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Home My WebLink AboutPermit Mechanical 1980-07-21ON LINE CITY OF SPRTNGFIEID- COI,IBI I{ATION APPLI CATION/PERMIT Job Address 5 A7a- -vl TL a0 Lega1 Description ERGY SOIJBCES:atH.H.\ Ran tlate" il"ute. F.]6F Eil He Owner JoneS Value of l,lork: . Fto. llain--_ Sq. Ftg. Access.--- Addrdss PhoneTDY]Q T Buileinq Pernrit Info: Describe Workf'Farnily Residence l.lith Attached Garaqe 'e., Build Single Scrnrn(,1Q''Hzof Pt.r nnp Construction Lender Addres s Phone RDtoos\ra\I DES i GN TEAI.I name addre s s S exD I res lphone no Pri ma ry St ructura I E I ectri ca I l"lechan i ca I CONTRACTORS name ( exni rpclics. no. )'ohone no- Genera I r\tt,o-t- f\anrls (11-3---r--- Pl umbi nq r El ectri ca l Itlec ha n i ca I PLUTlB I NG ELECTR I CAL MECHAN I CAL FEE CHARGE NO FFF CHARGF NO FFF .HAPGF Each sing)e fixture Residence of FTsQ furnace/burner to BTU' s Relocated building (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wai l SDace heat-er and vent Duplex (1 bath) each Addi tional bath Temporary Construction Apol iance vent seDa ra te tlater service Change in existing res i dence Stationary evap. cool er Sewer Industrial multifamily, comm. or Vent fan with sinole duct Storm Sewer 0f amp s.Vent systern apart from heatino or A.C. c0t4t1./IND. FEEDERS Mechanical exhaust hood and duct- Insta l I /al ter/rel ocatedistrib. feeders l'lood stove/heater -amp s.0f o CO ISSUANCF OF PFRI,IIT lo o TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I^IHERE STATE LAll REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Oivision .1JtlAl'lE(p1ease p"i;L IGNATUF t c t on for trmt and od ce rt ttha a n rmafo t oncompDCDap he reon ts ruehereb.y fy nda Lcorrec a nd cerrther t f tfutha a nda a t^/or k rrnedfo has dobe ne an ordacc tthvnypernce he 0rd na enc of het Ll tyr,ro fi e d nda th e La WS of theSDng Sta et of on rte a n to het rkWO ed c r bed n0regphere and atth NC PAIIC0ccu W'I be madeng o a uc retu thouW1 t fstrnytheSSoon th u d n D V1 0n fu rtpermo S trat uJl0n tth Buhe rde Sthertcerathregm.yfy fun rcefo dSrdBoa tha t f fanffeceatred0R5005tttbahe ro t on S ednot rehe 0n nda ttharequexempexemDby on bcsu t0n andractorsv s owh rea n com nca wl htemp0yee 7ot0r?s 055 T,J'I be u de no th s tecppro,j FOII OFFICE USE Oi,ILY al ue Val ue5q Flood Plain S tories 0c ; 0ccy Load Ftg . 0therc.y Gro oe/Const. Uni ts ToTAL VALUATI0N_ Val ue Zone Ftq . l'la i Fire Zone Bedrooms Ftg. Access x Plan Ck. Comm/Ind 65%/81do Per Fee rqe (1.57Svs Lna tems Deve opmentBUILDING PERI'1IT Charges anC Surcharges Plan Ck. Res 30%/81do Per Fee FencePLUI4BING PERMIT Charges and Su rc ha rges DEmo Sidewal kELECTRICAL PERIIIT Charges and Surcha rges I ,g Total Comb, PermitA/C Pavi ng Curb Cut1,lECHANICAL PERMIT Charges and Surc harges t b.u4TOTAL 0ther Add l+Jtrnn I I I I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Lega l Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SFFinEField Estates C. Name, etc. of owner and construction lenderD. Energy Sources1. examol e-2. exampl e-E. Square footag air gas II 1. example- 1250 sq. foot house, 500 sq. foot garage 2. 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 family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Sectjon 303 (a) of the Structural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Building D'ivision Staff must be able to contact appropriate persons regarding design information or job site correcti ons , etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except r,rhere blank spaces occur in the descriptionportion of the Mechanical and Electrical Scheduies, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. 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 thefull schedulesC. BUILDiNG DIVISiON STAFF l,JILL 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 electricalsupervisor. The general contractoris not authorizedto sign the electrical label App)icant to sign and date [,Jhenever possible, the initial application will be used as a worksheet only. l,lhere possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna tu re. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wil l be processed until thesefees are paid. All other fees and charges are due and payable when the permit is issued. III IV. V. FOR OFFICE USE ONLY PERMIT VALIDATiON Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from reg'istrat'ion with the Bujlder's Board because Additional Project Information : PLANS REVIEWED BY: name SI gnature date iIISP 726-L COI1BI iIATI ON APPL I CATIONIPERMTT 726-37 Job Address l-ega1 0escription Hea t [,later Heater Ranqe Owner Value of llork Ftg. Access. Sq. Ftg. 0ther _l,l ew___.Ad dJl te r_-l[EE- _Fe nce_Demo_C han ge/ U s e 0ther Sq Ftg. Phone n Fami I Bu Descce llitI [,,10 rk ;e., Bui ng e Construction Lender Addre s s Phone s \ra \) name Pri ma Structura I El ectri ca I llechan'i ca I l{echanical