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HomeMy WebLinkAboutPermit Fence 1982-06-13I NS PECT I 725-37 69 COMBI NATION APPLICATION/PERMIT 726-37 53 d2 .az 6l-egal Description Job Address l/7t) Ranqe. I'later Heater EIIERGY SOURCES Hea t Value of l,lork:25>--'' Ftg . l'la in_ Sq. Ftg. Access.-- Sq. Ftc. 0ther_ _l.lew--_rAdd-A 1 te r_Re p . Fence Demo_Change/Use Owner Address vn "{f{"14za J- d tZ-Builcii Fami ly nq Permit Info: Describe Work('Residence l,lith Attached Garaqd e., Build Single 04- qq(?fua,a- con(tr(ction Lender Go \q \\ N "0 Addres s Phone DLsIGN TEAI!na{qe address lics. no.exD l res ohone no. Pri ma ry r)nr'al)Structura I EI ectri ca] Mechani catr CONTRACTORS addres s 'I i cs, no.exn l res (ohone no- ) Qo,.ralGe -4/g3 A/4/rH/L a E l ectri cal ELECTR I CAL MECHAN I CAL FFF THAPAFNOFEECHARGENOFFFCHARGFN0. Each sing'!e fixture Residence of SQ. FT furnace/burner to BTU' S Relocated hui?dimg (new fix- a&itimal ) New ci rcui ts al ts. or extensions Floor furnace and vent S.F. Residence ( I har.h1)SERV I CES Recessed wal I Snacp hpatcr and vpnf Duplex (1 battr) each Addi ti onal hatih Temporary Constructi on Apol i ance vent seDarate l,later service ge in existing dence Chan res i Stati onar,v evap cool er mu1 ti fami 1 y, Tndustrial cornm. or Vent fan with sinole ductSewer Storm Serer 0f Vent systern apart from heatinq or A.C. coMtt./IND. FEEDERS l,4echani cal exhaust hood and duct Instal I /al ter/re1 ocate distrih- fpedprs l'Jood stove/heater amp s.0f KI I u t I ISSUANCF OF PFRIlIT TOTAL CHARGES TOTAL CHARGESTOTAL CHARGES WHERE STATE LALI REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this perm'it shall not be valiC until the labe1 has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFU{-LY EXA}IINED the completed apnlication for oermit, and do hereb.y certify that all info r,rAr'rE(please en;'nt'l -9'Te ue: E .Tns/a ud srcnar rc [.)t3/82 0req the B g 0 proj h and correct, .and I further certify that anyof Springfield and the Laws of the State of and all work performed shall be done in accordance with the on Dertaining to the work described herein, and that ll0of any structure without the permission of uildin Division. I further certify that my registrati Board is in full force and effect as required by ORS 7 1.055, that if exempt the with OPS 701.055 wilI be basis for exemption is only subcontractors and employees who are in comcliance used on this ect. h?r', rrmation hereon is true r 0rdinances of the City | 0CCUPANCY will be made on vrith the Builder's noted hereon, and that Ftg Ftg FtgFlood Plain l'la i n Val ue tsedrooms Stories Val ue Valu TOTAL VALUATION F x x X Units Load Sq Const. Group Fire Zone Zone Acces s 0the r Plan Ck. Conrn/Ind 65%/81rlo Per Fee Svsterns Deve Charqe (1.51 opmentBUILDING PERI'IIT Charges and Surcharges Plan Ck. Res 30%/81dq Per Fee Fence fl*PLUI4BING PERMIT Charges and Surcha rges Demo Sidewal kELECTRICAL PERI|IT Charges and Surcha rges Total Comb. PermitA/C Paving Curb Cut 6a>; I,IECHANICAL PERMIT Charges and Surc harge s TOTAL COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSfFiffiield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 4:#) VALI DATION 1. example- heat2. example- wateE. Square footage or /el ectrical ce i 'I or forced air gas e or solar vai uation, II l. example- 1250 sq. foot house, 500 sq. foot garage2. example- 'if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct singie family house with an attached garage2. example - remodel existing garage into family room3, example - convert single family residence into EGTiuFant (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, Buiiding Division Staff must be able to contact appropriate persons 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 only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and E)ectrical Schedulesare available at the Bui)ding Division1, To conserve space on the perm'it form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI 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 theeiectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electricai label.Applicant to sign and date trlhenever possible, the initial appl.ication wil l be used asa.worksheet oniy. Where possib'le, Building Division 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 OCCUPAIICY: Perm'it applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name sig na tu re date