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Home My WebLink AboutPermit Mechanical 1981-10-01TION LINE 69 CITY OF SPRINGFIELD COI,IBIIIATION APPL ICAIION/PERMIT ELECTRICAL E l ectri ca I llechanicaI PLUI{B I NG MECHAN I CAL Job Address r-esa1 Description /7 -AB* 3b -;q TL, €@ Ran EIIERGY SOURCES Hea t Val ue of tlork . Ftq. llain_ Sq. Ftg. Access._.-- Sq. Fto. Other__ _!,lew_AddrAl ter_Pep . _Fence_Demo Change/Use 0ther Owner \o76 T$o .e., Build SingieBur-li-nq Pernii t I nfo: Descri be tJork (' Family Residence l,lith Attached Garaqe.Addr6ss PhoneGs-iltVttr Waon S-rnvE Construction Lender Tb Sl. De \N Addres s Phone exnl res ohone no.'I ics. noDES I GN TEAI.I name (address Pri mary Structura I E i ectri ca I llechan ica l n I{0 CHARI],FCHARGENOFFFNO furnace/burner to BTU' sEach single fixture New c'i rcui ts al ts or extensions Floor furnace and vent Relocated building (new fix. additional) Recessed wal I Snacp hpaipr and vpnt S . F. Res i dence ( I bath)SERV I C ES Temporary Constructi on Apol iance vent seDa rateAdditional bath ge in existing dence Chan res illater service multifamily, Industri a l co[m. 0r Stationary evap cool er Vent fan with sinole ductSewer Vent systern apart from heatino or A.C.Storm Sewer .amp s.0f Mechanical exhaust hood and ductcoMr.t./rND. FEEDERS Instal I /a l ter/re.l ocate dictrih- feeders /l,lood stove/heater EoO -amps0f TOTAL CHARGES TOTAL CHARGES /s.@TOTAL CHARGES HHERE STATE LllJ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernit shall not be vali'l until the label has been signed by 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 a'll work oerformed shai'l be done in accordance with the 0rdinances bf the Cityof Soringfield and the Laws of the State of Oregon oertaining to the work described herein, and that tlO 0CCUPAI,ICY will be madeof any structure without the permission of the Building Division. I further certify that m.y reqistration with the Builder's Board is in fuli force and effect as required by ORS 701.055, that i only subcontractors and ernployees who are in compliance with ORS 701 l.lAl.lE ( pl ease pri nt )S on f exempt basis for exemption noted hereon, and that s Droj Zone l'la i n Val ue ToTAL VALUATI0N==._--- ?,(r)F0n x x Tyoe/ Con s t 0c cy Load SqFire Zone Be drooms USE T,TY al ue ValueAccess 0ther ts So Ftg Ftg FtgFlood Plain Stories Occ.y Grou Plan Ck. Conrn/Ind 65%/Bldo Per Fee terns o pmen tBUILDING PERMIT Charges anC Surcharges Plan Ck. Res 30%/Bldq Per Fee FencePLtJt4BING PERMIT Charges and Surcha rges DBmo Sidewal kELECTRICAL PERI|IT Charges and Surcha rges A/C Paving Total Comb. Permit Curb CutI,IECHANICAL PERMIT Charges and Surc harges ./6-o-o t loo 9/€, rooTOTAL liater Heater pYnr rpq ( r\honp no( addrpssCONTRACTORS CC'FFF Residence of s0. FT. Duplex (l bath) each ISSUANCE OF PFRIIIT /b,Og COMBI NATION APPLI CATION/PERMIT ( CAP) I. Appl icant to furni shA. Job Address B. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toS[ffiTietd EstaresC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. exampl e- heat/2. EII66]E- waterE. SquaiETi6Gee or 'I li forced airor so ar val uat on, etc II 1. examp-le- l3!!. sq. foot house, 500 sq. foot garageZ. example- if new project, check new - if add.ition, check add, etc.F. Bui)ding permit information: 11. example - construct single family house with anattached garage ?. example - remodel existing garaqe into family room3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc, Abbreviated Plumbing, Mechanical, & Electr.ical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjaientt0 the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare 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 orrthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labe] must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical iabelApplicant to sign and date Hhenever possible, the initial applicat.ion will be used asa worksheet only. Where possibie, Building Div.ision Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gnature. Fees and Charges Plan check fees are due and payable at the time of theapplicat'ion, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY : 'a 1 t : a :, , '| ' ,i : III IV. 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'l g na tu re date /O -/- y/ !q IIISPECTIOII LII]E 726-37 69 CITY OF SPRINGFIELD COI1BI iIATION APPL ICATION/PERMIT INFOfflATION LlNI 726-3753 Job Address l.iater Heater Ranqe EIIERGY SOURCES Hea t Va l ue of l.lork: So. Ftq . l.la i n Sq. Ftg. Acce Sq. Ftq. 0the tt- rrIEf[EEl- _Change,/ U se -0ther- l,ler.r Add A -Fence Deto l-eoal Description Owner :\D e., Build Single arni l n c rk ra.t l.l iAddressPhoneCOf Ni lYrrr Waoo SrnvE Construction Lender &' .