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HomeMy WebLinkAboutPermit Building 1989-09-266l=3Ea J 0li NE CITY OF SPRINGFIELD COMBI NATI ON RPPI. ICRTIOII/PERMIT tl3DJob Address Legal Di-.scri ption Ran.le_ llater Heater EIIERGY SOURCES Hea t ) 'flB, r-=8 -Val ue of# Sq. Ftg. l'1ain_ Sq. Ftg. Accesil-- Sq. Fto. Other__ _l,lew_Add-Al ter_Rep. _Fence_Demo_C han gel U se 0ther 0wne r s(>NlJ OrJt-t Bui I cii n Fami I y q Pernlit Info: Describe Work(' ltesidence llith Attached Garaqe .e., Bui ld Single Tlhl?- cFF 1 -l q E -r Q-rlQso,F rr tTtJ oo1":' t LLs cr:Gr:taG rer)' pt'o'" tltr5- (EUC:€9S \ q-lLil)l Sblt Construc uion Lender S-R-r.l trIOIP-G\.DSS eAP ShJEg.- r--t3Addre s s Phone DES I Gi,i TEAM name addre s s l ics. no.exD l res ohone no. Primary St.iuctura I F:l ectri ca I Hechani ca l name a ddrps s lics- no-'l exDt res ohone no. t trDf-'{t-UDPl umbi no 9l'{ ot-El ectri ca I I'lec ha n i ca I PLUI.IBI NG ELECTRI CAL MECHAN I CAL FEE CHARGE NO.FFF CHARGF NO FFF CHARGF Each singie fixture Residence of sQ. FT. furnace/burner to BTU' s Relocated building (new fix. additional) New circuits aits or extensions Floor furnace and vent S. F. Residence ( I harh)SERV I CES Recessed wal I Snacp hpatpr and vpnt Duplex (l bath) each Additional bath Apol i ance vent seDa rate [^later serv ice Change in existing rps i dence Stati onar-v evap cool er multifamily, comm. or Jndrrstrial Vent fan with s'inole ductSewer Storm Sewer 0f s.Vent systern apart from heatinq or A.C. c0Mr.1./rND. FEEDERS Mechanical exhaust hood and drrct Instal I /al ter/re l ocate di stri h- feeders l,Jood stove/heater 0f S. ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGESTOTAL 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 E)ectrical Supervisor and returned to the Building Division oertaining to the work described herein, and that N0 OCCUPANCY will be lding Division. I further certify that m.y registration vlith the Builder's only subcontractors and ernployees who are in comcliance with 0l?S 701. I'lAt'lE( pl ease print)S I GNATURE Ci ty made' 0reqon the Buit the permi and effect exemp 055 wi DE,foany of I HAVE CAREFULLY EXAI1INED the completed application for rmit, and do hereb.y certify that all information hereon is true and correct, and I further certify that and al I work per rmed shall be done in accordance with the 0rdinances of theof Springfield and the Laws of the Stateof any structure withou ssion of Board is in full force as required by ORS 701.055, that if t the basis for exemption is noted hereon, and that 'I I be used on t ect. Srs\ Qr>ss FF E Fire Zone Bedrooms 0ccy Load Sq, Ftg. Access x Value_ TOTAL VALUATION-- Ftq . l'la i Ftg 0ther X x Zone________Tyoe/ Con s t Val ueUni ts Val ueFlood Plain Stories. Plan Ck. Conrn/Ind 65'/,,/Bldo Ppr Fpp 5tBUILDING PERI.lIT Charges and Surcharges Plan Ck. Res 30%/B1dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges Dgmo Sidewal kELECTRICA.L PERtlIT Charges and Surcha rges A/C Paving Total Comb. Permit Curb Cut \Ra.@\ GratgS NECHAI'II CAL PERMIT Charges and Surc ha rges TOTAL Temporary Constructi on COMBINATION APPLICATION/PERMIT (CAP) L Applicant 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 toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION -w'$ I 1. exampl e-2. examp'l e-E. Square footag heat,/electrical ceil in or forced air qas wa ea e ec tr Ld or sol ar e or valuation, II l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if 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. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bui)ding Division Staff must be ab'le to contact appropriate persons regarding design information or job sitecorrections, etC. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descript.ionportion 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 Schedulesare 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 onthe abbreviated schedules you should consult theful I schedul esC. BUILDING DIVISION STAFF HILL 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 Applicant to sign and date Whenever possible, the initiai application will be used asa worksheet only. Where possible, Bu'ilding Division Staffwill prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for his s i gna ture. Fees and Charges P'lan check fees are due and payable at the time of theapplication, and no plans will 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 Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: PLANS REVIEWED BY name sig nature date,F €97 bqk Additional Project Information :