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Home My WebLink AboutPermit Mechanical 1980-10-01LINE COI1BI IIATI ON APPLICATION/PERMIT 726-3753 Job Address EIIERGY SOURCES Hea t l,later Heater Ranqe Ftg l'1a i n Sq. Ftg. Access._ Sq. Fto. 0ther__ l,lew AddJlter Pep. -Fence Oerno C hange/Use -0ther \S, -$ s l-ega1 Description E 10V Owner ) Varue or ,Uio.* ^dhdsslf#l /1/, //Z ffi" 7/,f=),Bui I cii n Farni ly q Pernrit Info: Describe Work(' Residence liith Attached Garaqe ,e., Build Single Cons tr on v Addres s Phone DES I GN TEAI1 name address I CS. nO PXO S n Pri ma ry Struc tura I El ectri ca I l'lec ha n i ca I CONTRACTORS n ame addres s "l i cs. no.pxol res ( nhone no ') El ectr i ca I Itlechani cal PLUIlBI NG ELECTR I CAL MECHAN I CAL N0-FEE CHARGE NO FFF CHARGF NO FFF C HARGF Each single fixture Res i dence of SQ FT furnace/burner to BTU' s Relocated building (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S. F. P.es i dence(l bath)SERV I CES Recessed wal I Soace heatpr and vFnt Duplex (l bath) each Additional bath Temporary Construct ion Apol iance vent seDa rate l^later servi ce Chan res i ge in existing dence Stationary evap cool er Sewer mu1 ti fami 1 y,c0mrn, or I ndust ri a l Vent fan with sinole duct- Storm Sewer 0f Vent system apart from heatinq or A.C. c0r,il.!./IND. FEEDERS Mechan i cai exhaust hood and duct Instal I /al ter/rel ocate distrih. feeders l'Jood stove/heater 0f amps. ISSUANCE OF PFRI,IIT TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES WHERE STATE Lltl REQUIRES that the E'lectrical workshall not be vali'l until the label has been signed by be done by an Electrical Contractor, the electrical portion of this permit an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for permit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the Cityof Springfield and the Laws of the State of 0reoon oertaining to the work described herein, and that NC 0CCUPANCY will be madeof any structure without the permission of the Building Division. I further certify that my registration vrith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and ernployees who are in comcliance with ORS 701.055 will be used on this oroject. I'lAl'lE(please print D/t.rl./a -/-k)I GNATURE Zone oelConst. Uni ts Ftq. l4a i n x Value Fire Zone Bedrooms Load Sq. Ftg. Access.I Flood Plain 0c c.y Gro Val ue TOTAL VALUATION Sto ri es Ftg .0ther BUILDING PERI'lIT Cltarges anC Surcha rges PIan Ck. Comn/Ind 65%/81do Per Fee Svsterns Deve' Charqe ( 1.51. opment Plan Ck. Res 30%/Bldq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence D6mo ELECTRICAL PERIlIT Charges and Surcha rges Sidewal k A/C 'Pav i ng Curb Cut Tota'l Comb. Permit I,IECHANICAL PERMIT Charges and Surc ha rge s X J-- 0 TOTAL /5bc COMBINATION APPLICATiON/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Lega l Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot i. Block 3, 2nd Addition to Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources i 1. exampl e-2, exampl e-E. Square foota {air gas s 1 example- 1250 sq. foot house, 500 sq. foot garage example- if new project, check new - if addition, check add, etc. 2. F Building perm 1. example - a t tac hed it information: construct single family house with an gara ge II 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 the Structurai Specialty CodeH. DESIGN TEAI.I 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. Abbreviated Piumbing, 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 adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Div'ision1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF l^IILL 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 electrical supervisor. The generai contractolis not authorizedto sign the electrical label. Applicant to sign and date lJhenever possibie, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for his s i gna ture. Fees and Charges Pian check fees are due and payable at the time of theapplication, and no plans wi)1 be processed until thesefees are paid. All other fees and charges are due andpayable v,hen the permit is issued. III. IV v. FoR oFFrcE USE oNLY PERMIT VALIDATION Perm'i t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registrat'ion with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s i gnature date LI c0rlB I ,T APPL I CATI ON RMIT3 Job Address EIIERGY SOURCES Hea t l.Jater Heater Ra So. Ftq. liain_ Sq. Ftg. Access._ Sq. Ftc. 0ther__ _f'lew Adalql ter_P.ep. _Fence_Demo Change/Use 0ther \ \--, -$ s l-egal Description varue or t'Ugo.