HomeMy WebLinkAboutPermit Plumbing 1990-05-31INSPECTION L
7?6-37 69
CIT\] OF SPR
CCIIBi IIATI Ci,I APPL i
ira aT ELD
N/ PERI'|I TanTIn 726
EIIERGY SOURCES
Hea i.
Val ue of l,lor k
e
l,ater He.1te'rS)ooLegal Description
Job Address !q. Ftg. Access.-._-
Sq. Ftg 0ther
Sq . Ftg . l'la i
:e. r Bui'ld Singlei
Famill, Residence I'lith Attached Garaqe)
Construction Lend
Addres s Phone
ohone no.Iics. no.addressname
Pri ma ry
Structura I IT-
El ectri cal
l.lechan i ca I
ohone no.addres s (1ics. no. ) (expires)ACTORS name
rytu-
cal
l)fr-)
I
YawPumb
I'techani cal
MECHAN I CALELECTR I CALPLUHB I NG
FFF CHARGF NO FFFFEECHARGENO
Residence of
SQ. FT
furnace/burner to
BTLI. sEach single fixture
New circuits alts
or extensions
Floor furnace
and vent
Relocated building
(new fix. additional)
SERV I CES
Recessed wal I
Soace heater and vent
S. F. Residence(l bath)
Duplex (1 bath) each
Apol iance vent
<pnaratFTemporary Constructi onAdditional bath r'"ff4r 2{@ e in existing
en ce
Chang
resid
Stationar.v evap.
cool er)llater servic" 13'f
multifam'i ly, comm
I ndrrstri a l
or Vent fan with
sinole ductSewer
Vent systern apart from
heatino or A.C.amps.0fStorm Sewer
Mechanical exhaust
hood and duct-c0Mr.1./IND. FEEDERS
Instal I /al ter/rel ocate
dictrih^ feeders l'lood stove/heater
.amps.0f
ISSUANCE OF PFRIlIT
TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES
WHERE STATE LAN REQUIRES that the Electrical work be done by an Electrjcal Contractor, the electrical portion of this permit
shall not be vali:J until the label has been signed by an Electrical Supervisor and returned to the Building Division
i HAVE CAREFULLY EXAHINED t:re completed application for oermit, and do hereb.y certify that ali information hereon is true
nd all work oerformed shall be done in accordance with the 0rdinances of the
regon Dertaininq to the work described herein, and that NC OCCUPANCY will be
t'lAtiE (pl ease pri nt S iGNATU
Ci ty
made
the permi
nd effect
ied t
and correct, and I further certify that any aof Soringfield and the Laws of the State of 0
istration with the Builder'sof any structure without ssion of the Building Division. I further certif tha t
Board is in fuil force a as required by ORS 701.055, that if exempt the ts tion is noted hereon, and thatonly subcontractors and employees who are in comcliance with 0l?S 701.055 wi]1
Uni t Value
Fire Zone
Flood Plain Value
TOTAL VALUATION
Zone x
x
oelConst
upSBedrooms
!q. rt s
xr Val, 0ccy Load
GroupStori es
l'la i n
Acce s s
0the r
q. Ftg
q.Fts
Pl an Ck. Conrn/Ind
65%/81do Per Fee
opmentSvs
cha
e 'I
)
teris Devrqe (1.5BUILDING PER}IIT
Charges and
Surcharges Plan Ck. Res
30%/81dq Per Fee
FencePLUI4BING PERMIT
Charges and
Surcha rges -BQ.isD Demo
SidewalkELECTRICAL PERI|IT
Charqes and
Surcha rges Tota l Cornb. Perm.i tA/C Pavi ng
Curb CutI,IECHANICAL PERMIT
Charges and
Surc harges ,3I SCTOTAL
Owner
Address Phone
oo
PERMIT VALIDATION
Permit Clerk
c'i-+
o"\q
N,
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 43
?. example- Lot 1. Block 3, 2nd Addition to
Springfield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
1. example- heat,/electrical ceiling/or forced air gas
2. exahple- waterheater/electrical/or solar
E. Square footage or valuation, etc.
1. 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 sing'le family house with an
attached garage
2. example - remodel existing garage into family room
3. erample - convert single family residence into
iElta-urant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Bui)ding
Division Staff must be able to contact appropriate
persons regarding design information or iob site
corecti ons , etc .
II. Abbreviated Plumbing, Mechanical, & Eiectrica'l Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrjcal Schedules,
the applicant need fill-in oniy the No. Boxes adiacent
to the appropriate item(s) to be installed
B. FulI Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedules
.. have bee-n abbreviated
2. If the item(s) to be instal'led are not covered on
the abbreviated schedules you should consult the
fulI schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is not authorized
to sign the electrical label.
III. Applicant to sign and date
}lhenever possible, the initial application wil'l be used as
a worksheet only. Where possible, Building Division Staff
will 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 payab'le at the time of the
appiication, 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
PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPANCY
permi t appl .icant exempt f rom reg'istrat j on wi th the Bu j I der' s Board because :
Additional Proiect Information :
PLANS REV I EIIIED BY :
dates i gnaturename