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Home My WebLink AboutPermit Building 1987-12-17 (2)NE COHBI I 74_ Legal Descr.iption -o?*o<a Ra Hea EI,IERGY SOURCES: I'later Heater 0wner Value of l/ork: 6a . 0ther I'la n Sq. Ftg Sq. Ftg Access. Add ence Address a :€., Btt Sing e Construction Lender Addres s Phone \ \$ N Prima Structura I E I ectri ca I Hechanical PLUI{B I NG ELECTRI CAL MECHAN ICAL Each single fixture Res idence of sQ. rr --. BTLI' s furnace/burner to Relocated buildino (new fix. additional)New circuits altsor extensions FIoor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal I Space heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDarate [,later servi ce Change in existing res i dence Stati onar.v evap cool er Sewer muitifamily, comm 0r I ndu stri a I Vent fan with sinole duct Storm Sewer 0f s.Vent system apart from heatinq or A.C. c0r,il'r./IND. FEEDERS Mechan ical exhaust hood and duct I n sta I I /a l terl rel ocatedistrib. feeders ['lood stove/heater ampt0f ISSUANCE OF PFRIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I',HERE STATE LAN REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed apnlication 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 Springfield and the Laws of the State of Oreoon pertaining to the work described herein, and that N0 OCCUPAI,ICY will be madeof any structure without the permission of the Building Div'ision. I further certify that my registration vrith the Builder's Board is in full force and effect as reguired by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in comcliance with 0l?S 701.055 l.ri'll be used on this Droject. t'lAt'lE ( pl ease pri nt )S IGiIATURE DA.TE FOI'I OFFICE USE ONLY d _ Sq. Ftg. Access x Value "r q.Ft;.nn""Wu;u"-767 TOTAL VALUATION steris 7y Deve 1.5% I -0cc.y GroFlood Plain Stori es Loa an an its Ne-fe-a- TYPelConst opment al ue Fire Zo Zone Bedrooms BUILDING PERI'IIT Charges and Surcha rges Res Per Fee Fto. l,lain x FencePLUI4EING PERMIT Charges and Surcha rges Demo Sidewalk Tota l Cornb. I'ermi t ELECTRICAL PERI1IT Charges and Surcha rges A/C Paving Curb CutI,IECHANICAL PERMIT Charges and Surc harges 1/ 77loTALfrq/E<r tu Job Address PERMIT VALIDATION Permit Clerk COMBINATION APPLICATION/PERMIT (CAP) I. APPIicant to furnish A. Job Address B. Legal DescriPtion Il'-e*arpte- iax Lot 100' Lane county Map Reference T7-0T-43?. example- Lot 1' Block 3' 2nd Addition to SFifigTieta Estates C. llame,'etc] of owner and construction lender D. EnergY Sources iti or forced air qas rr Sol are E aluation, e sq. footq.foot house, 500 I i arage proj ect, check new -if add ti on, F. Building permit information:- -1. example -'iontt"'Ct single family house with an ;TtaaIed qaraqe 2. eiampte -'ie'6oef existing- garage into family room 3: ffiFT" - tonv""t single iamity residence into restaurant (change of use) G. Value of *o.f-ui-J.tined in Section 303 (a) of the Structural SPecialtY Code H. DESIGN TEAM AND CONTRACTORS To avoid oesign oi construction delays' Building. Division Stafi must be able to contact appropriate persons t"gutdi;g-dtiign information or iob site corrections, etc' II. RUUreviatea plumUing, Mechanical, & Electrical Schedules n.- Except wnere blink spaces occur-'in the description poiiion of the Mechanical and-Electrical Schedules' lne appticant-need fill-in only the No' Boxes adiacent to thb appropriate item(s) to be-installed B. Frff pfuirbini, Mechanicil, and Electrical Schedules are availabli at the Building Division 1. To conserve space on the-permit form the schedu'les have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviited schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his eiectrical supervisor, The general contractor is not authorized to sign the electrical iabel. III. App'licant to sign and date I'lhenever possibie, the initial application will be used as a worksheet only. Where 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. IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY 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 ate -/2'ig nature a7