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Home My WebLink AboutPermit Building 1987-10-17I NSP 726- MELD COMBI ilATI ON APPL ICATION/PERMIT 726-37 Job Address EIIERGY SOURCES: Hea t l,later Heater Ra n Sq. Ftg. Access._ Sq. Fto . 0ther _l'l ew_Ad d_A1 te r_Re p . Fence 0ther_Demo_Change/ Use W \s 0\ N {, l-ega1 Description .2 0wner € Value of l,lork://2- a&' *' Address Phone n t Info: Describe .e., Build Single Gzf ec 7 izo,.-oof ,Hrz:z< Construction l-ender Address Phone name address exD r res ohone no. Prima Structural Mechani ca.l IACTORS n ire addres s lics. no^(exoi res )ohone no. 2a El ectrica'l l.techani caI ELECTR I CAL MECHAN ICAL FFF CHARGE NO FFF CHARGF NO FFF CHARGF Each s'n'mgle f,ixture Res idence of SQ FT furnace/burner to BTLI' s Relocated hritrdino (new fix. additidan)New ci rcui ts al ts or extensions Fl oor furnace and vent S. F. P,esidence ( I bath)SERV I CES Recessed wal I Soace heater and vpnt Duplex (1 bath) eactr Additiona'l bath Temporary Constructi on Apol iance vent sepa ra te I,later service Chan res i ge i n exi sti ng dence Stati onar.v evap coo'ler Sewer multifamily, comm. or Industrial Vent fan with sinole duct Storm Sewerr 0f .amps. Vent systern apart from heatino or A-C- c0r4r.1./rND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocatedistrib. feeders liood stove/heater 0f -amp s. 7r */5 Bzzpor z e 7 t-qr'/s ,Z=u,,.4e,v 2-7zs ,V-2')/A ,a ISSUANCF OF PFRt4IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE J-41,J REQJIRES that the Etecshal] not be va?r-d unti] the ]abel has bee trical work be done by an Electrical Contractor, the e'lectrical portion of this permitn signed by an Electrical supervisor and returned to the Building Divis.ion ,Y t comp eted a p l')lica all gon Buil, t 'I n r' oermit, and rformed shal ng to the wo do he re b.y c ert v th a t a 'I I 'I n fo rmat t 0n hereo n s trueandtco Spr any rdys rrectr.amd tr i ng?i'end and stnrctulre wi f,u rther cer t 'I fy tha t a ny a nd wo rk DE 'I be done I a cc orda nce wt th f he 0rd .I n an ces 0 f the c I tyoftheLawsoftheStateof0reDe rta 'I n 'I r k de sc r 'I bed here 1 n a nd th t NC 0cc UPAN CY wl I I be defthoutthepermi,l of a massntheding Divis 701.055, 'I on I fu rther certi fy tha t m.y re g I s tr a t I 0 n t/ l t h the Bui I der sBoaIs'I fu? I force a nd effe .f a s recl u I red by ORS tha t f e t t he bas I S f,o r 1 ted hereo nd thaonIubcontractorsandIwho'I I 'I s no n a t ernp oyees a re c0mD ance w.l th 0 I?S 701 055 I I ed 0n t h 1 s ct F llAt'lE(please print)S IGNAT zone Lf,2 st 'i ts Sq.Ftg Ftg Ftg , //2a d-at'la i ValueFire Zone Bedrooms Load ,/22 S q Acces s x lue Flood Plai Storie ccy eroup V-Z sq 0ther Val TOTAL VALUATION- BUILDING PERI'IIT Charges and Surcharges {?_8-_"5_26.7 Plan Ck. Conrn/Ind 65lolBldq Per Fee Sfo.tz Systems Deve Charqe (1.5% I opment I 22a-q,Do Plan Ck. Res 30%/91d9 Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence DEmo ELECTRICAL PERtlIT Charges and Surcha rges Sidewal k A/C Paving Curb Cut Total Comb. Permit I,IECHANICAL PERMIT Charges and Su rc ha rge s TOTAL Vlza, gg El ectri cal l- y l |\ . PERMIT VALIDATION Permit Clerk Zrt'qa-# tost{edru COI,IBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition to Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. example- heat/electricai ceiling/or forced air gas2. examETA waterheaTE7TeTectiJcIITor soTaT--E. Square footage or valuation, etc.l. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check new - if addition, check add, etc.F. Building permit information:1. examp'le - construct single family house with an attached garage 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 Structural Speciaity CodeH. DESIGN TEAM 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.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occulin the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be instal ledB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated2- If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I scheduIesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label.III. Applicant to sign and date Whenever 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 the applicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY: 4zzr.>.a,rcV+r.r-/7z.rr>r.a-%ah+na 2.o-r.^- Ez=c/fi/fu-/ ,7-.r*2u-rzr< /za ,1><- v- Permit applicant exempt from registrat'ion with the Builder's Board because: Addit'ional Proiect Information : name s'l date| /d-,/?