HomeMy WebLinkAboutPermit Demolition 1980-02-227
PECTION LINE
-37 69
CITY OF SPRINGFIELD
COI1BI i{ATI OI.I APPL i CATION/PERMIT 726-37
Job Address
l-ega1 Description
Hea
EIIERGY SOURCES
l.Jater Heater
Ranrl-.4-=\ -q\ \\aC)v-
0wne r
u""'$1"5/A
. Fto . I'la i n_
Sq. Ftg. Access._
Sq. Ftq. 0ther__
l,leq AddJi ter P.ep.
-0the
range/ Use
\Add/:lJ tY_)i'l nPhone)it, Info: Describe Work(
rce llith Attacbr:d Garaqe
.e., Buiid Single
I (r1
Construction Lender
(1Addres s Phone
o
8
e
DES I GN TEAI'I name address (no.s exD r res ohone no.
Primary
Structura I
El ectri cal
l4echan i ca l
CONTRACTORS n ame addres s (lics. no.)exot res ohone no.
Genera I
\yPlumbinq
-\
El ectr i ca I
l'lechanicaI
PLUIlBI NG ELECTR I CAL MECHAN I CAL
FEE C HARGF NN FFF l^ HAPGF It0 FFF CHA RGF
Each single fixture Residence of
FTsQ
furnace/burner to
BTLI' s
Relocated building
(new fix. additional )
New circuits alts.
or extensions
Floor furnace
and vent
S. F. Res i dence(t batn)SERV I C ES
Recessed wal i
SDace heater and vent
Duplex (l bath) each
Additional bath Temporary Construct i on Apol iance vent
sFDa ra te
l,Jater service ge in existing
dence
Chan
resi
Stati onar.v evap.
cool er
Sewer Tndrrsfrial
multifamily, comrn. or Vent fan with
si nol e duct
Storm Sewer 0f S.Vent systern apart from
heatino or A-C.
COMI'I./IND. FEEDERS Mechanical exhaust
hood and duct
Instal 1 /al ter/re1 ocate
disfrih fppdprc llood stove/heater
T\t i.\l\)Q)f ).amp s.0f
\
n ISSUANCF OF PFRI1IT
TOTAL CHARGES IOTAL CHARGESTOTAL CHARGIS
WHERE STATE LAt'l REQUIRES that tlte Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shal'l not be valil until the label has been signed by an Electrical Supervisor and returned to the Building Division
llAl.lE (pl ease n
e permi
effect xemp
5 r,ri
ca one r t0 rma onI nhereo s truetthaatcertapr)comp DE
nda rrecc0 t a Ind rtfu rhe 1cert t ha t Iia work rmed has II donebe ni daacc0r enc wl ht 0the 'Ird ann oces f het 1Candfyanyoerfo tyofIeIdIndaLawsthefohettaSnnnsprngfte0rtaIItol^lOthe kr ed cS berl here id n ndaof th ta cN UPOCC CY'4il Iwl l be madereqoDCg
s tutruc re thou thtof 'Ianyss ofn Buthe I,],]d Di sv1 on'l fu rrthe ticer tha t 'I +rs t,a 0'l vJln theth u I1 rde sIngfym.y reg
1Board is fun II fo andrce ha tandLshereonnotedbass'I rfo ex 'It onhett'Iu red 701ORS 550 th ta f'Ias empreqby
on ubco ntra d nctoanrsIrvhos1aren'II cean th 70t?s 1 05 'I I th s'I ec tbeSCud0n
'ly
ernD 0yee comD r0.lp
Ftg
Ftg
Ftg
its Val ue
Fire Zone Val ue
Fl ood Pl ai n Val ue
ToTAL VALUATI0N_
Zone x
x
x
S q
S q
Load Sq
Group
st. V un l'la i n
Stories
Bed rooms . Access
. 0ther
Plan Ck. Comm/Ind
65%/81do Per Fee
Svsterns Deve
charqe (t.5%opmentBUILDING PERMIT
Charges and
Surc ha rges Plan Ck. Res
30%/81dq Per Fee
Fence
\_
PLUI4BIN6 PERMIT
Charges and
Surcha rges D5rmo
Sidewal kELECTRICAL PERI1IT
Charges and
Surcha rges A/C Paving Tota'l Comb. Permit
Curb Cut
TOTAL
I,lECHANICAL PERMIT
Charges and
Surc ha rge s
,1 r
(
I
)(I
)_
iQ_o -
NlJ
COMBINATION APPLICATION/PERMIT (CAP)
I . Appl i cant to furn i shA. Job AddressB. Lega l Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 43?. example- Lot l. Block 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
1. example- hea2, example- watE. Square footage o
t/e cal or forced qir gas
ea or solarr vaiuation, e
l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition,
check add, etc.F. Building perm'it information:1. examp'ie - construct single family house with an
attached garage
2. example - remodel existing garage into family room3. examole - convert single family residence into- FGTi-urant (change of-use)G. Value of work as defined in Section 303 (a) of the
Structural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except vrhere 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 'installed
B. Full Plumbing, Mechanical, and Eiectrical Schedules
are available at the Building Division1. To conserve space on the permit form the schedules
have been abbreviated?. If the item(s) to be instalied 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 theelectrical contractor for signature by his e.lectricalsupervisor. The genera) contractor is not author.izedto sign the electrical label
Applicant to sign and date
Hhenever possible, the initial application wil l be used asa 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 ignature.
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 t/hen the permit is issued.
FOR OFFICE USE ONLY
D
II
III
IV
V Perm'i t Cl er
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY
Permit applicant exempt from registrat'ion with the Builder's Board because:
Additional Project information :
{
PLANS REVIEWED BY:
name signature