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HomeMy WebLinkAboutPermit Building 1984-12-11IISPEC 26-37 COHBI II!AP ,TI IT OF RI IE Job Address ! Lega l Description c Phone Phone Owne r Address Construction Lender Addres s re., Bu Sing e tl IERGY SOURCES I sAccesl,Jater Heater Hea t Ran qe Val ue nera Hechanical EI ectri cal Structura I Prima 'lectri PLUIIBI NG ELECTR I CAL 6 Each single fixture f*30.- Residence of SQ. FT furnace/burner to BTU' s Relocated bui lding (new fix. additional)New circuits alts \^Ehlion)qaae Floor furnace and vent s . r. Res iainiE-1l lattr)SERV I CES Recessed wal I Space heater and vent Duplex (I bath) each /lzr*< Du.zu ,dD@. Additional bath Temporary Constructi on ApoI i ance'verit sepa rate [^later service ge in existing dence C han resi Stationary evap cool er Sewer Indrrstrial multifamily, conrm. or /Vent fan with sinole duct 3i? Storm Sewer 0f S.Vent systern apart from heatinq or A.C. coHH./IND. FEEDERS Mechanical exhaust hood and duct Instal l,/al ter/rel ocate di stri h- fpedprs Hood stove/heater 0f s ISSUANCE OF PFRIlIT IIHERE STATE LAN REQUIRES that tlre Electrical work be done by shall not be valiC until the labe'l has been signed by an Electri jrc TOTAL CHARGES an Electrical Contractor, the electrical portion of this permit TOTAL CHARGES ca1 Supervisor and returned to the Building Division a|D I HAVE CAREFULLY EXAHINED the completed appljcation for permit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and al1 work performed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of Oregon oertain'ing to the work described herein, and that NC 0CCUPAI'ICY will be made of any structure without the permission of the Buiiding 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 comcliance with ORS 701.055 wil1 be used on this project. Ly'7liAl'lE(piease print)S I GNATUREoqih-I , . Fto. Access x Value.rri.o*uWr*"@ .4/tEffist Irain Y 1Ftg Fire Zone Bedrooms 0ccy Load Flood Plain Stories Occ.y Group Zone dhP nst TOTAL VALUATION AI VC 51, o 1 /u.,4 . Plan Ck. Conm/Ind 65%/Bldo Per Fee ll-9l\V} BUILDING PERI'IIT Charges anC Su rc ha rges ___34 -- Plan Ck. Res 30%/81dq Per Fee Fence v- ir I PLUI4BING PERMIT Charges and Surcha rges __se::_.2d Demo Sidewal k Tota'l Cornb. Permi t ELECTRICAL PERI|IT Charges and Surcha rges ___t_*=_ ,60 A/C Paving Curb Cut ?{.6/TOTAL I'ECHAIIICAL PERMIT Charges and Surc ha rges a .ro n,9 Sq.Ftg. Ftg. r =a R HECHAN I CAL ,?* TOTAL CHARGES r?|t*. COHBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot l. Block 3, 2nd Addition to SpIIn-ETield Estates C. Name, etc. of owner and construction Iender D. Energy Sources l. iiample- heat/electricll ceilir=rqlor fgrced air gas 2- effi'51e- waterhEITEi.zelectricaI/or solar E. Square foofage or valuation' etc' 1. example--1250 sq. foot house,.500 sq..foot.garage 2. A[mtTe- J-f new project, check new - if addition, EIEEE-6dd, etc. F. Building Permit information: 1. exampie - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. examplE - convert single family residence into Estaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural 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 biink spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent PERMIT VALIDATION III. to the appropriate item(s) to be installedB. Full Plumbing, Mechanica), 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 abbrev'iated schedu'les you should consult theful l schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label. App)icant to sign and date Whenever possible, the initial application will be used asa worksheet only. Where possible, Building Division Staffwili prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesetees are paid. All other fees and charges are due andpayab'le when the permit is issued. FOR OFFICE USE ONLY IV v Perm'i t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Informatjon : PLANS REVIEWED BY: name /^ant<ta ft&8 sisnature date