1. example- heat/electrical ceiling/o2. example- waterheater/electrical/orE. Square footage or valuation, etc. example- 1250 sq. foot house, 500 sq. foot g example- if new project, check new - if addi check add, etc.F. 'Building permit information: l). _etrggpl,-e_ - construct singie, fami ty hoLrse wi attached garage i?. _example --remocle t existing. qarage into faih," . exJmplE -'convert single lami iy residencei restauiant (change of use) .i; Ita'l rre o-i r^rork as def i ned i n Sect ion 303 (;r ) of 2 ara9e ti on, th an ily room i n i:,.1 the J t 1 II I '., ! l{ iit I i '''1 Ii i I t { i I i , iI : ; li : I i : ii ; iitruc.lura I r)t-sIGN 1'El\i'I r o at,o id des Di r.r'is ion Sta Specia l ty Code AND CONTRAC IORS j ignff or construction deIays, Bui'iciing must be able to con'tact appro P3"i a te si Le rI IlI persons.iegarding design informatlo;: or job correr-tions _ ctc. Al-rhrevial:rri' Plumbing, Mechan'ical, & Electrical SchedulesA. Except vrhere blank spaces occur in the descriptiorr- 'pbri:ion oi'ttre l,iechanical a;id Electrical Schedules, the applicant need i=iIl..in only the I'lo. Boxesiadjar:eiii , to the appropriate 'item(s) to be inslalleii iiB. Ful.l .P'l'umbing., Mechanical., aird Electrical SchedLrles are avai-lable at the Building Division t'1. To conserve space on the permit. form the schedu'lcs- havc been abbreviated- 2" If ttre item(.s) to be installed are not covered orr the abbreviated schedules you shou)d consiilt theful l schedulesC, BUILDING DTVISION STAFF WILL FI[.L OUT ALt. FEES AND CHARGES ON THE SCHEDULES iD. As noted on the CAP, the I abei must be'de'l 'ivererl to the'elecErical contractor for signature by his el'bctr.icalsupervisor. The gener'al contractor is not authorized 1:o sign the electrical label Applicant to sign and date Whenever possibie, the initial applicat'ion will be used as a worksheet only. Where possible, Buiiding Division Stai'fwill prepare a type r^rritten copy and return it to theapplicant at the time the actlral permit is issued for his s i gna ture.IV. Fees and Charges. Plan check fees are due and payable at the time <l.t theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due and.. payable'when the permit is issued. V. FOR 0FFICE USE 0NLY E:".' v-6Et ll PRO.]ECT C()NDITIONS TO BE SATISFIED BEFORE OCCUPAI'ICY: I rrni t Cl ci'k I Fermit.appl icanrl exempt from registratjon with the. Bu'ilder" s .Board because: PLANS REVIEWED BY: da tenamesigna tu re Add'itional Project Information : { I SP ECT I 6-37 69 IILL - C{]IIBl i]ATION APPL ICATION/PERMII N RIlATI ON 726-37 Job Address l-egal Description EIIERGY SOURCES Hea l.later Heater Ranqe a uE of l.lork Sq. Ftg. Access.---_- Sq. Fto. 0ther--_ l,ler"r Add Al ter P.ep. -reiEl oeilo Chanqe/Use 0ther - Ftq. l.la n_ Address PhoneS Builc.inq Pernrit Info: Describe l,lork(Family llesidence l{ith Attached Garaqe .e., Bui1d Single A Constructi on Lender -{11 n),a , Addre s s Phone :*t t=CialtJce -Ju DESIGN TEAH name addres s I ics. no exo i res ohone no. Primary JStructura I El ectri cal l4echanical CONTRACTORS n ame address )lics. .no. ) (expires Genera 1 Pl umbi CI.,1ARG F NO FFF anic PLUI1B I NG ELECTRICAI MECHAN I CAL c CHAAGF i Each single fixture Residence of SQ. FT furnace/burner to BTU' S Relocated building (new fix. additional ) New ci rcui ts al ts or extensions I Floor furnace and vent S. F. Residence(l bath)SERV i CES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Construction Apol'iance vent seoarate [,later service ge in existino dence Chan res i Stationary evap. cool er Sewe r Tndrrstrial multifamily, comrn. or Vent fan with sino l e duct Storm Sevrer 0f s Vent systern apart from heatinq or A.C. COI4H./IND. FEEDERS Mechanical exhaust hood and duct Instal l /a1 ter/re1 ocatedistrih- fpeders lJood stove/heater 0f s. ISSUANCF OF PFRI1IT TOTAL CHARGIS TOTAL CHARGES TOTAL CHARGES I,lAi.1E(please pri IGiIATU DA by an Electrical Contractor, the electrical portionrical Supervisor and returned to the Building Divis ton I,JH ERE STATE LAl,l REQUIRES that the Electrical r{ork be done EX At,1 I DNE the e tedI a II ac t rfocomp I t an d hedo rtce I hat at I1 Ipl-)n-Derm reb.y rma t0 on.I h Ireo n