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HomeMy WebLinkAboutPermit Building 1983-06-20EIISPECTIOII Li ?6-37 69 COIIBI ON LI RMIT n\y L, s) t avv) Job Address 5 Legal Description EIIERGY SOURCES: Hea t Ranqe l^later Heater Val ue,of l.lork:fl ts,no o Sq. Ftg. Access.-.- Sq. Fto. 0ther_ _l{ew_Add_Al Ter-[ep. - _Fence_Demo Change/Use -other- Sg. Fto . l.lai n naOwne r lr)ava /,, ess -F^^in a,€ri Address Fami I t Work :e.r BUild Single R.-^-^,. d .- I .Q Rr^ il.\ i nc - Construction Lender 6t dJ.40 I " o L/r;? ( o^J /t,n)s1 tA/^Ye,@L\r h qa-{;4n (Y t4I on bo ,4,Addres s Phone DL5iGN TEAM name address tcs. no.J exDt res ohone no. un<-fel 7v{ Structura l I "l a}'; E l ectri ca I Hechani cal name addres s Iics- no- )FXDl reS ohone no. El ectr i ca 1 l.lechanical PLUI{B I NG ELECTR I CAL MECHANI CAL N0.FEE C HARGE NN FFF CHARGF NO FFF NHARGF Each single fixture Residence of SQ. FT. furnace/burner to BTU' s /#Relocated building (new fix. additional)X New ci rcui ts ai ts or extensions2 6P hDR€ Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal i Soace heater and vent Duplex (l bath) each //q+r ?cxt>,Ge. Additional bath Temporary Constructi on Apol iance vent seDa ra tP Change in existing rpc i dpncp Stati onar,v evap. cool erl.later servi ce Sewer multifamily, coriln. or I ndu stri a I Vent fan with sinole duct Storm Sewer 0f amps.Vent system apart from heatino or A.C. c0Mr.r./IND. FEEDERS Mechanical exhaust hood and duct Instal i /al ter/re1 ocate di stri b. feeders l'lood stove/heater .r*a0f amps.X ,ktA QtaZ D-rcZtcaft< ISSUANCF OF PFRI,IIT ./d.E TOTAL CHARGES ??..6TOTAL CHARGES TOTAL CHARGES /sn" WHERE STATE LAN REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valil until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for oermit, and do hereby certify that all information hereon is true and correct, and 1 further certif,v that any and all work rrerformed shall be done in accordance with the 0rdinances of the Cityof Springfield and the Laws of the State of Ore1on oertaining to the work described herein, and that NC 0CCUPAI,ICY will be made of any structure without the permission of the Building Division. I further certify that my registration vlith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees r.rho are in comDliance with 0l?S 701.055 wi'll be used on this rrroject. I'lAl"tE( p lease print)r/a<t-{j'I Fire Zone!.,{-;---Bedroons l|*i , occy Load Sq Flood Plain/{12-stories / 0cc.y croup 7-? sq Ftt: Ftg Ftg 'I n x no-l.r-4"* 8(toon <-11' t,ta rcJs*E: r x Value_ ValuAcces s 0ther o2 T0TAL VALUATION zone CC lyoelconst. uni ts Svstems Deve' Charqe (1.5.%' opmentPlan Ck. Comm/Ind 65%/B1do Per Fee BUILDING PERI.IIT Charges anC Su rc harges __22_'_:_ Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surc ha rges Dgmo Sidewalk Total Cornb. Permit // v.v6 ELECTRICAL PERI,IIT Charges and Surcha rges __-/fr:-_- ,<a A/C Paving Curb Cut //9. =6 TOTAL MECHANICAL PERHIT Charges and Surcha rges .aa 6a J Nt\ t qi,, zoQe' COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition toSEffiETield EstaresC. Name. etc. of owner and construction lenderD. Energy Sources PERIVIIT VALI DATION l. examol e-2. ExamETe-E. Square foota gas 1. example- 1?50 sq. foot house, 500 sq. foot garagez. example- if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. examp_le - remodel existing garage into family room3. exampie - convert single family res.idence 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, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechan.ical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjaient _ to the appropriate item(s) to be installedB. Full Plumbing, Flechanical, and Electrical Schedulesare avai labie at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful l schedulesC. BUILDING DiVISION STAFF I.IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labei must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general conaractor ii not authorizedto sign the electrical labelApplicant to sign and date l'/henever possible, the initial application wilI be used asa.worksheet oniy. l,Jhere possible, Building Division Staffwil'l.prepare a type written copy and returi it to theapplicant at the time the actuai permit is issued for hissignature. Fees and Charges Plan check fees are due and payabte at the time of theapplication, and no plans will be processed until thesefees are paid. Al l other fees and charqes are due andpayable when the permit is issued. FOR OFFICE USE ONLY 0k_ un&4 II &3 III IV. v Permit Clerk PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAI.ICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s'l gnatu date 6-t?-8-,3