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HomeMy WebLinkAboutPermit Building 1980-10-13SPECTIOII LI 6- 37 69 726-37 Job Address EIIERGY SOURCES Hea l.later Heater ,:i-E{ , e Ftg n Sq. Ftg. Access Sq. Ftq. 0ther r ha e/Ung e 2 -/ r-esal Descri otionf 6 X* VO 7-r-Q Owner Vai ue of l.lork:t6:1P9oo Address Phone Builq,ino Pernrit Info: Describe l.lork(Farnily Residence l,lith Attached Garaqe I i .e., Build Single <,o{to 1 W,,?, is, Y*osTi,rvr - lera"rt r o C *<rtce co*til.tiU L.no".E/*s5r^ri* T- Address Phone name i Primarv to3 Struct';ra I l( ElectricaI I I rleahantCal t; n ilr..e addres s I i cs. no.exol res ohone no. t Cenera I I :1, -hi^^Ir Elecirical I ":c;:.ical PLUiIB I iIG ILLLl i1L^L MECHAN I CAL Ci:CHARGF Iln I rFc i cHARcF ll0 FFF CHXRCT Each single fixture A Res idence of V5.7-sq rT furnace,/burner to BTU' S I Peiocated buildinq (new fix. additiona l ) New ci rcui ts al ts or extensions Floor furnace and vent S,F. Residence ( l bath)-if,a:SERV I CE S Recessed wa l I Soace heatpr and vent Duplex (l bath) each Additional bath i*{)-l ,3aas Temporary Constructi on ,4./.:;{->: Apol iance vent s eDa ra te l,la te r se rv i ce C han res i ge in existing dence Stationary evap cool er Sewer multifamily, comm or Tndrrstrial l,Vent f an w'i th sinole duct !-cd Storm Seler 0f amps.Vent system apart from heatino or A-C. COI4I'1./IND. FEEDERS /itlechanical exhaust hood and duct Instal I /al ter/rel ocate dictrih- fepders llood stove/heater ,1aa 0f amps./ft€*r i?ovt o.&,cA I ISSUANCF 0F PFRIIIT /AgC TOTAL CHARGES {f,e1 TOTAL CHARGES 4{,.i:Jr Y TOTAL CHARGES 4q^9; L'HER shal I no E STATE LltJ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrica) portion of this pemit t be valil until the label has been signed by an Electrical Supervisor and returned to the Bu'ilding Division I HAVE CAREFULLY EXAI1INED the completed apniic,rtion for nerrnit, and do hereb,y certify that all information hereon is true and correct, and I further certify that any and all rvork oerformed shall be done in accordance with the Ordinances of the City of Soringfield and the Laws of the State of 0regon Dertaining to the work described herein, and that NC 0CCUPAI,ICY will be made of any structure without the perm.ission of the Building Division. 1 further certify that rny re-oistration vrith the Builder's Board is in full force and effect as required by ORS 701.055, that if exemot the basis for exemption is noted hereon, and that onl-v subcontractors and ernnloyees who are in comcliance with 0l?S 701.055 vrill be used on this oroject. Nl,lAtlE(please print)I Gi{ATURE DATE FOi? OFFiCI I]SE OIJL Zone T.yp e/Const. E*f Units /Ftg Ftg Ftg iratn /7t'{ x Acces s ,.ji*Ira vurr" , f,.5, vutr" t,i3 7c. Lifr 4 -i4'{.ca-KTif a,,) - 4Q 7.** /-nlL , y' i/ a. u t i Fire ZoneAedrocms Load Fl ood Pl ai n .Vf; Stori es ,-} lX 0c c.y Group &-?-sq o the r /.flsy!$fu i -1< -fi lft--u a 1 u e TOTAL VALUATION BUILDING PERI|IIT Charges anC Surcharges Plan Ck. Cornm/Ind 65%/Bldo Per Fee C.4- 9A, t n Svstems Deve Charqe (1.5t opment ti?s, # Plan Ck. Res 30%/Bldq Per Fee n?3,s a- PLUI4BING PERMIT Charges and Su rc ha rges {J-( a\A rJ<',i** Fence f 4*o Dgmo 0,*.e,x g\tia - /,1. bC ELECTRICP.L PERI.:IT Charges and Surcha rges {,&ee-Sidewalk Total Comb. Permit Curb Cut TOTAL 33F, A.y I,IECHANICAL PERMIT Charges and Surc harges ^1*'s-P-/,3 { ohone no - Af ;ii!-lS A/C -Pavi ng (P{7'52':, &rilk COMBINATION APPLICATION/PERI,IIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map ReferenI7t:--Ts2. qxqrnple- Lot l. Block 3, 2nd Addition toSpr-in!-iield EstatesC. Name, etc. of owner and construction lender0. Energy Sources ctry oF s.pRi['drtErD Ciry Holl o", "ti;::lierd'- o res on oFFf c;fi.f ::T;,y;.u, eiectricai c iti hea ter ec Ld or forced ar soTfF- frfo. B 54887]' examoIe- heat/2. EianrilE water SquaiET6otage or e I9 E valuation, etc d l. examole- 1250 sq. foot house, 500 sq. foot gZ. exampie- jf new project, check-n-ew - if addiEIEEk'-aod, etc.F. tsuilciing per:it inforr,:ation:1. exangle - construct single family house rvitattacnec oarege2. exancle - remodei ex.isting garage into fami3. examrfE - convert single iaiily-resiaence i r ^ restaurant {chan-oe of-use)G. Value of work as defined in Section 303 (a) of ._ Structural Speciaity CodeH. DESIGii TEAI,I AND COI{TRACTORS i To avoid design or construction dela_vs, BuildiDivision Staff must be able to contatt approprpersons regarciing design informat.ion or job sicorrections. etc. l Abbreviareo Plumbing, ilechanicai, & Eiectrical SclA. Except r,rhere blank spaces occur in the ciescriDortion of rhe i4echanicai and Electrical Schethe applicant need fill-in oniy the No. Boxes Ua,_ to rhe approoriate item(s) to be instailedB. Full PIurbing, i'techanjcal, and Electrica.l Sciare avaiiable at the Building Divisjon1. To ccnserve sDace on the permit form the herhave been abbre,r'iated2. If the item(s) r-o be installed are not cthe abbreviaced schedules you should conful I scnedules aC. BUILDIiiG DiVISION STAFF t^lILL FILL OUT ALL FI CHARGES Oi{ THE SCHIDULESD. As noted on the CAp, the label must be de.l i,electricai contractor for signature by his {cttsupervisor. The general coniractorr ii notto sign the eiectrical labelApplicant to sign and date ved For Permit Clerk z%a c q o iI t@II III t r, 4mo unt BY Whenever possible, the initial applicat.ion wil: e ua.worksheet oniy. i.there possibje, Building Di, {.-wili.preoare a type v,ritten copy and returi it+_-.appiicant at the time the actuai permit is issueci for his s i gna tu re. Fees and Charges P'lan check fees are due and payable at the time of theapplication, and no plans wiil-be processed unti.l theielees are paio. All other fees and charges are due andpayab'ie vihen the permi t is issued. FoR oFFI CE USE oillY €u€EnE oi graot ta![.s V P ROJ IE T ONC I IT N0 S TO E TJlA SI IF DE En D 0F RE 0 PCCU AN Y rmit applicant exempt from registration with the Builder,s Board because:Pe Add i ti ona I r -P ro e tC ni fj o orm t on PLANS REVIEWED BY name da teSigna tu re ) l / ( i I il t \ { U t