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Home My WebLink AboutPermit Curb Cut 1983-07-13NSP 26-ON INE COMB I CATI RMITL Job Address \,EIIERGY SOURCES Hea t t,later Heater Ranqe_ Ftg Ftq Ftg l.1a Sq Acces s 0therSq o4 ?4r\ w Legal Description Value of l,lork: Owner Addres s n t Info .e., Buil Single Construction Lender \ Addres s Phone DES I GN TEAI4 name addres s rcs. n0.exDl res Primary Structura I El ectri cal Hechan i ca I TACTORS name a ddres s lics. no.exDI res ohone no- ) Genera I r I I () Pl umbi nq El ectri ca I I'lechani ca I PLUIlB I NG ELECTR I CAL MECHAN i CAL FFF CHARGF NN FFF rHA ANF NO FFF l.HAAGF Each single fixture Residence of SQ. FT. furnace/burner to BTLI' S Relocated bui Idinq (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S. F. Residence ( l bath)SERVlCES Recessed wal I Soace heat-er and vent Duplex (l bath) each Additional bath Apol iance vent seDarate l.later serv ice Chan ge in existing deneerFs 1 Stationary evap cool er Sewer multifamily, comm. or i ndustri a I Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatino or A.C. c0Mt1./IND. FEEDERS Mechanical exhaust hood and duct- I n sta I I /a 1 ter/ re1 ocate di <tri h fecdprc tJood stove/heater 0f amps ISSUANCF OF PFRI'IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I^IHERE STATE LAl.l 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 Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereb.y certify that all information hereon is true and correct, and I further certif-v that any and all work performed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0regon pertaining 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 reqistration 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 employees who are in comcliance with ORS 701.055 wi1l be used on this Droject. I'lAl'lE ( p1 ease pri nt)S IGNA DA rEAZr-?s Zone Tyoe/Const Uni ts Sq . Ftg . t'la i x Value Fire Zone Bedrooms Occy Load Sq Flood Plain Stories Occ.y Group Sq Ftg. Access.''I ue Ftg . 0ther x Value ToTAL VALUATI0N_ BUILDING PERTIIT Charges and Surcha rges Plan Ck. Comm/Ind 65'/"/81do Per Fee Svsterns Deve charqe ( 1.5% opment Plan Ck. Res 30%/81dq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence D6mo ELECTRICAL PERIlIT Charges and Surcharges Sidewal k A/C Pavi ng Curb Cut {O ' Total Cornb. Permit I I,lECHANICAL PERMIT Charges and Surcha rges /b.RC TOTAL $ tt, ,80 Phone Temporary Constructi on CO|IIBINATI0N APPLICATI0N/PERMIT (CAp) I. Applicant to furnishA. Job AddressB. Legal Description I, example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSlrffifield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources PERMIT VALIDATION 1-t3-t3 b ts23 l. 2.E. Squa example- heat,/electrical ceil ino/ EximEI e- waterhEa-tEF/rcJeETrl c-a I /ore footage or valuation,-ETil- or forced air gasr sofar J. example- 1250 sq. foot house, 500 sq. foot garage2. examplE if-i'ew project, cheik-ir-ew - it aaaitioi, check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. example - remodel existing garage into family room3. example - convert single fam.ily residence intorestaurant (change of use)G. Vaiue of work as defined in Section 303 (a) of theStructural Speciaity CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrica'l SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Eiectrical Schedules,the applicant need fill-in only the No. Boxes adjaientt0 the appropriate item(s) to be installedB. FulI Plumbing, Mechanical, and Electrical Schedulesare available at the Building Division1, 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.llLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for s.ignature by his electricalsupervisor. The general contractor ii not authorized & II to sign the electricai labelApplicant to sign and date l,Jhenever possible, the initiaj application will be used asa.worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for hissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. Ail other fees and charges are due andpayable when the permit is jssued. FOR OFFICE USE ONLY IV. v Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s'l gnature date III.