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HomeMy WebLinkAboutPermit Building 1990-06-14N ? L CITY OF SPRINGFIELD CO}{BI NATI ON APPL ICATION/PERMIT the completed apnlication and correct, and I further certify that any and all work pe of Spri ng fi s tru eld and the Laws of the State of 726-3753 t, and do hereb.y certify that all in on hereon s true shall be done in accordance with the 0rdinances of the r Ci ty made cture wi thout s in full force a the permi nd effect 0regon oertaining the Building Divisssion of to the work described herein, and that NC 0CCUPAHCY will be'ion. I further certify that my registration vrith the Builder'sof any Board i only subcontractors and employees who are in comp Iiance with 0l1S 701.055 wilI be used on this oroiect tlAtlE(please print h^I GNATURi as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that DAIE 6.'1 -?t Job Address l-egal Description Ran Hea EIIERGY SOURCES llater Heater ""\dlilDo*Owner L Sq. Ftg. Access. Sq. Ftq. 0ther_ _l,lew____,Add1 I te r_Rep . _Fence_Demo Change/Use 0ther . Ftg n r Phone Builciinq Permit Info: Describe t,lork(i.e., Build Single Family Residence liith Atiached Garaqe) . \ e er.n[ Address r}IConstructr I4\*/td Addre s s Phone ICS- nO-resDE5I GN TEAI,I name address exD Pri mary Structura I EI ectri cal Mechan i ca I address 1ics. no.exot res ohone no.CONTRACTORS name drt rfir \Ai IC \?3 \Pl umbi nq E l ectri ca I l,lechani ca l MECHAN I CALELECTR I CALPLUI{B I NG FFF l^ HA PGF Nr FFF CHARGFFEECHARGENO furnace/burner to BTU' sEach single fixture Residence of FTSQ New circuits alts. or extensions Floor furnace and vent Relocated building (new fix. additional) Recessed wal l Snace heater and vFntSERV I CESS. F. Residence(l bath) Duplex (l bath) each Temporary Constructi on Apol iance vent seDarateAdditionaI bath ge in existing dence Chan rFsl Stationary evap. coo I ertlater service mul ti fami 1 y, Tndrrstrial comm. or Vent fan with sinqle ductSewer Vent systern apart from heatino or A.C.0f s.Storm Sewer Mechanical exhaust hood and duct-c0Mr.1./IND. FEEDERS I n stal I /a l ter/ re l ocate dicfrih- fepders lrJood stove/heater 0f amps. ISSUANCF 0F pFRtlIT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES WHERE STATE LAI,I REQUIRES that the Electrical work be done shall not be valiC until the label has been signed by an Elec bytri an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division ToTAL VALUATI0N_ x x. 0ther I Acces s l'la i n 'I u Ftg Group Sq. Ftg Const. Uni ts Sq. l-tg Flood Plain Stories Zone Fire Zone Bedrooms Occy Load Val ue opmentPlan Ck. Corrn/Ind 65%/81do Per Fee Svstems Deve Charqe (1.5q Plan Ck. Res 30%/Bldq Per Fee BUILDING PERMIT Charges and Surcharges Fence D6mo PLUI,IBING PERMIT Charges and Surcha rges SldewaIk Tota'l Comb. lrermitA/C Paving ELECTRICAL PERI1IT Charges and Surcharges Curb Cut CTOTAL T,IECHANICAL PERMIT Charges and Surc harges tld t't, Jni Ir lnne nn -.{i.tr"--- COMEINATION APPLICATIONiPERMIT (CAP) i Applicant to furnishA. Job AddressB. Legal DescriptionI' example- Tax Lot 100, Lane County l'lap Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SFTin:-fteta EstatesC. Name, etc. of owner and construction lenderD. Energy Sources l. exampl e-2. exampl e- E. Square footag hea t/el tri 0 r forced air gas sol arwateeae e or valuation, e1. 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 room 3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structurai Specialty CodeH. OESIGN TEAM 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.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. FulI P'lumbing, Mechanical, and Electrical Schedules are avai lable at the Building Division1. To conserve space on the permit form the schedu'les ..'have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful l schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de]ivered to theelectrical contractor for signature by his electrical supervisor. The general contractor is not authorizedto sign the electrical iabel.III. Applicant to sign and date lJhenever possible, the initial application will be used as a worksheet only. Hhere 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 P'lan 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. V. FOR OFFICE USE ONLY PERMIT VALIDATION # NE6U ("-14--qo Permit Cler PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name sig nature date