-8>g nature PLANS REVIEWED BY: INSPECTION LINE 726-37 69 COHBI NATI ON APPL ICATION/PERMIT 726-37 Job Address l-ega1 Description Ran tiater Heater EIIERGY SOURCES: Heat Value of tlork: Ftg . l.tai n_ Ftg. Access._ Sq. Ftg. 0ther_ _NewjddjlTetRep- _Fence_Demo Change/Use 0ther Sq owner rffiT)dorL DfEOa .e., Build SingleBuilciinq Permit Info: Describe Work( Fami'ly Residence [,lith Attached GaraqeAddress Construction Lender ^{ \ \ & iux Address r4-oo-1 Phone'- 2a./; exn res ohone no.address lics. noDESIGN TEAI.,I /name Structura I Pri ma El ectr Hechan i ca I nhone no - ')addrpss 'l i cs, no.exol resnameCONTRACTORS Pl umbi b \L l.techani cal MECHANICALELECTRI CALPLUITBING FFF (.HARGFFFFCHAAGFNOFFF I :HARGF NO furnace/burner to BTU' s Residence of FTSQEach single fixture 2?-9 Floor furnace and ventl-/New circuits alts. or extensions2 >,a *aa71e Relocated building (new fix. additional) Recessed wal I Soace heater and ventSERV I CESS.F. Residence ( l bath) Duplex (1 bath) each Apol iance vent seoa rateTemporary Constructi onAdditional bath Stationary evap. cool er Change in existing rpqi dencp[,later serv'ice Vent fan with sinole duct multifami ly, corm. or TndrrstrialSewer part from c. Vent systern a heatinq or A.t of .Zr=> amps.Storm Sewer Mechanical exhaust hood and ductc0Mr.1./rND. FEEoERS l,lood stove/heaterInstal I /al ter/rel ocate distrih- feeders ?z-qz0f * ?.e><- anps" ISSUANCF OF PFRI'IITurl TOTAL CHARGESTOTAL CHARGES f*TOTAL CHARGES REQU nti l bytri an Electrical Contractor, the electrical portion of this permit cal Supervisor and returned to the Building DivisionRESItthaEtheectrIcIIbeworkdoneST,t,JHERE Llt.lATE 1 :l u I bea hasI Sbeen 1 ed an EI ectheIshanot'I be va 'I gn by SIGNAllAl''lE(please pr 'int )D-L*l'lrlg._oI ' Oregon the Buiof any Board permi ffect xempt 5 wil onti reonhe s truenrtcefthaahedoanecatforonreb.y fyapEDcompp ncena ofs cithedonebencoacrdanceOrdi tyththermedfohasworkandrcertthafutDerrthendandtcorrecafy wl madebedescriworkhereibednthaandNCtOCCUPAI{CY any of rta n to thetatetheSofnddDEngLawstheafosprng fi th Bu der sthethatstrfaonv/tssofdiDisvlonfucertirtherregngfymytrucwlturetthou5the hereon tha tandnotedsbasforex0nhetfemptu707ORS055attheasredsnfufoIandrceereclbytseduth0nsnWIance0Rsth0705be0nubcontractosndrsawhosareemp0yeec0mDly ,l its TOTAL VALUATION 7 ano Val Ftg 0ther I Fire Zo Flood Plain Stories 0ccy Gro Load Sq. Ftg. Access x Value Ftg. l'la in tems Deiqe ( l.Svs Cha ve 5/" opmentPlan Ck. Comm/Ind 65%/81do Per Fee Plan Ck. Res 30%/Bldo Per Fee BUILDING PERI'IIT Charges and Surcha rges Fence Dgmo PLUI.4BING PERMIT Charges and Surcharges Sidewalk Tota'l Cornb. Permi tA/C Paving Charges and Surcha rges 7. ELECTRICP.L PERI.IIT + Curb Cut '/7 4rTOTAL I,IECHANICAL PERHIT Charges and Surcha rges ,<, c.-/ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legai Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION t. example- heat/electrical ceilino/o ?. 9&!SI"- waterhEaTEiTEfdcti] cTlTbr Square footage or valuation,-ttc.- r forced air gas E sol ai II. 1. example- 1?59. sq. foot house, 500 sq. foot garageZ. example- if new project, check new - if addition, check add, etc.F. Buiiding permit information:1. example - construct singie family house with anattached garage ?. example - remodel existing garage into family room3. example - convert single family-residence inio - restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty 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, & Electrical Schedu'lesA. Except where blank spaces occur in the descriptionportion of the Hechanical and Electrical Scheduies,the applicant need fill-in only the No. goxes adjaient _ to the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedulesare available at the Building Divisionl. 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 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 electricalsupervisor. The general contractor ii.not authorizedto sign the electrical labelApplicant to sign and date lJhenever possible, the initial application will be used asa.worksheet on1y. Where possible, Building Division Staffwill.prepare a type written copy and returi 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 wiil be processed unti.l thesetees are paid. Ail other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY tyllt III. 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 I nature date