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HomeMy WebLinkAboutPermit Building 1986-07-17 (2)w trUt - CITY OF SPRINGFIELD COHBI I,IATI ON APPL I CATION/PERI'I tT 53 Legal Description Job Address Hea Ranqe EIIERGY SOURCES: llater Heater owner *4{*tEW ?Dlcy,.tbot- -Ot6( n Value of#l.lork:92,ooo Sq. Ftg. Access. Sq. Ftg. Other .l'lain t Info: FamiI c ng ePhone I TConstructiLn LenJer U Addre s s Phone ooCo s -.f, name address lics. no.exo rFs %bc,r+eo* I M I knU,ids ?o. o, Pri ma ry Structura I l'|echani cal El ectri ca I IACTORS name I addrpss'Il(/IcxnirpsI ohone no. Aencrr I Pl umbi nq E l ectri ca l itechan i ca I PLUI1B I NG ELECTR I CAL MECHAN ICAL FFF CHARGF NO FFF CHA AG F I'10 FFF CHAIIG F Each single fixture Residence of FTsQ furnace/burner to BTLI' S <,52 Relocated bui Idinq (new fix. additional)New circuits alts. or extensions2 6,R br4RE ) Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wai I Soacp hcatpr end vpnt Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent s eDa ra te [.later serv ice ge in existing dence Chan res i Stationary evap cool er Sewer mu1 ti fami ly, industrial comn. or Vent fan with sinole duct Storm Sewer 0f s.Vent systern apart from heatino or A-C.b6.15rr*,/s*COI,!I.!. / IND. FEEDERS Mechanical exhaust hood and drrr:f I nsta I I /a I ter/ rel ocate di ctri h^ feedprs l'Jood stove/heater 0f s.'&z*hzt*lw /r+>urrc ?eo ,G. ISSUANCF OF PFRIlIT ?-5p TOTAL CHARGES I,IHERE STATE LAI.I REQUIRES shal I not be val i'J unti I the the ,| E ctrie c I rktaw0 be done a n E ectr1 Con tractorca1'I ethe ec'|tri 'Ia 'Ibyrt on ofpo abeI haI 1 nbeensa IE caectri I 'I asor rend rntu toed Buthe I1 Idbygned D I s1 '|Superv 0nng s perrii t @TOTAL CHARGES TOTAL CHARGES I HAVE CAREFULLY EXAi{INED the completed appl ication for oermit, and do that any and all work performed shall be done in accordance with the 0rdinances of the Ci l.lAl'lE ( pl ease pri nt )s ty made hereb.y certify that all information hereon is trueand correct, and I further certifyof Springfield and the Laws of the State of 0regon Dertaining to the work de sion of the Building Division. I further scribed herein, and that NC OCCUPANCY will becert'ify that m.y reqistration vrith the Builder'sof any structure without the permi sffect aBoard is in full force and e s required by ORS 701.055, that if t the basis for exemption is noted hereon, and thatonly subcontractors and ernployees who are in comoliance with 0l?S 701.055 be used on this Droject. FOI1 OFFICEOJS Oi{[Y T\ Ftg Ftg Ftg Access x Vaorn""@u t o.5 Flood Plain S tories cy Load Sq. TOTAL VALUATI ON 0c c.y Group Sq. Iue ue ts So l4ainZone lueFire Zone Bedrooms 0c P'l an Ck. Corm/Ind 65%/81do Per Fee 7.8 Svstens Deve charqe (1.52 opment ty3.BUILDING PERI.IIT Charges and Surcharges 6./o Plan Ck. Res 30%/Bldo Per Fee FencePLUt.lBING PERMIT Charges and Surcha rges /?a _ __/,4*_.-:_ _' '€;o Dgmo Sidewal kELECTRICAL PERTIIT Charges and Surcharges I A/C Paving Total Cornb. Permit z 19.?o Curb CutI,IECHANICAL PERHIT Charges and Surcharges ___/5=_.60 3tz.TTOTAL I tusp 1726-ll- \r Address q,?E Mill €*taf re [^lork ( I Garaop I LAI,,I )one no -AIEQadar I IIIt COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition toSFiiI!-fietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. exampi e- heat/2. EIIfrETIe- water SquaiE-Tit-tase or electrical ceiling/or forced air gas h=eaterT "f-aTi]*7.on, etc. r solar E valuati F l. example- 1250 sq. foot house, 500 sq. foot garage2. example- J-f new project, check-new - if additio;, check add, etc. Building permit information:1. example - construct single family house with an attached garage 2. examp.le - remodel existing garage into family room3. example - convert single famity residence intorestaurant (change of use) Value of work as defined in Section 303 (a) of theStructural Specialty Code DESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Bui)ding Division Staff must be able to contact appropriitepersons regarding design information or job site G H II corrections, 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 oniy the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are 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 should consult theful I scheduIesC. BUILDING DIVISION STAFF I"JILL 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 ejectricalsupervisor. The general contractor is not authorizedto sign the electrical Iabel. Appl icant to sign and date Whenever possible, the initial application will be used asa worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to theappiicant at the time the actuai permit is issued for hissignature. 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 when the permit is issued. FOR OFFICE USE ONLY Lt t,q 0f -Bag'll- III IV V Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Bu'ilder's Board because: Additional Project Information : PLANS REVIEWED BY: nu^" Lo7rve 74# ,ig nature date 7-2,/ -3e