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Home My WebLink AboutPermit Building 1989-04-10Sq. Ftg. Access.-- Sq. Fto. Other--_ _llewJdd_Al ter_Pep. _Fe nc e_Demo_C ha n ge/ U s e 0ther C()MBI APPL I 726-37 Owner G)Va.l ue o f. l,Jater lleater TI IT l-egal Description Job Address Ranqe EIIERGY SOURCES Hea t l.ri th AI hed ie., Build SingleAtld res s Phonc oIi Constructi on r s B D Address llhon c Pri ma ry Struc tura I El ectri ca I Mechani ca I n aille add res s I ics. no.exol res Iohone no. ) I( (Genera I , ,(ctq \ ELECTR I CAL MECHAN I CALPLt]IIB I NG FFF CHARGF NO FFF CIIARGFFEEC I]ARGT NO furnace/burner to BTU' sEach single f.i xture Residence of SQ. FT New circuits alts. or extensions Floor furnace and vent Relocated buildjnq (new fjx. additional ) SERVICES Recessed wal l SDace heater and vent S. F. Res i dence(l bath) Duplex (1 bath) each Temporary Constructi on Apol iance vent sepa rateAdditional bath Stati onar.v evap, cool er Change in existing res i dencel,later servi ce Vent fan with cinole ductTndustriaI multifanri1y, comm, orSewer Vent systern apart from heatino or A.C.,amps.0fStorm Sewer Mechanical exhaust hood and ductc0r.'[.1. /rND. FIEDERS InstaI I /aI ter/rel ocate dictrih. fcpders l'lood stove/heaterI ooaix B\dfiI \5.0o 0f--rM-;T ISSUANCF OF PFRI1IT TOTAL CHARGESTOTAL CHARGISTOTAL CHARGIS /1 ea l^llltRt STATE Lllj RIQUIRtS that the Electr.ical vtork be done shall not be valiI untiI the label has been siqned by an E.lect byri an lllectrical Contractor, the electrical portion of this pemlit ca1 Supervisor and returned to the Building Division com']etedappll.Cationforoerntjt,anddohereb.ycertif.ythata1linformationhereon.istrue and correct, and I further certjf.v that any and all work rrerformed shall be done in accordance with the 0rdinances of the City of Springfjeld and the Laws of the State of 0relron oertaining to the work described herein, and that NC 0CCUPANCY will be made of any sIructure without the permission of the Buildinq Diviiion. I further certify that m.y reqistration vrith the Bui]der's Board is in full force and effect as required b.y ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and erlployees who are in comcliance with ORS 701.055 vrill be used on this nro.ject. llAl'1E(please print)DATSI GIIATI.JRE eroup ,4-/ sq. Fts. otnerful/Qt*p.-xfua1ue €,42* l34lot/ Z A1ffi ToT^L vALUATIoN- x Val UpFire Zone Bedrooms- dccy Load So. F tq. l'lain lueconst. 6-1Y _unitsZone Flood Pl ain__=-.-_S tories 2 Sq. Ftg. Acces 's terns Deve r.5% Plan Ck. Comm/lnd 65"/,/81rlo Per Fee aq1, i-:I .l \Plan Ck. Res 30%/B1dq Per Fee BUILDING PERMIT Charges anC Su rc ha rges __*,f,?_- t ^(rt &.t)r t 11 AFesen\0rnnn$ ->")6*i w nt-- *" Sidewalk Total Cornb. Perm'i t PLUI4BING PERMIT Charges and Surc ha rges ELICTRICAL PERIlIT Charges and Su rc ha rges a? A/C Pavi ng Curb Cut ffi,*.-530314ECHANICAL PERMIT Charges and Surc ha rge s l lnhnnp nnnatre(address '*g llechani ca I opment +.++ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 o-3-r[32. example- Lot 1. Block 3, ?nd Addition toSffiffiield Estates C. Name, etc. of owner and construction Iender D. Energy Sources l. exampl e- heat/elqg!rua] qSj_l-!-lg/or forced a i r gas 2. examFl-e- waterEEEte7eTecT7l ciVor soTIF-- E, .Square footage or valuation, etc,l. example- 1250 sq. foot house, 500 sq. foot garage ?. example- if new project, check new - if addition, check add, etc.F. Bu i 1ding permi t information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into famiiy room 3. example - convert single family residence into restauiant (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 appropriate persons regarding design information or job site corrections, etc.II. Abbreviated Plumbing, Mechanicai, & Electrical SchedulesA. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. FulI Plumbing, Mechanical, and Eiectrical Schedules are available at the Buiiding DivisionI. 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 scheduies you should consult thefulI schedulesC. BUILDING DIVISION STAFF I^IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. 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.IIL Applicant to sign and date Whenever possible, the initial application will be used as a worksheet on1y. Where possible, Building Division Staffwili prepare a type written copy and return it to the appiicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Pian check fees are due and payable at the time of theapplication, 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 PERMIT VALI DATION I \34\o V I 3 *4 @Eq )3 5qo Permit Cler PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registratjon wjth the Bu'ilder's Board because: Additional Project Information : PLANS REVIEWED BY: name S1 gna tu date /-?