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Home My WebLink AboutPermit Fence 1987-06-19IN IL CITY OF SPRINGFIELD COMBI IiATI OI.I APPL I CATION/PERMIT 726-3753 SJob Address 2 l-egal Description //r7 Oe .{S ,E Z_ Ran l.Jater Heater EIlERGY SOURCES Hea t o Val ue of l.lork Sq. Ftq. t'lain_ Sq. Ftg. Access._ Sq. Ftc. 0ther_ _l,lew-Addrql ter_Rep . _Fe nce_Demo_C ha nge/ U se 0ther Owne r Addressafg 9-<g E. Ro u, p.-lvnons?5.4141 g Pernrit Info: Describe l^lork(i .e. , Bui ld Singie llesidence l,li th Attached Garaqri) Bui lci in Farni 1yq71Z€,Cres o,re // Or' Construction Lender Addre s s Phone :rv DES I GN TEAI.{name address I ics. no exoi res rhone no ^Electrical Structura l Prima i''lechani ca l CONTRACTORS n ame address lics. no.exD l res ohone no- Genera I {, v\l\Pl umbi nq ,/dEl ectri I PLUI{BI NG EL ECTR I CAL MECHAN I CAL FFF CHARGF NN FFF |.HAPGF NO FFF C HARGF Each si ngle fixture Residence of FTSQ furnace/burner to BTLI' S Relocated building (new f.ix. additional) New ci rcui ts al ts or extens i ons Fl oor furnace and vent S.F. Res.idence ( I bat-h )SERVICES Recessed wal I Snace heatpr and vpnt Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seDarate l,later servi ce e in existing ence C hanq resid Stati onary evap cool er Sewer I ndu stri a I muitifamily, comm. or Vent fan with sinole duct 0f ps.Vent system apart from heatino or A.C.Storm Sewer cOr.lt1./IND. FEEDERS i{echani cal exhaust hood and duct- Instal I /al ter/re1 ocate di str.i b. feeders ['lood stove/heater 0f amp s. ISSUAI]CE OF PFRIIIT TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES I,JHERE STATE LAI.I REQU sha l I not be val i I unti I IRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed application for oermit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all work rrerformed shall be done in accordance with the Ordinances of the Cityof Soringfield and the Laws of the State of 0regon oertainingof any structure without the permission of the Building Divisi Board is in full force and effect as required by ORS 701.055,t 701 I furtif iiAi'iE(piease pri S iGiiATIJRE I],^TE 's that who are in comcliance.4na tn/q he basis for exemption is noted to r certify that m.y registration vrith the Builder 1 oyees with 0 pro described herein, and that I'lC 0CCUPANCY will be made only subcontractors a Flood Plain Stories Occ.y Group S Val ue Val ue Value x x TOTAL VALUATI NN .0ther Fire Zone Bedrooms Occy Load Uni tCon st. q.Ftg Zone !q. Ftg. Access s So. Ftq. l4ai Plan Ck. Comm/Ind 65%/B1do Per Fee Svsterns Deve Charqe (1.57 opmentBUILDING PERI'IIT Charges and Su rcha rges Plan Ck. Res 30%/B1dq Per Fee Fence OO Demo PLUI-4BING PERMIT Charges and Surcha rges Si dewa I k Total Comb. Permit ELECTRICAL PERI,IIT Charges and Surcharges A/C Pav i ng Curb Cut Wscc)TOTALrb I,lECHANICAL PERMIT Charges and Surc ha rges COMBINATION APPLICATION/PERMIT (CAP) I. Appiicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SprTnlFie1d EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. exampl e- heat/2. example- water Square footage or air gas E II. 1. example- 1250 sq. foot house, 500 sq. foot garage2. exampie- if new project, check-n-ew - if addition, check add, etc.F. Building permit information:1. elqmple - construct single fami)y house with an attacirEa garage 2. example - remodel existing garage into family room3. example - convert singie family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructurai Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Building 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 insta.lledB. 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 onthe abbreviated schedules you should consult theful I scheduiesC. BUILDING DIVISION STAFF t^,ILL 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 Applicaiit to sign and date Whenever possible, the initial application wi l'l be used asa worksheet on1y. l,lhere possible, Building 0ivision Staffwill prepare a type written copy and return it to theapplicant at the time the actua1 permit is issued for his s i qna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wi ll be processed until thesefees are paid. All other fees and charges are due andpayable vrhen the permit is issued. FOR OFFICE USE ONLY III IV Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAITCY: Permit appl icant e.yempt from regist'raticn '*ith t.he Builde',^'s Board because: Additional Project Information : PLANS REVIEWED BY: name SI g nature da te