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Home My WebLink AboutPermit Plumbing 1986-09-10\-\c(_q}v HtPo INSPECTION LINE 726-37 69 COHBI L RMTT Job Address 2-B td. Legal Description Ran EIIERGY SOURCES: Hea t 5q. Ftg. Access._ Sq. Ftg. 0ther_ _l'lew_Add A1 ter_Rep. _Fence_Demo_C hange/ U se 0ther Sq. Ftg. l'la Value of [,lork: /4*a.oo0wner S(&tNoFt;ro CK&( sn*N C€{,'TE{ 'e., Build Singlenq Permit Info: Describe Work(' Residence I'lith Attached Garaqe Bu]ltn Fami'l yPhone)p{-$p1Address q*L N, >}-JrL /)^^P- u-J,* P^t1 il,lH Q) l,T 'l-/k"-I Ailluy& o'*r"tl,vt<a.a tloLfEConstruction Lender Cfufe/lh *t )a6-Ost\\ \t I u-"V drJl?*7".)i"tuAddre s s f.1o+f4u/L $uuh exDr res ohone no.addres s 'I ics. no.DES I GN TEAI,I name Primary St ructura I E l ectri ca l Mechan i ca I I i cs. no.exD l res (ohone no. )addres sCTO RS nameCONT Generat {vq,,f/E SAVJ *GRNJ|,C D4cK furt Plumbinq il ectri cal l'lechani cal MECHAN I CALELECTR I CALPLUIIBI NG FFF CHAPGFFFFC HARGF NOFFFCHARGFNO furnace/burner to BTU' S Residence of FTsQEach single fixture Fl oor furnace and vent Relocated building (new fix. additional) Recessed wal l Soace heater and ventSERV i C ESS. F. Residence(l bath) Duplex (l bath) each Temporary Constructi on Apol iance vent separateAdditional bath Stationary evap. coo I er Change in existing res i dencetlater service Vent fan with sinqle ductIndustrial multifamily, comm. orSewer 65.oo 0f apart from .c. Vent systern heatinq or A7fr'Storm Sewer Mechanical exhaust hnod and drrctCOMH./IND. FEEDERSfur,s. €R5?5a =z 75o/ l,Jood stove/heaterInstal I /al ter/re l ocatedistrib. feeders 0f ISSUANCF 0F pFRrlIT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES 72,ro WHERE STATE LAli REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Division and correct, and I further certif-v that any and al'l work oerformed shall be done in accordance with the 0rdinances of the City of Springfield and the Laws of the State of 0reqon oertaining to the work described herein, and that NC OCCUPAI,ICY will be made of any structure without the permission of the Buiiding Division. I further certify that m.y 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 employees who are in comoliance with 0l?S 701.055 will be used on this Droiect. DATEl,lAtlE(please print)I GNATURE5 the completed apnlication for oermit, and do hereb.y cert that all information hereon is true FOI1 OFFICE USE Ftg Ftg Ftg Uni ts Flood Plain Sto ri es Zone x al Fire Zo Bedrooms Occy Load Sq I Const Group Val ue TOTAL VALUATION l'la i n Access 0ther Plan Ck. Conm/lnd 65%/81do Per Fee at62,O Svsterirs Cha rqe Deve(t. sz I opment I aa6;bBUILDING PERNIT Charges and Surcharges Plan Ck. Res 30%/B1dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges 7Z..so 2.?o Dgmo Sidewal kELECTRICAL PERIIIT Charges and Surcharges A/C Paving -e.*Tota'l Comb. Permit 4lo.zo Curb Cut 2?.saMECHANICAL PERMIT Charges and Surc harges TOTAL 76o.zo l,later Heater_ New ci rcui ts al ts. or extensions I COMBINATI ON APPLI CATION/PERMIT (CAP ) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSliiigfietd EstatesC. Name, etc. of owner and construct.ion lenderD. Energy Sources PERMIT VALIDATION air gas E ga ra ge ition, F. BuiI ding permit information: example - construct singie family house with anattached garage 1 II. l. examp]e - remodel ex.ist.ing garage into family roomJ. exampte - convert single famiiy residence into ^ restaurant (change of use)G. Value of work ai defined in Section 303 (a) of the. Structural Specialty CodeH. DESIGN TEAM AND CON1RACTORS To avoid design or construction delays, Bui)dingDivision Staff must be able to contait appropriitepersons.regarding design information or jbU iitecorrections, etc. Abbreviated Plumbing, Mechanica'1, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fiil-in only the No. Boxes iOji6ent _ !o_!h9 appropriate.item(s) to Le instailedB. Full PIumbing, Mechanical, and Electrical Schedulesare available at the Building Divis.ion1. To conserve space on the-permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedujes you shou.ld consult theful 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 etectriiai'-supervisor. The general coniractor ii not authorizedto sign the electrical iabelApplicant to sign and date lJhenever possibie, the initial app)ication will be used asa.worksheet only. Where possible, Building Division Staiiwili.prepare a type written copy and returi it to theapplicant at the time the actuai permit is issued for hissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wiil be processed until thesetees are paid. AII other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY B u7o sq' q -/l-tr h III. IV v Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name s i gnature date 1 2 or valIexamp I e- exampl e- check add 1250 sqif new . foot I project,, etc. I 1 I /\ ?-1urL qou Htpc) TI 69 - - --- TITY OF SPRTNGFIELD COHBI NATION RPPI- I CRTIOU/PERMIT INFOR',IATION LINt 7?6-31s3L Job Address ?-B tL l-egai Description l,later Heater Ranqe EIIERGY SOURCES Heat Sq. Ftg Sq. Ftg Sq. Ftg Use . I'lai n . Access . Other Va I ue of l,lork : /Q*a.:oOwnerSCt?Kt sr7ftrv C(NIEL(&tNoFtFco .e., Build Singie I Builciinq Permit Info: Describe Work( Farni'ly Residence tlith Attached Garaqenhone/p{-elj/Address q*L N, >87+L n^^.2. h^J<;-" k4 JJH Q),U. a*t , N-&ill/V 'l- ^aU-e_.-A ^ l^t f6.Construction Lender CflvfeltJlhL fn,rtt< I ,r-,L dr* }O \)Ds |-\\:--\ Lau-" ^ptn6n")'2bNlUAddre s s ltro{ rywL $t-t/ b address 'I ics. no.exDt res phone no.DES I GN TEAI.I name Pri ma ry Structura I El ectri ca l Mechan i ca l name a ddres s (tcs, no.exot res ohone no. tvGw? SAMI) {G&*u6L \cK 9r'lGenera I Pl umbi nq il ectri cal l.lec ha n i ca I ELECTR I CAL 14ECHAN I CALPLUI,lB I NG N0-FFF CHARGF NN FFF CHAPT:F r'J0 FFF CHARGF Residence of SQ. FT Each single fjxture furnace/burner to BTLI' S Relocated building (new fix. additional ) New ci rcui ts al ts. or extensions Floor furnace and vent S.F. Residence(l trattr)SERVICES Recessed wal I Snaap hpatpr and venf Duplex (I bath) each Additional bath Temporary Constructi on Apol iance vent seDa ratp l,later servi ce ge in existing dence C han res i Stati onar_v evap cool er Sewer Tndrrstria l multifamily, cornm, or Vent fan with sinole duct 65.ooffi'Storm Sewer 0f Vent systern apart from heatino or A.C. ;/2 75aSzrr*<€.?s?ye COiTI./IND, FEEDERS Mechanical exhaust hood and duct Instal I /a l ter/rel ocate distrib. feeders l'lood stove/heater amp s.0f ISSUANCF OF PFRIlIT TOTAL CHARGES 72,uo TOTAL CHARGES TOTAL CHARGES WHERE STATE LAN REQUIRES that tlte Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed apnlication for permit, and do here on oertaining to the work described herein, and that NC 0CCUPAI'ICY will bee Building Division. I further certify that my reqistration vrith the Builder's only subcontractors and employees who are in comcliance with 0l?S 701 PFn*liAl,lE(please print)TE 7SI GNATURE Ci ty made0reg b.v certify that all information hereon is trueand comect, and I further certi f-v that anyof Springfield and the Laws of the State of and all work performed shall be do ne in accordance with the Ordinances of the of any structure without the Board is in full force and e permission of thffect as required by ORS 701.055, that i the basis for exemption is noted hereon, and thatf exempt .055 wi I I be used on this ect. Srev E FICEF Ftt: Ftg Ftg Val ue TOTAL VALUATION-- x Fiood Plain S tori es 0c c.y Group Sq Bedrooms ,0.cy Load ValFire Zone Val ue. l'lainZone___Tyoe/ Co n s t its So Acces s 0ther Plan Ck. Comm/Ind 65%/Bldo Per Fee 20.o6 Svs Cha teris Deverqe (1.52 opment 4@. aaBUILDING PERI.IIT Charges and Surcha rges Plan Ck. Res 30%/B1dq Per Fee FencePLUI,4BING PERMIT Charges and Surcha rges 22 <>Z a'e z.?a Demo Sidewal kELECTRICT,L PERIIIT Charges and Su rcha rges A/C Paving -a.e Tota'l Cornb. Perm.i t 4lo.zoffi"tr1:f,i 2?.sa14ECHANICAL PERMIT Charges and Surc ha rges 76o.zoTOTAL -\. 1 '..(, t coMBINATI0N AppLICATTON/PERMrT (CAp) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map ReferenceI7l5-T32. example- Lot l. Block 3, Znd Addition toSpiTilTietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. examo l e-^+t. examp I e- Square foota heat/eleqtricil cei l i1g/o wa terh ea teilElEc trJ c a JTor ge or valuation, etc. r forced air gas E !e.Er. I ? example- 1250 sq. foot house, 500 sq. foot garage example- if new project, check new - if add.ition, check add, etc. II. F. Bui lding permit information:1. example - construct single family house with anattached garage ?. example - remodel existing garage into family room3. example - convert single family residence inlorestaurant (change of use)G. Value of work as def.ined jn Sect.ion 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building0ivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated P)umbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the description - portion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjaientt0 the appropriate item(s) to be installedB. Full 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 thefull schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectricai contractor for signature by his electricalsupervisor. The generai contractor is.not author.izedto sign the electrical label.Applicant to sign and date }Jhenever possibie, the initial application will be used asa worksheet oniy. Where possib)e, Building Division Staffwill prepare a type written copy and return it to theappiicant at the time the actuai permit is issued for h.is s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theappl ication, and no plans will be processed unt.il thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY b70 sq (r/ */l-[ @/" III IV V Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit appf icant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY name sig nature date \ PERMIT VALIDATION