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Home My WebLink AboutPermit Mechanical 1980-11-21INSPECTION LINE 726-37 69 CITY ()F SPRINGFIELD CO}1BI iIATI OI'I APPL I CATION/PERMIT 726 Job Address EIIERGY Hea t lJater Heater e tg. l'la n_ :q. Ftg. Access._ Sq. Ftq. 0 ther I tE[flep. - Cha nge/ Use oa? _c U Legal Description value or ""I'rlqarcJreC{O{L\ Address r\Phone BuiIcii Fami I y ng Re Pernri t I nfo: Descri be l,lork (' sidence l,lith /l.ttached Garage .e., Build Singie 19b^Ulltl Construction Lender -n Addre s s Phone DES I GN TEAI.I name addre s s (lics. no.exD t res phone no. Pri ma ry Structura l E I ectri ca I i''!echanica l nane addres s 'Iics. no. )exDl res (ohone no. ) Genera I IPl umbi nq E I ectri ca I tlechan'i ca'l PLUI1B I IIG ELECTR i CAL 14ECHAN ICAL CHARGE NO FFF rHA RGF li0 FFF CHARGF Each sinqle fixture Residence of SQ FT furnace/burner to BTU' s Relocated bui 1 ding (new fix. additional) New ci rcui ts al ts or extensions Fl oor furnace and vent S . F. Res i dence(t bath)SERV I CES Recessed wal I Snaap heatPr and vpnt Duplex (l bath) each Additional bath Temporary Construction Apol iance vent seDa rate Llater servi ce Change in existing resi dence Stati onary evap cool er Sewer muitifamily, comn. or Industrial Vent fan with sinole duct Storm Sewer 0f amps. Vent systern apart from heatinq or A.C. C(]I4N./IND. FEEDERS Mechan i ca I hood and d exhau uct st Instal I /al ter/rel ocate distrib. feeders l'lood stove/heater 0f amp s. ISSUANCE OF PFRI,IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl.l REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed apn'lication for oermit, and do hereb-v certify that all information hereon is true and correct, and I further certif-v that any and all work performed shall be done in accordance with the Ordinances of the Cityof Soringfield and the Laws of the State of 0regon oertaining to the work described herein, and that NC OCCUPAI,ICY will be madeof any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 70i.055, that if exemot the basis for exemption is noted hereon, and that only subcontractors and ernployees who are in comcliance with 0l?S 701.055 will be used on this pro,ject. L* ^^ 6rar....,-.^DA.IE I / -l{Al'lE ( pl ease pri nt)S I6NATU l-,FOI1 OFFICE USE Oi,{LY U\ Zone Tyoe/ Cons t Uni ts Sct Fto. l'lain x Val Fire Zone Bedrooms Occy Load Sq Flood Plain Stories 0cc.y Group Sq Ftg. Access Ftg.0ther_ X Val ue l TOTAL VALUATI BUILDING PERMIT Charges anC Surcharges Plan Ck. Comm/Ind 65%/91do Ppr Fpc S vs tems Cha rqe Deve (1.5X opment Plan Ck. Res 30%/81dq Per Fee PLUi4BING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERTIIT Char ges and Su rcha rges Si dewa I k A/C Paving Curb Cut Total Comb. Permit I,IECHANICAL PERI,lIT Charges and Surcharges c iLII},L /5r,o Owner CONl ATTOR\ FFF COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County l4ap Reference 17-T3-43?. example- Lot 1. Block 3, Znd Addition toSFrlnlFietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. example- heat/electrical ceilino/Z. examp le- waterheater/electrical/oE. SquarE f66Tage or valuation,=Tc.- or forced air gas q-61)q x r soTar Ii 1. example- !2lQ sq. foot house, 500 sq. foot garage?. exarpig: JT-new project, cheikl-ew - if aodition, check add, etc.F. Building permit informat.ion:1. exampie - construct s'ingle family house with an eTE aled garase2. example - remodel existing garage into family room3. examole - convert single family residence intoiElTiiFant (change of -use) G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropr.iate persons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the l4echanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacentto the aopropriate item(s) to be installedB. Ful l PIumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the perm.it form the scheduies have been abbreviated?. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefui.l schedulesC. BUILDING DIYISION STAFF hIILL 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 general contractor is not authorizedto sign the eiectrical label. Applicant to sign and date Hhenever possibie, the initial application will be. used asa worksheet only. Where possible, Building Division Staffwill prepare a type rvritten copy and return it to theappiicant at the time the actual permit is issued for hissignature. Fees and Charges PIan check fees are due and payable at the time of theapplication, and no plans rvill 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: Permit applicant exempt from registration with the Builder's Board because: Add'itional Project Information : PLANS REVIEWED BY: name s'i gnature date