HomeMy WebLinkAboutPermit Building 1989-11-15CTTY r)F SPRINGFIELD
Cr)I1BI IIATI ON APPL I CATION/PERMIT
hro0(Job Address
l-egal Description 0
ngle5Cri€. p
Ga railSI
Va (,c)
'I
rmit I
dence
I'later Heater
3q. Ftg. Access.--EIIERGY SOURCES
Hea t
Addres s
It\c*rt.r.tion r$a"" '
9-l^rtJt,
sIp
UJ
Addre s s I'hone phone nocs. no.exoi r/ebaddressnameDF'IGN TEAM
Pri mary
St ructura 1
Electrical
Mec han i ca I
name
MECHAN I CALELECTRI CALPLUtlB I NG
Genera
P1
I ectri ca I
hani
furnace/burner to
BTLI, S
Res i dence of
FTSQEach single fixture
Floor furnace
and ventNew circuits alts
or extensions
Relocated building
(new fix. additional )
Recessed wal I
Snacp heater and ventSTRVICESS. F. Flesidence(l bath)
Duplex (l bath) each
Apol iance vent
seDa ra teTemporary Constructi onAdditional bath
Stationary evap.
cool erChanqe i n exi sti ng
resi dence[^la ter s erv'i ce
Vent fan with
sino'l e ductrnultifanrily, comm
Tndustrial
or
Sewer
Vent systern a
heatino or A
part from
c.0f s.
Storm Sewer Mechan i cal exhaust
hood and duct
-
c0r.11.1./lND. FEEDERS
l'lood stove/heaterI nsta l I /al ter/rel ocate
rl i stri b. feeders
0f amp s.
ISSUANCE OF PFRI.IIT
TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES
WHERE STATE LAI,I REQUIRES t
shalI not be vali'l untiI the l
the Electrical work be done by an Electrical
has been sicned by an Electrical Supervisor
Contractor, the electrical portion of this permit
and returned to the Bu'ilding Divisionhat
a bel
S IGNAtlAllE (pl ease pr int DA6
fypermi t
'formedny
of 0reoon
.he Bu ihe permi
effect exempt
055 wi'l
reon ts rueantformaonrthattdanat_t onhett",apcompFULL s theof ciht0rdthenance tyaccordancneW1bedonehaaworkandaperfucerrthertftthaandvandtco rrec WI madebethtaOCCUPANNOCYrhere ibed a ndnthetorkwoscdeartDCgLaofwsStathetefrefidandtheSpng Bui der Sta0ntvrlthehathtstrcertmyfurthe r regdDisonvlfytngssonoftructwltureoutthsf0 th taandshereonnotedsrtifoonsexemphebat,fthatORS557010sreda
any
rd n fu fo arce nd requ i bysBoa ec tbeousedthnpro.jthw17011s0ar^rho re n ceanacarsndc0mDnsntrubcotoernpoyeesv
Zone T'yoe/ Cons t
0c c.y Group Sq. Ftg . Other
x, ValueFtq. t'lain
Bedrooms
Stori es
Fire Zone
Flood Plain
Units
x Val ue
Load Sq. Ftg. Access x Val
Svstems Oevelopment
Charqe (1.52)IndPl an
Plan Ck. Res
30%/Bldg Per Fte-
BUILDING PERT'IIT
Charges and
Surcharges
.$c__
Fence
DErno
PLUI4BING PERMIT
Charges and
Surcha rges
Si dewa I k
Tota'l Comb. Permit
ELECTRICAL PERI,lIT
Charges and
Surcha rges A/C Pavi ng
Curb Cut 8+ 53TOTAL
I4ECHANICAL PERMIT
Charges and
Surc ha rges
. 0ther. Ftg
i-lr;r,
exnires'l (ohone no,'I irc nnaddrpss
rEE a llA onFFIFtHApllFNN
I'I
ToTAL VALUATI0N--
COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION
I Appl icant to furnishA. Job AddressB. Lega l Description1. example- Tax Lot 100, Lane County Map lieference
17-T'TII32. example- Lot I. Biock 3, 2nd Addition to
SIiTn-ETield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
l\-\t-8
1. 'example- heat/2, example- water
Square footage or
air gas
\
q)3
E
iI
l. examp'le- 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. example - construct singie fami)y house with an
attached garage
2, example - remodel existing garage into family room3. example - convert single family residence into
rEST;IiFant (change of-use)G. Value of work as defined in Section 303 (a) of the
Structural Specialty 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.
Abbrevjated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be instal'led are not covered on
the abbreviated schedules you should consult theful l schedulesC. BUILDING DIVISION STAFF t,lILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical labelIII. Applicant to sign and date
l,Jhenever possibie, the initial application wil'l be used as
a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant 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 theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the pernrit is issued.
V. FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit applicant exempt from registration vvith the Builder's Board because:
Additional Project Informat'ion :
PLANS REVIEWED BY:
name s'l gnature date
.. r:t tt i.i Ii l; .;i
i:: _
36.L ii;i-iHLt.EY tT
TIb;SilE: 'tTI! I-AYEA !JT IIF:YITIALL
*fri,lNHE*
tiEilrEftEY hlAL$H '.345-;lSlt
44 iJEST ErftilAnljAY +4S+
EUf:iENE, flHI{fifiN S74C' I
* 1F{80-
rrt, l'rA ??rr\f.:,r l{ rI(
{: nHi{Hn': IrtL
5300
i.rLl It,r l:i{li Ir ILi 1S IIri{ Jr"iB{,
*tHiiAL-
LUI I'tl-tlt.r.-
,triif i1l; r' i:lfiit11'l
- [ N'iiiii ri Y " - iiT il T]g -
!'ii:'iT 1* ;l- itlIn:i :i'ilNill{:;lt- *Tftft l:f;:i }it,[r:[!Iiltl li',l
h:*l]i:H* EE[rlii'l ';{:i: G!]p
LJN J.Ti;
i;{3 rEE:.-
riiiNSll:rYFE
.- f. i1 ilT E A i'''f li I/ cl-
*ui"iL*lrE t{i{Y i}Aii:T ij I"
(]ilNTnAi:TUR Ft-r*Nt]--
Llf ME.--I iilif,r
f1f !air?r
,* L't'Ll-_llir:rll
!rt.'L:Ul\
ilfiAl 1 ir
srrlA1i']
t-'tNAI
-VFTLIJH--
'i fififi r-\
E r_,8'y' r-..t ri" .si}-'r,
liHr-i-HEnii IEHtl PliHl,i ITS- -. f I:l:-!iif,:i:.i{ARiii'j*iJF}liE*REUE IPT*I'HRi{ IT**.-*****UAI"UE*""-
ilfi'i-.i1r-r1.-E{ii!'Tii'l'hln'i}]:i;'i"tT1' IIfi'{d1 :l i1ll !:rril'!'tq'!qar:-.4 *. lfi i-inflre4!.vr.
$rjii*FiINliiijl'i INi:iFHr:TIiji.i5 + rti'iiiiJil{il14Ehi:f****-- -..-i:Yr, il^'rE,..--*ArjT IrArH-
$[t1..- IN$li]:*T liltlli---*---C0i''1i'{Hl'lT$* -rATE--.--I{ESULT** IN$p-*-
#0 1 *0 l. 1 -it'H Y. IiJALL
Ou.J-O].'.J-E INAL ELI ILN INfi
riti 1-+11*trr{YidALL
* $:1." 0 1 l. - t' It Y ld A t, L,
0ft3-019*f INtIL BU tlft INti
L'ALT, fif.I I,J " LHASH $ ITIE *NT,Y 1}"IIt
tlfini 1 1
{lftfr1 1?
cIf\n 1 1 ':}
trill-:' *iil
r r Lr '-r l-,