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Home My WebLink AboutPermit Mechanical 1980-10-14L CIIY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT RI,IA 37 Job Address <.7 EIIERGY SOURCES Hea l.later Heater e So. Ftq. liain-- Sq. Ftg. Access._ Sq. Ftq. Other__ _l{ew__.AddJ1 ter_Rep . Fence Demo Chanqei{Usefu.ner-lt '-ood4htu o W N ( l-egal Description 4rt t 2 Owner //n Value of llork*/oo ue Addrdss 41"7 =. z//5T!we/ PhoneT4llo-Quil-cing Pernrit Info: Describe lJork(i.e., Build SingleFarniIy Residence I'lith Attached Garaqe) 67t11 Construction Lender -\T(,qD 3lB5 Addre s s Phone DE5I GN TEAI.'I nafite addres s I i cs. no.exDl res no Primary St ruc tura I il ectri ca l i'iec ha n i ca l C RA n ame address )l'i cs. no.exot res ohone no Generat \N n/f Plumbing El ectri ca I "echani ca I PLUT{B I IIG ELECTRI CAL MECHAN ICAL FFF CHA RGF Nn FFF CHARGF N0.FEF CHARGF Each single fixture Res idence of SQ. FT furnace/burner to BTL'' S Pelocated buildinq (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S, F. Residence(l bath)SERV I C ES Recessed wal I Soace heater and vent Duplex (l bath) each Additiona.l bath Temporary Construct ion Apoi iance vent seDa ra te l,iater servi ce Change i n exi sti ng res i dence Stati onar,v evap cooi er Sewer multifamily, comm, or Industr.ial Vent fan with sinole duct Storm Sewer 0f -amp s Vent systeni apart from heatinq or A.C. COI.!I.!./IND. FEEDERS Mechani cal exhaust hood and duct- Instal I /al terlrel ocate distrib. feeders l,Jood stove/heater 5,4 <OOt), - 0f s. ISSUANCF oF PFRI'IIT /0,o9 TOTAL CHARGES c TOTAL CHARGES -n-TOTAL CHARGES t5,o9 I^JHERE STATE LAl,l REQUIRES that the Electrical woshall not be valil until the Iabel has been siqned rk be done by an Electrical contractor, the electrica] portion of this permit by an Electrical Supervisor and returned to the Building Division I HA VE I he COMD I erted apnl ica any and all r of Oregonof the Buil, t .I n r Derm t, and do hereb.y certi fy t ha t a l I I n fo rrna t 'l on hereo n .I s true Ci ty made and comect,and i further certify that w0 rk oe rformed s ha I I be don e ,l n ac cordanc e 1 t h the 0rd 'I n an ces o f thf Soringfi eld and the Laws of the State DC rta 'I n 'I n cJ to th work desc ri bed he ret n and tha L NC OCCUPAN CY wl I I befanytructurewlthoutthepermiss0ndIngD'I I S I furt herf exempt .055 I'ri I I ce rt .I ry L ha t m.y re -q 'l S tr a L 'I 0n tJ l t h the Bu I I der I sBoardIsInfuiIforceandeff,ec t a s requi red by ORS 707 0 55 tha t I the ba s 'I S for exempt 1 o n 'I s no te d hereo n a nd th a tonIvsubcon tra cto a nd ernD I 0yees l^rho a re I n c0mD an ce wl th 0i?s 7 0 1 be us ed on L hi s nro,j ect tlAl.lE (p l ease pri n ] GhATURE DATE I E zone Zl /Const 1 t-c S E-la Ft; Ftg l4a i Val ueqx Fire Zone * Bedrooms Flood Plain Stories 0c cy Load - Sq c.v Group F/5 sq Acce s s 0the r xr Val ue 0c x dI Ip T0TAL VALUATi0N /nfi o! BUILDING PERI'1IT Charges and Su rcharges Plan Ck. Comm/lnd 65%/81do Per Fee Svsterns Deve Charqe ( 1.5E opment Plan Ck. Res 30%/B1dq Per Fee PLUI,IBING PERMIT Charges and Su rcha rge s Fence DCmo ELECTRICT.L PERI,:IT Charges and Surcha rges C-Sidewal k A/C Paving Total Comb. Iermit 14ECHANICAL PERMIT Charges and Surcha rges <o_t , (oO Curb Cut TOTAL /< /"Ottt e_ COMBINATION APPLICATiON/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description i. