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Home My WebLink AboutPermit Building 1990-03-22i 7 LINE CITY OF SPRINGFIELD. COHBIIIATION APPLICATION/PERMIT Job Address 2r l-egal Descri ptic,n EIIERGY SOURCES Heat Sq Ftg Itq .l'1ain-_ . Access. l.Jater Heater Sq. Fto. 0ther_ l,ler.l Add A1 ter--P-ep. _]ence-oemo Cha-nge/ Use 0ther Ranqe Val ue of l,lork #.e t In scr .€. t ngr N \ \ Owner Addre s s Phone Lenfe.Constructi on ,1k bzu-,*Ba,D Qo.ea;* zzat* gm Addre s s Phone DESIGN TEAI.I name addre s s lics. no.exDt res Pri Structura l El ectri ca I Mechanical CONTRACTORS name addrcss'lics- no-exot res ohone no. W. Genera I EI ectri caI I'lecha ni ca I PLUI.IB I NG ELECTR I CAL MECHAN I CAL FEE CHARGE NO FFF rHA PAF I'10 FFF Each single fixture Residence of SQ. FT furnace/burner to BTLI' s Relocated building (new fix. additional) New circuits alts or extensions Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wal I Snacp hFatPr and vpnt Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra te tlater service Change in existing rps i dcncp Stationary evap. cool er Sewer multifami1y, cornm. or Industria l Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatinq or A.C. c0Hr1./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/re1 ocate di stri h fpedprs I'Jood stove/heater 0f S E-Z77z/,-r Zo-,?-d-,>R 5z az fu7a7a, rQ 4,=DBr*7 7z v2/7-ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L,1ll REQUIRES that the Electrical work shalI not be vali:l until the label has been signed by be done by an Electrical Contractor, the electrical portion of this permit an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAHINED the completed application 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 Soringfield and the Laws of the State of Oregon oertaining to the work described herein, and that l{0 0CCUPANCY will be madeof any structure without the permission of the Building Division. I further certify that m.y registration r,rith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemotion is noted hereon, and that only subcontractors and enrp)oyees who are in comcliance with OPS 701.055 will be used on this oroject. llAl'lE(please print IGNATU rc 322.^7o F zone4%2.21. TyoelCon Fire Zone' Bedrooms st t q Ftg Ftg Ftg . l{ain Val ue Load . Access x Val ue Flood Plain Stortes 1 }cc.y Group '7'^1 nrn""Muutr.-FE IoTAL VALUATIoN_ BUILDING PERNIT Charges anC Su rcharges _78-Plan Ck. Conrn/Ind 65%/81dq Per Fee 2<:d9 s terns opment Plan Ck. Res 30%/Bldq Per Fee PLUI4BING PIRMIT Charges and Surcha rges Fence Dgmo ELECTRICP.L PERI|IT Charges and Surcha rges Sidewal k A/C Pavi ng Total Comb. Permit {2. /7 I,IECHANICAL PERMIT Charges and Surc ha rges Curb Cut TOTAL 6r, F6 CHARGF COMBINATION APPLICATiON/PERMIT ( CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. glggq]g: Tax Lot 100, Lane County Map Reference17 03 432. example- Lot I. Block 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION I. example- heat,/electricai ceilino/t. examp te- waterheater/eiectrical/o Square footage or valuation, GIE.-- or forced air gas E r solar II 1. examp]e- 1250 sq. foot house, 500 sq. foot garagez. exampie- if new project, check new - if addition,' check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. example - remode'l existing garage .into family room3. example - convert singie fam.ily 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, Build.ingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated 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 adjaientto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Eiectrical 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 onthe abbreviated schedules you shou)d 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 delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrica'l labelApplicant to sign and date I'lhenever possible, the initial application will be used asa worksheet only. Where possibie, 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. Fees and Charges PIan check fees are due and payable at the t.ime of theapplication, and no plans will be processed until thesefees are paid. Ail other fees and charges are due andpayable when the permit is issued. III. IV.k lnvlw V. FOR OFFICE USE ONLY Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAI{CY: Permit app'licant exempt from registrat'ion with the Builder's Board because Addi ti onal Project Informat'ion : PLANS REVIEWED BY: name Si gna tu re date f'7Z->a