-try CJL COI,IB I . Ftg . l'la i n.nd* Owner Sq. Ftg. Other_ _!,lew_.Add_AlTil[6p. - _Fence_Demo Change/Use -other-_-- Ra 5q. Ftg. Access.-_.---- l,later Heater Val ue of l,Jork I CAT Job Address l-egal Description EIIERGY SOURCES: Hea t Addres s Sz H Phonet Farn i t s te. 'n9 eDesc Construction Lender Address l)lronc t DESIGN TEAI.I nailte address lics. rlu.) l exol res phone no. Pri ma r Structura I El ectri cal l"'lechan ica I CON .RACTORS n ame address (lics. no.)exDl res ohone no-nGenera I /)n 1 E'l ectrical l'1ec ha n i ca l PLUIlB I IIG EL ECTR I CAL MECHANICAL N0.FEE C HARGE NO FFF THARGF I'lo FFF CIIARGF Each si ngl e fi xture Residence of FTSQ furnace/burner to BTTI' S New c'i rcu'i ts alts or extens'ions FIoor furnace and vent Relocated bullding (new fix. additional ) S. F. Iles idence(l bat.h)S[RV I CTS Recessed wal I SDace heater and vent Duplex (1 bath) each Addi tional bath Temporary Construct ion Apol iance vent seDa ra te l,iater servi ce ge i n exi sti ng dence Chan res'i Stationary evap. cool er multifanrily, Tndrrstrial conrn. orSewe r Vent fan with sinole duct Storm Sewer 0f Vent systern heatino or A apart from .c. COI,II.I./IND. FEEDERS Mechanical exhaust hood and duct- I nsta I I /a1 ter/re1 ocate di stri b. feeders l'lood stove/heater 0f amp s. ISSUANCF OF PFRI,IIT TOTAL CHARGES TOTAL CHARGESTOTAL CHARGES WHERE STATT L\N 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 sig;ned by an Eiectrical Supervisor and returned to the Building Division I HAVE CAREFULLY IXAMIN[D the.completed apolication for oermit, and do herebv certif.y that all information hereon is true and correct, and I further certif-v that any and all work rrerformed shall be done in accordance with the 0rdinances of the Cityof Soringfield and the Laws of the State of 0regon nertaining to the work described herein, and that t,l0 OCCI,PAI,|CY wil'l be madeof any structure without the permission of the Building D.ivision. I further certify that my registration v,ith the Builder's Board is in fu1.l force and effect as required b.y ORS 701.055, that if exempt the basis for exemption is noted hereon, and that onl-y subcontractors and emplo.yees who are in comcliance with 0l1S 701.055 ni'lI berused on this rrroject. 7-3o -&IlAt'lE(please print)S IGTIATUREl[re t Bn eTELs' FOR ( TFICT USE OI,ILY Fi re Zone_Bedrooms _ _ 0c Fl ood Pl ai n_Stori es 0c Ftg Fto Ftg Val ue ToTAL VALUATI0N_ x x x Val cy Load Sq. c.y Group rVa lueUni ts l'la i nZone_._Tyoel Cons t . Access . 0ther Svsterns Deve Charqe (1.57 opmentPlan Ck. Comm/lnd 65"/,/B1dq Per Fee BUILDING PERI.lIT Charges anC Su rc ha rges Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Su rc ha rges ( ___1 <uo>,D6mo Sidewa'l k Total Comb. Permit ELECTRICAL PERIIIT Charges and Surcha rges A/C Pavi ng Curb Cut (s,79-TOTAL I,IECHANICAL PERMIT Charges and Surc ha rge s q\(' /L> I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot l. Block 3, Znd Addition to SElinsfield Estates C. Name, etc, of owner and construction Iender D. Eriergy Sources1. examole- heat,/electrical ceiling/or forced air gas 2. example- waterheater/electrical/or solar E. Square footage or valuation, etc. 1.'example- 1250 sq. foot house, 500 sq. foot garage 2: example- lFnew proiect, 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 room 3. examFle - convert single family residence into EiTEIFant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays' Building Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. IL Abbreviated Plumbing, 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 adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Ejectrical Schedules are available at the Building Division 1. 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 thefui'l schedules C. BUILDING DIVISION STAFF I,IILL 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 possible, the initial application will be used as a worksheet only. 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 plans will be processed until these fees are paid. AII other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PTRMIT VALIDATION tv'{ r b 3-30'g? Permit Clerk P PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Perm'it applicant exempt from registration with the Builder's Board because: Additional Project Information PLANS REVIEWED BY: name si g na tu re date