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Home My WebLink AboutPermit Electrical 1990-04-06TION LIIiE 69 I,IECHANICAL PERMIT Charges and Surc ha rge s CiTY OF SPRINGFIELD COHBI IIATI ON APPLICATION/PERMIT Job Address T Legai Description EIIERGY SOURCES Hea l,later Heater Ra . t'td Sq. Ftg. Access._ Sq. Ftg. 0ther_ _!,lewJddJl ter_Pep. _Fe nce_Demo_Change/ U se 0therVal ue of l.lork( aou eA S f ,truestrne,nf s Jn c , Owner Addres s I Phone Builci in Fami l y q Permit Info: Describe llorl Residence I'lith Attached Garar {i..., Build Single l Construction Lender Iii Addres s Phone DESIGN TEAI.I name address ohone no. Pri ma ry Structura I E I ectri ca I Hechanical n ame address I i cs. no.exDt res nhonp no- Genera i Pl umbi nq ctn i $T r1 PLUI.IB I NG ELECTR I CAL MECHAN I CAL FEE CHARGE N0-FFF CHARGF NO FFF .IIAPGF Each single fixture Residence of SQ FT furnace/burner to BTU' s Relocated building (new fix. additional) New circuits alts. or ext?nfionr *gdirlq Floor furnace and vent S. F. P,esidence ( I bath)SERV I CES Aoo[ \qt )5L Recessed wal I Sne.p hp:tpr and vpnt Duptex (l bath) each Additional bath Temporary Constructi on Apol i ance vent seDa ra te I.later servi ce Change in existing rps i dence Stati onar.v evap cool er Sewer multifamily, comm 0r Indrrstrial Vent fan with s'inole duct Storm Sewer 0f .amp s.Vent system apart from heatinq or A.C. COMI.I./IND, FEEDERS Mechani ca l exhaust hood and duct instal I /a l ter/re1 ocate di<trih. fepders l'lood stove/heater 0f amp s. ISSUANCE OF PFRIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE L.lN REQUIRES that tlte Electrical wo shall not be valiC until the label has been signed rk be by an done by an Electrical Contractor, the electrical portion of this permit Electrical Supervisor and returned to the Build'ing Division the comp I e ted app on r DE rm1 t a nd do he re by ce rt 'I fy tha t a I n forma t i 0n he reon 'I s t ru a nd c0 rrec Spri ng f any str rd is iy subco t and I fu rth e r ce rt '|fy t ha t any and all work of Oregon oerta of the Bui1ding uired by ORS 701 perfo rmed sha I I be done 'I n ac co rdan ce wl th t he 0rd i na nce s of the City be madefteIdandtheLawsftheState1n'I n g to th e wor k descri bed he re 'I n and tha t NC OC CUPAI'ICY wt 1 I f 'ucture without the permiss n full force and effect as rntractors and employees wh 'I n D 'I 'I S 'I 0n I fu rt he r ce rt 'i fy tha t m.y re g 'i s tra t 1 on vrith the Builder ,ted hereon, and 37A3 5 S Boa req 055 t ha t 'I f ex emp t th e ba s ,l s for ex empt 'I 0 n I s no tha L n I are I n comD I i ance wl t h 0l?S 707 0 55 l{l I I be us ed on th I s p ro,j ect l,lAl.lE( p1 ease print)f IGiIATURE DATE Zone Tyoe/Const. Units Sq.Ftg l'la i n lue Fire Zone Bedrooms 0ccy Load Sg. Ftg Acces s 0the r x Val F'lood Pl ai n Stori 0c c.y Grou lue TOTAL VALUATION 5q. Ftg BUILDIIIG PERMIT Charges anC Su rc ha rges Plan Ck. Corm/Ind 65%/8ldq Per Fee Svs Cha ter,ls Deve rqe ( 1.52 opment PIan Ck. Res 30%/BIdq Per Fee PLUI4BING PERMIT Charges and Surcha rges Fence D6mo ELECTRICAL PERI1IT Charges and Surcha rges Sidewalk A/C Pavi ng Total Cornb. Permit Curb Cut KTOTAL :TORS 3q coMBrNATr0N AppLTCATI0N/PERMIT (CAp) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. glglglg Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION I. example- heat/electrical ceilino/o2. examplE- waterEEaTEiTEfEitrJGl7br Square footage or valuationlEE.l. example- 1250 sq. foot house, 5002. ExampTF if new project, cheik-new check add, etc. r forced air gas E ' solar sq. foot garage - if addition, II F. Building permit information:1. example - construct single fami)y house with an attached garage2. example - remodel existing garage into family room3. exampie - convert single family residence into iElTEuFant (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 appropr.iitepersons regarding design information or job s.itecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedu'les,the applicant need fill-in only the No. Boxes adjaientto the appropriate item(s) to be installedB. FulI Plumbing, Mechanical, and Electrical Schedulesare available at the Building Divisioni. To conserve space on the permit form the schedules have been abbreviated?. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labe'l must be delivered to theelectrical contractor for signature by h.is electricalsupervisor. The general contractor .ii not authorizedto sign the electrical labelApplicant to sign and date l,lhenever possible, the initial applicat.ion will be used asa.worksheet only. Hhere possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. AII other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III lbbtT IV V Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s'ig nature date +V