HomeMy WebLinkAboutPermit Plumbing 1987-06-29EL6-CITY
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PLI CAT IT
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726-Job Address \.t
l-egal Description 3
noF
Y SOURCES:
l,later Heater
EIIERG
Hea t
Owner Val ue of
5q. Ftg. AcceG
Sq. Fto. 0ther
Jlew_Add AlEer -GD:-
_Fence_DEFo Chanqe/use
0ther
Sq tg. f'la n
Addres s
Phone)InFami'l
n sc
c
.e., Bu siberk e
Construction Lender
Addre s s
Phone
n
I
tStructura I
EI ectri ca l
Mechanical
n
Genera
PLUI4B I NG ELECTR I CAL I"1EC HAN I CAL
FEE CHARGE NN FFF CHARG F NO FFF l^HAANF
Each single fixturej4,7,6o 5C2>Residence of
SQ. FT BTU's
furnace/burner to
Relocated bui lding
(new fix. additional )*
New ci rcui ts al ts
or extensions
Fl oor furnace
and vent
S. F. Residence(l batrr)SERV I C ES Recessed wal I
Soace heater and vent
Duplex (1 bath) each
Additional bath Temporary Constructi on Apol iance vent
se oa ra te
l,later servi ce ge in existing
dence
C han
res i
Stati onar-v evap
cool er
Sewer Tndustria l
multifami 1y, comm. or Vent fan with
sinole duct
Storm Sewer 0f S.Vent systern apart from
heatinq or A.C.
c0r.1t1./IND. FEEDERS Mechanical exhaust
hood and drrct
I Instal I /al terlre l ocate
di stri b. fpedprs l'Jood stove/ heater
h(0f r )/:
d \a
"..
O l-l t 5bb '/-4 \
\(,
ISSUANCE OF PFRI,lIT/
22 >'oTOTAL CHARGIS TOTAL CHARGES TOTAL CHARGES
WHERE STATE Llll REQUIRES that the Electrical workshall not be valid until the label has been signed by
be do
an El
ne by an Electrical Contractor, the electrical portion of this permit
ectrical Supervisor and returned to the Building Division
I HAVE CAREFULLY EXAI'IINED the completed application for oermit, and do herecorrect, and I further certif-v that any and all work oerformed shall be
oertaining to the work described herein, and that NC 0CCUPANCY will beDivision, I further certify that my registration vrith the Builder's
055, that if exempt the basis for exemption is noted hereon, and that
tlAl'lE (pl ease pri nt )G.\s&TI GiIATURE
ng
707
ty
made
bv certi that all information hereon is true
and done in accordance with the 0rdinances of the CiofSpringfield and the Laws of the State of 0reoon
of any structure without the permission of the Buil di
Board is in full force and effect as reciuired by ORS
only subcontractors and employees who are in comcl i ance wi th 0l?S 701.055 r^ri lI be used on thi s pro.ject
\ .".r* o,
E
Val ue
TOTAL VALUATION
X
xFtg0ther Val
Load Sq. Ft!. Access
Qcc.v Gro
Val ueFire Zone Bedrooms
Flood Plain Storie
\__7Ftq. l{ainZone__Jyoe/Const. Units
Plan Ck. Comm/Ind
65%/81dq Per Fee
Svsterns Deve
charqe (1.52 opmentBUILDING PERI'|IT
Cltarges andSurcharges -..! '
/c o-e
Plan Ck. Res
30%/Bldq Per Fee
Fence
Charges and
Su rc ha rges /?o
tt a2_5
PLUI4BING PERMIT
D5lrno
Si dewa I kELECTRICAL PERI|IT
Charges and
Surc ha rges Total Comb. PermitA/C Pavi ng
Curb Cut 3s ?eTOTAL
I1ECHANICAL PERMIT
Charges and
Surc ha rge s
\(.]i..*FXn I rpq (nhonp nn
PERMIT VALIDATION
Permit Clerk
l./'
i
L /,,(
I
COMBINATION APPLlCATION/PERMIT (CAP)
I . APP] i cant to furni sh
A. Job Address
B. Legal DescriPtion
1.- e*a*pte- Tax Lot 100, Lane County Map Reference
17 03 43
2. example- Lot 1' Block 3, 2nd Addition to
SpFffigFi e1d Estates
Name, etc. of owner and construction lenderC
D 1. exampl e-
2, exampl e-
E. Square footag
Energy Sources
example- 1250 s,
example- if new
check add, etc.
heat/e1 ectr!li orca
WA ter e ors
e or valuation, e
forced air gas
ol ar
500 sq. foot garage
new - if addition,1
L.
q. foot house,
project, check
F. Building permit information:
1. exampje - construct single fami)y house with an
attached garage
2. example - remodei existing garage into family room
3. bxamplE - convert single family residence into
restaLrrant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Bui)ding
Division Staff must be able to contact appropriate
persons regarding design information or iob site
corrections, etc.
I I . Abbrevi ated Pl umbi ng, Mechani ca I , & El ectri ca I Schedul esA. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacent
to 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 the
ful I schedul esC. BU]LDING 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 electrical
supervisor. The generai contractor is not authorized
to sign the electrical label.III. Appiicant to sign and date
Whenever possibie, the initiai application will be used as
a worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to the
applicant at the time the actuai permit is issued for his
s i gna tu re.IV. Fees and Charges
Plan check fees are due and payable at the t'ime of the
application, and no plans will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit app'l'icant exempt from registration with the Builder's Board because:
Additional Project Information :
PLANS REVIEWED BY:
da tenameSignature