HomeMy WebLinkAboutPermit Mechanical 1981-05-12-t
CIIY OF SPRINGIIETD
COMEINAITCN APPTICATION / PERMIT
INFORMAIION TINE
72U7753INSPECTION LINE
77e3769
tn
Job Ad
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Owner
Sq. ttg. Other
-New_-Add -Alrer-RcP.- -Fence-Demo-Chongei Ure
-Other
ENERGY SOURCES:
Woter Heorer
Volue of Work:
Heot
oo
Fo
Sq. Itg. Accesr.
Permit lnfo:
Residen
Dercribe Work (i.e., Build Single
Artoched
Sq. Frg. Moin
PhoneAddrer:
il.uc
o
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N
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#IAddrerrPhone
ne no.)(licr. no.)(oddress)DESIGN TEAM (nome)(expires)
Slructurol
Electricol
nicol
ne nomc)ACTORS
no res)
Electricol
CHARGE
Mechcnicol
,\AECHANICALPIUMBING
FEENO.
EIECTRICAT
FEEC!-IARGENO. r I lr:
furnoce/burner toResidence of
--rq. fr,Eoch ringle fixture Applioncc vcnt
5epqrole
New circuils, olte.oliont
or exientions
iRelocoted building
(ncw fix. odcjirionoi)Slolionory evop,
coolerSERVTCE5
S.F. Reridence
(l borh)Vent fon with
sinqie duciTemporory ConslruclionDuolex (l both) eoch
Vent syslem oport from
heoting or A.C.Amp:.Additionol both
Mechonicol exhou:t
hood ond ductWoter rervice
Wood stove/ heoter
Scwer
Heol PumprEED ERS
Air hondler to
I0,000 cri{Ampr.
Scwcr
Air hondler over
r 0,000 cFl,{
i
ISSI,I.ANCE OF,PERA,UT
Zone
-Type/Con:r.-Units
Sq. Ftg. Moin
Flood Ploin
-Slorier
Occy Group-Sq' Ftg' Olher-
TOTAI. CHARGESTOTAT CHARGESIOTAL CHARGES
t/r,/ t t
DAIEt*t+A t rcart
oofrliorrlhirnot:holl unrilbcvqlidclcctricolthadoneE!erlrilhc Conlroctoz,Po permit<qlrhcctricolElebeworkwtARESREOUIbythot5rVJHEREATE
d cheddlro rhelo olectri colEqnConlrsGlot ponel.bern o n lactricolho:signod bylobel
de of ony
s requireci
ond ffur?heolllholhereoinformotionncorrect,lrue ond3docerliforondlyh erebyEDNtheiedleREFCAttUEXAr^l comP opplicotion permit,YVEHA'theqnd Lo theof ofStoteotheof Oregonofcilhewithrdino nces Springfieldl,lbetndoneccordqnceqosho llcerlithotondpe rforredonyfy furthertheolDi v isio n.Buthewithouilructure Idingpermi:sionoewillndNOthdtOCCUPANCYthcde:criixdwork her i n,I ngpertoin bothe It notedfor3rsoRS701tho,f.055,exemPt exemptioncleffebylnI5ondfullfor ceth8ui lder'rhc Boordihoimyregirtrolionertif y rhisnirh70ORS.055 bewill ouredtnIqnce proiGGt,owho re @mPondrubontrsclorgemployeerondthotonlyheron.
Bosir lor Builder'r Soord crcmption;
NA,\lE (pleose print)
fOR OFFICE UsE ONIY
SIGNATURE
x
----Voluex Yoluc
1-Volue
TOTAT VAIUATION
.,r-0 c.
Fire Zone-Ecdroomr occy lood Sq. Ftg. Access
Sy5tems DeveloPment
Choroe ( I .5?'o)
Plon Ck, Comm/lnd
65iLl Blde Pet Fee
Plon Ck. Rer
3o7o/8ldq Per Fee
BUITDING PERAAIT
Chorger ond
S u rch orge:
Fe nce
Totol Comb. PermitDemo
PTUA{BING PERMII
Chorger ond
Surchorges
Sidewolk
A/ C Povinq
Chorger ond
Surchorger
ETECTRICAI. PERMIT
15 boTOTAT
I
I
MECHANICAI. PERIAIT
Chorger ond
Surchorger
Pltrmbino
.H APGFNO.
-BTU'S
Curb Cut15 co--- .T;5-
coMBTNAT|ON AppLtcATloN/pERMtT (CAp)
l. Appliconr. to furnish
A. Job Address
B. Legol Description
'1 . exomple-tox lot 100, Lone County Mop Reference IZ 03 432. ex#FC-Lor l. Block 3, 2nd Addiiion to Springfield Esrores
C. Nome, etc. of owner ond construction lender
D. Energy Sources
lectricol ceili /or forceC oir go:
2 eoter,.ect /or-I61il--col
E. Squore footoge or voluotion, etc-I. exomole-1250 sq. foot house, 50! sq. foot goroge
2. e x o m FIE- i ?rr e--w p r o i e c r, c h e c k iE-w - i i o d d i tio n, ci ec k
odd, etc.
F. Building permit informotion:
l. exomple-construct single fomily house with on oltoched
goroge
2. exomple-remodel existing goroge into fomily room
3. glffiFC.converr single fomily residence into
restouront (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Division
Sloff must be oble to contoct oppropriole persons regording
design informotion or iob site corrections, etc.
ll. Ab6revioted Plumbing, Mechonicol & Elecrricol Schedules
A. Except where blcnk spoces occur in the description portion
of the Mechonicol ond Electricol Schedules, the opplicont
need fill-in only the No. Boxes odioceni to the oppropriote
- irem(s) to be insrolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division
l. To conserve spoce on the permii form the schedules r
hove been obbrevioted
2. lf the irem(s) to be insrolled ore not covered on the obbrevi-. oted schedules you should consult the full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, the iniiiol opplicotion will be used os o
worksheet only. Where possible, Building Division Sroff will
prepore o typewritten copy ond return it to the opplicont ot
the time the oouol permit is issued for his signolure.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of the opplicotion,
ond no plons will be processed until these fees ore poid. All
other fees ond chorges ore due ond poyoble when the perrnit
is issued.
V. FOR OFFICE USE ONLY
PERMIT VALIDATION
Qoo+ ocTt e6-tz c(
Permit Clerk
PROJECT CONDTTTONS TO BE SATISFIED BEFORE OCCUPANCY:
(
Additionol Pro[ect lnformotion:
nome signoture dote
PTANS REVIEWED BY: