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HomeMy WebLinkAboutPermit Fence 1988-05-18I 7 em COMBINATION APPLICATION/PERMIT 726-375 Job Address 3 tO V"r r'\\I{EIIERGY SOURCES Hea t llater Heater Ran n Sq. Ftg. Access._ Sq. Ftg. other_ _l,lew_Ad d_A1 te r_Pe p . _Fence_Demo Change/Use 0ther s CO D + &)p l-egal Description (, tr*-kt .t i,V s I oo Owner o Value of tlork: Soo'' -v'|, n_-rAddressl3ts s A-nnon{J}-(,7}f-Bui Fanr n n scr Ga ra re., Build Sinqle Fo- t.e- - gu c-lonq Construction Lender So-o* s Address I 0 +\ + ULo -lq-{r,r. 6j.r--70 ri )- Phone DESIGN TEAI.I name address s n exD t res ohone no. Pnimary Structura l El ectri cal Mechan i ca I CONTRACTO RS name a ddrps s lics. no.exDt res (ohone no^ ) Genera I Pl umbi nq El ectrical l'lechan i ca I PLUTIBI NG ELECTR I CAL MECHAN I CAL NO FEE CHARGE NO FFF CHA RGF NO FFF .HAAGF Each single fixture furnace/burner to BTU' s Relocated building (new fix. additional) New ci rcui ts al ts or extensi ons Floor furnace and vent S. F. P,es i dence(l hath)SERV I C ES Recessed wal I SDace heater and vent Duplex (| bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra t-e [,later servi ce Change res i de in existing naF Stationary evap coo l er Sewer multifamily, conn. or Tndrrctrial Vent fan with sinole duct Storm Sewer 0f Vent systern apart from heatino or A.C. c0Mr'1./rND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate distrib. feeders llood stove/heater 0f amp s. rE}J CE 5e ISSUANCF OF PFRIIIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES 65- ee WHERE STATE L{li REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Div'ision i HAVE CAREFULLY EXAI1INED the completed application for oermit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that NC OCCUPANCY will be madeof any structure without the perm'ission of the Buiiding Division. I further certify that m.y registration urith 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 ernployees who are in compliance with 0l1S 701.055 will be used on this nroject. l,,lAt'lE ( pl ease pri nt )'("I-IGNA C DATE Zone Cons t.Uni ts Sq. Ftg. l4ai al Fire Zone Bedrooms Flood Plain Stories Load Ftg Access x Val ue 0cc.y Group Sq. Ftg. 0ther Val TOTAL VALUATION BUILDING PERNIT Charges and Surcharges Plan Ck. Comm/Ind 65%/81tio Per Fce Svs Cha terns Derqe tl.VC 57 opment Plan Ck. Res 30%/Bldq Per Fee PLUI4BING PERMIT Charges and Su rc ha rges Fence I 5,oo D6mo ELECTRICAL PERIlIT Charges and Surcha rges Sl dewa l k A/C Paving Curb Cut Tota'l Comb. Permit I4ECHANICAL PERHIT Charges and Surc harges TOTAL 6se Residence of SQ. FT. COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County l 17 03 432. example- Lot 1. Block 3, 2nd Addit Springfield EstatesC. Name, etc. of owner and construction l,D. Energy Sources l. example- heat/electrical ceiling/o?. example- waterheater/elbttilcalTorE. Square footage or valuationl-eTtl- PERMIT VALIDATION Map Reference ion to ender r forced air gas sol ar F l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add, etc. Building permit information :1. exampie - construct single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use) Value of work as defined in Section 303 (a) of the Structura'l Specialty Code DESIGN TEAII AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, &A. Except where blank spaces occurportion of the Mechanical and E the applicant need fill-in only Electrical Schedulesin the description 'I ectrical Schedules, the No. Boxes adjacent B. to the appropriate item(s)Full Plumbing, Mechanical, to be installed and Electrical Schedules III are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. If the 'item(s) to be installed are not covered on the abbreviated schedules you should consult theful l schedulesC. BUILDING DIVISION STAFF HILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor .is not authorizedto sign the electrical label Appiicant to sign and date Hhenever poss'ible, the initial application will be. used asa worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for hissignature. Fees and Charges PIan check fees are due and payable at the t.ime of theapplication, and no plans wi1) be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY IV. v rmit Clerk Pr * //5,3 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name S1 g nature date