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Home My WebLink AboutPermit Building 1988-10-04IN 72 E COIIBI I{ATI ON APPL ICATION/PERMITt.-726-3753 Job Address a ? I'later Heater Ranqe EIIERGY SOURCES Heat Legal Description 7$^4t? ^O!-27.os Value of l.lork: ]6*-* Sq. Ftg. Access..- Sq. Ftg. 0ther_ )gJ'lew_AddJ1 ter_Pep . _Fence_Demo_Cha nge/ U se 0ther Ftq. l'lain. Owner {-,m-,Drs-.f-=g Permit Info: Describe Work( Residence l,lith Attached Garaqd Bui lcii n Fami'l y re., Bui1d SingleAddressPhoneT2{,/zsz( 9r E-*zrn-.oq,,- r+B 24 r la / Construction Lender ,6,gzse*4o=-.r-ry:. W $ 1 Addres s Phone DES I GN TEAT.,I name addre s s l ics. no exDt res phone no. Primary Structura I El ectri cal Mechani ca l name address )(lics- no.)exDt res ohone no. Pl umbi l.lechani cal ELECTR I CALPLUIlB I NG MECHAN I CAL FEF CHARGF NN FFF . HA PAF NO FFF CHARGF Each singie fixture Residence of sQ. FT. furnace/burner to BTU' S Relocated building (new fix. additional) New ci rcui ts al ts. or extensions Floor furnace and vent S.F. Residence(l bath)SERVICES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Apol iance vent sFoa ratF l,later servi ce ge in existing dpnce Chan resi Stationary evap cool er Sewer Indrr<tria l multifamily, comm. or Vent fan with sinole duct Storm Sewer 0f amps.Vent system apart from heatinq or A.C. c0t1r.1./rND. FEEDERS Mechanical exhaust hood and duct I nsta I I /a I ter/ rel ocate d'i stri b. feeders l.Jood stove/heater amp s.0f * ISSUANCF OF PFRI,IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl,l REQUIRES that tlte Electrical work be done by an Electrical Contractor, the electrical portion of this pernitshall not be vali,l until the label has been signed by an Electrical Supervisor and returned to the Buildin! Division of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that t,l0of any-structure without the permission of the Building Division. I further certify that my reqistratiBoard is in full force and effect as required by ORS 701.055, that if exempt the basis for Lxemption isonly subcontractors and employees who are in comoliance with OI?S 701.055 will be used on this oroject. I.lAl'lE (pl ease pri nt )S I GNATURE DATE ca t foon r t nda heredo certcomp tDerm lap r)b.y fy nd tcorrec a nd fu rrthe ticer tha ta nda a wo performedrk sha be do n afyanyne cc ncorda e ht ethwl rmation hereon is true 0rdinances of the City 0CCUPAI'ICY wil l be made on urith the Builder's noted hereon, and that Group Sq. Ftg. Otn""Ea4qfaryfu-7,tu1ue TOTAL VALUATION Sq .-D ilpr Bedroom s Load .Z*-fAtnits sq. Ftntns tlain/%dv tArt Qt// /f ualueZo(_. Ftg. Access x ValFi re Flood Plain Stories 0cc.y Plan Ck. Conrm/Ind 65%/Bldo Per Fpc z*o3 S v s terns Cha rqe Deve (1.52 opment 7?;*Charges and Surcharges /-?38.5-DBUILDING PERI'IIT PIan Ck. Res 30%/B1dq Per Fee FencePLUt4BING PERI'IIT Charges and Surcha rges Dgmo Si dewa I kELECTRICAL PERtlIT Charges and Surcha rges A/C Paving Tota'l Comb. Permit /a.13 Curb CutHECHANICAL PERt,lIT Charges and Surcha rges TOTAL ,fl,{3 )lo btoc :TORS Generat V--zz*, t?=7s.^rA --?.4a'E Ep-/+z-zffi-.;/,/q t, .l Temporary Constructi on COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish . A. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map ReferencefT5-as?. example- Lot ]. Biock 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sourcesl. examol e-^+a. examD I e-E. SquaFe--Tbo-tag 1. examp_le- 1?50 sq. foot house, 500 sq. foot garaget. example- if new oroject, check new - if addition,EIecf' add, etc. a ir gas rit informat'ion: construct singie family house with an garage F Building perm1. example - a ttac hed II III ?. example - remodel existing garage into fam.ily roomJ. example - convert single fami)y residence intorestaurant (change of use)G. Value of work as defined .in Section 303 (a) of theStructural Specia lty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contatt appropriitepersons.regarding design information or job sitecorrections, etc. Abbreviated P)umbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion 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 Electricai Schedulesare avaiiable at the Buitding Divis.ion1. To conserve space on the-perm.it form the scheduleshave been abbreviated2. If the item(s) to be instal1ed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING 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 electricalsupervisor. The general contractor ii.not authorizedto sign the electrical labelAppiicant to sign and date Whenever possible, the initial