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Home My WebLink AboutPermit Electrical 1987-07-15I 7 CITY OF SPRINGFIELD COMBIIIATION APPLICATION/PERMIT 726-3753 Job Address {)e ,2 l-egaI Description EIIERGY SOURCES Heat l^Jater Heater Range Fto. l.lain_ !q. Ftg. Access.-- Sq. Fto. 0ther__ _l,l ew_Ad d__-_rA 1 t e r_lle p . _Fence_Demo_C ha n gel U s e -other- \\ \, \ N I Val ue of llork ,/,Owner )n 6ars<.2 AddressZZz> Sa 2r>27 Phone Builciin Fami'l y g Re Permit Info: Describe t,jork(' sidence l'lith Attached Garaqe .e., Build Single Szrtb . aR../-26'rr5?>,Ar.nu o,a c>7=87> F(F<>^ Constructi on Lender /Z',rBr u27,.>- 7-^ Addres s Phone DES IGN TEAI.I name addre s s 'I f cs. no.exD l res ohone no. Pri ma ry Structura I I E I ectri ca I i'lec ha n i ca I lACTORS name addresq )(lics. nn.pYnt rPc nhnne nn Genera I Pl umbi ng PLUIIBI NG EL ECTR I CAL I'4ECHAN i CAL N0-FFF CHA RGF NO FFF CHARG F NO FFF CHARGF Each single fixture Residence of SQ FT furnace/burner to BTU' S Relocated building (new fix. additional )L.New circuits alts.o\*!^))onpr,7, "2-:b Floor furnace and vent S. F. Residence(l bath)SERV I C ES Recessed wal I Snaap hpiter and vpnt Duplex (l bath) each Additional bath Temporary Construct ion Apol iance vent sFDa ra te bJater service Change i n exi sti ng rpc i dcncp Stati onar.v evap cool er Sewer multifamily, comm. or I ndu stri a I Vent fan with si nol e duct Storm Sewer 0f Vent systen apart from heatinq or A.C. COMI'I./IND. FEEDERS Mechanical exhaust hood and duct Instal l /al ter/rel ocate dicfrih fppdcrs tr'Jood stove/heater 0f s. -fr, I ISSUANCE OF PFRI,lIT TOTAL CHARGES TOTAL CHARGES 22-r?TOTAL CHARGES WHERE STATE LAN REQUiRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be val'i,i until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed apnlication for oermit, and do hereb.y certify that al1 information hereon is true and correct, and I further certif_v that any and al'l work rrerformed shall be done in accordance with the 0rdinances of the City of Soringfield and the Laws of the State of Oregon oertaining to the work described herein, and that NC 0CCUPANCY will be made of any structure without the permission of the Building Division. I further certify that rn.y registration r,rith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and ernployees lvho are in comcliance with 0l?S 701.055 will be used on this rrro,ject. I IlAl,lE(please print)S I GiIATURE Zone Tyoe/Const. Units Scr Ftmi; ,, Ftg. Access x Val ue Fire Zone Bed ro oms Load Val ue Fl ood Pl ai n Stories Occ.y Group Sq.FtS Val ue TOTAL VALUATI nN .0ther BUILDING PERMIT Charges and Surc ha rges Plan Ck. Comm/Ind 65%/B1do Per Fee Svsterns Deve charqe (t.s%opment Plan Ck. Res 30%/81ds Per Fee PLUI4BING PERMIT Char-ges and Surc ha rges Fence Demo ELECTRICAL PERI1IT Charqes and . \ Surcharges v\ .-'---)?-5a___a_lz Sidewalk A/C Pavi nq I Curb Cut Total Comb. Permit TOTAL 2J"62MECHANICAL PERMIT Charges and Surc ha rge s Electricat ,r(,hzgr+^, 7o..- zD 3 7c rc7.3 /5^ oQ "7 l'lec ha n i ca I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, Znd Addition to Springfield Estates C. Name, etc. of owner and construction lenderD. Energy Sources 1. example- heat/electrical ceiling/o2. examp.le- waterheater/electricaL/or Square footage or valuation, etc.1. example- 1250 sq. foot house, 500 sq. foot garage 2. exampje- if new project, check new - if addition, check add, etc.F. Building permit informat'ion:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specia lty 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,iL Abbreviated Plumbing, I'lechanical, & E)ectrical 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 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 on the abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF l,JILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be del.ivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorized Whenever possible, the initial app)ication wi'll be used asa worksheet onjy. Where possible, Bui)ding Divis.ion Staffwi1'l prepare a type written copy and return it to theapplicant at the time the actual permit is issued for h.issignature.IV. Fees and Charges Plan check fees are due and payable at the time of the appi i cati on, and no p l ans wi l l be processed unti l thesefees are paid. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY III r forced air gas sol ar E to s ign the electrjcal label Applicant to sign and date PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Informat'ion : datenameSigna tu re PLANS REVIEWED BY: L - -__.TTI_IFSPRI-NGRT L D COMBI IIATION APPL ICATION/PERMIT Job Address Z e ,2o Legal Description EIIERGY SOURCES Heat Ran . Ftq. l.la in_ Sq. Ftg. Access._ Sq. Fto. 0ther_ Ilew_AddJl ter_Pep. _Fence_Demo Change/Use -other- \s N \ N, I Va l ue of l,lork:,/r- 6ars<.4Owner AddressZZa Sa ?r>Ar Phone Builriinq Perntit Info: Describe l.lork('FaniIy Residence l.lith Attached Garaqe .e., BuiId Sinqle Sprtb DR .//6-4r22 ./,7FR D,a 6)rz--D F(F<>- Construction Lender /ZBru,/-7,c- -. Addre s s Phone 7 N TEAI.'I name 'I CS . nO.exDl res nhone no- Primary Structura I Electrical Mechani ca l C0NTRT ACTORS name (lics. no-)( pxni rps )Dhone no. Genera I P l umbi no Etectrical,r(/,hr+-fn 7*.r.,/23 F< =<7,3 /5^ o*"7 ftlechan i ca I PLUI{B I NG ELECTRI CAL MECHANICAL FFF CHARGF NN FFF .}.IA PGF NO FFF CHARGF Each single fixture Residence of SQ FT furnace/burner to BTU' s Relocated building (new fix. additional )?New ci rcui ts al ts. '\ *n20n%.?a "2-> Floor furnace and vent S ( .F. ResidenceI bath)SERV I CES Recessed wal I Snace heatpr and vpnt Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent s eDa ra te [,later servi ce Change in existing rps i dpncp Stati onar-v evap. cool er Sewer multifamily, comm. or Tndrrcfrial Vent fan with sinole duct Storm Sewer 0f Vent system apart from heatino or A.C. cor,lr.r. /rND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate di stri b. feeders l'Jood stove/heater 0f amp s. ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAL CHARGES 22-r?TOTAL CHARGES -I^,HERE STATE Lll,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 cal Supervisor and returned to the Building Division I HAVE CAREFULLY EXAIIlNED the completed appiication and correct, and I further certify that any and all work of Soringfield and the Laws of the State of 0regon oerta of any structure without the permission of the Building Board is in full force and effect as required by ORS 701 only subcontractors and er,'rpl oyees lvho are i n comcl i ance for oermit, and do hereb.y certify that all information hereon is true performed shall be done in accordance with the 0rdinances of the City .ining to the work described herein, and that NC 0CCUPAI'ICY will be made Division. I further certify that my registration with the Builder's .055, that if exempt the basis for exempt'ion is noted hereon' and that with 0l?S 701.055 wilI be used on this nroject. l.lAl'lE ( p1 ease pri nt )S IGNATURE DA.TE Zone_____Tyoe/ Cons t.ts Sq.'ln Val ue Fire Zone Bedrooms Load Sq. Ftg Access 0ther I up Flood Plain Stories Occ.y Group Sq. FtS Val ue ToTAL VALUATI0N_ BUILDING PERNIT Charges and Su rcha rges PIan Ck. Comm/Ind 651,lB1do Per Fee Deve t.5/. opment Plan Ck. Res 30%/Bldo Per Fee PLUi4BING PERMIT Char-ges and Surcha rges Fence Demo ELECTRICAL PERI1IT Charges and Surcharges _te /z Sidewalk A/C Paving Total Comb. Permit I4ECHANICAL PERMIT Charges and Surcharqes Curb Cut TOTAL 23.62 l,later Heater_ C ?Y OF SPRINGFIELD CltY Hdl SPringfeld' Orcgon Dcpartmont ol Publlc Workr OFFICIAL RECEIPT No. BCOMBINATiON APPLICATION/PERMIT (CAP ) Applicant to furnish A. Job Address B. Lega'l Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 ?. example- Lot 1. Block 3, ?nd Addition to Springfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources F ( C (t (t () o o (l C 68628 I $g Cm Address 220 ,A 2.f? rr 1. example- heat2. example- wateE. Square footage or /el ectri ter e /or forced air gas or solar For: valuation, etcl. 2. example- 1250 sq. foot house, 500 sq. foot garage example- jf new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room3. examp.le - 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 site corrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occurin 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. Ful'l Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedu'les. have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consuit 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 electrical label.III. Applicant to sign and date Whenever possible, the initiai application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gna tu re.IV. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed unt'il these fees are paid. A1l other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY 7".1 2-5e z/4 v 2 .G;2 Amount Received rt { U1\t v Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: datenameS1gnature