HomeMy WebLinkAboutPermit Sidewalk 1989-05-18L
r?
Legal Description
Job Address Sq.'Ftg. Access.-
Sq
Value of l,lork:
4>->
Owner 6,qn.-rr-.5...e- Suild SingleIoDes
chedFarniI
fz.zp
co*t*.fron Lender /
\0
--V7--
Addre s s Phone
Struc tura l
Pri ma
E l ectri cal
Mechani cal Iicq- no-exDt resadd res sn ame.OI'ITRACTORS
MECHAN I CALELECTRI CALPLUI{B I NG
furnace/burner to
BTU' S
Residence of
FTSQEach single fixture
Floor furnace
and ventNew circuits alts.
or extensions
Relocated building
(new fix. additional )
Recessed wal I
Soace heater and ventSERV I CESS. F. Residence
( I bath)
Duplex (1 bath) each
Apol iance vent
seoa rateTemporary Constructi onAdditional bath
Stationary evap.
coo l erChange in existing
resi dencel.later servi ce
Vent fan with
sinqle ductmultifamiIy, conrn
I ndustri a'l
or
Sewer
Vent systern aPart from
heatino or A.C.0fStorm Sewer Mechanical exhaust
hood and ductCOMI.I./IND. FEEDERS
llood stove/heaterI nsta l I /a'l ter/rel ocate
di ctrih- feeders
0f s.
ISSUANCT 0F pFRtlIT
L1!l bytriQU'it
SHARGE
,AL
CTOTESCHARGALTOT,ESCHARGALTOT,of sthi teectrIcaI1on'I
1a ntraCo ctor het port permidoneEecctrian1cabew0rktriEIecthetthaRESII,JH STATEERE RE vl 0n1BuIIdiDisandortoreturnedngthecSuIrvtsEecIpeans'I nedIbeahasI bybeentheha5IItnoVAbe1Iucnts
l.lAt''lE ( pl ease pr j nt)
Fttt
Fto
Ftg
Fire Zone
0therFlood Plain Stories.
TOTAL VALUAT
DATEI
Zone
Bed rooms
'lu e
Acce cq
1
st. Uni ts
Value
Ci ty
made
perm
ffect f exemp
.055 wi
s trueonlhereonn'|rt tha t acehedodtanfyreb.yctao,l forn permeted.I
Y comp pp ofnances the0rdihetthcewlIhaIaccordanIndonebe'I w01 perk srformedrIthandaataIndfurthecertanyndarrec tco fy
Y vfl I'I ben'|NO OCCUPAHCtthaanddesbedcr1rehe,|rta nt theto workofhettaSofteng'|f I andd Lawsthe DE0regonSofn9pri Bu 1'I der Sthets tra onI thvr1cerr1tthatdDi1sonhem.y reg iIfurt'I Iss ofon th uB 1 '|1 fyn9turucWIretthouethtsaofny tha tand0n1sItednohereontbassIforthethaIt0557exemptred10Rs01sa'I fun 'II andforce bye1Boardsrequ
ed th0n s'I ect'I I u roJpbe701IInceathwi011sreawho'Iand s comp10nsuontractorsbcoyeeempv
l'la i n
Group Sq
Load
opmentSvstems Deve
Charqe (1.5%Plan Ck. Conrn/lnd
65%/Bldo Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERNIT
Charges and
Su rcharges
Fence
D0mo
PLUt,lBING PERMIT
Charges and
Surcha rges
Sldewal k
Tota'l Comb. PermitA/C Paving
ELECTRICAL PERi,IIT
Charges and
Surcharges <'4 eCurbCut<?4 c>2>32TOTAL
COMBI L
EIIERGY SOURCES
Hea t
l,later Heater
Ran
. Ftg.
--22
lnpxnl rps( addres sDE5I GN I LAI.I ( name
NECHANICAL PERMIT
Charges and
Surc ha rge s
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map ReferenceIf05-432. example- Lot l. Block 3, Znd Addition toSfiiiffiield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
I air gas
2E. Squa
II
l. example- 1250 sq. foot house, 500 sq. foot garage2. exa;pie- JT-new'project, cheik-i-ew - if additio;,
check add, etc.F. Building permit information:1. example - construct single family house with an
attached garage2. example - remodel existing garage into family room3. exampTe - convert single iaiily-residence inioEtIFant (change of-use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. OESIGN 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 oniy the No. Boxes adjaientto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedu'lesare available at the Building Divisionl. 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 thefull 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 electricaisupervisor. The general contractor is not authorizedto sign the eiectrical label.
Applicant to sign and date
l,lhenever possib]e, the initial application will be used asa.worksheet only. Where possible, Building 0ivis.ion Staffwill prepare a type written copy and return it to theapplicant at the time the actual perm.it is issued for his
s i gna ture.
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
III
IV
V Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information :
PLANS REVIEWED BY:
name s'l g nature date A E'=:_
=.----.--._---
ON LINE
COHBI APPL I CAT I
.lcb Address
l-eqal Description
Ran
Hea tEIIERGY SOURCES:
Sq. Ftg. 0ther -llew Add Alter tlep.
-Feni6 D6ilo Chl-nge/Use
-0ther-
sAcces
Sq
5q Fto
Va1ue. of tlork
a:*
Owner F-€ax'
n9 escri be !ilo
Fami 1
nAddress?Phone
Constructi on Lender
\0
Addre s s
Pri ma
Struc tura I
Electrical
Mechani ca I
n
E'l ect
hanic
MECHANICALELECTRICALPLUI{B I NG
furnace/burner to
BTLI' S
Residence of
FTSQ
Floor furnace
and ventNew circuits alts
or extensions
Relocated building
(new fix. additional )
Recessed wal I
sna.e heater and ventSERV I CESS.F. Residence(t uath)
Duplex (l bath) each
Appl iance vent
<FDarateTemporary Constructi onAdditional bath
Stationary evap
cool erge in existing
dence
Chan
resil"later servi ce
Vent fan with
sinole ductI ndrrst-ri a 1
multifamily, comm. or
Sewer
apart from
.c.
Vent system
heatino or A0fStorm Sewer Mechanical exhaust
hood and ductCOMH./IND. FEEDERS
llood stove/heaterI n sta I I /a I ter/ re1 ocate
distrib. feeders
0f
ISSUANCE OF PFRTIIT
TOTAL CHARGESTOTAL CHARGES
S I GNATURTI'lAtlE(please print)DATE
0regon
the Buiperm
ffectof any
Boa rd
s trueIa11onformatrtce'I thatheredoandtb.y fytcaoIfornItedepermXAMNIEDap r)I comp of cthe thetnances tyOrdicordanceacthwlsIha'I ne'Idonbe'Ia WO1 rk rformed1hattndDEandaftrthUrecertanyIndarreccotfy Y wl 'II madebet0cCUPANC'NOnhereiandthatheworkdcrlesbed'Irta tonlngtheofStetaofDEIfIanddLawstheofngSpr i Bu '|
1 r sde5'I ttra onI th1,, I the1tthaonv1fuherrtcertregm.yIdi'I Di s fyss1onIon9ruttucw1retthouthes hereon a tha tndtonIsInotedbassIrfoItftheexempthaxempt1ORS701055redassIn1IfuforceIeandrequbytnS1705051wtbe'I used proj ec1
'I cean thwl 0Rs 1Iawho'Ire nontrac tors and comp10nsubcempoyeesv
electrical portion of this permit
the Building Divisionrk be done by an'Electrical Contractor, the
by an Electrical Supervisor and returned toLll,l REQUIRES that the Electric
'I i'l unti I the Iabel has been si
al wo
gned
TOTAL CHARGES
WHERE STATE
shall not be va
Fire Zone Bedrooms - 0ccy Load - -- Sq.
ts Ftg . l4a i
Group -Sq' FtS . Other '|
Flood Plain S tori es
luenst. UniZone
ToTAL VALUATI0N_--
Ftg.Access - - x Value-
tems
51,Pl an Ck. Conrn,/ Ind
65%/8ldq Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERI.IIT
Ctrarges and
Surcharges
Fence
DEmo
PLUI4BING PERMIT
Charges and
Surcha rges
SldewaIk
Total Comb. PermitA/C Paving
ELECTRICP.L PENt!IT
Charges and
Surcha rges
?,-7 d"
<) ,/.curb cut <?4:e32TOTAL
NECHANICAL PERMIT
Charges and
Surc ha rge s
l,later lleater-.---
n
(lics. no.( a ddres sCNNTRACTORS
rrr auaonFNN
Each single fixture
th
COMBINATION APPLI CATION/PERMIT ( CAP )
Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference17ITlf32. elgmple- Lot l. Block 3, 2nd Addition toSEffiETield EstaresC. Name, etc. of owner and construction IenderD. Energy Sources
I
.ITY OF SPRINGFIELD t
CltY Hall
Sprlngfield, Oregon
Otlice ol Community and Economic Development
OFF]CIAL RECEIPT 'r4590
19
From
ived For:
Q.
2'
examD'le-
examp I e-
ET66::tas
Address
forced air gi
2.
E. Squa
2.
example-
,
examol e-
check addF. Buildi ng perm
e or valuation,
foot house,500
projec t, check new
or soTar
sq. foot garagt
- if addition,
hea t/e I tri ca
wate
1250 sqif new
examp l e
a ttached
2 example -
example -
res tauran
3.
G. Value of work
t (change of
as defined
Structural Specialty Code
, etc.it information:- construct single family house with an
garage
remodel existing garage into family roc
convert sin le f,amily residence into
C'O
1
I
use
in Section 303 (a) of the
DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Eiectrical Schedujes,the applicant need fill-in only the No. Boxes adjaiento the appropriate item(s) to be installedB. Ful I Plumbing, l"lechanical, and Electrical Schedulesare available at the Build.ing Divisionl. To conserve space on the permit form the schedule.
have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I 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 tlelectrical contractor for signature by his electricalsupervisor. The general coniractor ii not authorizedto sign the electrical labelIII. Applicant to sign and date
llhenever possible, the initiai application wjll be used asa.worksheet only. l.lhere possible, Building 0ivision Staffwill.prepare a type written copy and returi it to theapplicant at the time the actual permit is issued for hissignature.IV. Fees and Charges
Plan check fees are due and payable at the time of theapplication, and no plans wiil-be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued.
V. FOR OFFICE USE ONLY
H
Amounl Received 37a-o
BY
I
SIG
FlAffthf eusrru;ss FoBMs. rNc. 15031342-8149 r587i
Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY:
Permit applicant exempt from registration with the Builder's Board because
Additional Project Information :
PLANS REVIEWED BY:
name s1 date I ^ g-A-=g nature
r,fffz6/6