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Home My WebLink AboutPermit Mechanical 1980-12-19II INFORIIATION LINE 726-3753COMB I ERMITAPITI l-egal Description i1 0 a > LDJob Address l.later Heater Ranqe- EIIERGY SOURCES Heat fcr L* txsn Owner 0tt t!9-Value of l,lork: b38 So. Ftg. l'1a i n_ Sq. Ftg. Access._ Sq. Ftq. Other_ _f 'l ew__.Ad d,--A 1 te r_Pe p . Fence Demo Chanqe/Use Fother- Address :€.;Singlenit I^.t 'idence ilith A Construct i Jn 'Lender d OA I Addre s s Phone @ o !., (,\ ..1 DESIGN TEAI{name address exo i res ( phone no Primary Structu ra I E lectri ca.l l'lec ha n i ca 1 n ame a ddrps s (lics. no.exoi res (ohonp no. PLUIlB I NG ^rechani PI E I ectri ca l ELECTR I CAL .i0.Erc CHARGE NO FFF I^HA RGF Each singie fixture Residence of SQ. FT Rel ocated bui 1 ding (new fix. additional ) New c ircu'i ts al ts or extensions MECHAN I CAL furnace/burner to BTU' s Fl oor furnace and vent S . F. Res i dence(l batn)SERVICES Recessed wal I Soace heater and vent Duple>: (1 bath) each Additional bath Temporary Constructi on Apol iance vent spoa rate l,later service Change in existing res i dence Stati onar.v evap cool er Sewer multifamily, comrn, or I ndu stri a I Vent fan with sinale duct Storm Sewer 0f amps.Vent systenr apart from heatino or A.C. c0r.rH./IND. FEEDERS Mechanicai exhaust hood and duct Instal I /al ter/rel ocate dist-rih. fepdprs /l,lood stove/heater 509 5.uo- 0f amps. ISSUANCF OF PFRI'IIT /O,O: TOTAL CHARGES OTOTAL CHARGES C),5."9TOTAL CHARGES I^lHERE I not STATE LAI,I REQUIRES that the Electrical work be done by be valil until the label has been signed by an Electric an El al Su ectrical Contractor, the electrical portion of this permit pervisor and returned to the Building DivisionshaI I HAVE CAREFULLY EXAI1INED the comp'leted application for oerriiit, and do hereb.y certify that atl information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the Cityof Soringfield and the Laws of the State of Oregon oertaining to the work described herein, and that NC 0CCUPANCY wil'l be madlof any structure without the permission of the Building Division. I further certify that m.y reqistration 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 comoliance with 0l?S 70i.055 will be used on this Dro,ject. D:/?f?EtlAl'lE(p1ease print)S iGNATUR DATEw FON rJFFICE USE Oi,I Plan Ck. Comm/Ind 65%/B111o Ppr Fce Svstens Develooment Charqe (1.51)BUILDING PERI'IIT Charges and Su rcha rges ee Plan Ck. Re 30%/Bl dq Pe srF Val ue r0TAL VALUAT IoN (o,3832 x x o 0c cy Load On c.yFlood Plain - :Stories Fire Zo - Uni ts s x Value Co tns l'la i n Val ue Zone Ftg Ftg Ftg Acces 0ther FencePLUI4BING PERMIT Charges and Surcha rges O D6mo SidewalkELECTRICP,L PERIIIT Charges and Surcha rges O A/C Paving Total Comb. Permit Curb Cut t< bO/-), / NECHANICAL PERMIT Charges and Su rc ha rges t /< oo TOTAL C) PhoneTyC,.f(V l^CJ 0v. CON TRACTORS General (1u>*O{ -), COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. exampie- Tax Lot 100, Lane County Map Reference 17 03 43 ?. exampie- Lot 1. Block 3, 2nd Addition toSpIiffiieid Estates C. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALiDATION 1. example- heat/electrical cei l ing/2. example- waterheater/electrical/o E. Square footage or valuation, etc. or forced air gas r sol ar 1 example- 1250 sq. foot house, 500 sq. foot garage example- if new project, check new - if addition, check add, etc. ding permit information : examole - construct single famiiy houEe with an;itaal.td sarase 2 F. Bui I 1. II 2. example .. remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of $rork as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI4 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. Abbreviateo Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the l4echanical and Electrical Schedujes, the applicant need fill-in only the No. Boxes adjacentto the aopropriate 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 WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. 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 Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possib)e, Building Division Staffwill prepare a type written copy and return it to theapp)icant at the time the actual permit is issued for h.is III s i gna ture.IV. Fees and Charges Plan check fees are due and application, and no plans wi p I ayable at the time of the 1 be processed until thesefees are paid. Ail other fees and charges are due and Payable when the permit is issued. FOR OFFICE USE ONLY Permit Clerk PROJECT CCNDITIONS TO BE SATISFIED BEFORE OCCUPANCY Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name Si g nature da te c CONBI iIA TI N APPLICATI IT 26-37 ,lob Address t,EIIERGY SOURCES Hea t Ft9 ln Sq. Ftg. Access.-- l-egal Description t'l 0 a liater Heater So. Ftq.0ther Ranqe l,lew Add A -Fence Demo lIeYLPet._ Cha nge/ Use Value of l.lork f-ot her- Owne r 0_ N o D $Address Phone Builclino Perntit Inl Fami Iv Residence i.li Descri be l,lork :€., Build Single ( v\-tr+G-(t r*-4 iunsar{ -, 4 itV,l.,r Cons tructiln Lender Addre s s Phone a-a name address exo i res no Pri ma r Structi.rr'a I Electrical l'lec ha n i ca I NTRA n arne a ddres s lics- no-)exo i res phone no. EI ri I PLUiIB I IIG ELECTR I CAL MECHAN I CAL 'ic FFF CHARGE u0 FFF I^HA PGF Each singie fixture Residence of SQ FT furnace/burner to BTU' s Floor furnace and vent Relocated bui idinq (new fix. additional)New circuits alts. or extensions S . F. P.es i dence(l uatn)SERV I CES Recessed wal I Soace heater and vent Dupler: (l bath) each Additional bath Temporary Construction Apol iance vent seoa ra te l"la ter serv i ce Change i n exi sti n-q res i dence Stationary evap cool er Sewer mui tifami 1y, comm or I ndus tri a i Vent fan with sinole duct Storm Sewer 0f Vent system apart from heatino or A.C. COi4I.I./IND. FEEDERS Mechanical exhaust hood and duct insta I I /a I ter/re1 ocate distrih- fepdcrc /l'lood stove/heater 5P9 5.oo- 0f amps. ISSUANCF OF PFRIlIT /o.o! TOTAL CHARGES o TOTAL CHARGES O TOTAL CHARGES /5.sO WHERE STATE L.ltJ REQUIRES that the Electricat work beshall not be valil until the Iabel has been signed by an done by an Electrical Contractor, the electrical portion of this permitElectrical Supervisor and returned to the Building Div.ision I L Y INE D the c0mp I a pl't c at 1 on Derrni t an d certi fy tha t a I 1 'I n fo rma t on he reon i s trueand correctof Springfiof any stru, Board is in only subcon a nd I fu rt he r cert I fy t ha t any and te of 0re, n of the I I l^Jor k pe rfo rmed s ha I I be done n accorda nce th t he 0rdi na nce s of the |-I tyeIdandtheLawsottheSta!on oerta 'I n1 ng to the work des cri bed here i n a nd th a t t,tc OCCUPAI,ICY wl I I be madectuwlthoutthermt,lress Bu 1 I d I ng D 1 'I s I n i fu rt he cert i fy t ha t m.y reg I s tr,a L I 0 r//t th t he Bu I 1 der sfuIIforceandeffectasrequ j red bty ORS 7 01 055 tha t 1 f exempt the ba 'I S for exemDt 'I o n 'I s noted he