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Home My WebLink AboutPermit Building 1989-04-24O <*v f,lew Add A -FenI-e Derno gel U se -0t Sq I ter_Pep. Chan her a I Ft9 Ftg Val ue of l,lork ITLICATICOHBI y2 ol-egal Description Job Address t,later Heater Sq. EIIERGY SOURCES Hea t Ranrle I'la i n_Access.-- 0ther Desc r ac n it dence1FarnI G re., Build SingleArld re s s Phonc ,/o.aron Z*-z== an 2D<a,/Vtgazrz* tr,y -{4 . ? zsd6 Constr".fien teryrdFr- / t "224r) z./-><.'e4-v1 lql< ) zz /-,ls) 'Mrna7zo.sE ,fr,< E 7V f- / \ "N Nv Addres s Phonc address exDt res ohone no.DESIGN TEAIJ name Prj ma ry Structura I ElectricaI i'lechanical pYn I rpqCONTRACTORSn ame add res s (lics. no.l ohone no. Gene ra I 4or.*,4b2*, Bc,/e W7S -7q>€6>7 E ect I'lechanical ELTCTRICAL MECHAN I CALPLUI1B I NG CHARGF FFF rHA ANFN0.FEI NO NO FFF CHARGF Each single fixture Residence of SQ. FT furnace/burner to BTLI' s 22<' Relocated building (new fix. additional )/-Dlew circu.i ts alts, or extensions2a,?,b2,&€ Floor furnace and vent S. F. Res i dence(l bath)SERVICES Recessed wal I Soace hpater and vFnt Duplex (l bath) each Temporary Construction Apol iance vent qpDa rateAdditional bath l,later service Change in exi sting res i dence Stationar.v evap. cool er Sewer Industrial multifanri iy, conm. or Vent fan with sinole duct Storm Sewer amps.0f Vent system apart from heatinq or A,C, COI,III. / IND. FEEDERS Mechanical exhaust hood and duct Insta l I /aI ter/re1ocate di stri h, fpcdprs llood stove/heater 0f amps. ISSI'ANCF OF PFRIlIT TOTAL CHARGES <2-E;eTOTAI CHARGES TOTAL CHARGES I^JHERE STATE Llll REQUIRES that tlte Electrical work be done by an ilectrical Contractor, the electrical portion of this permitshall not be valjl untjl the label has been signed by an Electrical Supervisor and returned to the Building Divis'ion I HAVE CAREFULLY [XAlllNED the completed apnlication for oermit, and do hereb.v certif.y that all information hereon is true and correct, and I further certif,v that any and all rvork performed shall be done in accordance with the 0rdinances of the Cityof Soringfield and the Laws of the State of 0reoon Dertaininq to the work described herein, and that NC OCCUpAl,lCy will be madeof any structure without the permission of the Building Division. I further certii"y that m.y registration with the Bujlder's Board is in full force and effect as required b.y ORS 701.055, that if exempt the basis for exemption is noted hereon, and thatonly subcontractot"s and employees who are in comcliance with ons 7n1.055 rvill be used on this nroject. l,lAl'lE (pl ease pri nt )S I GIIATLIRE DATE Bed rooms B-7Flood Plain-_.'.-...'*-.-S rories /t2rZz,,"*,/8122-- 0N------ x lueoe/Const. -;rTT-y'\l . Unils Loa d--__-=---.- Gro Sq.F ts. other k,?7>E-:c u ar TOTAL VALUATIf.nhsso. Ftq. l'lain x Va Val ueFi ne Zone Zone Sq. Ftg. Access. Plan Ck. Comm/Ind 65%/81rlo Ppr Fpc //a,97. /-3-4 Svstems Deve charqe (1.57 opmentBUILDING PERI',IIT Charges anC Su rcha rge s _ l?_r. z?___6.zz Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PTRMIT Charges and Surcha rges D6mo Sidewal kTLECTRICAL PERIiIT Charges and Su rcha rges ___= Tota'l Comb. Permi tA/C Paving Curb CutI,IECHANICAL PERMIT Charges and Surc ha rge s fi ra ?/.BaTOTAL COMBINATION APPLICATION/PERMIT (CAP) Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot I. Block 3, 2nd Addition to SpiingField EstatesC. Name, etc. of owner and construction lenderD. Energy Sources e I 1 r forced air qas ea soiar E valuation, el. example- 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 single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence into iestaurant (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. II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occulin the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are ava'ilable at the Building Division l. To conserve space on the permit form the schedules have been abbreviated?. If the item(s) to be instalied are not covered on the abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF l,llLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to the eiectrical contractor for signature by his electricai supervisor. The general contractor is not authorized to sign the electricai iabel.III. Applicant to sign and date Hhenever possible, the initial application will be used as a worksheet only. ldhere possibie, Building Division Staff will prepare a type written copy and return it to the applicant 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 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. V. FOR OFFICE USE ONLY PERMTT VALTDATT AN tbrl. t6lUtyb* rzo;/ ffi Permit Cler PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAITCY: Permit applicant exempt from registration with the Bu'ilder's Board because Additional Project Information PLANS REVIEWED BY: name si gnature dat e /-){-*,