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HomeMy WebLinkAboutPermit Building 1987-03-02..--:-* CITY OF SPRINGFIELD COHBI NATI ON APPLI CATION/PERHIT Job Address 7-A7 52 Lesal Description /2^O-_=Z-<2 O qL/O/llater Heater EIIERGY SOURCES Heat r.Yalue of llork:1ae(---a Ftc. l.lai n-- __ Sq. Ftg. Access._ Sq. Ftg. Other n n 5C .e., Build Single7r'"Phone )7(-o/52Zp 4u:o*?*uu^ ,*zr Df €Nz-szzxz- Construction Lender Address Phone h\l 0 u U DESIGN TEAI.I name address exDr res ohone no. Structura I El ectri ca I Hechanica l name addres s (lics- no exot res ohone no- Genera I Pl umbi nq E l ectri ca l i'lechanical PLUI,IB I NG ELECTRI CAL HECHANICAL FEE CHARGE NO FFF CHARGF NO FFF CHARGF Each single fixture Residence of sq. FT furnace/burner to BTU, s Relocated buildino (new fix. additional)//-New circuits alts or extensionsOm€ ast(?{o" Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wal I Snacp hpetpr and vent Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seDarate [.later servi ce in existing CE Change res i den Stati onar.v evap cool er Sewer multifamily, conrn. or I ndu stri a l Vent fan with sinole duct Storm Sewer 0f s.Vent systern apart from heatins or A.C. COMI.{./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/rel ocate distrib. feeders l,lood stove/heater 0f ISSUANCE OF PFRI,IIT TOTAL CHARGES TOTAL CHARGES ./9.""TOTAL CHARGES ricai work be done by an Electrical Contractor, the electrical portion of this permit signed by an Electrical supervisor and returned to the Buildin! Divis.ion oertaining to the work described herein, and that NC OCCUPANCY will be Flood Plain Stories ,/ Occy eroup/Q_sq. Fts (please print)I GNATU RE Value rE3-e -97 luexrVa Ci ty made caap r) 0reoon its ED the comple on for permit,certify that all information hereon is trueand correct, and I further certify that anyof the State of and all work performed shall be done in accordance with the Ordinances of theof Springfield and the Lawsof any s Board is tructure without the permission of her certify that my reqistration vrith the Builder,sthe Bui I ding Division. I furtin fulI force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and thatonly subcontractors and employees who are in compiiance with ORS 701.055 wi used on this nroject WHERE STATE LAt'l REQUIRES that the Electshall not be valiC until the label has been soA) Zone ___€ 1____I ypel Co n s t. TOTAL VALUATION lu"-@-_oP._ Ftg . t'la i Fire Zone Bedrooms Ftg. Access PIan Ck. Corm/Ind 65%/B1do Per Fee 7/.s;Systeris Deve Charqe (1.57 opmentBUILDING PERI'IIT Charges and Surcha rges _-fu-&_z-62 Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surcharges D5rmo Sldewal kELECTRICAL PERIIIT Charges and Surcha rges .(e 456 A/C Paving Tota'l Comb. Permit 6A./z Curb CutHECHANICAL PERI.,IIT Charges and Surc harges TOTAL /oo. 7, CONBINATION APPLICATION/PER',IIT (CAP) {. Appticant to furnishA. Job AddressB. Legal Descriptionl. examole- Tax Lot 100, Lane County Map Referencer-7T3 4-432. example- Lot 1. Block 3, 2nd Addition toSpfing-Field Estates !. Name, etc. of owner and construction lenderu. Energy sources { - ctTY OF SPRTNGFTELD Ctty Ha[ Sprlngffeld, Oregon Dcpertment ol publlc Workt OFFICIAL RECEIPT No. B I I (6787 19 From I exampl e- examp I e- re foota, Address 2. exampl e- examp I e- EIecl-addF. Bui lding perm1. example - a ttac hed hea t/e cal cei wa CC ca or solarIqqed air sa: foot garage if addition, eE. Squa ge or valuat on,I 2 1250 sqif new foot house,500 sq.project, check new -etc.it information construct single family house with angarage remodel