reon a nd t ha ttrtorsandernpIoyeeswhoareIncomcI'|an ce t{l th 0l?s 7 0 05 5 vJl 1 'I be used 0 f h t s l)roj ect t,lAi'lE ( p I ease pri nt )S IGNA &DATE Zone l7 I e/Cons t.Uni ts - Srl Ftg Ftg Ftg l,la i n ValFire Zone * Bedrooms 0ccy Load _ Sq . Access x V alue Flood Plain - Stories _ 0cc.y Group q Val ue TOTAL VALUATION C>-oo S 0the r BUILDING PERI'IIT Charges and Surcha rges O PIan Ck. Comnltna 65%/81dq Per Fee Svstems Deve Charqe (1.5u opment Plan Ck. Res l0%/Blds Per Fee PLUI4BING PERMIT Charges and Surcha rges O Fence Demo ELECTRIC!,1 PERI|IT Charges and Surcha rges O Sidewal k A/C Paving Total Comb. Permit IlECHANICAL PERI"IIT Charges and Su rc ha rges /.< oo b -fr-- - I Curb Cut IOTAL c GN I tAI.l (n General J)u>f-A{ Plumbinq ^rechanical ltn IF;auADctr /s,o9 t .: I lectrical cei I i ortereecor valuat 0n, COMB INATION APPLI CATI ON/PERI,IIT ( CAP ) I. Applicant to furnishA. Job AddressB. Legal Description1. e&mole- Tax Lot 100, Lane County Map RefT7-I]-432. example- Lot l. Block 3, ?nd Addition toSffin-gfield Estates 9. Name, etc. of owner and construction lenderD. Energy Sources1. example- he2. exffi6lE wa SquaiE-T6oTase 2. examo I e- example- Elec t<- add 1250 s q. foot house,500 sq. foolT-i'ew, etc proj ect, check new - if a .. F. Building perm i t information PERI'lIT VALIDATION OF SPRINGFIELD Ciry Holl Springfield, Oregon Deportment of Public Workr OFFICIAT RECEIPT I{0. B 55428 , CITY tlat/force so-Ta r E Dote lJ-/q s30 , Rec'd From FrO il k L,Si'data t/ y'/o ch oo l. examole - construct singie famiiy house w;ttacla garage2. examole - remodel ex.isting garage into far3. @ - convert single iaility"resioence ^ ;es-"aurant (change of'uie)- ' * G. Value of work as defined in Section 303 (a) o.Structural Specialty CodeH. DESIGN TEAI{ AND CONT.RACTORS To avoid design or construction delays, Buitd.Division Staff must be able to contatt approprpersons-regarding ciesign information or job i;corrections, etc. Abbreviated Plumbing, l,lechanicai, & Electrical SciA. txceDt vrhere blank soaces occur in the descripportion of the llechan.ical and Electrical Schecthe appl icant need f il l-in only the l,lo. Boxes - to the appropriate item(s) to be installedB. Full PIumbing, Mechanicat, and Electrical Scheare availabie at the Building Division1. To conserve space on the-permit form the shave been abbreviated2. If the item(s) to be installed are not covthe abbreviated schedules you should consuful'l schedulesC. BUILDING DIVISION STAFF I^IILL FILL OUT ALL FEES CHARGES ON THE SCHEDULES0. As noted on the CAp, the label must be deliverelectrical contractor for signature by his e.lesupervisor. The generai contractorii not autto sign the electrical labelApplicant to sign and date llhenever possible, the initial appiication wi.ll bea.worksneet oniy. Uhere possible, Building Divisirwill.prepare a type vrritten copy and returi it to . applicant at the t'ime the actual permit is issued: s i gna ture. Fees and Charges LPlan check fees are due and payable at the time of theapplication, and no plans wiil-be processed until theserees are paid. AII other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY (t (r (l (l (5 o t b II III. (i, ( rin, to ( hi f nl Received /5. a_o AUfHORIZEO SIGXATURE sHEllox.luRtluLL PirntaRS EUGETE oi tTao! Permit Clerk G 0 IV v PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registratjon with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s i gnature da te ( Received For: 4E^,.(oU I