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Home My WebLink AboutPermit Electrical 1985-02-06INSPECTION L 7?6-37 69 NE COMB I LI Job Address I a EIIERGY SOURCES: Hea t l,later Heater Ranqe So. Ftg. l.la in_ sq. Ftg. Access.- Sq. Ftg. Other_ _tlew_Add_A1 ter_Pep. _Fence_Demo_C ha nge/ U s e -other- dN Doa+ Oa tJ LegaI Description Value of l.Jork Owner ss PO Box 430 W-400 Be .f €,exas Des e.,n9 e Farni Gara Construction Lender Addres s Phone f U I -( DE5 I GN EAI.l name address I ics. no.exDt res ohone no. Pri mary Structura I E I ectri ca I Mechan i ca I CONTRACTORS n ame address''I i cs. no.exDt res ohone no- ) Genera I Pl umbj nq /7 I PLUI4B I NG ELECTR I CAL I4ECHAN I CAL NO FFF C HA RGF NN FFF CHA PG F l'lO FFF C HARGF Each single fixture Residence of SQ FT furnace/burner to BTU' S Relocated building (new fix. additionai ) New ci rcui ts al ts oa exten s i on s -ott> Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal I Soace heater and vent Duplex (l bath) each Al4-A**ttt-t50 Additional bath Temporary C#structi on Apol iance vent seoa ra t-e [,later servi ce Chan res i ge in existing dencp Stati onar-v evap, cool er Sewer multifami1y, comm. or Tndristrial Vent fan with sinqle duct Storm Sewer 0f s Vent systern apart from heatinq or A.C. c0Mr.1./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/re1 ocate di stri h- fpedprc l,Jood stove/heater 0f amps ISSUANCF OF PFRI,IIT TOTAL CHARGES TOTAL CHARGES #TOTAL CHARGES WHERE STATE Lltl REQUIRES that the Electricat work be done byshall not be valiC unti'l the label has been signed by an Electri, an Electrical Contractor, the electrical portion of this pernit ca1 Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI"IINED t he comp Ieted apnlication for oermit, and do hereb.V certify that all i rformed shall be done in accordance with nformation hereon is trueand correct, and I further cer tify that any and all work 0e the 0rdinances of the Cityof Springfield and the Laws of the State of 0regon Dertaining to the work described herein , and that NC 0CCUPAHCY will be madeof any Board i structure without the permission of the Buil di ng 70t Division. I further certi fy that my reqistration r,rith the Builder'ss in full force and effect as required by ORS .055, that i f exempt the basi 055 wi'l I be used s for exemption is noted hereon, and thatonly subcontractors and employees who are in comcliance with 0l?S 701 on this nroject. I'lAl'tE(please print et-crr'I 5 Zone Const ts Sq. Ftg t, l{a i n Va luexFire Zone Bedrooms Load Ftg. Access.Value Flood Plain Stories Occ.y Group Sq. FtS x Value TOTAL VALUATION_---- . Other BUILDING PERI'IIT Charges and Surcharges Plan Ck. Comm/Ind 65%/81dq Per Fee Systems Deve Charqe fl.51 I opment I Plan Ck. Res 30%/81dq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence v D6mo ELECTRICAL PERI|IT Charges and ,, iSurcharges P' 't Si dewa I k A/C Paving Total Comb. Permit T,IECHANICAL PERMIT Charges and Surc ha rges Curb Cut TOTAL 3/.ry HlilUzl COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot 1. Block 3, 2nd Addition to SFFTn--n g f i e I d E s ta tesC. Name, etc. of owner and construction lenderD. Energy Sources r ) 1. exampl e-2. eiffiI-e-E. Square foota hea t/e ical or forced air gas wa r e or solar ge or valuat o0'c. 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. example - construct single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert singie family residence into restaurant (change of use) Value of work as defined in Section 303 (a) of theStructural Specialty Code 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 G. H corrections, etc.II. Abbreviated Plumbing, Mechanical,A. Except where blank spaces occuportion of the Mechanical and the appl icant need fill-r'n onlto the appropriate item(s) toB. Full Plumbing, Mechanical, and are available at the Building &r El, v be E Di, Electrica l Schedules'in the description ectrical Schedules, the No. Boxes adjacent installed lectrical Schedules vision1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be instal led are not covered on the abbreviated schedules you should consult thefulI 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 theelectrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label.III. Appiicant to sign and date l,Ihenever possible, the initial appfication wiII be used as a worksheet only. l,lhere possible, Building Division Staffwill prepare a type wnitten copy and return it to the applicant at the time the actual permit is issued for his signature.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable r,/hen the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION p # Lqtar alt/n' Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit app'licant exempt from registration with the Builder's Board because: Additional Proiect Information: PLANS REVIEI,JED BY: name Si g nature date