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Lnd Addition to SErinqfietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources i. example- heat/electrical ceiling/2. examole- waterheater/electrical/o Souare fooTage or valuatjon, etc. or forced air gas r sol ar E iI. III. 1. example- 1250 sq. foot house, 500 sq. foot garage ?. example- if new project, check new - if addition, iFec['a-dc, etc.F. Brrilding pernit information:1. exarnple - construct single famiiy house with an a"tacneo garage 2. exarnple - rernodel existing garage into family room3. example - convert single family residence into relTiuiant (change of use)G. Value of work as defined 'in Section 303 (a) of the Structural Specialty CodeH. DESIGi.i TEAI,I AND CONTRACTORS To avoid design or construction delays, Building Div'ision Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. A.bbreviateo Plumbing, Mechanical, & Electrical SchedulesA. lxcept r.rhere blank spaces occur in the description :crtion of the }lechanical and Electrical Schedules, the applicant need fill-in on.ly the No. Boxes adjacent:c the approcriate item(s) to be instailedB. Ful l Plu,:b.ing, llechanical, and Electrical Schedules are avaiiable at the Building Division1. To conserve space on the permit form the schedules have been abbreviated 2- if the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedules C. BUILDING DIVISiO}I STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his eiectrical supervisor. The generai contractor is not authorized to sign the electrical label. Applicant to sign and date Lihenever possible, the initial appl ication wil l be used as a worksheet only. !,Jhere possible, Building Division Staffwill prepare a type written copy applicant at the time the actual s ignature.iV. Fees and Charges and return it to the permit is issued for his 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. FOR OFFICE USE ONLY PERMIT VALIDATION Permi t Cl erk PROJECT CONDiTIONS TO BE SATISFiID BEFORE OCCUPAI{CY: Permit appf icant exempt from rnegistration with the Bujlder's Board because: Add'itional Project Information : PLANS REVIEWED BY: name s i gnature date ON LiIiE coMB I i{Aii 0N -lpFt- t clr t on/ PERM I T 726- 5TJob Address l-egal Description Hea EIIERGY SOURCES Ran'?e l.Jater Heater tq. llain- Sq. Ftg. Access._ Iei-Tep.Sa 1 c Ftq. Other Use sq. Value of llork* / oo""sOwner tI GaraFarni I th 'i ld Sinq e PhoneAddres s b -<tA5TI,3DConstruction Lender -:o W N , Addres s Phone addres Pri mary St ruc tura I il ectri ca l i'lec ha n i ca I n drne Genera I "echa ni MECHAN I CALELECTR I CALPLUiIB I IiG i't0FEE iCIIARGEirnFEE furnace/burner to BTLI' s Residence of FTSQEacn single fixture Fl oor furnace and ventNew ci rcui ts al ts or extensions Relocated building (new fix. additionaI) Recessed wal I Soace heater an<l leltSERV I CESS.F. Residence(l bath) Duplex (l bath) each Apoi iance vent qpDa rateTemporary Constructi onAdditional bath Stationary evap cool erge in exist'i ng dence Chan res il,la ter servi ce Vent fan with sinole ductIndrrstrial multifamily, conm. or Sewe" Vent system aPart from heatinq or A.C.0f 5. Storm Sewer Mechani cai exhaust hood and ductCOMI.I./IND. FEEDERS <4 aoo-),'-llood stove/heaterI nsta i I /a I ter/ rel ocate distrih- feeders 0f lSSUANCE OF PFRIlIT /c,o9 TOTAL CHARGES t-<.q9TOTAL CHARGES -L )TOTAL CHARGES be done by an Electrical Contractor' the electrical portion an Electr.ical Suoervisor and returned to the Building Divisi of this pernit onl,lHERE STATE LlN REQUIRES that the E'lectrica I work shal'l not be valil untiI the label has been signed by DATES IGiIATUREI,lAtlE (pl ease pri ts Ftq Ftg Ft9 lno o! x x l4a i oe rmi t 'fo rmed gon Bui forany rd true1innhereo1S'I ath at I'I ndanheredocertfyb.y'II dLc o1 foreapr)heI NED tA11 comp cihe1fotcerdanItheth0rdnance s tySIhabeInedonIcc0andIat^/o'I kr r0eat1thaaIndfuthe rr ertcndactc0 rre fy IIthaNCt0cc,AIICYUP wl be madeandrl^/o