HomeMy WebLinkAboutPermit Plumbing 1984-10-16INS
tLo
CITY
COMB I NATI ON TI
D
PERMITL 726-3753
Job Address
Legal Description
EIIERGY SOURCES:
Hea t
llater Heater
Ran
cn
"-l
Sq
tg
Ftg
Ftg
I'la n
-Fe
Access.
0
I'lew
e
A1 ter P.ep.
Val ue of rk AOwner il:€.,eInI^lo
e
DescrAttFarn
nPhoneAddres s
Cons t L Lend
Addre s s Phone
Prima
Structura I
Ei ectri ca l '
Mechanical
El ectri
hani
MECHAN I CALELECTRI CALPLUIlB I NG
FFENOFFFCHARGENNFFFCHARGEfurnace/burner to
BTLI' s
Residence of
FTSQEach single fixture
Floor furnace
and ventRelocated building
(new fix. additional)
Recessed wal I
Soace heater and vent.SERV I CESS . F. Res i dence
( I bath)
Duplex (l bath) each
Apol iance vent
sPDa rateTemporary ConstructionAddi t.i onal bath
Stat ionar.v evaP
cool erChange in existing
rpsi dencctlater service
Vent fan with
sinole ductmultifamjly, comm
Industrial
0r
Sewer
Vent systern apart from
heatinq or A.C.amps.0fStorm Sewer
Mechani cal exhaust
hood and ductCOMI'!,/IND. FEEDERS
['lood stove/heaterInstal I /al ter/rel ocate
distrib. feeders
gmps.0f
ISSUANCE OF PFRI1IT
TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES
WHERE STATE LAI'I REQUIRES that tlre Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shall not be valil until the label has been signed by an Electrical Supervisor and returned to the Building Division
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 rrerformed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0regon oertaining to the work described herein, and that NC OCCUPAI'ICY will be madeof any structure without the permission of the Building Division, I further certify that my registration vrith 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 comoliance with Oi?S 701.055 will be used on this proj
tl,llAl.lE (p1 ease pri nt )-/6f,L SIGNATU
x
S
S
Flood Plain Stori Aq
Fire Zo np Load
Ftg 0ther
ts lue
Group
Zone
ToTAL VALUATT0N_
Val ueBedrooms
Cons t.
Val ue
o. Fto. l'lain x Va
q. Ftg. Access
Plan Ck. Comm/Ind
65%/B1dq Per Fee
Svstems Deve
Charqe (1.52 opmmtBUILDING PERI'IIT
Charges and
Surcharges Plan Ck. Res
30%/81dq Per Fee
FencePLUI4BING PERMIT
Charges and
Surcha rges Dgmo
Sidewal kELECTRICAL PERt,IIT
Charges and
1., r cha rges Total Comb. Permit
Curb CutIIEiHANICAL PERMIT
Charges and
Surc ha rges t trTOTAL
cc.c
,qn=\-r H1-,
New circuits alts.
or extensions
A/C Pavi ng
coMBrNATr0N AppLrcATroN/PERMIT ( CAp)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. Sglplg.: Tax Lot 100, Lane County ilap Reference17 03 432. gxaTplq: Lot t. Block 3, ?nd Addit.ion tospringfie)d Estatesq. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
1 example- heat/
example- water
rre footage or
el ectri ca i 'I or forced air gas
2 r or sol arE. Squa va I uati o[,
exampl e-
exampl e-
check add
1250 sq
if new
. foot house, 500 sq. foot garagepro;ect, check new - if addition,2
etc.F. Buitding permit informatjon:1. .I?*p]. - construct single fami.ly house with anattached garage
l. exqmp]e --rem6del existing garage .into family roomJ. exampte - convert single family residence iniorestaurant (change of use)G. Value of work as defined in Section 303 (a) of the. Structurai Specialty CodeH. DESIGN TEAM AND CON1RACTORS
To avoid des.ign or.construction delays, Build.ingDivision Staff must be able to contalt appropriitepersons.regarding design .informat.ion or jbb iitecorrections, etc.
Abbreviated Piumbing, Mechanical, & Electrica.l SchedulesA. Lxcept where blank spaces occur .in the descriptionportion of the Mechanical and Electricat Sctreautes,the applicant need fill-in only the lto. goxes iajiient
^ !0_!h9 appropr.iate item(s) to te instal.ledB. Ful l Plumbing, Mechan.ical, and Eieiirical Schedulesare avaiiable 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 shou.ld consult thefull schedulesC. BUILDING DIVISION STAFF t^lILL 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 electricai -
supervisor. The general contractor il not authorizedto sign the electrical labelAppiicant to sign and date
trJhenever possible, the in.i tial appl.ication wil l be used asa.worksheet only. Where possibie, Building D.iv.i s.ion Staffwill prepare a type written copy and returi it to theappiicant at the time the actual permit is issued for h.issignature.
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. All other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY
lC- lb-tq
vr Lpal.}5
III
IV.
Permit Cler
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 s i gnature date