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Home My WebLink AboutPermit Mechanical 1980-03-05COMB I APPL I CATI ON RMIT 7)A_ L Job Address Legal Description EIIERGY SOURCES: Hea t l,later Heater Ranql3I a< N-- varue of ,*.SQS.O Sq. Ftg. Access..---- ter__.-GE-- c n Sq. Ftq. 0ther llew Add Al hange/ Use Sq. Ftq Address Phone Builtlinqperniffi Farnily llesidence I'lith Attachea Garaqd e., Build Single -&.lLConstruction Lender \ )'.F Addres s Phone dcc _cJ I]L5I GN TEAI.I name address (lics. no.exD I res phone no. P ri ma r.y Structura I l"lec ha n i ca I name a ddres s I'i cs. no - '(exoi res Dhone no. E LECTR I CAL 14ECHAN I CAL I,1e El ectri Each single fixture Residence of FTSQ furnace/burner to BTLI' s Relocated buildino (new fix. additioial ) New ci rcu.i ts al ts.or extens i ons FIoor furnace and vent 5 (I F. Residence bath )SERV I CES Recessed wal I i Soace heater and vpnfi Duplex (l bath) each Additional bath Temporary Construction Apol iance vent seDa rate l.la ter serv i ce Change i n exi sti ng res i dence Stati onar.v evap cool er Sewer Industrial multifamily, comm. or Vent fan with sinole duct- Storm Sewer 0f -arnp s.Vent systern apart from heatinq or A.C, c0l.4r.1./IND. FEEDERS Mechani cal exhaust hood and duct Instal l /al ter/re1 ocate di stri b. feeders t'lood stove/heater -1 Y 0f .amp s. ISSUANCF OF PFRM:JT 6)t TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I QUIRES that the E'lectrical work be dil the label has been signed by an E tlAl.lE(please print S IGIIA perm i t and of of Boa onl any ofngfie struc IXAIl EDN het erLL trml a dond he re c rtrfooncacompapr)DE e I th ta I II fo rman It heon 'Ire0nb.y fy trus errec0tandIfurcthe r 'Iert t tha d a II work shrmed 1a 'I doanfype rfo be ne nI cca rdano ce tth Ord ihe nna Srce theof 1c ty'Ir dI andSo th e La r^/s Staofthe te 'Irta 1n n theto rWO konpe de rsc bedI ereh n'I an thad NCt CUOC PAII0regg CY I beI madel/'/ratunywlre0uthtthe1ermss0n1fp0the'Iu diI Di S on fuIng Lrther 'Iert th ta sI rat 0n.iLI thurl Bu I'I der sfyregm.y thei 'I fun IIs,1rd ll rceo eand tffec sa tha 1 fredIORS00515t het ba S'I rfo Irequexemptt on otedn rehe 0n tha tandbyexemp SU onbc rac to rst and Iv l./hs ao 'Ire comn I aIernpoyee WInce ht 7010r?s 055 i be sU np0ed th S'I ec tpro,j one by I ectri an Electrjcal Contractor, the electrical portion of thiscal Supervisor and returned to the Building Division WHERE STATE L,II,I RE shal I not be val i.i unt l4ain Fire Zone Bedrooms Stori esFlood PIain Zone x TOTAL VALUATI __v alue Load Ftg Group Sq al ue 0N ': Acce s s Val ue Const. Un i ts So. Ftq Ftg.0ther Plan Ck. Comm,/Ind 65%/81do Per Fep Svstenis Deve' Charge ( 1.5c' o pmen tBUILDING PERMIT Charges and Su rc harges Plan Ck. Res 30%/81dq Per Fee Fen cePLUI4BING PERMIT Charges and Su rc ha rges Derno Su C Povi n9 rges \\{e'Nt\ Curb Cut TOTAL tonb. lermit PEP.MITMECHAII Charges and Surc ha rge s Electrical lcl.., (oC l\J' I i\0 i PLUtlBI NG I FFF NHA RGF NN FFT al..tADcF Irn FFF 1^1IADNF 'I PERMIT VALIDATION Permit Clerk COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference T7-T3-43 2. ' example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender 1. example- heat/electrical ceiling/ 2. example- waterheater/electrical/o E. Square footage or valuation, etc. F. Building permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. examp.le - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI'I AND CONTRACTORS To avoid des'ign 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 SchedulesA. Except urhere blank spaces occur in the description portion of the l.lechanical and Electrical Schedules, the appl icant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, 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 schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to the electrical contractor for signature by his electrical supervisor. The generai contractolis not authorized to sign the electrical label.III. Appiicant to sign and date Whenever possible, the initial application will be used as a worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signature.IV. Fees and Charges 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. 1250 sq 'i f new exampl e- ExampTar EIEEE add D. Energy Sources or forced air gag r solar foot house, 500 sq foot garage project, check new - if addition, , etc. