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Home My WebLink AboutPermit Building 1989-09-27ON L INT APPL I CA RM ITCOMBI -l'1 I l-ega1 Description Job Address [,later lleater Hea EIIERGY SOURCES Ranqe iq. Ftg. Access.--- llew Add Al ter -Fence Oemo Ch -0ther- '_P.ep. ra nge/ U se 0the rSq. Ftc Ftg . l'la i Va l ue of llork: ]O, ooo0wner nh..44l 173radress []'[ Lt I .e., Build Single Ga raarni l es i den U e rnl ch B F ng n o: Des $ Construction Lender G{I Address Phone 'I ics. no.exDr resname(addressDES I GN TEAI.1 M o, ri. R e oreg l4tA r CoLuva RDPri ma ry 5o3- 3 42 bg tl1to Structura I El ectri cal € l{echani cal ohone no. )exoi res )a ddres s (lics. no.IACTORS name Lee R,j' Lt i)- A^" 2l+11 iarr..c IGenera I o -lo .8q Cg I3'r toIa.JE .ao.lt(^u Pl umb.i nq /./,4 MECHAN I CALELI CTR I CALPLUIlB I NG trE llec FFFNOFFFCHARGECIIARGFNOFEENOfurnace/burner to BTU, S Residence of SQ. FTEach single fixture 7219, Fl oor furnace and vent,Dkw' ci rcui ts al ts."a.2*^*wRel ocated bui 1 dinq (new fix. additional ) Recessed wal I Soace heater and ventSERV I CESS. F. Ilesidence ( I bath) Duplex (l bath) each Apol iance vent qpDa ra t-eTemporary ConstructionAdditional bath Stati onary evap cool ere in existing encP Chang rpsidl,later servi ce Vent fan with si nol e duct multifamily, comm, or IndustrialSewer ./@ Vent systern apart from heatinq or A.C.z€t(or* s"*..Mechani cal exhaust hood and ductc0Mr.1./lND. FEEDERS I'Jood stove/heaterInstal I /al ter/rel ocatedistrib. feeders dPtL."amp s.0f ISSIJANCT OF PFRI'IIT TOTAL CHARGES a4 TOTAL CHARGES e-5?TOTAL CHARGES P.ao I,JIIERE STATE LlN REQU shall not be val i'l unti l IRES that the Electrical work be done by the label has been signed by an Electrj an ilectrical Con ca1 Supervisor ancl tractor, the electrical portion of this Permit returned to the Building Division for^.oermit, and,lo here[y certtf.y ttat a]i information hereon is true and correct, and I further certif-v that any anil all work oeriormed shall be done in accordance with the 0rdinances of the City of Sprinofield and the Laws of thi State oi oregon oertaining.to the work described herein, and that l'l0 0CCLlPAl'lCY will be made of any structure withoul ihe permission of the nuilbing Diviiion. I further certify that m.y registration with the Builder's Board is in full force and effect as required by oRS 761.055, that if exempt the balis for exemption is noted hereon, and that only subcontractors and ernployees who are in comoliance wjth 0l?S 7n1.055 will be used on this Dro.ject. S IGiIATURE DA1Eq-27 -37/1,>I.lAl,lE(please pr int)C>ea*c-a / , L; its Load .x___---Va Il'la i n 5q. Ftg . Access Val Ftq ION Val ue Zone_ Tyoe/Const Fi re Zone Flood Plain Stori es cy Groulr 7^2 Sq. Ftq. rr -- Svst6r,rS Deve charqe (1.57 opment I *4Se.UQ5 A\PPlan Ck. Comm,/Ind 65%/B1dq Per Fee Plan Ck. Res 30%/Bldq Per Fee BUILOING PERI.IiT Charges and Su rcha rges +a 6.f Fence Dgmo PLUI,IB I NG PERMI T Charges and Surcha rge s ^? Sidewalk ?4Ar-a3Total Comb. PermitA/C Pavi ng ELICTRICAL PERI,IIT Charges and Surcha rges -- -- Curb Cut 7/7. a3TOTAL IlECHANICAL PERMIT Charges and Surc ha rges 4P -T $u 0f amPs 1+ COMBINATION APPLICATlON/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Lega l Description 1. example- Tax Lot 100, Lane County l,lap Reference 17 03 432. example- Lot 1. BIock 3, 2nd Add.itjon toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources r forced air gas so'l ar l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into famjly room3. example - convert single family residence into restaurant (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, Build.ing Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, & E)ectrical SchedutesA. Except vrhere 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 instal ledB. Ful l Plumbing, Mechan.ical, and Electrical Schedules are avai lable at the Bui lding Division1. To conserve space on the permit forrn the schedules have been abbreviated2. If the itenr(s) to be installed are not covered on the abbreviated schedules you should consult theful I schedul esC. BUILDING D]VISION 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 superv'i sor. The general contractori s not aLrthorizedto sign the electrical iabel.III. Appl icant to sign and date Whenever possible, the initial application will be used as a worksheet only. l,Jhere possible, Building Division Staffwi1) prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for hissignature.IV. Fees and Charges PIan check fees are due and payable at the time of theapplication, and no plans vri1l be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is jssued. V. FOR OFFICE USE ONLY I. example- heat/electrical cei ling/o2. exarnpT-e- wa terEEa tETTETec tl:iciJ7orE. Square footage or va)uation, etc._- PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registratjon with the Builder's Board because Addit'ional Project Informat'ion : PLANS REVIEWED BY: s i gnaturname dat , €<<ffi -J7 Eq ,14