HomeMy WebLinkAboutPermit Electrical 1986-05-19L INE
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CITY OF SPRINGFIELD
COHBI NATION APPL ICATION/PERMIT
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726-3153
Job Address L L
Lesal oescription / 7.O7.26-2/ OZGe
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llater Heater Nt
EIIERGY
Hea t
a
Owner 1*1,rir r- ( J. d.'rqt'=,,r< M.Cr,^r,,
Val ue- of tdork:9 {{8, Qa:c,,
Sq. Ftg. Access._Sq. Ftq. l.lain
rddresQg 6 ? o Sr-,..{ gFw@A R [ln*" 7yJ D scrnq
Re s dence
,e., Build Single
Afffi-to>l fl Ewtc-77*,0- OFFtr-a
Construction Lender S a, ( €.lJsul ELB*QtzAl <FG,/ii-F
Address Phone sfTE <4arte.e*
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7{6-r,=<<Structura l
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El ectri cal
Hechani cal
n ame addres s lics. no.exDI res ohone no-
Genera l
Pl umbi no
El ectri cal
ilechanical
ELECTRI CAL MECHANICALPLUI1B I NG
CHARGF NN FFF CHARGF FFF CHARGFFEE
Residence of
FTSQ
furnace/burner to
BTU' sEach single fixture
38 Floor furnace
and vent
Relocated bui ldinq
(new fix. additional)
New circuits alts.
T',j4o^b*rqa
Recessed wal l
Snacp hpatpr and vpntS ERV I CESS. F. Residence(l bath)
Duplex (1 bath) each
TemporarS, Constructi on Apol iance vent
spoa rateAdditional bath
Stationary evap.
cool er
Change in existing
res i dencel.later serv i ce
Vent fan with
sinole duct
yriibnm-} ormul ti fami l
I ndustri a ISewer
77e Vent system apart from
heatino or A,C-?,*/0f 2 Od anPs.Storm Sewer <#
Mechanical exhaust
hond and ductCOMI.I./IND. FEEDERS
uJood stove/heaterInstal I /a1 ter/rel ocatedistrib. feeders
0f
ISSUANCE OF PFRIlIT
TOTAL CHARGESTOTAL CHARGES
aTOTAL CHARGES zo.o-
I.IHERE STATE LII,I REQU
sha l'l not be val i:J unti I
IRES that the Electrical work be done by
the label has been signed by an Electri
an Electrical Contractor, the electrical portion of this
cal Supervisor and returned to the Building 0ivision
permi t
SItlAtlE (pl ease pri nt
(
t
Ci ty
made
ny
of
the permi
nd effect exempt
t55 wi l
n s trueatnf,rmat on hereocertianddotthahereb.ycatonYFULLl-)apcomp thwl he nances0rdi oft thedonebennceaccordasharmed1workandcertthaaffu rtherandndatcorrec fy I bethaNCtw1OCCUPAHCYandw0rderlscherebednkrtantothetheStateofoeng0regoneanddethLawsofsprng fi r strasontith1r/ l deButhecfurtherertthatt0nsstheofBudvlDisonmyreg isuretructthoutwlofngfyany tha tandonhereonnotedbasforsthefexemptthatasred0R",055701Boardsfunaforcerequ i by
ect0usbe0nedthiswhonw1anceORS7oLthareprojonStracubconandtorsempoyeescompv
uetfur1
z.
4
its .zl_Ftg. t'lai r
Load Sq. Ftg
croup--.81J-sq. Fts.
Cons t.
Fire Zone Bedrooms
TOTAL VALUATrcN,/8,^8.*
Acces s
Flood Plain Stori es ue 292.*
l7?,22Svstems Deve'
Charqe (1.51.opmentKzqoPlan Ck. Corrn/Ind
657./B1do Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERI'IIT
Charges and
Surcharges
__il6--*_-
f,*Fence
D6mo
PLU!.IBING PERMIT
Charges and
Surcha rges
20"*
Sldewalk
Total Comb. Permit 26[/63a.,A/c PauinsQQT(T
ELECTRICAL PERIIIT
Charges and
Surcharges
&
I
17,46Curb Cut /'?y'/a,68TOTAL
I,IECHANICAL PERMIT
Charges and
Surcharges
So. Fto. Other
ltewjgeaa7!tr]tilP€p--
_Fence Demo Change/Use
-other-
:TNRS
I
_4,.
COI4BINATION APPLI CATI ON/PERMIT ( CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference
17 03 432. exampie- Lot 1. Block 3, 2nd Addition toSpFingfietO EstatesC. Name, etc. of owner and construction ienderD. Energy Sources
l. example- 1?50 sq. foot house, 500 sq. foot garaget. elample- if new project, check new.- if add.ition,
check add, etc.F. Building permit information:1. example - construct single family house with anattached garage
?. example - remodel existing garage into family roomJ. exampte - convert singie family residence intorestaurant (change of use)G. Vaiue of work ai defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building0ivision Staff must be able to contait appropriitepersons_regarding design information or job sitecorect ions , etc.
Abbreviated Plumbing, Mechanical, & 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 aajiient_ t0 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 scheddleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF I,JILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES0. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricai -
supervisor. The general coniractor ii not authorizedto sign the electricai labelApplicant to sign and date
l,lhenever possible, the initial application wi.l .l be used asa.worksheet oniy. lthere possibii, guilding 0ivision Staiiwill.prepare a type written copy ind returi it to theapprrcant at the time the actual permit is issued for hissignature.
Fees and Charqes
Plan.check feis are due and payable at the time of theapplication, and no plans wiil-be procesied unti.l theserees are paid. All other fees and charges are due andpayabie when the permit is issued.
FOR OFFICE USE ONLY
II.
III
IV.
v
I
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E
2.
Squa I uati on ,
ceili forced air gas
or solar
PERIVIIT VALIDATION
Perm'it Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
A
Permit app'licant exempt f on with the Builder,s Board because:rom registrati
Additional Project Information:
PLANS REVIEWED BY:
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