HomeMy WebLinkAboutPermit Building 1988-09-14I NSPE
7?6-3 69
CITY OF SPRINGFIELD
COHBI IIATION APPLI CATION/PERMIT -3753
JobAddress Gta S. S<=,oJb $5l',
Legal Description
Range-
llater Heater
EIIERGY SOURCESHeat Gn s
\Owner !625grJ Cf.tt"r-r (<-A r-v I ue of l,lork
/, oos>
Sq. Ftq. I'lain_
Sq. Ftg. Access._
Sq. Ftc. 0ther
_l,lew_Add_AlIaT m;-
_Fe nce_Demo_C ha nge/ Us e
0ther
Sr PhoneAddress 4, o (" (6'<-ort Builciinq Pernit Info: Describe Work(
Family Residence t,lith Attached Garaqd
,e., Build Single
(?ISm
^)Rer'r.r>rf-f- <r-)rf-sfr NG R ervts
Construction Lender d afr.r<F
Addres s Phone
name address exnires ohone no.
AaarStructura I
Pri ma
v{b I
Hechanical
name addres s I i cs. no.(exoi res ohone no )
^t 6rs 8sr SSf ?zz* o?13J" xJ S,{.u
PI /1-6"crO a*NT flrL!-
">/r
PLUIlB I NG ELECTR I CAL MECHAN ICAL
FEE NO FFF CHARGF NO FFF CHARGF
Each singie fixture Residence of
SQ. FT
furnace/burner to
BTLI' s
Relocated buildino
(new fix. additioial)/'New circuits alts.
Or extensions /tyt orful
rJo rJn) Ltae4rT<7-s z.*Floor furnace
and vent
S. F. P.es i dence(l bath)SERV I CES Recessed wal I
Soace heater and vpnt
Duplex (1 bath) each ?rgr-rZa=>'tia)
Additional bath Temporary Constructi on Apol iance vent
separa te
[.later servi ce Change in existing
res i dence
Stationary evap
coo I er
Sewer multifamily, comm. or
Industria l
Vent fan with
sinole duct
Storm Sewer 0f Vent systern apart from
heatinq or A.C.AD> 4 Fr zaf COMI.I./IND. FEEDERS Mechanica l exhaust
iood and duct
36>21tta.tfQs Instal I /al terlre1 ocatedistrib. feeders ['lood stove/heater
iJ.'LsD cJstLr^,6 0f a mp s.-Z:.J*AL1 C ,uVA<
/L Ltq$T Fr<rqa fs cuTLt"Ts FeOn^t
ds "tfr,s c_,ACt,\tTS,
rx t>7 /^/s sys-Tpl
ISSUANCF OF PFRIIIT
I GiIATURE
TOTAL VALUATION
DATE
&1Kr5x.un
Resv.I Fee
. Access x Value_
.otne@atue?@.-a
an
an
its
Ftg
x 'I ue
Zone 1/V st
?.so
NAI"IE I ase e(p ntrIp )
0regon
the Bui fyany
rd
perm
ffect f exempt
.055 wi'l
L the ecomp onIIac t dl-)ap 0ermI an do rtce 1 thahereb.y t 'Ia n'|formafy t 0nI reonheand 'IandIco rrec t s truefurthcr'Iert t tha afy aand II worny k rformedpe has I1 be '|done accon anrd wlce tth Ordihe ncna ofesofS t a IhefiIeanddpringthewsLaof tytheStafaof'|rta 'In to thoe e workng descr bed'I 'Ihere n thand at NC wlOCCUPAI'ICYof 'II be madesructturewtouthtthe'I Ss 0n'I of dI 'I ,l
D 'I 'I on fur therIng c Iert th a s'It ttra 0'|v/tn thmyIBoareg the utB der1 ssn'|Ifu I fo rce and as 1ue red 0RSreq 0701 55 thby at 1 t he bas 'I s r0 ex 0n'InIemp t s'|tednobcsunt nhereo tha tandvandractorsIwhoempoyeea'|re c0mDn I 'I cean thWI t?s0 07 I u edbe 0n Ith ectrojp
REQU
untiI
TOT AL RGCHA ES CTOTAL SHARGE <EfCHARGETOTALs
t,JH ER E STA,TE L,1l,l RESI ttha het 1E rect 1 ca workI be d 0ne an ecEl triby c Ia raCont ctor het e 'I ectr caI I 'I 0n thof IhaS
'|I port tlI,1vabetn0 permithIeIabebeenhasIsnedansbyEec'I
1tr Ica s 'IrV as0r ndupe re rnedtu to t he B Iut d 'I Di I '|s onng
Fire Zone Bedrooms
Flood Plain Stories
q-(11-?t
(.
"1)
BUILDING PERIIIT
Charges andSurcharges A
Occy Group_fue_pq. Fts
Ftg . l,la i
FencePLUI4BING PERMIT
Charges and
Surcha rges Dgmo
Sidewa l k
ELECTRICAL PERi,|IT
Charges and rSurcharges l)
zz-s;o
/. 13 Tota'l Comb. Permi tA/C Paving
Curb Cut
HECHANICAL PERMIT
Charges and ,-Surcharges t TOTAL laf,.o/ -
't+L-xtlLl
E l ectri ca i
Load Sq.
Systerns Devel oonrentCharse (1.52) 'k4
/5=_-2s
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, 2nd Addition to
Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. example- heat,/electrical ceiling/or forced air gas
2 . E fi m pE wa t e rE e a t e TTETEETFj c a-l / o r s o=TIT-.-E. Square footage or valuation, etc.1. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition,
ElecR-add, etc.
PERMIT VALIDATION
F.Bui lding perm
1. example -
a ttac hed
it information:
construct single family house with an
garage
2. example - remodel existing garage into family room
3. example - 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
persons regarding design information or
corrections, etc.
apj propri ate
ob site
II. Abbreviated PIumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adiacent
to the appropriate item(s) to be installed
B. Fu11 Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedules
have been abbreviated
2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
ful I schedu'les
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is not authorized
to sign the electrical label.
III. Applicant to sign and date
Whenever possibie, the initial application wi'll be used as
a worksheet on1y. Where possible, Building Division Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
si gnature.
IV. Fees and Charges
Plan check fees are due and payable at the time 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 Permi t Cl er k
tz=r?l- Q,\
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
permit applicant exempt from registration with the Builder's Board because:
Additjonal Proiect Informat'ion:
PLANS REVIEI{ED BY:
name si g natur date />S 82