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Home My WebLink AboutPermit Mechanical 1986-04-29rffA PECTION LINE -37 69 CITY OF SPRINGFIELO COHBI NATI ON APPLI CATION/PERMIT 7?6 3o c Job Address Lega) Descri ption I'later Heater Ranqe EIIERGY SOURCES: Heat FoBrus DO>a1 lO oToo Owner Pac W.us-r Val ue^ofJ l,lork: aoo Sq. Ftq. Access.--- So. Ftg. 0ther_l{ eur-q6 6_11 te r_Rep . _Fence_Demo Change/Use 0ther Ftg n_ Address l/ I S.t/), 5fl1 flik A?500t'"'" f|[o Quii(in-g Pernrit Info: Describe |^iork(Farnily Residence [,lith Attached Garaqe .e., Build Single Pa<tl*nt4 , oP" ?z aos I,,vS f4 L( 4 *fou of Gt S Constructi on Lender U tJ i+ fier++z,< Addres s Phone eoqJ _s P DESIGN TEAI{name address I ics. no.exoi res phone no Pri ma ry Structura I E I ectri ca I i''lechan i ca I ACTORS name addres s lics- no- I exoi res ohone no- e"""t t'il€.f Lf Cea/Sf-" lO t/nN t3t)<6a1 q-rsr- I Y-t7 Pl umbi nq Electrical rrlechanicar #na()&4 y Ppfce (b., ?otS ttJtlea'e r ufuy 77 /o-3t-tO 7 V6- /6At PLUI1BI NG ELECTR I CAL I"IECHAN ICAL FFF CHARGE N0-FFF CHAQG F NO FFF CHARGF Each singie fixture Residence of FTsQ furnace/burner to AeS_ OOO Bru,s - 1p Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S. F. P,es i dence(1 bath)SERV I CES Recessed wal I Snacp hpatpr and venf Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent seoarate l,later servi ce i n exi sti ngChange res i de ncp Stationary evap cool er Sewer multifamily, comm. or Tndrrstrial Vent fan with si nol e duct Storm Sewer 0f Vent systern apart from heatino or A.C. c0r.1r'1. /IND. FEEDERS Mechanica.l exhaust hood and duct- Instal I /al ter/rel ocate di stri b- feeders t'lood stove/heater 0f amps.Srr-r:2,cD \5: ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES IOTAL CHARGES WHERE STATE Llll REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be vali,l until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed apnlication for oermit, and do hereb.V 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 0rdinances of the Cityof Springfield and the Laws of the State of 0reqon oertaining to the work described herein, and that NC OCCUPAI'|CY will be madiof any structure without the permission of the Building Division. I further certify that my reqistration vrith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for Lxemption is noted hereon, and thatonly subcontractors and employees who are in comoliance with 0l1S 701.055 will be used on this nroject. -fr^. P JL*-*a* DArE ?-)t t9I GNATURE16 SaKan.ralJQrvt€s D,P<fct C'c:.l.lAl.'lE(pl ease pri nt) FOP. OFFICE USE OiILY Flood Plain Stories 0cc.y Group Sq Ftu Ftg Ftg Val ue Val ue ToTAL VALUATI0N_i,1fr,*'so x 1 ue S q Fire Zone Bed rooms its Load Sq l'la i nZone___Tyoe/ Cons t. _Un Acces 0ther Plan Ck. Conrn/Ind 65%/81do Per Fee cl^t. t=rqe (1.52 Svs Cha terns Deve opmentEUILDING PERTIIT Charges and Surcharges Plan Ck. Res 30%/81do Per Fee *g Gb3tto FencePLUI4BING PERMIT Charges and Surcha rges Dgmo l cY j.*ls Sidewal kELECTRICAL PERIlIT Charges and Surcha rges Total Comb. PermitA/C Paving Curb CutI,IECHANICAL PERMIT Charges and Surc harges TOTAL $ \g:5 COMBINATION APPLICATION/PERMIT (CAP) I . App I i cant to f urn'i shA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources PER}4IT VALIDATION 1. exampl e- he2. examp'l e- waE. Square footage air gas 1. example- 1250 sq. foot house, 500 sq. foot garage2. erdmplil-if new project, check-new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. 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 theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bui)ding Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrica'l SchedulesA. Except where blank spaces occur in the descr.iptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Piumbing, 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 on the abbreviated schedules you should consult thefulI 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 h.is electricalsupervisor. The general contractor is not authorizedto sign the electrical label.III. Appi icant to sign and date }lhenever possibie, the initial 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 actuai permit is.issued for hissignature.IV. Fees and Charges PIan 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. V. FOR OFFICE USE ONLY I tnV qt/ tp Permi t Cl erk bq PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Bu'ilder's Board because: Additional Project Information : PLANS REVIEWED BY: na s'l gnatu date ?\ \V ,,,e