Ls rUfy e a Ind fu rt rc0trrecndahe cer It t Lha a nda Ia \{oI krfyny rfo rmed ha5 lI ncco rda wlacn,]edonbeDE e t thh 0rde na1 esnc theof Ll tyf1itIeadndoSprngtheofLa vrs het taS ofte 0re n'Ioe rta I n thto deswork crl n!on g bed he 'I nda ath ilct CCUPA0 t,lL ,l 1Ire madebefosructturet houwi thL 1ss n of ianypermitheBu dI I D I 'Is no furt r 'Iinghecert t tha re I tras 'It no thv|t het 1 'Ifyn.y g de su'I fun Is'IrdBoa I afo rce efnd ctfe sd u I h tat ,l fredORS0170s5 the ba 'Is fors .l 1on nos tedreqbyexemptexempt tLhaIonsuontbctorsracdanIesawhovernpIren'II cean th 70l?s 0oyec0mD 1 05 5 t{1 I I be US ed on t Ih s ect shali not be vali:l until the label has been signed by an Elect D r v Ftg Ftg Ftg Zone Uni ts Value ToTAL VALUATI0N.-------------.-.- '- X S q y Load Cons t Stori es c.y Group l''la i n Val ue Val ue FIood Plain Access 0t her Fire Zone Bedrooms Occ Plan Ck. Comm/ind 65%/Bldq Per Fee Svstens Deve charqe ( 1.52 opmentBUILDING PERI'IiT Charges and Su rcha rges Plan Ck. Res 301t"/B1dq Per Fee FencePLUI'4BING PERMIT Charges and Su rcha rges Dgmo I SidewalkELECTRICA.L PERIlIT Charges and Surcha rges A/C Paving Total Cornb. l'ermi t Curb CutI,IECHAIIICAL PERMIT Charges and Surc ha rges TOTAL '-1( ( nhonp no of this permit tcD Add'itional Project Informat.ion : PLANS REVIEWED BY: datenameSIgna tu re COMBI NATI ON APPL I CATI ON/PERMIT i. Applicant to furnish A. Job Address B. Legal Description (CAP) l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpfiiqfield Estates Name, etc. of owner and construction lender Energy Sources 1. examol e- hea?. ffi wat SquaiE-Tootage o t,/electrical ceilin or r valuation, e PERMIT VALIDATION CITY OF SPRINGFIELD Ciry Holl Springfield, Oregon Deporlmenl of Public Works OFFICIAT RECEIPT wl tn - 12^E r,1 i,.rFr+lr--\{L/+\rLJJ e ec forced a' olar D (, ( { f'' (, (ors E F 1. examole- 1250 sq. foot house, 500 sq. foot gt 2, example- if new project, check new - if addil check add, etc.B Buitding permit information :1.. example- - construct single, family house. attached garage2, exarnole - remocie'l existing, garage into fafii11 3, . exaffilE -,convert single iamil.v-resicience;ini iestauiant (change of-use) iG. Vcrlue o-i r,rork as defined in Section 303 (a) of tl Struc[uia] Specjal'ty Code iH. DtSIGi\i TtAi.r ANo corllnRcrons i't'o a'.,oid ciesign or construction delays, Bui'l ding Dirrision Staff must be able to contact approp4ia'''persons .r egarding design .information or job s.ite. corrections. ctc. Abbreviat.ed Plumbing, l'lechanical, & Electrical SclredrA. Except vrhere blank spaces occur in the descriptir- 'pbrtiorr r.r'i" the I'iechanical and Electrical Schedulr the a:pplicanl need Fill..in only the No. Boxesiad.' to the appropriate itenr(s) to be inslal leci i;B. Ful.l .Plumbing., Mechanical., and Electrical Schadu are avai-lable at the BLrilding Division :. 1. To conserve space on the permit: form tlre schr- 'have been abbreviated' ?. If the item(s) to be installed are noL cover(' the abbreviated schedules you should consiiltful l scheduiesC, BUILDIiIG DIVISION STAFF I,IILL FII.L OUT ALL FEES AI CHARGES OI'I THE SCHEDULES ..; D. As noted on the CAP, the label must be'deliverecl'elecLrical contractor fo-. s-ignature by his electr supervisor. The general contractor is not authoto sign the electrical label. Applicant to sign and date l,,lhenever possible, the initial application will be u: a worksheet oniy. l^lhere possible, Bui)ding Divisionwill prepare a type !^/ritten copy and return it to th, app)icant at the time the actr.tal permit is issued fo' s i gna ture. Fees atrd Charges. Plan check fees ane due and payab'le at the time o't t, application, and no plans will be processed until th, fees are paid. Ail other fees and charges are due ar payable-when the permit is issued. +_ P.e:r'mi t Cl tii-k I .t ole Rec'd Add Received For t9 ( t't' I r ( ( ( ( ( ( ( iI. III. IV. OO (,t {"t (i ( Amounl Received BY AUTHORIZED SIGNATURE RN6ULL PFINTERS EUCENE OR g7'OI { V. FOR CFFICE USE ONLY PRO"IECT CONDITIONS TO BE SATiSF IED BEI'ORE OCCUPAI'ICY : " :'- '-H H-::5=Er::::a5eE- Fermit.applicant exempt from registrat'ion with thc Buildev''s.Board because: 7,.OO ('E-.