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HomeMy WebLinkAboutPermit Mechanical 1981-05-20TiON LIIIE 69 COMB I L RIlA 377 ress EIIERGY SOURCES: l,later Heater Kd Ftq, tlain_ Sq. Ftg. Access._ Sq. Fts 0ther _l.lew_Ad d_A1 te r_Pe p . _Fe nce_Demo_C ha nge/ U se 0ther ?ac ("Ir :/) L") l-egal Description l-10 "T( 5 Value of lJork ,\-0wner V;t,*r-t- Address Z O Z -Ll- o o ..Phone tJul l (, t Fami I y no Pernlit Info: Descnit' Res idence I,li th Attachet .e., Build Single t 211 -81 zS 4 Construction Lender J i -l-t^^1 n^-) eJA 4t) rJ,^., Addre s s Phone a /t./ DES I GN TEAI'I name s ICS. nO.exDr res Primary Structura I Electrical l'lechanica'l n ame lics. no.PYN] TPq nhonp no- ) Genera I Pl umbi nq El ectri cal q o- PLUIlBI NG ELECTR I CAL MECHAN 1 CAL FFF CHARGF NO FFF l.HAPG F NO FFF Each single fixture Residence of SQ FT furnace/burner to BTLI' 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 C ES /Recessed wal l Soace heater and vent ((,o o Duplex (l bath) each hrl=-I J oc) Additional bath Temporary Construct i on Apol iance vent qF na ra te [,later servi ce Change in existing rpc'i dpncp Stationary evap cool er Sewer multifamily, comnn.or Industrial Vent fan with sinole duct Storm Sewer 0f Vent systern apart from heatino or A.C. COMI.I./IND, FEEDERS Mechanical exhaust hood and duct I n sta I I ,/a I ter/ rel ocatedistrib. feeders tJood stove/heater 0f IssuANCF oF pFRrlIT lo'o) TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I,,HERE STATE LAI,J REQUIRES that the Electrical work be done by an Elec shall not be vali,J until the label has been signed by an Electrical Supe trical Contractor, the electrical portion of this permit rvisor and returned to the Building Division idohereb.ycertifythatajlinformationhereonistrue and correct, and I further certif-v that any and all work performed shall be done in accordance with the 0rdinances of the City of Soringfield and the Laws of the State of 0regon oertaining to the work described herein, and that NC OCCUPAI{CY will be made of any slructure-without the permission of the Buildinq Division. I further certify that my registration urith the Builder's Board.is in fuil 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 compliance with OPS 701.055 will be used on this r;roiect. I'lAtlE(please print)G- E, Pr tce r !@aS IGiIATURE Zon e__________Ty o e/ Co n s t Fire Zone Bedrooms nits Sq.Ftg. l'lain x Val ue 0c cy Load Sq. Ftg. Access x Va lue Flood Plain Stories Occ.y Group Sq. Ftg x Value TOTAL VALUATI 0ther BUILDING PERMIT Charges and Surcha rges Plan Ck. Comm/Ind 65"1,/81do Per Fee S v s terls Cha rqe Deve (1. 5% opment Plan Ck. Res 30%/Bldq Per Fee PLUI4BING PERMIT Charges and Surcha rge s Fence Demo ELECTRICAL PERIIiT Charges and Surcharges Sidewalk A/C Pav i ng Curb Cut Total Colrb. Permit I4ECHANICAL PERMIT Charges and Surc ha rge s s t-,or^, f ? ?z- )e I Work Garaor rnnp nn :TORS :d) COT'BINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal DescriptionL examole- Tax Lot 100, Lane County l,lap ReferIroT":2. example- Lot l. Block 3, Znd Addition toSpringfield Estates 9. Name, etc. of owner and construction lenderD. Energy Sourcesl. examole- heat/electrical ceilinq/or forcedz. .dilE- "ate.Fffi#i;' r"fti:i. SqrraE-TGrage or vaiuaEioI. examole- 1?50 sq. foot house, 500 sq. foot?. exadie- JT-iew'p"o;.ct,-iteik=n.,, - if addEfrEEI-i-dd, etc.F. Building perr,rit information:1. example - construct single family house witattacned garage?. exarnole --rem6del existing garage into fami'3. exaffiiE - convert single iufiifv'res.idence irrestaurant (change of use)G. Value of work as defined in Section 303 (a) of.Structural Specialtv CodeH. DESI6N TEAi.I AiID CONiRACTORS To avoid design or construct.ion delays, BuildinrDivision Staff rnust be able to contalt'upp.op.iipersons regard.ing des.ign information or job site - corrections, etc.. Abbreviatect plumbing, I,lechanical, & E.lectrical SchecA. Except rvhere blink spaces o.iu" in-ih. ats..iptiportion of the Hechanical and Electricai Schedulthe applicant need fill-in only the No. Boxes io_ to the appropr.iate item(s) to -be instal ledB. Full plumbing, tlechanicif, ina-ifecirical Scheduare avaiIable at the Bui lding Divis.ionl. To conserve space on the-permit form the schhave been abbreviated2. If the item(s) to be instal.led are not coverthe abbreviated schedules you should consultfull schedulesC. BUILDI|iG OIVISIOi\I STAFF WILL FILL OUT ALL FEES ACHARGES OiI THE SCHEDULESD. As noted on the CAp, the label must be de.liveredelectricai contractor for signature Oy iris eieiisupervisor. The general conlractor is not auti., to sign the electrical labelApplicant to sign and date lJhenever possib'l e, the.initial application wi.l I be .a-worksheet only. lJhere possibte, Auilding 0ivisicwrll.prepare a type written copy and return it to tapplicanr at the time the actuii permit is issued fsignature. Fees and Charqes Plan check fe6s are due and payable at the time ofapplication, and no plans wjil-be proceiied until t,rees are paid. All other fees and charges are due ,payable when the permit is issued. FOR OFFICE USE ONLY CITY OF SPRINGFIEL City Holl Springfield, Oregon Deportment oI Public Works OFFICIAT RECEIPT J B 56543 Dole I9 t Received For: ror { { ( ( II { ( {e (r'BY (Amount Received ----rl Dote F ( III CITY OF SPRINGFIELD(, Ciry Hol! Springfield, Oregon Deportmenl of Public Works OFFICIAT RECEIPT ilo. B 56544 19 (l u il ( { ( i ( L L IV V e PROJECT CONDITIONS TO BE SATISFIED BEFORE -= \r{ Received For: r I I L \c2> Permit applicant exempt from registration Additional Project Information: PLANS REVIEWED BY: Amounl Received m SIGNATURE SX€LION-TURXEULL PRIN'ER5 EUGENE Oi 97'OI '45!I'A L v name s'l g .l_na tu re BY da te t- I ( rArm-;