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Home My WebLink AboutPermit Plumbing 1988-06-28PECTION L -37 69 NE CITT OF SPRTNGFIELD COMBI NATI ON APPL ICATION/PERMIT 726 Job Address *q 3( Legar Description l-? A3 3- 3A ObqAl lJater Heater Ran EIIERGY SOURCES Hea t 0wner tr..)o \tro,. BazntLu,-, Ar-to lr-\rect-i*. Val ue of l,lork Sq. Ftg. Access._ Sq. Ftg. 0ther-- _l{ew_Ad d____.1A i te r_Re p . _Fence_Demo_C hange/ U s e 0ther nq. Ftc BU'i Farn i ng Pernri t I nfo: Descri be l^lork ( v Residence trlith Attached Garaqe re. r Build 5ingleAddressIPhonea.+G s. tGrL b' .J'er^>o--r U:r-- Construction Lender dD (,tt 6- \ Addre s s Phone lics. no.exoi res ohone no - Pri mary Structura I 4\otg:EI ectri can UMechani ca'! ACTORS (marnre 'I CS. nO.exDl res ohone no. Genera I PI I 1b (a-s l.techani call P[UFI&TITIE ELECTRI CAL MECHAN I CAL FrI C.HARGF NN FFF l^ AACF NO FFF CHARGF Eacle simgtre fixtr:rre Residence of FTSQ furnace/burner to BTLI ' S Rel ocate.d turindinq (neu f.ix- additT-dan) New ci rcui ts al ts. or extensions Floor furnace and vent S.F. Residemce(I baflh)SERV I C ES Recessed wal I Soace heater and vent Duplex (1 hatltn) each Additionall bat,ln Temporary Constructi on Apol iance vent seDa ra tp l,latel serv:ice in existingChange res i de nce Stationary evap. cool er 3d Sewer OAgCI €oe multifamily, cornm. or I ndus tri a I Vent fan with sinole duct Storm Seuen 0f Vent systern apart from heatinq or A.C. c0Mr'1./rND. FEEDERS Mechanical exhaust hood and duct Instal I /al terlre1 ocate d i st-ri h- feeders ['Jood stove/heater 0f ISSUANCE OF PFRI1IT oL) TOTAL CHARGES \:)TOTAL CHARGES TOTAL CHARGES WHERE STATE LAIJ REiQUIRES that the Electrical work shal I not be val l-C lr,mit'rr'll the label has been signed by be done by an E l ectri ' an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division Ci ty madengfieid amd struct'ure vi 0reoon the Bui fyof any Boa rd perm ffect -2r# het eted 'I1 atc 0'I forn I t and do he re ertc 'I acompDapDermth aI II n onrmati 'Ihereon truesb.y fy ,Iand cifur"ther Icorrectandert tha at a and 1I kw0r rformed has II n'Ifynydonebe ccoa cerdan thwl het naOrdi ofnces hetpe of S t&e ofLaws Stathe ofte 'Irta 1n to kpriethwor 'Idescr herebed n'I and hat NCt OCCUPANC'Iwl beIpeng s1 'Is ofon d1 n'|D 'I sI 'I n rIttfrolrthee c lert ttha s'I rat 0nti thvtI Buthe I1 rfurthregmy Sde s1 fun'lm 1 f,orce eand a red ORS,l 7 g 0 055 I frequthat bathe 'Is fors t oI '|n noteds reonhe tha tandbyexemptexemp 0n s andubcontractons n 'II aarewhos1y nce thwl 7o0t?s i 505 II.l I beI sedu n0 tecIcomDproj 66INAI'1E I asee(p pri iGNAS TURE DATE Ftg Ftg Ftg Val ue Value TOTAL VALUATION- x Val ilpFire Zone Eed rooms 0c cy Load Sq Fl ood Pl aln Stori es 0cc.y Grou Const. UnitsZone .l'lai . Access . 0ther PIan Ck. Comm/lnd 65%/B1do Per Fee Svstems Deve Charqe (1.51 opmentBUILDING PERI'IIT Charges and Surcha rges PIan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges 0) 6A Demo Sidewal kELECTRICAL PERTIIT Charges and Surcha rges A/C Paving Tota'l Cornb. Permi t Curb CutI,IECHANICAL PERMIT Charges and Surcharges e/OaTOTAL COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17-TT rt-: 2. example- Lot 1. Block 3, ?nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. exampl e-2. exampl e-E. Square footag hea t/e I ca I in or forced air gas wa e or soTar e or vaiuat oD' 1. example- 1250 sq. foot house, 500 sq. foot garage2, exampje- if new project, check new - .if addition, check add, etc.F. Building permit information:1. example - construct single family house w.ith an attached garage 2. example - remodel existing garage into fam.ily room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Speciaity CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Div'ision Staff must be able to contact appropr.iate persons regarding design information or job sitecorrections, etc.II. 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 adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. 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 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 contractor is not authorizedto sign the electrical iabel.III. Applicant to sign and date Hhenever possibie, the initial application will be used asa worksheet only. l,lhere 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 gnature. IV, Fees and Charges Plan check fees are due and payable at the time of theapplr'cation, and no pians will be processed untii thesefees are paid. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY PERMiT VALIDATION anos,er * // st/ Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI,ICY: Permit applicant exempt from registration w'ith the Bujlder's Board because: Additional Project Information: name sig nature date PLANS REVIEWED BY: