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Home My WebLink AboutPermit Plumbing 1980-11-26INSPECTION LiNE 726-37 69 CITY OF SPRINGFiELD COMBI NATION APPLICATION/PERMIT 7 Job Addr'ess l-ega1 Description Ranqe tlater Heater EIIERGY SOURCES: Hea t -)U Access._ Sq. Ftq. 0ther-- _l,lenR66-ql ter--Iep. _Fe n ce_Demo_C ha n gel U s e -other-- l'1a nSq. Ftg. Sq. Ftg. Value of l,lork 0wner DescritI Single'I el^lo rk (:dAddressPhone ---:rr Addre s s Phone name Pri ma Structura I Ii ectri ca I l-iechan'i cal PI umbi I ectri ca I ELECTRI CAL tJn FFF C HAPGF r.10 MECHAN I CAL CHAPCF PI-UIlB I IIG EE i CHARGE I iacn singie fixture Residence of FTSQ furnace/burner to BTU' s Relocateo bur'iding (nex fi x- addi ti onal ) New ci rcui ts al tsor extensions Fl oor furnace and vent S.F. Residence ( l bat-h)SERV I CES Recessed wal I Soacp hpatcr and vpnf Dupiex (l bath) each Additional bath Temporary Constructi on Apol iance vent seDa ra te 'viater :erv'r ce ge in existinEChan resi K Sewer mu I ti farni 1y, Industrial comm. or -Ea-q l er Stati onar-v evap Vent fan with sinole duct Storm Sewer 0f S. Vent system apart from heatino or A.C. c0Mr'!./rND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate d i stri h. fecders ['lood stove/heater 0f s. ISSUANCF 0F opq1111 TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE ST. shail not be ATE LAI.I REQUIvalil until RES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI1INED the completed application for oermit, and do hereb.y certi nformation hereon is true the 0rdinances of the City , il0 0CCUPAI'ICY will be made 'ation vrith the Builder'sis noted hereon, and thatonly subcontractors and employees who are in comcliance with 0lls 701 t'lAl'lE(please priht 74'ffaIGNA4; pe fe exemp 055 vri .T fy that al1 i and correct, and I further certif_v that any and allof Soringfield and the Laws of the State of Oreoon work performed shall be done in accordance lvith oertaining to the work described herein, and thatof any structure without the rm'i ss i on of the Bu i I ding Division. I further certi,'y that my registr Board is in full force and ef ct as required by ORS 701.055, that 'if t the basis for exemption 'I I be used s nroject Zone Bedrooms 0ccy Load Sq. Ftg. Access ts x SFlood Plain Stori es Cons t. Group TOTAL VALUATION- Val ue Value Val ue Zone Fi re r So. Ftq. f,lai q. Ftg.Other Plan Ck. Comm/Ind 65%/B1do Per Fee Svstems Deve Charqe (1.5% opmentBUILDING PERI'IIT Charges and Su rcha rges Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rge s fr Dgmo S i dewa.l kEL,ECTRICAL PERIlIT Charges and Surcha rges Total Comb. PermitA/C Paving Curb CutMECHANICAL PERMIT Charges and Surc harges TOTAL loo r \qz,ff) ")constl'uc{lon Lender I I tAt.1 arldress )one no - I inc vr^t|..,,::::n as!e addrpsc nhnnc nn \ffl ll -\- COMBINATION APPLICATiON/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County l,lap Reference 17 03 43?. example- Lot 1. Block 3, ?nd Addition toSpringfield EstatesC. Name, etc- of owner and construction lenderD. Energy Sources 1. example- heat,/eiqqtrical ceiling/or forced air gas 2 . e La m tl-e - wa t e rh--e a teEElEETil cil7o r s oTaF-E. SquareT6otage or vaiuation, etc.1. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, .check aod, etc.F. Building permit information:l" qEIsLq - construct s'ingle family house with an attacned garaEe 7. examole ." remodel existing garage into familJr rooin3. example - convert single iaiily-residence inio resEaurant (change of use)G Value of wo!k as defined in Section 303 (a) of the H Structural Specialty Codr: DESiGN TEA|I AIID CONTRACTORS To avo'id clesign or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or" job sitecorrections, etc.II Abb: {-:viated Plumbing, i!'lechanical, & Elect|ical Schedules.fi" !-xcept qhere blank spaces occur in the description:3rtion of ihe Mechanical and Electrical Schedules,:ne appl.icanr neeC fill-in only the l,lo. Boxes adjacent'ic the appropriate item(s) to be installedS.. Full Plurnbing, l',1echanical, and Electrical Schedules are available at the Building Divisiorr1. To ccnserve 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 the fu'l I schedulesC. BUILDING DiVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the Iabel must be delivered to theelectrical contractor for signature by his electr.icalsupervisor. The general contractor is not authorized III to sign the electrical label APpl'irant t-? 1if,. :l",il-date Hhenever possibie, the initial appiication wi'll be. used asa worksheet only. l,Jhere 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 Charqes Plan check fees are due and payable at the time of theapplication, and no plans will be processed until these fees are paid. All other fees and charges are due andpayable when the permit is issued. V. FOR OFFICT USE ONLY PERMIT VALIDATION *tbal'l \ Permit Clerk 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 Si g nature date