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Home My WebLink AboutPermit Building 1990-04-03PECTION L -37 69 N - --TTil_OF-SPRIXGITE L D CCtlBI iIATI ON APPLI CATION/PERMIT 72 \Job Address l-ega1 Descripti;n-\ n llater Heater Ranqe EIIERGY SOURCES: Hea t "'[dBtbgo Sq. Fto. l'1ai n-_ Sq. Ftg. Access.--- Sq. Fto. 0ther_ _l,lew_Ad d-A1 te r_Re p . _Fe n ce_Demo_Cha n gel U se 0ther Owner nt Re Bui I ci Farni ly Pernit Info: Describe tlork( sidence llit[ Attached GaraqeAddres {(c Constructi on re'a{ I ,e. , Bui ld n9 e \ Addre s s Phone exot res ohone no.DESIGN TEAI.I name address Pri ma ry St ructura I El ectri cal l''lechani cal Dhone no-n ame address'lics. no.exDt res Z oIra U \tPl umbi nq I E l ectri ca I l.'lechani ca l ELECTR I CAL MECHAN I CALPLUI,,IB I NG THAPGFFFFCHARGFNOFFFCHARG F NO FFFN0. Residence of FTSQ furnace/burner to BTLI' s Each single fixture New circuits alts or extensions FIoor furnace and vent Relocated bui'lding (new fix. additional) SERV I C ES Recessed wal I Snecp hpatpr end vpnt S , F. Res i dence ( l bath) Duplex (1 bath) each Temporary Constructi on Apol iance vent seoa rateAdditional bath Change in existing rpc i dpnce Stationary evap coo l ertlater service Vent fan with sinole ductSewerIndustrial multifamily, comm. or 0f s.Vent systern apart from heatinq or A.C.Storm Sewer cOr.il.'!. / IND. FEEDERS Mechanical exhaust hood and duct lJood stove/heaterInstal I /al ter/rel ocatedistrib. feeders nf S ISSUANCF OF PFRtlIT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES WHERE STATE LAl,l REQUIRES that the Electrical work shall not be valiC until the label has been signed by be done by an E l ectri ' an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division and correct, and I further certify that any and all work oerformed shal of Soringfield and the Laws of the State of Oreqon oertaining to the wo of any structure without the permission of the Building Division. I fu do hereb.y certify that all information hereon is trueI be done in accordance with the 0rdinances of the City rk described herein, and that t.lO 0CCUPANCY will be made rther certify that m.y registration vrith the Builder's t{AtlE(please print)DATEIGiI /( I HAVE CAREFULLY EXAHINE D the completed application for oermit, and u!, E o tBoard is in full force and effect as required by ORS 701.055, that if onlv subcontractors IA and ernpl i.n comcliance with 0l?S 701 nQ 'i s for on is noted hereon, and that viilI be FI r Uni ts Val ue Fire Zone Bedrooms Val ue Flood Plain Stories Val ue TOTAL VALUATION-._--- Zone XT'yDe/Const S SLoad SGroup q. Ftg. l'lain q. Ftg. Access x q. FtS. Other x 1 VC 501. opmenttems rqe Plan Ck. Conm/Ind 65%/81do Per Fee BUILDING PERI'IIT Charges and Surcharges PIan Ck. Res 30%/Bldq Per Fee FencePLUMBING PERMIT Charges and Surcha rges Dgmo SidewalkELECTRICAL PERI1IT Charges and Surcha rges A/C Paving Total Comb. lermit Curb CutI,IECHANICAL PERMIT Charges and Surcharges TOTAL tp: Lo3 ( COMBINATION APPLICATION/PERHIT (CAP) I. Appl icant to furnishA. Job AddressB. Legai Description I. geIp.l_g: Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot l. Block 3, 2nd Addition toS[Fii'frietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sourcesl. examDI e-2. "**1.--Square foota hea t/el tri I ceiIin or forced air qas !ta ge e ec tr ca or solar E or valuat on, etc1. example- 1250 sq. foot house, 500 sq. foot garage2. exarnpie- JT-i-ew project, check new - if additio;, 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 Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avo'id design or construction delays, Build.ing Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in oniy the No. Boxes adjacentto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Eiectrical Schedules are avai Iable at the Building Divisioni. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be instal1ed are not covered on the abbreviated schedules you should consult theful l 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 electricalsupervisor. The general contractor is not authorizedto sign the electrical label. Applicant to sign and date l,lhenever possible, the initial application will be used asa worksheet only. Where 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 ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY II III IV. v PERMIT VALIDATION 3 ) +\t 584 Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit appf icant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name SI g nature date