HomeMy WebLinkAboutPermit Building 1980-12-31'
SPEC
5-37
LIIi . - C I-TY c}F SPR i NGF I ELD
COI1BI iIATI ON APPL ICATION/PERMIT
TJl
l-eqal DescriPtion
<S'O
Ranqe
l.Jater Heater
EIIERGY SOU
Hea
lue of t,iorkAo0
T/_ 7100
Sq. Ftg. Access._
So. Ftg. Other_
---1{ewlfdd_AlGt[ep.-_Fence_Demo Change/Use
_other---
. Ftq. l.lai
E, Build single
Family l'lesidence },lith Attached Garace)Addriss "1-i /ddtD\o Phone
dr1,4r-'n .4?/ond .n4at m' 'u- /7&3
oofficL (;36'*
Construction Lenoer $D 7 4
@
C
Ptinvl
arlr)^d-)n'/rr/-n -rtevlt: Pr,:n/", .Address lSOO Vo-lleq iiosZ no.)exDt res phone no.addres sDESiGN TEAI1 name
CONTRACTORS Ltanq
n
tri ca I
PI
FFF CHARGF NOt',to
ELECTR I CAL
FEE CI!ARGE
":chanic:'l
MECHAN I CALPLUI16 I IIC
_ I CHARG,I
Eacn st,rgle fixture
t-!rfu
furnace/burner to
BTU. S
Floor furnace
and vent
New ci rcui ts a'l ts
or extensions
Relocated building
(new f ix. addit'ional )
Recessed wall
Snace hpatpr and ventSERV I CESS.F. P,esidence(l bath)
0uplex (1 bath) each
Apol iance vent
seDa rateiiTenporary Constructi onAdditional bath
Stati onar,v evap
coo I er
ge in existing
dence
C han
res il,la ter serv i ce
4Vent fan with
sinole duct-IIndustrial
multifamily, comrn. or
Sewer
apart from
.c.
Vent systern
heatinq or A0famps.Storm Sewer Mechanical exhaust
hood and ductCOI,1I.l. / IND. FEEDERS
[,lood stove/heaterI nsta I I /a I ter/ rel ocate
distrib. feeders
0f amp s.
ISSUANCF 0F PFRI{IT i '1 !';'
/ +,€-rTOTAL CHARGESt5"!TOTAL CHARGESTOTAL CHARGES
WHERE STATE LIN REQUIRES that the Electrical work be
shall not be valil until the label has been signed by an
do ne
E'l ec
bytri an Electrical Contractor, the electrical portion of this permit
cal Supervisor and returned to the Building Division
S I GiJATUREllAl''lE( pl ease pri nt )€An 5s P flaroruJ
fyDermi
rforrne
fythe pe
nd effe
rmatfo on ereonh s ruetncertathatandhereatnforctbyetedtULCAREFLEcompl")ap
na0rdi esrrc ciofthe tyhencc0awlthancerdthasdonebedkrDEafuerrthcerttthaaandakocotrrecndnyndaf_v
YPAilC'wt be madendanfthaNCOCCUdesc r b heed reworkntothdndawstheteStafoonrtaeatheL0regnclf0ngfispr theth Bu der Strastvri0nonhefu rt cer rt hat trmls0ntofheudD rn.y req ingtsturucwlreuthotf0any he nreo a nd th atnsotedthaftbasforSexemDtthe5exempctsared7ORS050requbyfunsrdBoarce0aect70tOP.S tr'l055 usbe oned th swhoreanancerhwi ProjsnubcoactorstrandCScomconempoyev
Value
ToTAL VALUATIoN 2.O ZA':j,(i
xrVa lueFire Zone -* Bed rooms
Val
7o
i Ftg.0ther
ne F.l Type/Const y r(J unlts I so. Fto.t,la n
cy Load - Sq. Ftg. Acce
Flood Plain
-
Stories T- 0cc.y Grou
Svsteris Develooment
Charqe f1.52) 'lan Ck.n
'.46.-asq
BUILDING PERNIT
Charges and
Su rcha rges : t'.l ee
Plan Ck. Re
30%/Bl dq Pe
srF ww,m
Fence
Demo
Sidewalk
Total Comb. I'ermitA/C Paving
Curb Cut Sl+0, "13
TOTAL
l,a .,ll1 ,--
-t,ta-!
laJ
PLUI4BING PERMIT
Charges and
Surcharges
ILECTRICAL PERI:IT
Charqes and
Surcha rges
IIECHANICAL PEP.HIT
Charges and
Surc ha rges
Pri ma
Structura I
El ectri ca I
iiechani ca I
"tob Address
0wner
l
Inhono no'I ie < nn pYnt rFs
..;')
Residence of
SQ. FT.
/0 ov'
I
COMBINAIION APPLICATION/PERMII (CAP)
I. Applicant to furnishA. Job Address
B. Legal Description
1. examole- Tax Lot 100, Lane County Map17T3l.:.. 2. exampje- Lot 1. Block 3, Znd Addition
Springfield EstatesC. Narne, etc. of owner and construction IendeD. Energy Sources
t. examole- heat/electrical ceiling/or for?. exampl-e- waterFeaiE7efEdEFJtI r soTit. square iootage or valuation, etc.
PERMIT VALIDATION
CITY OF SPRINGFIELD 'CirY Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAT RECEIPT
No. B 55508r1. example- 1250. sq. foot house, 500 sq. t (S?. exampidiT-new project, cheik-iEw - it
c-fiEEf-I-ad, etc-F. Building permit informatjon:1. examDle - construct single fami-ly house th
atTacnEa garage
2 exanole - remodel existing garage .into
3. C19!91E - convert single iai'i ly-resiienr
FEsTlIiFant (change of -use)
G. Value of work as defined in Section 303 (a) '.,
Structural Speciajty CocjeH. DESIGII TEAI.I AND CONTRACTORS
To avoid design or construction delays, Buil t!Division Staff must be able to contact appro :.
persons regarding design information or job
corrections, etc.
Abbreviated Plumbing, i'lechanicai, & Electrical S, nu,A. 9xcept vhere blank spaces occur in the descr \^.
oortion of the i'!echanicai and Electrical Schtthe applicant need fill-in only the No. Boxelfo the appropriate item(s) to be installed /B. Full Plumbing, Mechanical, and Electrical Scl (r.
are available at the BuiJding Division1. To conserve space on the permit form the
have been abbreviated /?" If the icem(s) to be installed are not co \a
the abbreviated schedules you should cons.ful I scheduiesC. BUILDIIIG DIVISI0N STAFF HILL FILL OUT ALL FEE: rD
CHARGES Oi,I THE SCHEDULES \
r9
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III.
0. As noted on the CAP, the label must be deliverelectricai contractor for signature by his e1eSupervisor. The general contractor .is not aut ttto sign the electrical label
Applicant to sign and date
l,lhenever possible, the initial application wilI bea-worksneet only. Where poss.ible, Building Divisi, ,,.will prepare a type written copy and return it to (
applicant at the time the actuai permit is issued isignature.
Fees and Charges
Plan check fees are due and payable at the time of (
application, and no plans will be processed until t,fees are paid. All other fees and charges are due tiupayable when the permit is issued.
FOR OFFICE USE ONLY
A
1(
Amount Received
BY
(,
b
E
5XELtot lurl!u!! PRIiTERS
SIGNATURE
alcEie oR 97aol !tlt!'6
IV
V Permit Clerk
PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAIICY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information :
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PLANS REVIEWED BY:
date /2-3 /-8onamef,; Saar gna tu rtLon si
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