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HomeMy WebLinkAboutPermit Building 1987-07-28. CC)MBI IiATI OI.I APPLI CATION/PERMIT 7 Job Address a, Ran qe l^,later Heater EIIERGY SOURCES Hea t l-ega1 Description ov-2 8a Owner Value of l,lork:9q.ffin !q. Ftg. Access._ Sq. Ftg. Other__ _liewrAddrql ter_Rep. _Fence_Demo_Cha n ge/ U s e 0ther Sq. Fto. l'1a r\ddress I n-4 Phone ng Permit- Info: Describe t^lork(i.e., Build Single Residence l,lith Attached Garaqe) Bui I cli Fami'ly3{//SL,b 3 a aa N N\-N Construction Lender /: Addre s s Phone tr/- DESIGN TEAI.I name addre s s CS. NO exDr res ohone no- Primary Structura I El ectri ca l Mechanical A name a ddres s 'l ics. no. ) (expires)ohone no. IPl umbi nq El ectri cal Itlechanical PLUI,lBI NG EL ECTR I CAL MEC HAN I CAL NO FFF CHARGF NO FFF THARGF Nn FFF CHARGF /Z Each single fixture 7sb 7a,-oI I Residence of FTSQ furnace/burner to BTU' s 3* Relocated building (new fix. additional)New ci rcui ts al ts. or extensions22rq iaerl€ Floor furnace and vent S,F. Flesidence(l bath)SERVICES Recessed wal i Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDa rate [,later servi ce Change in existing resi dence Stati onar.y evap cool er Sewer IndustniaI multifamily, comm. or /Vent fan with sinole duct -rv1 Storm Sewer 0f .amp s.apart from .L. Vent systern heatinq or A COI,II.1,/ IND. FEEDERS l,lechanical exhaust hood and duct Insta l I /al ter/rel ocate distrib. feeders l'lood stove/heater 0f amp s.A <zzn Dx>uzan 7/1 6. ISSUANCF OF PFRII,IIT TOTAL CHARGES 2?-s-TOTAL CHARGES /Vby. /S o' l,lHERE STATE LAI'I REQUIRES that theshall not be vali,l until the label has Electrical work be done by an Electrical Contractor, the electrical portion of this permitbeen signed by an Electrical supervisor and returned to the Buildinb Division TOTAL CHARGES I HAVE CAREFULLY EXAI1INED the and correct, and I further certifvof Springfield and the Laws of theof any structure without the permi Board is in full force and effect only subcontractors and ernployees , I work performed shall be done in accordance with the 0rdinances of the cioertaining to the work described herein, and that NC 0CCUPANCY will be ma llAl.'lE(please pri nt)S iGNATURE 76ED,5R TE ty de 55 completed apnlication for permit, and do her'eb.v certif.y that all information hereon is truethat any and a1 State of Oregon further certify that m.y re-oistration r.rith the Builder,sssion of the Buil ding Division. I as recluired by oRS 701.055, that if exempt the basis for exemption is noted hereon, and thatwho are in comcliance with OPS 701.0 'I i be used on this Tyoe/Const. {-/v Unlts Yalue 251 ood, x ry 0c cy Load 0c c.y croup B- 2 Sq Sn Ftg Flood Plain S tories / TOTAL VALUATION-_--7 Zone f'la i n Value Val ueFire Zone Bed ro oms Ftg. Acces Ftg. 0ther PIan Ck. Cornm/Ind 65%/B1dq Per Fee / / 0,83 ?-t5$',o pmen trS vs Cha I ) tems Deverqe (1.52 /y4.BUILDING PERTIIT Charges and Su rcharges f,o Plan Ck. Res 30%/B1dq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges AD /Demo Sidewal kELECTRICAL PERIlIT Charges and Surcha rges ---?3.25"--A/C Paving Total Comb. I'ermit Curb CutI,IECHAI'IICAL PERMIT Charges and Su rc harges 6-A 75 TOTAL 3/2.7/ COMBINATION APPLICATiON/PERMIT (CAP) I. Appf icant to furnishA. Job AddressB. Legal Descniption l. exampje- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. exampl e-2. exampl e- Square footag heat/electrical ceiI in r forced air gas sol arl^/a te ea ter e ec tr ca 0r E e or valuation, e II 1. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add, etc.F. Bui lding permit informatjon:1. example - construct single family house with an attached garage 2, example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. Abbrev'iated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occulin the descriptionportion of the Mechanical and Electrjcal 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 the ful I schedul esC. BUILDING DiVISION STAFF t^IILL 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 authorjzedto sign the electrical label Appl icant to sign and date Whenever possibie, the initial app)ication will be used as a worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actuai permit is issued for his signature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wi l1 be processed untiI these fees are paid. All other fees and charges are due and payable when the permit is issued. III IV V. FOR OFFICE USE ONLY PERMIT VALIDATION lBbr 615' 1- )g'8/) Permit Clerk PROJECT CONDITIONS TO BE SATiSFIED BEFORE OCCUPAI'ICY: Permit applicant exempt from registration with the Builder's Board because: Addi t'ional Project Informati on : PLANS REVIEI,JED BY: name sig nature date .?) L COHBI AP IT { 5 \ \ Job Address Legal Description Value of Ranqe -. FtqJ'laln-ll !q. Ftg. Access.-1 I sq. rtq. other I | _H."_rladjl ter-rP6'p. -{ _--Fence_oemo_Change/ U seI other t-t_Owner Address Phone 3 :e., Bu'i 1d Single Fami I n @ Construction Lender Addres s Phone // DtSIGN TT.AI4 name address 'I CS. nO.exDt res (phone no. Pri mary Structura I qtfLJ /-<rt/l El ectri cal Mechani cal Ge PI nical PLUI{B I NG ELECTR I CAL MECHANICAL FEF CHARGE NO FFF CHARGF NO FFF /Z Each single fixture 7,t>t a7a.:o Residence of furnace/burner to BTLI' s 2"2Fc Re'located buildinq (new fix. additionai)New circuits alts.or extensions2?r4 ^2a)4E Floor furnace and vent S.F. Residence(l baLh)SERV ICES Recessed wal I SPace heater and vFntDuplex (l bath) each Additional bath Temporary Constructi on I iance vent l.later servi ce Change in res i dence ex i sti ng Stationary evap. coo i erSewermultifami Industria ly, conrn. or I /Vent fan with sinqle duct 3-"Storm Sewer 0f 'I Vent tSsy fromrtapa c0r4H./IND. FEEDERS Mechanical eitriulT-- hood and ductInsta I I /a I te.Tiet ocitE-distrib. feeders l'Jood stove/heater 0f s. /C'v.t c O ISSUANCE OF PFRIIIT TOTAL CHARGES 2 D>IOTAL CHARGES its Ftg Ftg Ftg Flood plain Stories ry Value Iue TOTAL VALUA stFire Zone . l,lain Acces s 0ther an ck Conun/ BUILOING PERIII Charges anC Su rcha rges T ).1.5/, opment FenceE PI.UI48IN6 PERMIT Lnarges and Surcha rges o'a Demo Sidewa I k-.j-> Tota l Cornb . Perynit A/C paving Curb Cut €e >g IOIAL 3 /2,7/ CAL and IlECHANI PERMIT k EIIERGY SOURCES:Heat- \,later Heater sQ. rr. TOTAL CHARGES Load e- -Jq. c"orp__6-3_sq. _/?_o_,_z?__ ?2 --- -- a __19_ ELECTR ICAL Charqes andSurcha rges PERI,'I T Y .a I I PERMIT VALIDATION Permi t Cl erk lfl br b q5 " 1')g'8/) COMEINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. if* OreO; Tax Lot 100, Lane County Map Reference 2. gxample- Lot_1. Block 3, Znd Addition toSprTffiield Estaiei-" !. Name, etc. of owner and construction .lender0. Energy Sources l. example- heat/2. example- water Square footage or1. example- 1250 sq. foot house, q0! sq. foot garage2. example- if-new project, check-new - if aadition, Efieck-add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction de)ays, Building Div'ision Staff must be able to contact appropriate 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 fill-in only the No. Boxes adjacentto theB. Ful I Pl appropriate item(s) to be installed umbing, 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 shouid consult the ful 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 the e'lectrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical Iabel. Applicant to sign and date l,lhenever possibie, the initial application wiII be used as a worksheet only. t,lhere possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnature . Fees and Charges Plan check feis are due and payable at the time of the application, and no plans will be processed until these tbls are paia. All bther fees and charges are due and payable when the Permit is issued. FOR OFFICE USE ONLY air gas E II III IV. V PRoJECTCoNDITIONST0BESATISFIEDBEF0RE0CCUPAI.ICY: Permi t eSaucdrberdeSBoa'lBu It1thehoiWn1rttaSfromtregtexempan1cIapp Addi t'io nal Proiect Information: PLANS REVIEI^IED BY: date si gnature name ?