HomeMy WebLinkAboutPermit Demolition 1980-04-14INSPECTION LiNE
726-37 69 Cc)14B I CATI ERMIT 726-3753AP
Job Address
l-ega1 Description
Hea
Rancle
EIIERGY SOURCES
l,later Heater
\)
0wn
Value of l.lork:\\,i A
Access..-
Sq. Fto. 0ther--_
l{ew Add--Al ter Pep.
-rence(ffi\hanqe/Use0ther.-
Sq. Fto. l'lai
5q. Ftg.
Addres s Phone e., Build SingleDest
ence trii th AFarni
u I^]ork
Ga
Constructi on Lender I t/\ rnr rI If,\F{\
Phone
w
DE5lGN TEAI.I name address 'I ics. no.exD l res phone no.
Pri
Structural
El ectri cal
l'lec han i ca I
CONTRACTORS n ame address )lrcs- no. ) (expires phone no. )
Pl umbi nq
El ectr.ical
tlechanicaI
PLUIIBI NG MECHAN ICAL
N0.FEE CHARGE NN FFF CHARGF NO FFF CHARGF
Each single fixture Residence of
FTsQ
furnace/burner to
BTLI ' S
Relocated buiIdinq
(new fix. additional )
New ci rcui ts al tsor extensions
Fl oor furnace
and vent
S. F. Fles i dence(l bath)SERVICES Recessed wal i
Soace heater and vFnt
Duplex (l bath) each
Additional bath Temporary Construct'i on Apol iance vent
sepa rate
l,Iater service e in existing
ence
C hang
resid Stati onar-v evap
cool er
Sewer Industnial
muitifamily, comm. or Vent fan with
sinole duct
Storm Sewer 0f S
Vent systern apart from
heatinq or A.C.
\Quurgl-c0r,1r!./IND. FEEDERS Mechanical exhaust
hood and duct\n(()Instal I /al ter/rel ocatedistrib. feeders l'Jood stove/heater
0f s.
ISSUANCF OF PFRI1IT
TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES
Group
s
r
L
nd
Fee
x eFire Zone Bed r00ms
X
0c cy Load
Val
I b.y
e
be
P q
I
ts
ED the comp eted apnl icat on for Dermit, and do here certify that a 'information hereon is t, and i further ruecertifv that anvof the State oi
and all work oerformed shall be done i n accordance with the 0rdinances of the City
NC 0CCUPAI'ICY will be made
eld and the Laws oregon Dertaininq to thethe Building Division. I
urork described herein, and thatcture without the oful.l force and efi,
ermi ssion of further certify that my regist ration with the Builder'sect as requir ed by ORS 701.055, that if the basis for exempti on i s noted hereon, and thattractors and ernpl oyees lvho are i n comcliance with Oi?S 701.05
xempt
5 wilI n this project
4tt4 '" L--{(/zIGNA DATE
Val u
Re
Pe30i6BI
WHERE STATE LAN REQUIRES that the Electricshall not be valil until the label has been si
al work be done by an Electrical Contractor, thegned by an Electrical Supervisor and returned to
electrical portion of this permit
the Building Division
tems
rge
Deve
I.5.1
0pmen
Cone/Ls
TOTAL VALUATION=.-
F]ood Plain Stories al ue
Pl an
P'lan Ck
Zone
BUILDING PERTIIT
Charqes and
\UlChtrges
Ftg. Access
Ftq. 0ther
Ftg. l,la in
and correctof Springfir
of any stru,
Board is in
only subcon
I'lAt'lE ( pl ease
FencePLUl,tBiNG PERMIT
Charges and
Surcha rges Demo
Sidewal k
L-
ELECTRICI.L PERIIiT
Chorges and
Surcharges A/C Pavinq Total Cornb. Permit
Curb CutMECHANICAL PERI,IIT
Charqes andti , '..- '. I r-::-..:IOiN L ll 40
Addres s
ELECTR I CAL
\
PERMIT VALIDATION
CITY OF SPRINGFIELD
Ciry Holl
Springfleld, Oregon
Deportment of Public Works
i OFFICIAL RECEIPT
Dlo. B 532S9
COI'|BI NATION APPLI CATION/PERMI T ( CAP)
I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County lrlap ReferenceI7-I3-q32. gxarlple- Lot 1. Block 3, Znd Addition toSpringfie)d Estates
Name, etc. of owner and construction lender
Energy Sourcesl. exarnole- heat/electrical ceilinq/or forced air oas2. exarn: I e- waterheaTErTEGctiJZi-l r so-lar-
I examole- 1?_50 sO. foot house, 500 sq. foot garagez. examole- rt new pro;ect, check new _ if addition,check add, etc.
Bui )di'ng permit information :1. example - construct single family house w.ith anattached garage
?. exan:p]e - remodel existing garage into family roomJ. example - convert single family res.idence .into
restaurant (change of use)
Value of work as defined in Section 303 (a) of theStructural Specialty Code
DESIGN TEAI.I AND CONTRACTORS
To avoid design or construction delays, Bu.i ldingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrecti ons , etc.
?.
c
F.
u.
h.
9
ved For
Ii. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except vrhere blank spaces occur in the descr.iptionportion of the Mechanical and Electrical Schedules,the appl icant need f.i I l-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanicai, and Electrical Schedulesare available at the Building Div.ision1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUiLDItiG 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
Whenever possible, the initial application will be used asa worksheet only. Where possible, Building Division Staffwill preoare a type written copy and return.it to theapplicant at the time the actual permit is issued for his
si gnature.
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 vrhen the permit is issued.
V. FOR OFFICE USE ONLY --
PLANS REVIIWED BY
unl Received
AUTHORIZED
EUGENE OR 97'01
(
Perm'i t Cl erk
I L
From
PROJECT CONDITIONS TO BE SATiSFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registration with the Bu'ilder's Board because:
Addjtional Project Information:
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name s 'i gnatu re da te
(
(.
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