HomeMy WebLinkAboutPermit Electrical 1982-06-26MLD
CO},IBI iIATI OI'I APPL I CATION/PERMIT 7?6-3753
Job Address 4
Legal Description
EIIERGY SOURCES
Heat
l,later Heater
Ranqe
Ftq. l'1ain
5q. Ftg. Access.-.---
Sq. Fto. Other__
_llew_Add_A1 ter_Pep.
_Fence_Demo_Cha n ge/ U se
0ther
Da
3
S.'
T,\JDa
I ,4 .4 Value of l,lork:
0wner
Address Phone Builciinq Permit Info:
Fanlil y Residence l,lith
Describe t^lork('
Attached Garzs€
.e., Build Single
bq 7/2-t z/r)e .a ,
?L/l-2/83Construction Lender
Addres s Phone
DESIGN TEAI.{name address I ics . no.exDt res ohone no.
Pri mary
Structura I qLlr t 4qoo
Ei ectri cal (-
l'4ec han i ca I
CONTRACTORS name addres s (lics. no.exoi res ohone no.
Genera l
Pl umbi nq /)7^,4+iL ,,L
Itlechani ca l
PLUTlB I NG ELECTR I CAL MECHAN I CAL
FFF CHARGF NN FFF I^HA PG F NO FFE CHARGF
Each single fixture Residence of
SQ. FT
furnace/burner to
BTLI ' S
Reiocated building
(new fix. additional)
New ci rcui ts al ts.
or extensions
Fl oor furnace
and vent
5. F. Residence(l bath)SERV I CES Recessed wal I
Soace heater and vent
Duplex (l bath) each
Additional bath Temporary Constructi on Apol iance vent
seDa ra te
tlater service Chan
res i
ge in existing
dpnce
Stati onar.v evap
coo'l er
Sewer multifami1y, comm. or
Tndricfrial
Vent fan with
sinole duct
Storm Sewer 0f Vent systern apart from
heatino or A.C.
C()I,lI.I. /IND. FEEDERS
Mechanical exhaust
hood and duct
I nstal I /a1 ter/re1 ocate
distrih fppdprs l'Jood stove/heater
0f
ISSUANCF OF PFRI,|IT
TOTAL CHARGES TOTAL CHARGES IOTAL CHARGES
I^,HERE STATE LII,I 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 EXA|{INED the completed apnlication for oermit, 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 Spring
of any st
field and the Laws of the State of Oregon Dertaining to the work descri bed herein, and that NC OCCUPAI,ICY will be madetify that my registration urith the Builder's
basis for exemption is noted hereon, and that
used on this nroject.
ructure without t he permi
effect
ssion of the Building Division. I further cer
Board is in full force and as required by ORS 701.055, that if e;empf'the
oniy subcontractors and employees who are in comcliance with 0l?S 701.055'wi
l,lAl,lE(please pri nt)fuL Muftl S IGiJATURE DATE
FON OFFICE USE dI{LY
Tone e/ Cons t it o. Ftg. l,lain AI
Fire Zone Bedrooms Occy Load !q Ftg. Access Val ue
Flood Plain Stories Group Val ue
TOTAL VALUATION
s q. Fts . 0ther
BUILDING PERMIT
Charges and
Su rc harges
Plan Ck. Comm/Ind
65%/81r1o Ppr Fec
Svsterns Deve
Charqe (1.51 opment
Plan Ck. Res
30%/81do Per Fee
PLUI4BING PERMIT
Charges and
Surcha rges
Fence
Dgmo
ELECTRICAL PERIIIT
Charoes and r
Surc[arges u\
5,ffi
,bo
Sidewal k
A/C Paving Total Comb. Permit
NECHANICAL PERMIT
Charges and
Surcharges
Curb Cut
TOTAL /g.(,
2'
COMBINATION APPLICATION/PERMIT (CAP)
I . App l i cant to furni shA. Job AddressB. Legal Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, Znd Addition toSErlnTfietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
I . examp.'l e- heat/ei e.ctri ca I ce i I i nglo2. examp I e- wa terhea-terli:lEcTilcalTorE. Square footage or valuation,-ETil-
r forced air gas
!g]-qr-
1. example- 1250 sq. foot house, 500 sq2. examp'ie- if new project, check-new -
check add, etc.F. Building permit information:
foot g
if addi
a rage
ti on,
II
1. example - construct single family house with an
attached garage2. example - remodel existing garage into family room3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructurai Special ty CodeH. DESIGN TEAI.I AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriitepersons regarding design informat.ion or job sitecorrections, etc.
Abbreviated Plumbing, l"'lechanical, & Electr.ical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in oniy the No. Boxes adjacentto the appropriate item(s) to be instal ledB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Building D.iv.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 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 general contractor is not author.izedto sign the electrical label.
Applicant to sign and date
Whenever possible, the initial appl.ication w.ill be used asa worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for h.is
s i gnature.
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. All other fees and charges are due andpayable when the permit is issued.
L [,/r;;
0-26-{1
III
IV
V. FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit applicant exempt from registration w'ith the Builder's Board because
Additional Project Information:
PLANS REVIEWED BY
name sig nature da te
Oc
- _ snvr o uR SENIORS , INC . \-
901 South Z3thSpringfield, OR 97+77 Phone 741-?1e3
tttt*t(Jttt.tti(.*t(**)r{.nt()f t(}rt(t(*)ei(xJrr(t(r(J(*xlr)tt()tt(ttrfrtltl(l(ttt(xxltl()txt€rtt(xr(*')f*ttr(*)t*J+rtx
July 11t 1987
IVlr. Dave Peunt
225 N. 5th StreetSpringfield, Oregon 97477
Dear Mr. Peunt:
Iam
ide hook-u
the operati-on
Thelma OpeIa,
regard t
Springfie
at 901 South
use of the
in o our use of eLeetricity
in ld as you re sted. Ourq.ue
inswhich was recen tlv talled, 1s limited to
two (2)chest freezers.Prof
I hope this supplies the lnformation you needed fo:r yourrecords. Thank you for your time.
Sincere lYt
0/uA
#esident
For File
MEETING NOTES
6-30-87
GW, Dave, Jackie
SAVE OUR SENIORS
901 South 28th Street
SUB Board approved installation,water and electrical service to mobile home -
work has already been done, 6-29-87 SUB called for inspection.
1. Mob'i I e home exi sti ng,2. acknowledged by City in 1983;3. mobile home used seasonally (summer) as distribution center for food.
If services approved by City:
f. in no way impljes mobile home to be used as res'idence2. electrical hookup for mechanical equipment only - outside the mob'ile home -
equipment removed during the winter months3. water to be hooked up outsjde the mobile home - used for cleaning produce
Use is pre-existing, non-conforming. 0ur approval of hookups will aid in abating
a heal th and sani tat'ion probl em.