existi ng garage into famil y roory residence into \/4 .7- convert si ngl e famil & ( 3 H. DESIGN TEAM exampl e exampi e res ta ura 2 fa '-)ant (change o f use)G. Value of work as defined 'in Section 303 (a) of theStructurai S A) -/D "?opec i AND alty Code CONTRACTORS ( (. ( To avoid design or.construction delays, BuildingDivision Staff must be able to contiii appropriatepersons.regarding design information or jbO itte--corrections, etc.Abbreviated plumbing,. Mechanica.l, & Electr.ical Schedu.lesA. Except where otjnt ipiiei-;;r; in-ir,. o.r."iptionportion of the Mechanical and Electriiat Scneiujes,the applicant need fill_in onty iire lro. aorei-ijjaient_ t0 the appropriate item(s) to -Ue insiitteUB. Full Plumbing, t",techan.iCii, .ra-if ".iricat Schedulesare available at the Building Division1. To conserve space on the-perrnii iorm the schedulerhave been abbreviated2. II tt,:. item(s) to be installed are not covered onthe abbreviated schedu.les you should .onirit-tt"'ful l schedulesC. BUILDING DIVISION STAFF HILL FILL OUT ALL FEES ANDCHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to ile'lectrical contractor for signaiur" Oy ti, .i"i[ri.ui'supervisor. The general coniractor i's not authorized- to sign the electrical labelApplicant to sign and date I'lhenever poss.ible, the initial application will be used asa.-worksheet onty. Where possibt;; Buiidi;s Division ata;i l]]j.0regarg ? typg written copy and returi it to theapptrcant at the time the actual permit is issueJ io" f,i,s i gna ture. Fees and Charges Plan.check fees are due and payable at the time of theapplication, and no plans wiit-oe proieilid until thesefees are paid. Alt btner fees and .f,i.g.i-u". due andpayable when the permit is .issued. FOR OFFICE USE ONLY 16 II. III. a/2. ( (I BY-l Amount Perm'it Cl er o.?5- ' Fr.t,trtbr gusrru€ss FoBMs. rNC (503)3a2.8r49 6: IV v PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: cant exempt from registration with the Builder,s Board because:Permit appl i Additional Project Information : PLANS REVIEWED BY: datename /oz,lE 7c gnature ?-aFSA si i ( ONL APPL ICA l,later Heater e2 ngle5*7r'"ami l COHBI ft-7 (> 0 A 27 Heao/Ftg. l'1a n ^22 3753 l-egal Descri ption Job Address Ranqe Val 0wner Address r€. ePhone EHERGY SOURCES ERMIT So. Ftq. Access. Construction Lender h! 0 r./ U Addre s s Phone Q4oa Mechani cal El ectri cal Structura I Pri ma nhonp no - )exDl resaddres s (lics. no.lname General P l umbi nq El ectri cal I'lechani cal ELECTRI CAL MECHAN I CALPLUI{B I NG FFF .HAAGFNNFFFCHARGFNOFEECHARGE furnace/burner to BTU' sEach single fixture Residence of FTSQ /'New circuits alts or extensionsbtvE <3;:t<?{o" Floor furnace and vent Relocated building (new fix. additional) SERV I CES Recessed wal I Snacp heatpr and vpnf S. F. Residence(l bath) Duplex (l bath) each Temporary Construction Apol iance vent seDa rateAdditional bath ge i n exi sti ng dence C han resi Stati onar.v evap cool er[^later servi ce Indrrstrial multifamily, comm, or Vent fan with sinole ductSewer Storm Sewer 0f Vent system apart from heatino or A.C. COMI.I./IND. FEEDERS Mechan i cal exhaust hood and duct Instal I /a l ter/re l ocatedistrih. fccders frJood stove/heater 0f ISSIJANCE OF PFRI,IIT TOTAL CHARGES TOTAL CHARGES ,/9.o"TOTAL CHARGES WHERE STATE LAW REQUIRES that the Electrical work be done by an E]ectrical Contractor, the electrical portion of this permitshall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for permit, and do and correct, and I further certify that any and all work performed shall beof Springfield and the