PLUIIB I NG EL ECTR I CAL I,IECHAN ICAL FFF CHARGE NO FFF .HAPCF NO FFF CHARGF Each single fixture Residence of SQ. FT BTLI' s furnace/burner to Relocated buildino (new fix. additjonal)New ci rcui ts al ts. or extensions Floor furnace and vmt 5-F. Residence(l bath)SERVI CE5 Recessed wal I Space heater and vent Duplex (l bath) eash Adtritional bath Tanporary Constructi on Apoliance vent sepa rate !h1er serv'ire -oe in existinq derre Chan res i Stat.i onary eva.o- cool er Sewer Industrial multifamiiy, conrn. or Vent fan with sinole duct Stonm Ser.rer apart from .L. Vent systen , heatinq or A colll.l./IND- FEEDERS Mechanical exhaust hood and ductlnsta 1 I /alter/rel ocatedistrih. fpedcrc liood stove,/heater 0f I <tlQrrnD ;q) t rssuANcE oF pFP.rllr la oonTUTAL CHARGES TI'TAL CHARGES Plan Ck. Comm/Ind 65%/8ldq Per Fee Svs Cha tems Deverqe ( 1.52 opment Plan Ck Re Pe30%/81dq ee s rFr Fence D6mo Sidewalkta.oo-- 6+-A/C Pavi ng Total Comb. Permit Curb Cut TOTAL t u.u4 shall not be valiC been signed by an Elec , the electrical portion of th.is permi t and returned to the Building Division YE t comp eted apnl i cati on r Dermit, and do hereb.y certify that al l information hereon is trueand correct, and I further certi fy that any and al I work performed shall be done in accordance with the Ordinances of the TOTAL CHARGE5 WHERE ST TE LAII of Sori ngfield and structure wi I REQUIRES that tlre Eunt'il tte ]ab€l has perm ffect ectrical work be done 0reo heB by an Electricaltrical Supervisor the Laws of the State of on oertai ning to the work described herein , and that ilO 0CCUPAI,ICY will beof Boa any rd 'i s in full force and e as required by thout the ission of t Ci ty madeuilding Division. ORS 701.055, that I further certil"y that m.y reqistration vrith the Builder,sift the basi s for exemption is noted hereon, and thatexemp 155 uionly'subcontractors and employees lvho are i n comcl i ance wi th 0l?S 701.0 ll be used on this oroject l,lAl.lE (pl ease pri e SIGIIATUF Zone__________Tyoe/Const. Uni ts So. iire Zone Bedrooms 0ccy Load Sq. Ftr-: Ftg Ftg l4ain Acce Val llp x Val ue:1ood Plain Stories BUILDING PERI,lIT Charges anC Su rcha rges PLUI'4BING PERMIT Charges and Surcha rges ELECTRICP,L PERIiIT Charges and Surc ha rges NECHANICAL PERMIT Charges and Su rc ha rges Group.Val0the r x TOTAL VALUATION I Addressc)tlly-\ Q yr -l (addrpss exnt rFq ( ohonp nn ( addres s )(ohnne no ) of anrps. I COI1BINATION APPL I CATi ON/PEP,I,IIT (CAP ) Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane Cornty M^" 17-01-432. example- Lot 1. Block 3, Znd A di.Sprjngfield EstatesC. Name, etc. of owner and constructicD. Energy Sources1. example- heat/electrical ceil in { ,2. EfimpIe-le- rvaterhTaTerZelEctilcaf, \ -- E. Square footage or valuation, etc.1. e:1amp1e- 1250 sq. foot house, 5[2- e-affil+ -if new project, check n {iEEF-add, ctc- \ F. Building perr,rit infornration:1. example - construct single famiil attached garage (-2. example - remodel existing garage3. example - convert single family r, restaurafit (change of use)G- Ii};:.:l.y'il.:i.ffi'i::"in section 3( f, II. OESIGII TEAII AND CONTRACTORS SPRINGFIELD CirY Holl PERMIT VALIDATION ,o regon Public w orks Ho. a"40t t65tl'a D^t-c ITY OF Soringlield DePortment o[ OFFICIAL RECEIPT B 54081r ( To avoid design or construction delays Divisisn Staff must be able to contact fLpersons regarding design 'information or r{ corrections, etc. Afibreviated Plumbing, Itlechanjcal, E flectriA. Except where blank spaces occur in the , lrportion of the Mechanical and Electrica, \r, the applicant need fill-in only the No.to the appropriate item(s) to be instal l ( ( 1I ( B. Full Plumbing, Mechanica l , and Electrica fn.are available at the Building Division1, To conserve space on the permit form have been abbreviated2- If tte item(s) to be installed are no /rvtfie a-bbreviated scheduis you .should \,' ful'l schedulesC. BUITDING DIVISION SIAFF Mlt FTI_L OI,IT ALL { u]. CHAREES OIT T'{E SCHEDULESD- As notEd on the CAP, tte label mrst beelectricai contractor for signature bysupervisor. The general contractor isto sign the electrical 'label. Fpplicam to s'ign ard date l.Jhenever possible, the initial application del C his not ( wi'11 t- ( nt ,ived SHELlOR IUFNBU a rrrorksheet on1y. ldhere possible, Building Divwiil prepare a type wriflen copy and return it 1 y'jt applicant at the'time the actual perrit is issue t"" y---.signature. t Fees and Cirarges \- ( ]V v P'lan check fees ar.e due and payab'le at the time rapplication, and no plans will be processed untii fees are pairi. All other fees and charges are du payable when the permit is issued. FOR OFFICE UsE ONLY \es Permit Clerk PROJECT CONDITIONS TO BE SATISFJED BEFORE OCCUPAIICY: Permit app'licant exempt from registration r,rith the Bujlder's Board because: Additional Project Information: PLANS REVIEWED BY: name s i gnature dat ( (