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAITCY: Permit applicant exempt from registration with the Builder's Board because: Additiona'l Project lnformation : PLANS REVIEI^JED BY name da tes't gnature , LI 3 CI COI4BI iIAT OF SPR APPL i IELD -ON/ PERMi T litrl CATI NFO 7 53 l-ega 1 Descr.i pt i on Job Address Ranqe l,later Heater EIIERGY SOURCES: Hea t Val ue of l,lork '5Qgrp Sq. Ftq. Access So. Ftg. Other ' Ftg n Addres s Phone Si entdeoora i ) Builclin qPe Res i e l^,lorkFarni I y nce l/i nn ttac hed Ga Construction Lender Address Phone n res I l''lec ha n i ca I El ectri cal Structura I Prima ohone no-I PLUtlBING t. I I I,4ECHAN I CAL NO FEE C HARGF ELECTR I CAL Each sing)e fixture furnace/burner to BTLI ' S Relocated buildinq (new fix. additional ) New circuits alts.or extens i ons Floor furnace and vent S . F. Res i dence(l bath)SERV ICES Recessed wal I i SPace heater and ventr; Duplex (l bath) each Additional bath Temporary Construction Apol iance vent sepa rate l,later servi ce ge in existing dence Chan res i Stationary evap cool er Sewer multifamiiy, comm. or Industria l Vent fan with sinole duct Storm Se'rrer 0f amps.Vent systern apart from heatinq or A.C. cor,ilr./IND. FEEDERS Mechanical exhaust hood and duct I ns ta I I /a I terl re1 oca te di stri h. fpederc llood stove/heater 31 0f s. ISSUANCE OF PFRI1IT t TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES UIHERE srATE LAI,J REqUIRES that tlre Electrical work be done by an Electrishall not be vali'i until the Iabel has been signed by an Electrical supervi l.lAl.lE( p1 ease pri nt)DATE YE cal Contractor, the electrical portion of this perrilit sor and returned to the Building Division and of of Boa onl HAVE etedI atheD noccompat t an d dopl-)Derm l 'Irt t tha I Ihe I fon irrna t onfyreb.y he 'I ts erureontco rrec a Ind rtfu rhe ticer tha t nd Ia Iaf-v wo kr rfo rme sd Iha Ipe ecorda nc twl h rd IacnIedonbethe0 n nca CS of het Ci ty'I If Ie ad thend any ofSorngofLawsethtaS 0rete 'Ioe rta 1n n thto e work!0n des bedcrl he nrel and th ta Ng C UPOCC AHC 'I 1I be madeaucstrretuLwlnyLhouthe'Iss n of IpermitheI3udI'I ID 'I .I S In9 hefu rt r 'Irt t tha re 'I str I no tht4l heL Bu I1 r sdefym.y gfunIIsIrdafo rce efnd ctfe sa 1 ha ,l fured0Rs017550t bathe 'IS fors e oI 'Ireqbyexempt n0S hereonted andxempt tha tsuonbctracvtoransdIwhoesaernpren'I I anI wlceoyecomc th 0l?s 05 5 l,l l I 1 be onused hiL s e ctpro,j IGi{ATU Ftg Ftg Ftg Uni Valxq x x Fire Zone Bed ro0ms Const 0ccy Load Flood Plain Stories 0cc.y Grou Val ue Val u Zone l'la i n Acces s 0the r Plan Ck. Comm/Ind 65tlBldo Per Fee Svstems Deve Charoe ( 1. s2 opmen t I BUILD]NG PERI'IIT Charges and Su rc ha rges Plan Ck. Res 30%/81dq Per Fee Fen cePLUI4BING PERMIT Charges and Surcha rges Dgrno Sidewalk A/C Pavi ng Total Comb. Permit Curb CutI,IECHANICAL PERMiT Charges and Surcharges Cha and Su s ELECTRICAL PERTlIT TOTAL lbuo I Nn FFT itn FFT I^HAQCI:Residence of : sQ. FT. PERMiT VALIDATION CITY OF SPRINGFIETD eirY Holl Springfield, Oregon Deportment of Public Works OFFICIAL RECEIPT (. No.B 52959,Fl\J :ived For :unl Received AUTHORIZED SXELTON-TURNBULL PRINIERS EUGEilE OR 97'O! Perm'i t Cl erk COMBINATION APPLICATION/PERMIT (CAP) L Appl i cant 'to furni shA. Job Address B. Lega) Description 1. example- Tax Lot 100, Lane County Map Reference l7I3rr3 2. i example- Lot 1. Block 3, 2nd Addition to SEITnITield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/elqctrical cqilj or fgrced air gas 2. examtle- rvaterhEateTTETecTiJcilTor soTar E. Square footage or valuation, etc.l. examole- 1250 sq. foot house, 500 sq. foot garage 2. exanQlE JT-new project, check-i-ew - if addition, Efeck-add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. examole'- remodel existing garage into family room 3. example - convert singie family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty Code .H. DESIGN TEAI.l AND COI.ITRACTORS To avoid design or construction delays, Building Div'ision Staff must be able to contact appropriate persons regarding design information or job site corrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except urhere biank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Ful l 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 the ful 1 schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labe'l must be deljvered to the electrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the eiectrical 'label. IIL Applicant to sign and date Whenever possible, the initial application will be used as a urorksheet on1y. l,lhere possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gna tu re.IV. Fees and Charges Plan check fees are due and payable at the time of theappiication, and no plans will be processed until these fees are paid. All other fees and charges are due and payab)e r.rhen the permit'is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit appl'icant exempt from registrat'ion with the Bu jlder's Board because: Additional Project information: PLANS REVIEWED BY name s'l gna tu re date ( ( ( (