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Home My WebLink AboutPermit Building 1983-02-03E CITY OF SPRINGFIELD COI,IBI IIATI ON APPL ICATION/PERMIT 726 3l-ega1 Description Job Address Hea Ranqe. EIIERGY SOURCES liater Heater .l''lain_ . Access.-..-. . 0ther Add AlTilRep. - _f ence-Oenro-C ha n ge/ Use 0ther Sq Sq l,ler^r Ftg Ftg Ftg Val ue of l,lork -baae,L - owner rfl.ngQ-7 r/asn€e., Build SingieEuiltinq Pernrit Info: Describe Work( Farni'l y Res i dence l.li th Attached GaragePhoneAddress /r) <D2 c ,t/€ttL fillfrz.,;alntL l/ru-9:- ?.uzqtEV r4ao6,r'Constructi on Lender CO A +.?aoFPhoneAddress exD l res phone no..address lics. no.DES IGN TEAI'I name Pri mar Structura l El ectri cal l''lec ha n i ca I exDt res (phone no.)add res s (lics. no.nameCONTRACTORS ral Plumbinq EI ectri cai -v ^ D^ z-.2 Etlz-dtrrf,9?4O-? z//ofo/ l''lecha n i MECHAN I CAL 7 ELECTR I CALPLUIlB I NG FFF CHARGFc l..ta pll F It0FFFFFFCHARGENO furnace/burner to BTU' S Residence of FTSQEach single fixture Floor furnace and ventNew circuits alts or extensions Relocated building (new fix. additionaI) Recessed wal I Soace heater and ventSERV ICESS. F. Res i dence(l bath) Duplex (1 bath) each Apol iance vent sena ra t-eTemporary Constructi onAdditional bath Stationar-v evap cool er ge in existing dence Chan rpcitlater service Vent fan with sinole ductTndrrstrial tifamily, comm. or Sewer Vent systern apart from heatino or A.C0f amPsStorm Sewer Mechanical exhaust hood and ductc0r,1r'1. / IND. FEEDERS 5(>c)I [Jood stove/heaterInsta l I /al ter/re1 ocate di stri h. feeders 0f S. ,tr**r oF PFRrlrr /0.oc> TOTAL CHARGESTOTAL CHARGESTOTAL CHARGIS by an Electrical Contractor, the electrical portion.of this permit rical Supervisor and returned to the Building Division llAt''lE(please pri nt 2 IGNA ? WHERE STATE LAN REQUIRES that the Electricai work be shall not be vali'l until the label has been signed by an done El ect f_v perm i'fect '|a I1 nI f 'Irmat hereonon1certthatdoaItfor0ncfyandLDEhereb.yheDtc0mppapAVEHI tth 0rd n'I ncesa ofhe tIIdoIneanordaccwlnceaIIperfoworkshrmedabeaIndfucrthe r 'Iert hat t andcotrrecanynda iln PAOCCU NC Iw'l Ik1rhbed'Iere thaand tn'Irta 'I n theto rWO de scdndathLaWSofStateoff1Iee0regoDEgoSprngfithe v/l tth Bu I'IheIrtthat'I ts tira on'I 'Id Di S on'I fu thr cer e regIss0n'I theof Bu I fy m.ythengsturetrucw1thoutfoany reonhe abaISforse0'I n noteda'It f the xemptth055fexemptsaredORS701Ud'Ird 'Is n Iu l fo nd efrcea requ i by t 'lh s tecth10vJl055I'I usbe onedORSarewho1nIIceanwl pro,jonu bcons actr rSto and I c0mD1yempoyees s true he City be made der' s nd that Flood Plain Stories Occ.v Group Sq FI TOTAL VALUATION x x Val nit Val uel4ain Val ue0ccy Load Ftg. Ftg. Ftg. Acces 0ther Zone Type/Const Fire Zone Bedrooms opments 5 Plan Ck. Corrn/ind 65%/Bldo Per Fee Plan Ck. Res 30%/B1dq Per Fee BUILDING PERNIT Charges and Surcharges Fence Demo PLUI4BING PERMIT Charges and Surcha rges Sidewal k Tota'l Cornb. Permi tA/C Pavi ng ELECTRICP,L PERI1IT Charges and Surcharges Curb Cut l/, bd/sJ.TOTAL 14ECHANICAL PERMIT Charges and Surc harqes ,-J mu COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. exampie- Tax Lot 100, Lane County Map Reference 17 03 432. exampie- Lot 1. Biock 3, Znd Addition to SEFTngTield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. exampl e- heat,/ 2 . Exarnp-l e- wa terE. Square footage or electrical cei or forced air gas ter e ec or soTar va I uat o[, l. examp_le- 1?50 sq. foot house, 500 sq. foot garage2. elample- if new project, check-iEw - it adaition, check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. example - remodel existing garage into family roomJ. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Bui)dingDivision Staff must be able to contatt appropriitepersons regarding design informatjon or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur .in the description - portion of the Mechanical and Electrical Schedules,the applicant need fi'll-in only the No. Boxes adjaient , to the appropriate item(s) to be installedB. Fu11 Plumbing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectricai contractor for signature by his electricaisupervisor. The general contractor ii not authorizedto sign the electrical jabelIIL Appiicant to sign and date Whenever possibie, the initial application wi.ll be used asa.worksheet only. Where possible, Building Division Stafiwill prepare a type written copy and return it to theapplicant at the time the actua) permit is issued for his s i gna ture.IV. Fees and Charges PIan check fees are due and payable at the time of theapplication, and no plans wiil be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is .issued. V. FOR OFFICE USE ONLY 4?c OMfl CruoL- I bosa5 Permit Cler PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Informat'ion : PLANS REVIEWED BY: s't gna ture datename ,ltotr-Bfi