HomeMy WebLinkAboutPermit Building 1990-06-08CITY OF SPRlNGFIELD
COMBl I{ATION APPLICATiON/PERMIT 726-37PECTIOIi L
-37 69
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Job Address o rh-
l-egal Oescripticl /[,later Heater
Ranqe
EIIERGY SOURCES:
Heat Sq. Ftg. Access.-.--
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Val of l,lork a>Owner
ng le
Nith At
Construction Lender
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Addre s s Phone
frame
Pri ma
Structura l
E l ectri ca I
ical
MECHAN I CALELECTR I CALPLUIIBI NG
FFF CI.{ARGFFFFNHARGFNO:HARGE NO-FEE furnace/burner to
BTU' sEach single fixture
Floor furnace
and ventNew circuits alts
or extensions
Relocated building
(new fix. additional)
Recessed wal I
Snacp heater and ventSERV I CESS. F. Residence
( I bath)
Duplex (l bath) each
Apol iance vent
seoarateTemporary Constructi onAdditional bath
Stationary evap.
cool erChange i n exi sti ng
rps i denceblater service
Vent fan with
sinole ductTndrrstri a I
muitifamily, comm. or
Sewer
Vent system apart from
heatinq or A.C.0fStorm Sewer Mechanical exhaust
hood and ductCOI,lI.1. / IND. FEEDERS
llood stove/heaterInstal I /a l ter/rel ocate
distrib- feeders
0f a
ISSUANCE OF PFRI1IT
TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES
_ _DA.IE / - g- ?aS IGiIATUREl.lAl'lE(please print
Uni ts Ftg
Ftg
Ftg
TOTAL VALUATION-
xZone e
I
Const Val u
cal Contractor, the electrical portion of this permit
sor and returned to the Building DivisionREQU
unti I
triecE1anIbeworkdonetthaEtheectrIca'IRESISTATEt.lHERE L1\l,l I SucaIanecEl
bytri pervihaa bel beensI gned byhetbe'Iva j1Ishanot'|
' 0regon
the Bui
'Ireon ts rueonta1IItcertiddohereb.yantonI1catr)apheNEDtIcomp ofs fthe 'Iwltheth0rdn'I ance tyIIdo'Ine an ccordancermedhabeaIIworkandtaIndfuerrth1certthandatcorrecfy wl 'II madebetht.l0 ,ANCYOCCUPatandbed'|Ihere nknthetorwodescr
anyrof '|1rta gDEdndaLawsthet0Stathete'I Ieofsprngfi
1ul rde Ststirav,r0n theth B'Irt tha t0n'IV1 CE my regiIfu rthe rd1
,l
1D s fyngwItthoutheIssn0ofstutrucpermireofany tha tandInsIhereonnotedbaIsfortha'It f the exemptexemptORS0170s5'Iaseffect redu'IBoard 'IS fun I1 fo and byreqrce
0n th sI ect7ol550w11
'I usbe ed roj'II wiance ht 0lls pIwhos'Iare n comDandonubcontrsactorSemp0yee1y
0the r
Va'l ueFire Zone Bedrooms
Flood Plain Stories
l4a i n.
AcceLoad Sq
Group__ Sq
^/z ^
Svsterils Deve'
Charqe (1.57.
opment
I//.74_Plan Ck. Conm/Ind
65%/81dq Per Fee
Plan Ck. Res
307,/8ldq Per Fee
BUILDING PERNIT
Charges and
Surcharges a8s2
Fence
Demo
PLUMBING PERMIT
Charges and
Surcha rges
SldewaIk
Total Comb. PermitA/C Paving
ELECTRICF.L PERI'IIT
Charges and
Surcha rges
Curb Cut ??.?6TOTAL
I,IECHANICAL PERMIT
Charges and
Surc ha rge s
iur:arl
)e l^lork (I GaraoeAddress {ZS 6non"
=-;D'P;>?,I nhnno nnpxnt res( addressI)h5IGN ILAI'1
Mechani ca l
Residence of
SQ. FT.
PERMIT VALIDATION
bltho
Permi t Cl erk \99
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COMBINATION APPLICATION/PERMIT (CAP)
Applicant to furnishA. Job Addressts. Legal Description1. example- Tax Lot 100, Lane County Map Reference
17 03 432. exanple- Lot L Block 3, 2nd Addition to
SEffiETield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
1. exampl e-2. example-
E. Square foota1. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition,
check add, etc.
air gas
it information:
construct singie family house with an
garage
F Building perm
1. example -
attached
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
Structural Specialty CodeH. DESIGN 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 occulin the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in onl
iate item(s) to
v
be
the No. Boxes adjacent
instaI Iedappropr
umbing,
to theB. Full Pl Mechanical, and E)ectrical Schedules
III
are available at the Building Division1. To conserve space on the perm'it form the schedules
have begn abbreviated2.'lf the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
fui i schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to theelectrical contractor for signature by his electrical
supervisor. The general contractor is not authorized
to sign the electrical label.
Applicant to sign and date
Whenever possibie, the initial application wilI be used as
a worksheet only. Where possr'ble, 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.
Fees and Charges
PIan 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.
FOR OFFICE USE ONLY
IV.
V
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registration with the Builder's Board because:
Add'iti onal Project Informati on :
PLANS REVIEWED BY:
name s't gnature date 6
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