application will be used asa.worksheet only. Where possible, Building Division Staiiwill prepare a type wr.itten copy and returi it to theapplicant at the time the actual perm.it is issued for hissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed unt.il thesetees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY IV V PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAITCY: PERMIT VALIDATION . + lzssb Permi t Cl erk ,/o - Permit applicant exempt from registration with the Bu'ilder's Board because: Additional Project Information : PLANS REVIEWED BY: date /2'//A=nane /L>a/E ft:"O s'l gnatu I NSP 726-COHBI NATI ON APPLICATION/ PTKMI I -37 s3 Job Address )vD l-egal Description l,later Heater EIIERGY SOURCES Heat Sq. Ftg. Access.-Ftg. tla n- Value of llork Owner e uild S ng e PhoneAddres s Construction Lender $ u Address Phone Structura l El ectri cal Mechani cal exnl res (ohone no.lics. no.a ddressnameIRACTORS I ectr m ELECTRI CALPLUt,lB I NG FFF CHARGFFFFCHARGFNOFFFCHARGENOfurnace/burner to BTU' s75DEach single fixture Floor furnace and vent New circuits alts or extensions Relocated bui lding (new fix. additionaI) Recessed wal I Soace heater and ventSERV I CESS.F. Residence(l bath) Duplex (1 bath) each Apol iance vent seDarateTemporary Constructi onAdditional bath Stationary evap. coo l er in existingChan ge reqi de nae(*'/5,-/l,later servi ce Vent fan with sinole duct multifamily, I ndrrs tri a l comm.0rSewer Vent system apart from heatinq or A.C._amps.0fStorm Sewer Mechan ical exhaust hood and ductc0Mr'1./IND. FEEDERS l'lood stove/heaterInstal I /al ter/rel ocate distrih. feeders 0f amps. .{n.W>nx,+*5a,rz ae ISSUANCE OF PFRt,IIT TOTAL CHARGES /t*TOTAL CHARGES 225? WHERE STATE LAt,l REQUIRES that the Electrical work be done by an Electrica'l 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 and correct, and I further certify that any and all workof Springfield and the Laws of the State of 0reoon oertaof any structure without the permission of the Building Board is in full force and effect as required by ORS 701 only subcontractors and empioyees who are in comoliance for permit, and do hereb.y certify that all information hereon is true performed shall be done in accordance with the 0rdinances of the City ining to the work described herein, and that NC 0CCUPAI,ICY will be made Division. I further certify that my reqistration vrith the Builder's .055, that if exempt the basis for exemption is noted hereon, and that with 0l1S 701.055 wi1l be used on this nroject. tlAl.lE(please print)S I GNATURE rE./.2--_?!=i2 comp onapr)ca Flood Plain Stories Occy Group Sq. Ftg Ftg Ftg Zone xLoad Sq l'la iCons t. Val ue ts So. Fire Zone Bedrooms Val ue TOTAL VALUATION Val ue . Access .0ther Plan Ck. Conm/Ind 65%/8ldq Per Fee 0pmm 5r. BUILDING PERI'IIT Charges and Su rcharges Fee Plan Ck. Res 30%/Bldq Per FencePLUI.IBING PERMIT Charqes and FSurciarges ) 2,Z.SF 3 D6mo Sidewal kCharges and Surcha rges ,l/'6o----/?-'----ul ELECTRICAL PERIIIT A/C Paving Tota'l Comb. Permit Curb CutHECHANICAL PERMIT Charges and Surc harges TOTAL 7?,24. V..ar,fZ= )e I WO TK Garaor E7p-77='r -*.rrz<a a ;S T GN TFAI.I ( addres s MECHAN I CAL Residence of SQ. FT. TOTAL CHARGES PERMIT VALIDATION / 0-74 Permit Clerk iz0?b COMBINATION APPLICATION/PERMIT (CAP) Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 43?. example- Lot 1. Block 3, 2nd Addition to Springfield EstatesC, Name, etc. of owner and construction lenderD. Energy Sources1. example- he2, example- waE. Square footage a t,/e l ectr i ca I forced air gas e ec or solar or vaiuat ofl,1. 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 - remodei existing garage into family room3. exampie - 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 TEAI'I AND CONTRACTORS To avoid design or construction delays, Bu'ilding Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc.II. Abbreviated Plumbing, Mechanica'1, & Electrical SchedulesA. Except where blank spaces occulin the descriptionportion 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 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 schedules 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 Iabel.III. Applicant to sign and date Whenever possible, the initial application will 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 s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no p)ans 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'ICY: permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEt,lED BY: t?e tdate name sig nature -r/ i