HomeMy WebLinkAboutPermit Building 1989-08-17INSPECTION LINE
7?6-37 69
CITY OF SPRINGFIELD
COMBI NATI ON APPL I CATION/PERMIT
INFORI4ATION LTNE
726-3753
Job Address
l-egal Description rlr
Ran
l,later [leater
EIIERGY SOURCES:
Hea t
Sq. Ftg. Hain_
sq. Ftg. ncceif]
Sq. Ftg. 0ther__
I'lew Add A1 ter Rep.
,__Demo Change/Use-F ence
-0theru""('5"Aoo,d,
Owner
n '|I Des
Ga
.e., Bui ld SinglePhoneAddress
Cons truc t Lender
$
P
6da,
ohone no.address exDr resname
Pri ma ry
Structura I
Electrical
l''lec ha n i ca I
exD I res ohone no.addres s (lics. no.name
Genera
Pl umbi nq f\i
E l ectri cal N
l,lechanical N
ELECTR I CAL MECHAN I CAL
t
PLUI,IBI NG
FFF {:HARGFFFFCHARGFI'10FEECHARGENON0.
furnace/burner to
BTU' s
Residence of
FTsQEach single fixture
Floor furnace
and vent
New c i rcui ts al ts.
or extensions
Relocated bui Iding
(new fix. additional)
Recessed wal I
Soace heater and ventSERV I CESS. F. Residence(l bath)
Duplex (l bath) each
Apol iance vent
seoa rateTemporary Constructi onAdditional bath
Stationar-v evap.
cool er
i n exi sti ng
CE
Change
res i denllater service
Vent fan with
sinole ductIndrrqtrial
multifamily, corm, orSewer
Vent systern apart from
heatinq or A.C.0f amps.Storm Sewer
Mechanical exhaust
hood and ductCOMI.I./IND. FEEDERS
l'lood stove/heaterInsta l I /aI ter/reI ocate
dictrih. feeders
0f amp s.
ISSUANCF OF PFRIIIT
TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES
WHERE STATE LAt,l
sha I I not be val i ,l
REqUIRES that the Electrical work be done by an Electrical Contractor, the elec
until the label has been signed by an Electrical Supervisor and returned to the
trical portion of this permit
Bui1ding Division
for permit
rrerformed Ci ty
madengfie
struc fy
exempt
t55 wi'l
s truertthaattformaonreonhendaheredocetcaonfyEDNtheeappcompfcerdanthwl0rdthenan0cestheshadonebenaccoIrkwondco rrec t a nd f rtheu cer rt t ha t aandfyany
tha il0t CY0ccuPAt'l w1 benandnntothkworbeddescrirehertofteanddLawsthetheoftaspertaI0regonSp rsttravllnhttheude ss0nrfurt he rtce t thafwltthouthessnotheofBudDretu regm.yperm i ng
on ted hereon and ha ttsforsbasthefany
rd exemptBoahattnfuforceefandasfecturedORS017.055reqby
th sUSwhosarenwianceht7010Rs0be ponsubcontractorsandvempoyeec0mD
DATtlAl''lE ( pl ease print)
M 0L q.?n.g
xZone
2
Ftg. l'lain Val llP
Occ.y Group x Ftg 0ther
Load Sq. Ftg . Access
1ue ZZA-e-q----1-
Const. Uni ts
Val ueFi re Zone_pedrooms.
Flood Plain Stories
T0TAL VALUATI0N_
opment5433Svstems Deve'
Charse (1.57Plan Ck. Conrn/Ind
65%/Bldo Per Fee
Fe e
Plan Ck. Res
30%/Bldq Per
BUILDING PERMIT
Clrarges and
Su rcha rges
_fu-_a?__
O3
Fence
Dgmo
PLUI4BING PERMIT
Charges and
Surcha rges
Sldewalk
Tota'l Comb. Permi tA/C Paving
ELECTRICAL PERI,IIT
Charges and
Surcha rges
Curb Cut gl;7TOTAL
I4ECHANICAL PERMIT
Charges and
Surc harges
')3
T S'/
)
COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION
Applicant to furnishA, Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, ?nd Addition toS[Iiffiield EstatesC. Name, et'c. of owner and construction lenderD. Energy SourcesI. examole-2. exampl e-
Square foota
hea t/el trical cei I
wa ea e ec
E ge or valuation, e1. example- 1250 sq. foot house, 500 sq. foot garage2. exampie- if new project, check new - if addition,
EhEE[-add, etc.F. Building permit information:1. example - construct single family house with an
attached garage
?. example - remodel existing garage 'into family room3. example - convert single family residence into
resTalFant (change of-use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. 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 SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedules
are available at the Building Divisionl. 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 the
fu l I schedulesC. BUILDING DIVISION STAFF I^JILL 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 contractoris not authorizedto sign the electrical label.III. Applicant to sign and date
Whenever possible, 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 his
s i gna ture.IV. Fees and Charges
Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. Ail other fees and charges are due andpayable when the permit is 'issued.
V. FOR OFFICE USE ONLY
f,
\5\ub
Permit Cle
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 i gnatu ate /2./6..8?
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001.-00?-BU ltt| ING PEBt.t IT 80.50 4.03 s90B}5 14635 $ 9 ' 5oo
, STN-UINII.IUI'I IN$PECTIONS + REflUIEEI.IENTS _---EXP TIATE---ACT NATE.
' 890901001-008-R00r lNG
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001-008*R0CIrING 890901 uH 38