Loading...
HomeMy WebLinkAboutPermit Building 1985-05-13L _-____TTTTO-S P RING F I E L D COHBI i{ATI ON APPLICATION/PERMIT u- Legal Description Job Address Hea EIIERGY SOURCES: Ranqe llater Heater a Sq. Ftg. Access._ Sq. Ftg. Other_ l.lew Add A l ter P.ep . -0ther-FenE6 Derno Change/ Use Ftq. f'lai Value of llork:fu,*0wner .e., Build SingleBuilciinq Permit Info: Describe Farni I y Res i dence l'li th Attached I l^lork ( Ga raqeAddress-.*ucn\Z?G*g7po.7 fr%Tti'.Be tUar* 70Construction Lender rt e4 U UI { 2ry7<€ BA/12/r%.Addre s s Phone res ohone no.I ics. no.exDaddre s sDESIGN TEAM name Pri mary Structura I El ectri cal llechanical ( cxni res )icq- no- )ohone no-add res slACTORSname Pl umbi nq El ectri cal I'techani cal ELECTR I CAL MECHAN I CALPLUIlB I NG FFF l^HAACFFFFCHARGFNnFFFCHARGFNO Residence of SQ. FT. furnace/burner to BTU' sEach single fixture Floor furnace and vent Relocated building (new fix. additional) New circuits alts or extensions Recessed wal I Sn:ap hpitcr and vpnt S.F. Residence(l hath)SERV ICES Duplex (l bath) each Temporary Constructi on Apo) iance vent seDa rateAdditional bath rcc i dcnre Change in existing Stati onar-v evap cool erfo'l.later serv ice /d,'o Indrrctrial multifamily, conrn. or Vent fan with sinole ductSewer /5nStorm Sewer I 0f lCA Vent systern apart from heatinq or A.C. hnod and drrct Mechanical exhaust/fi&,qstow Der,2<€so'COI,III./IND. FEEDERS Instal I /ai ter/re l ocate di stri b- feeders llood stove/heater amps0f ISSUANCF OF PFRIIIT TOTAL CHARGES ls'"TOTAL CHARGES /s'o TOTAL CHARGES l.lHERE STATE L.ll,l REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernitshall not be vali'l until the label has been signed by an Electrical Supervisor and returned to the Building Division and do hereb.v certify that all information hereon is truehall be done in accordance with the Ordinances of the City work described herein, and that NC 0CCUPAIICY wil'l be madefurther certify that my reqistration vrith the Builder'sf exempt the basis for exemption is noted hereon, and that .055 wilI be used on this Droject. DA.TEJI TJ.9I 'l{Al.tE(please print S IGi,IATURE of any Board e ca trmrforonapl")comp DCtc0 rrecand an d cerfurther ti ttha a oerfowork srmedandfy efi d thand La ofws Statheof any ofngteSpri rta n n thetooe0regonsructtwluretthouhetn0permSStheofBudV]Di s 0nng s fu force nd ffec t uas red ORS 70t 55 tha treclby SU tracbcon rsto nda sv arewho n ance thwl 7ot0l?sempoyeecomD FireZoneBedrooms0ccyLoadSq.Ft9.AccessxValue- Flood Plain Stories 0cc.y Group F-? Sq. Ftg. Otn""lfCtcWaraz&rry Uu1r. ?atG) .. TOTAL VALUATIOH Zone_--X?-4__rype/Const. r*/! un its Ftg . l'la i Value Plan Ck. Corrn/Ind 65%/Bldo Per Fee Svstems Deve charqe (1.57 opmentBUILDING PERI'IIT Charges and Surcharges ob ./d Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surc ha rges --.4-floo____t Dgmo SidewalkELECTRICAL PERI1IT Charges and Surcha rges ao -€a Total Comb. Permi tA/C Paving Curb Cut I,IECHANICAL PERMIT Charges and Surcha rges TOTAL {/;a n- COMBINATION APPLICATiON/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptr'on l. glaTplg: Tax Lot 100, Lane County Map Reference17 03 432. gxarlplq- Lot l. BIock 3, 2nd Addition toSpringfield Estatesq. Name, etc. of owner and construction lenderD. Energy Sources l. examp]e- heat/electr.ical ceilinq/or forced a.ir oas_ ?. exampje- waterrreitEiZeT6dtFTEi7o" ,offit. Square f ootage or vai uationlEE- l. glgrq].- 1250 sq. foot house, 500 sq. foot garagez. example_.if new project, check-iEw _ if additio;,EIEI-f-dd, etc.F. Building permit .information: 1. C1]lp]S - construct single family house with anattached garage 1. llgrpJ" - remodel existing garage into family roomr. exarlpte _ convert single family residence intorestaurant (chanqe of use)G. Value of work as defined in iection 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CON1RACTORS To avoid design or construct.ion de.lays, BuildingDivision Staff must be able to contatt appropriitepersons_regard.ing des.ign information or job iitecorrections, etc.II. Abbreviated plumb.ing, Mechanical, & Electrical SchedulesA. Except where blink spaces ociri in the a;;c;i;ii;;--portion of the Mechanical and Electrical Schedulei,the appticant need fiil-in on.ly the no. aoiei-iajaient _ to the appropriate item(s) to be installedB. FulI Plumbing, Mechanicil, and Electrical Schedu.lesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated2. If the .item(s) to be insta.lled are not covered onthe 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 ii not autnor.izeato sign the electrical labelIII. Applicant to sign and date llhenever possible, the initial application wi.lI be used asa.worksheet only. Where possible, Building Divisio, Staiiwill prepare a type written copy and return it to theapplicant at the time the actuai permit is issuJJ io" f,issignature.IV. 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. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION Perm'it Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name Lqxa s'l g na ture oate S