-Izr ut€-): DOtb S\ De \N Addre s s Phone DESIGN TEAII name addre s s exo i res eno Primary Structura I ( I El ectrical !'lechanical n ame add rps s I(lics. no-)PXnt res (honp no- )CONTRACTORS I IE I ectri ca I CHARGE NN F'FF ELECTR I CAL NO FFF PLUtlB I NG MECHAN I CAL CHARI]F Each single fixture Residence of FTsQ furnace/burner to BTU' s Relocated building (new fix. additional ) New circuits alts. or extensions Floor furnace and vent S. F. Residence(l bath)SERVICES Recessed wal I Snacp hpaipr:nd venf Ouplex (1 bath) each Additional bath Temporary Construct i on Apol iance vent seDa ra te [.later serv i ce ge in existing dence Chan res i Stationary evap coo l er Sewer mu1 ti fami 1y, Tndrrstrial comn. or Vent fan withsinole duct amp s.0fStorm Sewer Vent systern apart from heatinq or A.C. coMr.r./IND. FEEDERS Mechanical exhaust hood and duct I nsta I I /a l terl rel ocate dist-rib. feeders /l/ood stove/heater go! 0f .amps. ISSUANCF 0F PFR||IT /D,Ag TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES /s.q I,HERE STATE Llll REQUIRES that the Electricai work be done shall not be vali'l until the label has been signed by an Elec bytri' an Electricai Contractor, the electrical portion of this permit cal Supervisor and returned to the Building Division I HAVE CAREFULLY EXAIIINED the completed application for Dermit, and do hereb.v 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 bf the City-of Soringfield and the Laws of the State of Oregon oertaining to the work described herein, and that NC 0CCUPAI,ICY ilil1 be made only subcontractors and ernployees who are in comoliance with 0l?S 701. l.lAi.lE(please pri nt)SI ssion of the Building Division. I further certi i"y that my registration with the Builder's us 0n basis for exemptionas recluired by ORS 701.055, that if exempt of any structure without the Board is in full force and e permi ffect noted hereon, and that s Drojec Flood Plain Stories 0cc.y Group Sq. FtS. 0ther____________x Va1 TOTAL VALUATION llp Ra drooms Load Sq. Ftg. Acces Val ueFire Zone Zone al uenst. Units Sq. Ftg. l'lain Plan Ck. Conrn/lnd 65%/B1dq Per Fee rqe (1.5.2 Sys Cha terils Deve 0pmentBUILDING PERIIIT Charges anC Su rcha rges Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Su rcha rges Demo SidewalkELECTRICAL PERIlIT Charges and Surcharges A/C Paving Total Comb. Permit Curb CutI,TECHANICAL PERMiT Charges and Su rc ha rges ./S.o-o tbo TOTAL F/€, roo 4 (J COMBINATION APPLICAIION/PERMIT (CAP) Applicant to furnishA. Job AddressB. Legal Description l. q&mple- Tax Lot 100, Lane County Map Reference17-If ,R PERMIT VALIDATION CITY OF SFRINGFIEI.D City Holl Springfield, Oregon Deporlment of Public Works OFFICIAT RECEIPT No. B 573ii r9 GA Amount Received 2. example- Lot 1. Block 3, Znd Addition toS[iTigTield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. examol e- heat/el ectricai cei I i nqlor forced a ? . e x a np I e - rva t e r h ea t e r/ e I ec tiJ c a l-l o r s o-Ta-F-E. SquaiE-TiiTage or valuation, eTc. - l. example- 1250 sq. foot house, 500 sq. foot g,2. exa;EiE Tf-new project, check-i6w - if addi EIecT-Tdd, etc.F. Building permit information i .l. example - construct single family house with;tffifed garage ?. example - remodel existing gara-qe into famil,3. examole - convert single famiiy residence in:EsTiuFant (change of-use)G. Value of work as defined in Section 303 (a) of flStructural Specialty Code lH. DESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Building0ivision Staff must be able to contact approprii.persons regarding design information or job sitecorrections, etc, (tJ' les ( ( ( ( ( ( II III. IV. Abbreviated Plumbing, MechanA. Except where blank spaceportion of the Mechanica the applicant need fill-to the appropriate item(B. Full PIumbing, Mechanica V. FOR OFFICE USE ONLY ical, & Electrical Schedr rs occur in the descriptirI and Electrical Schedulrin only the No. Boxes ad;s) to be installedl, and Electrical Schedu' tnf are available at the Building Division1. To conserve space on the permit form the scht have been abbreviated2. If the item(s) to be installed are not cover(the abbreviated schedules you should consultfull schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES A} CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be deliveredelectrical contractor for signature by his electrsupervisor. The general contractor is not authorto sign the electrical label Applicant to sign and date Hhenever possibie, the initial application will be usa worksheet only. Where possible, Building 0ivisionwill prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for s i gna ture. Fees and Charges Plan check fees are due and payable at the time of thapplicatjon, and no plans will be processed until thefees are paid. All other fees and charges are due anpayable vrhen the permit is issued. (as ri ( ( EY AUTH STGNAYURE SHELTON IURNBULL 'iI(IERS EUGEiE OR O"OI +- Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Additional Project Information : PLANS REVIEWED BY: name date /O -/-y/s'l g na tu re aec"iuea ror,# 7[0 693 ( -1 ( Permit appljcant exempt from registration with the Builder's Board because: