HomeMy WebLinkAboutPermit Building 1989-01-23PECT I ON
-37 69
CITY OF SPRTNGFIELD
COMBl NATION APPLICATION/PERMIT 726-3753
Job Address p
l-egal Description
EIIERGY SOURCES
Hea t
l,later Heater
Ran
Sq. Fto. l'lain_
Sq. Fts..Accelll--
Sq. Ftq. \ther
_t'l er^r_Ad d_A l tilne p .
_Fence_Demo_C ha n ge/ Use
0ther
m
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B
vltVal ue of tlork
5@/try aF {m.*an6<-z>0wne r
aAddres s ?4/-Sa r€4 5n z,Esyzu Builciin g Permit Info: Describe Work(i.e., Build Single
Residence Iiith Attached Garaqe)Farni 1ylr.oz D3.,Moya 1,ga2q72a77za4- &-, <.22*,/Construction Lenden .&a->, D,y 5,h ,> 2a7=,*.
Addres s Phone ZEry 5F Z-7.,-ru,o-ro. a Se-.
DESiGN TEAtrq n.ifine address 'I ics. no.exDl res Dhone no.
Pri ma ry
rt.
f
JEl ectri cal
Mechanr'ca1
CONTRACTOftS,n,atlte address lics. no.'exDl res ( nhone nn - 'l
Genera I
Itlecha n i catr
ptr_l!'jtr,{&flYr6 ELECTR I CAL MECHAN I CAL
FEE CHARGE N0.FFF THAPAF NO FFF CHARGF
Each singtre ffxtlrre Residence of
sQ. FT.
furnace/burner to
BTLI' s
Rel ocated ,hr.rildimu
(new rFix- addl-tidal )r/'New c i rcui ts al ts.
or extensions? aA fr?r/4,8 22-u'
Floor furnace
and vent
S.F. Residence
( I bat,h)SERV I CES Recessed wal I
Soace heater and vent
Duplex (il bath) each
Addi t i,omal bath Temporary Constructi on Apol iance vent
seDa ra te
[,later service Chan
res i
ge in existing
dence
Stati onar.v evap
cool er
Sewer mu1 ti fami 1 y,comm. or
Indrrstrial
Vent fan with
sinole duct
Storm Sewen /0f 140 S.22.fd Vent systern apart from
heatinq or A.C.
COMI.1./IND. FEEDERS Mechanical exhaust
hood and duct
2,, Lr)Instal I /al ter/re1 ocate
distrib. feeders l,Jood stove/heater
0f .amp s.
4n , 16r
ISSUANCF OF PFRIIIT
TOTAL CHARGIS TOTAL CHARGES <.t{ aa TOTAL CHARGES
I^JHERE STAT.E LAI.I REQIJIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Division
I HAVE CA,REF]U,LLY EXAI1INED the completed application for oermit, and do hereb.v certify that all information hereon is true
and correct, and I further certif-v that any and all work performed shall be done in accordance with the Ordinances of the Cityof Springfietrd and the Laws of the State of Oregon pertaining to the work described herein, and that NC 0CCUPAI,ICY will be made
of any structu!'e,rnn'thout the permission of the Building Division. I further certil"y that m.y registration urith the Builder's
Board is in fuXll f,orce and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subconti"actors and ernployees who are in comcliance with 0l?S 701.055 wi'll be used on this project.
tlAl'lE ( p1 ease p I srcnnuafr/,,tgu4 ecgrl oorc t /4/gq
FON OFFIC : USE ONLY
Zone__Type/ Con s t Uni ts Ftq. t,lain Val
Fire Zone Bedrooms 0ccy Load Sq. Ftg. Access alue c% o>
alue 4 GFl ood Pl ai n Stori es 0c c.y Grou
.i,D TOTAL VALUATION
lt
Ftg . 0ther
BUILDING PERI'IIT
Charges and
Surcharges
ae
.?5
Plan Ck. Comm/Ind
65%/81dq Per Fee
Svsterns Deve
charqe (t.sz opment
Plan Ck. Re
30%/Bl do Pe
srF ee
PLUMBING PERMIT
Charges and
Su rc ha rges
Fence
Dgmo
ELECTRICAL PERIlIT :___zt_"_?_Charges and
Surcharges I 2. 2s
Sidewal k
A/C Paving Tota'l Comb. Permi t
MECHANICAL PERMIT
Charges and
Surc ha rge s
Curb Cut ,rr^rv#*r.7/aftE
Structura I
COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION
Applicant to furnish
A. Job AddressB. Legal Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, Znd Addition to
SErfn-qfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
1 air gas
2
E squ
I ga
it
rage
2 10n ,
F. Building permit information:1. example - construct singie family house with an
attached garage
2. example - remodel existing garage into fami ly room3. example - convert single family residence into
restaurant (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 s.itecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occulin the descriptionportion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Div'ision1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be instajled are not covered onthe abbreviated schedules you should consult theful l 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 generai contractor is not authorizedto sign the electrical label.III. Applicant to sign and date
Hhenever possible, the initial application wi'll be used asa worksheet on1y. Where possible, 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.IV. 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 andpayab)e when the permit is issued.
V. FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information :
t
PLANS REVIEWED BY:
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