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HomeMy WebLinkAboutPermit Sidewalk 1983-07-06ECTIi 37 69 L c0llBI AP RMIT Job Address .Lh v EIIERGY SOURCES: Hea l,later Heater Ran Sq. Fto. l''lain_ Sq. Ftg. Access._--- Sq. Ftg. 0ther_ _llew_AddrA l ter_Rep . _Fence_Demo Change/Use 0ther cog oo+t) l-egal Descri ption Val ue of l,lork 0wner Address 3.a-m-Phone 7 Bui l cii Farni I v nq Permit Info: Describe Work(' Residence l{ith Attached Garaqe ,€., Build Single Si ? o ^-,{rlConstruction Lender qqo' Addres s Phone DESIGN TEAI{name address exol res Primary Structura l El ectri ca I Mechan i ca I CONTRACTORS n ame addrpss'lics^ no.)PXOI res ohone no-' Ge ral J t () Pl umbi nq E l ectri cal l'1ec ha n i ca I PLUIlB I NG ELECTR I CAL MECHAN I CAL FFF CHARGF NN FFF NHARGF NO FFF Each single fixture furnace/burner to BTLI' s Relocated building (new fix. additional) New ci rcui ts al ts. or extensions Floor furnace and vent S. F. Res i dence ( l bath)SERV I CES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent qpna rafp llater service Chan resi ge in existing dence Stationary evap. cool er Sewer multifami ly, comm or I ndrr st-ri a I Vent fan with sinole duct Storm Sewer 0f amp s.Vent systenn a part from C.heatino or A COMI.I./IND. FEEDERS Mechanical exhaust hood and duct- InstaI I /aI ter/rel ocate distrih. feeders [,Jood stove/heater 0f amps ISSUANCF OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LlN REQUIRES that the Electrical work shall not be vali'l until the label has been signed by be done by an Electrical Contractor, the electrical portion of this pennit an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed application for oermit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the Cityof Soringfield and the Laws of the State of Oregon pertaining to the work described herein, and that NC OCCUPAI,ICY will be made of any structure without the permission of the Building Division. I further certify that m.y registration vrith the Builder's Board is in full force and effect as required by ORS 701,055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and ernployees who are in comcliance with 0i1S 701.055 rnrill be used on this project, t'lAtlE(please print)IGNATU Tb83' Zon P /Const Uni ts Ftg Ftg Ftg . l'lain x Value_ Fire Zone Bed rooms Load . Access x Val ue FIood Plain Group $q 0ther Val TOTAL VALUATION Stori es BUILDING PERI'IIT Charges and Surcharges Pl an Ck. Conrn,/ Ind 65%/Bldq Per Fee 1 Rq Plan Ck. Res 30%/Bldo Per Fee PLUI4BING PERMIT Charges and Surc ha rges Fence DBmo ELECTRICAL PERI|IT Charges and Surcha rges Sldewalk qb Eo A/C Paving Total Comb. Permit I,IECHANICAL PERMIT Charges and Surc ha rge s Curb Cut TOTAL $qb to Residence of sQ. FT. ue-_ 'sterns rarqe ( COMBINATION APPLICATION/PERMIT ( CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 43?. elaryrple- Lot 1. Block 3, 2nd Addition toSFFii!-fieta EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION I. example- heat/2. e'frfrFlE waterE. Square footage or electrical cei l in or forced air gas r solarterec0 C tzsvvai uati O0' l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add, etc. F . Bui lding permi t information:l. example - construct single family house with an attached garage ?. example - remodel existing garage into family room3. example - convert single family residence intoEiTIFant (change of-use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid design or construction delays, Bu.ild.ingDivision Staff must be able to contact appropr.iite persons regarding design information or job sitecorrections, etc, Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fiil-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Fu]I 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 onthe abbreviated schedules you should consult theful l schedulesC. BUILDING DIVISION STAFF WILL FILL OUI 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. Applicant to sign and date lJhenever possible, 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 gna ture. Fees and Charges PIan 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 I II III. IV v Permit Clerk 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 i gnature date