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Home My WebLink AboutPermit Plumbing 1989-04-02INSPECTION LINE 726-37 69 CITY OF SPRINGFIELD COI1BI I1ATION APPL ICATION/PERMIT TN-f0AI{A-'Il0ll-fIilr 726-37s3 Ranqe_- l.later Heater EIIERGY SOURCES: Hea t Owner l-ega 1 Desc ri pt i on Job Address vatue fr'rA Sq. Ftg. I'lain_ Sq. Ftg. Access.-- Sq. Ftg. 0ther_ _l{ ew_Ad dJ 1 t e r_Ae p l- _Fe nce_-Demo_C ha nge/ U se -other-- Add res s Phon n t i ) ,e., Build Single Constructi\n Lenaer -l \ Addres s Phone Dos E -ac DESIGN TEAII name address lics. no.exDl res phone no. Pri mary Structura I Electrical l4echanica'l CONTRACTORS n anre address (lir< nn exol res ohone no- l 'al P PLUIlB I I,JG ELECTR I CAL MECHANICAL FFF C I]ARGF NN FFF CHARGF I'10 FFF CIIARGF Each si ng1 e fi xture Residence of SQ. FT furnace/burner to BTLI' s Relocated bui lding (new fix. additional ) New circuits alts or extens'ions Floor furnace and vent S. F. Residence(l bath)SERVICES Recessed wal l Snace hpatpr and vcnt Duplex (l bath) each Temporary Constructi onAddi tiona'i bath Apol iance vent seDa rate l.la ter serv i ce Change i n exi sti ng res'i dence Stationary evap cool er Sewer multifamily, comm. or Industrial Vent fan with sinole duct Storm Sewer tt ,l Ven hea system apart from nq or A.C. t \if\ttNvft$xIL scc c0r,il.!./IND. FEEDERS Mechanical exhaust hood and duct Instal I /a I ter/rel ocate diqtrih- fcPdFrs ljood stove/heater 0f I SSI'ANCF OF PFRI/iIT TOTAL CHARGTS <DL<- ).TOTAI. CIIARGES TOTAL CHARGES i^lli[Rt STATE L1N RTQUIRIS that tlre Electrical work be done shal l not be val'i I unti l the label has been signed by an ilec bytri an ilectrical Contractor, the electrical portion of this permit cal Supervisor and returned to the Building Division I IIAVE CARTFULLY trXAlllNtD the completed apnlicatjon for oermit, and do hereb.y certif.y that all information hereon is true and correct, and I further certif_v that any and all urork rrerformed shall be done in accordance with the Ordinances of the Cityof Sprinqfield and the Laws of the State of 0reqon nertaininq to the work described herein, and that N0 0CCUPAIICY will be madeof any structure withouL the permission of the Buildinq Djv.ision. I further certify that m.y reqistration vrith the Builder's Board is jn full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that onl-y subcontractors and enrnloyees who are in comcliance with C)nS 701.055 will be used on this Dro.ject. l,lAl.lE (pl ease pri S I GIIATURE D/1.TE /*z-xr Val ue Tyoe/ Con s t ToTAL VALUATI0N-- Zone x 'I ilp x Val i ts Load_Sq. Ftg Gro Ftg Bed rooms Stories Fi re Zone Fl ood Pl ai n 0ther Access Fto. l,lain Plan Ck. Conrn/lnd 65%/fr1do Pcr Fep s tems opmentBUILDING PERI.lIT Charges anC Su rcha rges Plan Ck. Res 30%/B1dq Per Fee Fence Sidewal k Domo Total Comb. Permit PLUI4BING PERMIT Charges and Surc ha rges ELECTRICAL PERI,:IT Charges and Surcha rges A/C Pavi ng Curb Cut \b.t'iTOTAL I,IECHANICAL PERMIT Charges and Surc ha rge s 0f _ _ amps COMBINATION APPLICAT]ON/PERMIT (CAP) I Applicant to furnish A. Job AddressB. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot ]. Block 3, 2nd Addition to SFFTn-ETield Estates C. Name, etc. of owner and construction lender D. Energy Sources I. example-2, example- E. Square footag hea t/ ei ical ceiIi or forced air gas solarwa e or valuat o[t examp l e- exampl e- check add 1250 sqif new foot house, 500 sq. foot garage proj ec t ,check new - if addition, , etc F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exarnplE - convert single family residence into iiltaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specia'lty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be installed B. Full PIumbing, Mechanical, and Electrical Schedules are available at the Building Division l. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractoris not authorized to sign the electrical label.III. Applicant to sign and date l,lhenever possib)e, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy applicant at the time the actual s i gna ture .IV. Fees and Charges and return it to the permit is issued for his 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 when the permit is issued. FOR OFFICE USE ONLYV PERMIT VALIDATION A0p Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY name s'r gnature date 4