Laws of the State of 0reoon pertaining to the work drof any structure without the permission of the Building Division. I furthe Board is in full force and effect as required by ORS 701.055, that if exemp.only subcontractors and ernployees who are in comcliance with ORS 701.055 wi' hereb.y certify that all information hereon is true done in accordance with the Ordinances of the City escribed herein, and that NC 0CCUPAI,ICY will be mader certi fy that m.y regi strati on vri th the Bui I der' st the basis for exemption is noted hereon, and that liAt'lE(please print)IGNATUREAJ rEs -e -97oA-) used on this oroject Zone--E1---rype1const.5 /,4,.7. units So Ftg Ftg Ftg 'I llF Fire Zone Bedrooms 0ccy Load 77 Val ue Group l'la i n TOTAL VALUATION..__..--.-..-- Val u 276 Acces Flood Plain Stories Plan Ck. Conrn/Ind,\ 65%/Bldq Per Fee / l.)7/.s;Svs Cha tems Deve rqe (1.51 opment Charges and Surcharges -fu*P__z-62 ^ BUILDING PERI'IIT Plan Ck. Res 30%/B1dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges Dgmo Sidewal kELECTRICP,L PERIlIT Charges andSurcharges 4 .(o <>6 A/C Paving Tota'l Cornb. Permi t 6A./z Curb CutI4ECHANICAL PERMiT Charges and Surc harges TOTAL /oo- 7f of l,lork: /T. ---l!--- ( \ coMBrNATr0N AppLrcATI0N/PERMIT (CAp) I Applicant to furnishA. Job AddressB. Lega) Descriptionl. example- Tax Lot 100, Lane County Map ReferenceIz-T'3-T:2. gIgIp.lS_ Lot_l. Btock 3, Znd Addition to5prtngtield Estates I, Name, etc. of owner and construction lenderD. Energy Sources PtrR,NIT VALTOATION T3 62822 I t/tri ca'l i I in or forced a E. Squa e or so arr valuat on, etc.I example- 1250 sq example- if new Eh-Eck--add, etc. foot house, 500 sq. foot 2 proj ect, check new - if add ga it rage ion, F Buil ding permit informa example - construct attached garage ti on 1 singie family house with an 2.example - example - res ta uran remodel existing garage into family room2convert s i n 9le fami I y residence into G. Value of work t (change of use )as defined in Section 303 (a) of theStructura) Sp eci aity Code CONTRACTORSHDESIGN TEAM AND II To avoid design or construction delays, BuildingDivision Staff must be able to contait appropr.iitepersons.regarding design information or jbU iit. - corrections, etc. Abbreviated Plumbing, Mechan.ical, & Electr.ical SchedulesA. Lxcept where blank spaces occur in the descr.ipt.ionportion of the Mechanical and Ejectrical Schedulei,the applicant need fill-in only the No. Boxes iajaient ^ !o_!h9 appropr.iate item(s) to Le instailedB. Full Plumbing, Mechanical, and eteiiiical Schedu.lesare available at the Building Division1. To conserve space on the-permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consu.lt theful I 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 coniractor i! not authorizedto sign the electrica'l label Appi icant to sign and date lJhenever possible, the.in.i tial applicat.ion wi.l .l be used asa.worksheet only. Where possible, Bu.ilding Division Staifwill.prepare a type wr.itten copy and returi it to theapplicant at the time the actuai permit is issued for his s i gna ture. Fees and Charges PIan check fees are due and payable at the t.ime of theapplication, and no plans wiil- be processed unt.il thesefees are paid. All other fees and charges are due andpayable when the permit is jssued. FOR OFFICE USE ONLY III. IV. V Permit CIer PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY: Perm'it applicant exempt from registration with the Builder's Board because: Additional Project Information: r( PLANS REVIEWED BY: nane /on,/y'Z fx F-S $s'l gnature date 5- +-A)