descrk b'I heed Ire n0reartn1'I thet0 any of ngofS'Ir f 1 d'I nda th Lae ofws the S ta te 0eng S1 dtr It n0 thvri het u 1'I de r sfurec'Irt t thadIn1Disvlon'I ther regm.yiturestrucwlthtouheLsIsn0theoffypermiof 0nI s1 and tha tfthebaissexempt g n th ta055 i17ORS exemptsIniIfuIfoercefandectAS'IU redBoarecl by ed thon s'I rn ec t'i thwl 0i?s n l')jbeusI'It,I5051emDndIarewhonIancecomDonontrsubctoacrsvoyees Val ue r Val ue r Val ue TOTAL VALUATiOII Acces s 0ther terns rqe 0 1 ve 5dl- Plan Ck. Comm/lnd 651/A1dq Per Fee Plan Ck. Res 30%/81do Per Fee EUILDING PERNIT Clrarges anC Su rc harges -e- Fence Demo PLUI,IBING PERMIT Charges and Su rc ha rge s Si dewa I k Total Comb. PermitA/C Pavinq ELECTRICP.L PERIlIT Charges and Su rcharges C- Curb CutI,lECHAI'IICAL PERMIT Charges and Surc ha rge s o\,,_t , (oO /< bo/tJTOTAL nhonp nneYn I rPq'l ir< no-(acidress noted hereon, Fire Zone - Bedrooms - OccY Flood Plain - Stories .*-. 0cc.Y Load - - Sq. croup h[/5 so. Zone [z I Tvoe/const. corqBINAIr0N AppLI CATI0N/PERMIT ( CAp) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map R. -]7ITT:2. example- Lot l. Block 3, Znd Addition tS[Fjigfietd Estates 9. Name. etc. of owner and construction lenderD. Energy Sources PERI4I T VAL I DATI ON OF SPRINGFIELD CirY Holl Springfield, Oregon Deporiment of Public Works OFFICIAT RECEIPT No. B 54837 CITY I eI ectni ca I I in ea ter e ( 6iZ. E. Squa or forrr so-Tal0 examo i e- ExamETF EIETTaa 1250 sq.if new p etc vaiuation,etcfoot house,500 sq. fcroject, check new - if ,,,.tit a-lv rs6 ciF. Building pernit .information: 1. exan:ole - construct single famiiy house , ;ttacne-.o garage?. exan:ole - rernodel existing garage into ft3. e;amole - convert single iaiily"resiaenct _ restaurant (change of use)G. Value of work as defined in Section 303 (a) cStrucEural Specialty CodeH. DESIG|i TEAI.I AND CONTRACTORS To avoid design or conjtruction delays, BuildDivision Sraff must be able to contalt approppersons.regarding design information or job scorrections, etc. Abbreviareo Plurnbing, l"techanicai, & Electrical SciA. :xcept vrhere blank spaces occur in the descrir:orcion of tiie l{echan.ical and Electrical Schecthe applicant need fill-in onl_v the lto. Boxes ^ :c_the-appropriate item(s) to be .instal.led B- Full Piunbing, i.lechanical, and Electiical Scheare available at the Buiiding Division1. To conserve space on the-permit form the s,have been abbreviated2. If the item(s) to be instajled are not cov(the abbreviated schedules you should consu,full schedulesC. EUILDIIIG DIVISIOiI STAFF I.JILL FILL OUT ALL FEES CHARGES Oi{ THE SCHEOULISD. As noted on the CAp, the iabel must be delivereelectrical contractor for signature by his elecsupervisor. The generai contractor is not authto sign the electrical labelAppiicant to sign and date l/henever possible, the init.ia] application wilI be ra.worksneer only. Where possible, tsuilding Divisiorwill prepare a type vrritten copy and returi it to tlapplicant at the time the actual permit is issued fo s i gna ture. Fees and Charqes Plan check feis are due and payable at the time of tapplication. and no plans wii'l'be processed untii thrtees are paid. All other fees and charges are due ar1_payable when the permit is issued. FOR OFFICE USE ONLY d kli it rri r tl tin sl ress ftre te 6 fs Rece ived For:<.w TC o 2tUt II. III. IV. u ,€(t (s ba Ji ,.8 F ,t'T € { ( <a.9 c-Arc lzAmount Received Iurxoatzeo sIcNATURE gXf,LTOt_YUFXtUL! Pilxiiis EuGENE OR 97'ol !alll a v Permit Clerk PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from r.egistration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY datenames'l gna tu re i. I ( (r o9 / -c