* Owner maressgr,g.ga A/. //Z {nY"" zr!4);,Bui Fan I c.i nilv q Pernrit Info: Describe tlork( llesidence llith Attached Garaqe .e., Build Single S rrrin,i{ iz/J . DE 77r'22 ,E i t,/rr *s'lz tt tT Construc6on LEn/er ,/t/:s;lI /"X z l/ S.i'-;z;J- Address Phone DESIGN TEAI1 name address lics. no.exn i res ohone no. Primary Struc tura I Electrical l'lechani ca l CONTRACTORS name a ddres s I i cs. no.exoi res ohone no. Gener I PI El ectri ca 1 l'!echanical PLUIlB I IIG ELECTR I CAL MECHAN I CAL ti0 FEE I CHARGE NO FFF CHARGF NO,FFF CHAPI]F Each single fixture Residence of SQ FT furnace/burner to BTU' S Relocated building (nevr fix. additional ) New c i rcu'i ts al ts or extens'i ons Floor furnace and vent S. F. P.es i dence(l bath)SERV I C ES Recessed wal I Snacp hpaJ-pr and vpnf Duplex (l bath) each Additional bath Temporary Construction Apol iance vent s eDa ra te l,later servi ce Change i n exi sti ng rp< i dpncp Stati onary evap cool er Sewer multifamily, comrn. or Industrial Vent fan with sinole duct Storm Sewer 0f . amps. Vent systern apart from heatino or A.C. COI.II.I./IND. FEEDERS Mechanical exhaust hood and duct I nstal I /ai terlrel ocate di stri b. feeders lJood stove/heater 0f TOTAL CHARGES ISSUAI,ICE OF PFRIlIT TOTAL CHARGESTOTAL CHARGES LIHERE STATE LlN REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valil until the label has been signed by an Electrica'l Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for oermit, and do hereb.y certify that ail information hereon is true and correct, and I further certif-v that any and all r.rork oerformed shall be done in accordance with the 0rdinances of the City of Soringfield and the Laws of the State of 0regon oertaining to the r,,ork described herein, and that NC OCCUPAHCY will be made of any structure without the permission of the Building Division. i further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and ernployees urho are in comcliance with 0i?S 701.055 will be used on this nro.ject. DA.rE./u -/'k)llAl,lE( p lease pri nt )IGiIATURE F0t C Zone e/Const Uni ts, Sq. Ftg. l'lai n x Val ue Fire Zone Bedro oms 0ccy Load 5q. Ftg. Access x Val Flood Plain .Stories Group Val ue TOTAL VALUATION S q.Fts .0ther BUILDING PERT.lIT Charges anC 5u rcharges Plan Ck. Comm/lnd 651"/Bldo Per Fee Svster,ts Deve Charoe (i.52 o pmen t PIan Ck. Res 30%/Bldq Per Fee PLUI4BING PERI4IT Charges and Surcha rges Fence Dgrno ELECTRICAL PERIiIT Charges and Surcha rges Sidewaik Curb Cut Total Comb. Permit IlECHANICAL PERMIT Charges and Su rcha rges X 0 TOTAL /5bc I 7 O*/m o rt-, A/C 'Pavi nq COMBINATION APPLICATION/PEP.I"IIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. glalple- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSpringfield Estatesq. Name, etc. of owner and construction lenderD. Energy Sourcesi. examol e- heat/electrical cei I ino/t, exarf, I e- waterheacer/el ectri ca I /oE. Square footage or valuationl-eTE-- PERMIT VALIDATION :ITY oF SPRINGFIELD (, CirY Holl Springfield, Oregon Deporlmenl of Public Works OFFICIAT RECEIPT il0. s9O B 54i 66r I IJ i-A </S/L or forced air s arrso 1. examo_le- l?5q sq. foot house, 500 sq. foot garagez. exa,rple- if new project, check new - if additio;,Eiecr-Ed, etc.F. Building permit information:1. q-UUS, - construct single family house vrith anattached garage ?. e.ranole - remodej existing garage .into family room3. exanpie - convert single fami)y-res.idence inio - restaurant (change of"use)G. Value of wcrk as defined in Section 303 (a) of theStructural Specia lty CodeH. DESiGIi TEAI.i AIID CONTRACTORS To avoid design or construct.ion delays, BuildingDivision Staff must be able to contatt approprijtepersons regardino design information or job sitecorrections, etc. Abbreviated Plumbing, i,lechanical, & Electr.ical SchedulesA. txcept l.rhere blank sDaces occur in the descriptionportion of the l'lechanical and Electrical Schedules.the appticant need fijl-in only the No. Boxes iOjiiunr - to the appropriate jtem(s) to be installedB. Full P'lumbing, t'lechanicil, and Electrical Schedulesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated2. If the irem(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUILDIIJG DiYISION STAFF }.IILL FILL OUT ALL FEES AND CHARGES Oi{ THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by his electricai - supervisor. The general contractor ii not authorizedto sign the electricaI labelApplicant to sign and date l,lhenever possibie, the initial application will be used asa.worksheet only. tJhere possible, Building Divisio, Stuiiwill -prepare a type r,rritten copy and returi it to theapplicanc at the time the actuai permit is issued for his s i gna ture . Fees and Charces Plan check fees ara due and payable at the time of theapplication, and no plans wiil- be processed until theserees are paid. All other fees and charges are due andpayable vrhen the permit is .issued. FoR oFFICE USE oNI,Y (FLD ess /' "ed For: ,:l (t (E f iI #, i { III IV. ,nl Received Permi t Clerk AUTHORIZEO SIGNATURE sHELIOX-ruFNeu!! Pirn,€45 EUGENE OR 9"ot 5651!'A V PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY t applicant exempt from registration with the Builder's Board becausePermi Additional Project Information name da tes'l gna tu re PLANS REVIEWED BY: ( (