HomeMy WebLinkAboutPermit Building 1987-04-03l.later Heater
Ranqe
EIIERGY SOURCES:
Hea t
Owner
O
L
Job Address
l-egal Description
Value of tlo ,nn
9q. Ftg. Access._
Sq. Ftq. 0ther_
llew Add Alter--T;D.-
Jence_Oemo_C hai-ge/ U se
-other-
q.Ftg
Addres s hone Builr.ino P(/nrrt Info: Describe tiork(FamiIyJesidence llith Attached caraqe
ngeS e
Constructi on Lender
V
,\dd re s s Phone
OESIGN TEAII name addres s no exoi res ohone no.
Pri ma ry
v
4
Structura I
EI ectri ca I vl{echanical
CONTRACTORS n ame a ddres s ( pvni rps'I i cs - no - )ohone no.
/ntGenera I z2
tn o
I I
PLUI1B I NG ELECTR I CAL MECHAN ICAL
FEF CHARGF NN FFF CHARGF NO FFF CHARGF I
I Each singie fixture 7b z.*Residence of
SQ. FT
furnace/burner to
BTLI' s
Relocated building
(new fix. additional )t/.llew ci rcui ts al ts.
or extensions2 aB ,zffi€??5 5
Floor furnace
and vent
S . F. Fles i dence(1 bath)SERV ICES Recessed wal I
SnaaF hpatcr and venl
Duplex (1 bath) each
Add.i ti onal bath Temporary Construct'i on Apol iance vent
seoarate
l,later servi ce Change i n exi sti ng
rps i dpncp
Stat'i onary evaD
cool er
Sewer Industrial
multifamily, corm, or Vent fan with
sinole duct
Storm Sewer 0f amps.Vent system apart from
heatinq or A.C.
COMI1./IND. FEEDERS i'lechanical exhaust
hood and duct
Instal I /al ter/rel ocate
di ctri h feedcrs l'Jood stove/heater
/<4amps.of /@
?^
\r6l
ISSUANCE OF PFR!1IT
TOTAL CHARGES 22.5a TOTAL CHARGES 7z-sa TOTAL CHARGES
I,IHERE STATE LlIi REQUIRES
shaII not be valiJ untiI the
that the Electrical work be done by an Electrical Contractor, the electrical portion of this perrilit
label has been signed by an Electrical Supervisor and returned to the Building Division
I HAVE CAREFULLY EXAI1INED the completed apolication for Dermit, and do hereb.v certify tirat att infornratr'on frereon ls tnreand correct' and i further certif-v that any and all work performed shall be done in accoidance with the 0rdinances of the Cityof Soringfield and the Laws of the State oi Oreoon pertaining to the work described herein, and that NC OCCUPAI,ICY will be madeof any structure without the permission of the Buildinq Diviiion. I further certify that m.y reqistration vrith the Buiider,sBoard is in full force and effect as required by ORS 701.055, that if exempt the baiis for bxemption is noted hereon, and thatonly subcontractors and enployees r.rho are in comcliance with Ol?S 701.055 will be used on this nro.ject.
l.lAl.lE(please pri nt)[ny (IGNATDou c fitc
FFI
Load ?? Sq. Ftg. Access x Val
eroup FnZ sq. Fts. otn""/rp7. BF)zzsf>gc uut
btos
2eue
tq. l'lain
Stori es
ToTAL VALUATI0N_
Flood Plai
.Tyoel Const
Bed roomsFire Zone
Zone Val ue?'/F8 5frfrts sq.
Plan Ck. Com/Irid
65.%/B1do Per Fee p5,c3 q-3-g)Svs
Cha
terns Deve'roe ( t. sz,
opment H.4Charges anC
Surcharges
^
-ff=/' ,9
BUILDING PERI'IIT
Plan Ck. Res
31%/Bldq Per Fee
FencePLUMBING PERMIT
Charqes and (-7a Demo
SidewalkCharges and
Surcha rges
:>
"t
ELECTRICAL PERI,!IT
A/C Paving Total Cornb. Permit /oz. qq
Curb CutI,IECHAN I CAL PE
Charges and
Surc ha rqe s
RMIT
L,/oz-77TOTAL
6-69
CITY OF SPRiIIGFIELD
COIIBI IIATION APPL I CATION/PERMIT 726-37
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COMBINATION APPLICATION/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 1. Block 3, 2nd Addition toSpringfield Estates
C. Name, etc. of owner and construct.ion Iender0. Energy Sources
PERMIT VALIDATION
1. example- hea2. example- watE. Square footage o
t/el ectri ca i cei I i or forced air gas
r
ea ter,e ec tr ca or sbJar
val uation,
l. exampie- 1250 sq. foot house, 500 sq. foot garage?, exampie- if new project, check-new - if additio;,
EIEER--add, etc.F. Building perm
1. example -
a t tac hed
rit information:
construct single fami ly house with an
garage
2. example - remodel existing garage into family room3. example - convert single family residence inlorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specia lty CodeH. DESIGN TEAI{ AND CONTRACTORS
To avoid design or construction delays, Build.ing
Division Staff must be able to contact appropriite
persons regarding design .informat.ion or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical , & E'lectr.ical SchedulesA. Except where 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 installedB. Ful I Plumbing, Mechanical, and Electrical Schedules
are available at the Building D.ivis.ion1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult theful I 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 electricajsupervisor. The general contractor is not authorized
b uro
4-f 'f
to sign the electrical labelIIIApplicant to sign and date
l,Jhenever possibie, the initial app)icat.ion will be used asa worksheet only. Where possible, BuiIding Div.ision Staffwill prepare a type written copy and return.it to theapp'licant at the time the actuai permit is issued for hissignature.
Fees and Charges
Plan check fees are due and payable at the t.ime of theapplication, and no plans wil l be processed until thesefees are paid. A1l other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY
IV,
Permit Clerk ((/
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAITCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name E-i gnature date /-2 -A )