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Home My WebLink AboutPermit Mechanical 1986-02-17rI 7 L CITY OF SPtrTNGFTEID- COHBI IIATI ON APPL ICATION/PERMIT 726-37 Job Address 7//s. Lega1 Description Ran Hea EIIERGY SOURCES l,later Heater Sq. Ftg. Access.--- Sq. Ftg. 0ther_ _l,lew-AddJl ter_Rep. ence_Demo_Change/ U seFr Ftg. I'la n_ Val ue of l,Jork owner Desc ng eAddress //7h/Phone s7b I Construction Lender c( "-So Addre s s Phone name ress Pri ma r '\4"{}rStructura I El ectri cal Mechanical CONTR,\CTORS name address'I ics. no.exDl res ohone no- Genera I Pl umbi nq ELECTRI CAL MECHANICALpuilmo FFFFEFCHARGENOFFFCHARGFNO Each single fixture Residence of FTsQ furnace/burner to BTU' S New ci rcui ts al ts or extensions Floor furnace and vent Relocated building (new fix. additional) Recessed wal I Snacp hcatpr and vpnt S. F. Res idence ( I bat-h)SERV I CES Duplex (1 bath) each Temporary Constructi on Apol iance vent seoa rateAdditional bath Stati onar.v evap cool erI^later servi ce Change in existing resi dence I ndu stri a I multifamily, cornm. or Vent fan with sinole ductSewer 0f amps,I Vent systenn apart from heatinq or A.C,Storm Sewer coMr'r./IND. FEEDERS Mechanical exhaust hood and duct tJood stove/heaterInstal l /al ter/re l ocatedistrib. feeders 0f ISSUANCE OF PFRI1IT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES WHERE STATE LIl,l REQUIRES that the Electrical work be done by shall not be valiC until the label has been signed by an Electri, an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division - I nIV\/E CAREFULLY EXAMINED the completed apnlication for oermit, and do hereb.y certify that alI information hereon is true and correct, and I further certify that any and all work performed shalof Springfield and the Laws of the State of 0regon oertaining to the wo of any structure without the permission of the Building Division. I fu Board is in full force and effect as required by ORS 701.055, that if e only subcontractors and employees who are in comcliance with 0l?S 701.055 DATEI'lAl'tE ( pl ease pri nt )IIGNA I be done in accordance with the Ordinances of the City rk described herein, and that N0 OCCUPANCY will be made rther c ify that m.y registration vrith the Builder's basis for exemption is noted hereon, and that n is project. ;l used F Ftg Ftg Ftg Value ToTAL VALUATT0N_ ltpBed ro oms Occy Load Sq al Group Zone______Type/ Con s t.Uni ts tories Fire Zone Fl ood Pl a'in S Acces s. 0ther l'lain x Value- Svsterns Deve Charqe (1.51 opmmtPlan Ck. Corm/Ind 65%/Bldo Per Fee Plan Ck. Res 30%/Bldo Per Fee BUILDING PERNIT Charges and Surcharges Fence D6mo PLUI,IB ING PERMI T Charges and Surcha rges Sidewal k Total Comb. PermitA/C Paving ELECTRICAL PERtlIT Charges and Surcha rges Curb Cut IJ O TEETOTAL I,IECHANICAL PERMIT Charges and Surc ha rges a '/Zt I n COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. glalnple- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources PERMIT VALIDATION 1. exampl e-^+l, examD I e-E. SquaFffi-oa hea t/Lr gas water 9e or II i. examp-le- 1?50 sO. foot house, 500 sq. foot garaget' el3rn!.l-g if nerv project' check new - if addition, check add, etc.F. Building permit information:1. example - construct singie family house with anattached garage ?. examp]e - remodel exist.ing garage into family roomJ. exampte - convert single family residence into - restaurant (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, BuildingDivision Staff must be ab'le to contact appropr.iitepersons.regarding design information or job iitecorrections, etc. Abbreviated P)umbing, Mechanica'1, & Electrica.l SchedulesA. Lxcept where blank spaces occur .in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes iajiient _ t0 the appropriate item(s) to be installedB. Fuil Plumbing, Mechanical, and Electrical Schedu.lesare available at the Buiiding Division1. To conserve space on the-permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING OIVISION 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 e.lectricaisupervisor. The general coniractor .ii not authorizedto sign the electricaj labetAppiicant to sign and date Whenever possible, the initial appl.ication will be used asa.worksheet oniy. Hhere possible, Building Divis.ion Siaiiwill.prepare a type written copy and returi it to theapplicant at the time the actuai permit is issued io, niss'i gna tu re. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wiil-be processed until thesetees are paid. All other fees and charges are due andpayable when the permit is .issued. FOR OFFICE USE ONLY M? 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 si g na tu re date