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HomeMy WebLinkAboutPermit Building 1988-07-12Ftg.0ther. L COHBI IT h m I N Structura I El ectri cal Hechanical Ge El I MECHANICAL ISSUANCE OF PFRIIIT WHERE STATE !-l}d REQUIRES that the Electrical work TOTAL CHARGES shall not te valiC until the label has been signed by be done by an Electri, an Electrical Contractor the electrical portion of thi s pernitcal Supervisor and returned to the Building Division the comp apr)on for t, and do reb,y certi that all in tioncatand correct, aod I further that any and a'll work oe shall be done in acc ordance with the 0rdi nances of the is trueof Springfield and the Lawsof any siructute withou Board is in full force State of 0reoon ssion of the Buil cert i fyof thet the permi and effect oe rta ining to the work described n, and that N0 0CCUpAl,lCy will beherei Ci ty madedingDivision. I further certi fy that my registrati on with the Builder,sas requi red by ORS 701 055, that if exempt the basis for exemption is noted hereon, and thatonly subcontractors and emp l oyees who are in compl i ance wi th ORS 701 .055 wi] I be used on this project. (please print)IGNATURE st.ts Ftg. l,lain lueFire Zone Bed rooms Load Sq. Ftg. Access x Va lue F lood P'l ai n-Stori es Occv Gro Val TOTAL VALUATIOTI s Job Address a Legal Oescription l,,ater Heater Ranqe EIIERGY SOURCES: Hea t Owner Value of l.lorkdlr Sq. Ftg . Access Sq . tla Address e??Phone A t ce s ng e 2{ Addres s Prima (lcs. no-(exoires -Lhone no. nl PLUAIN6 ELECTR I CAL FEE CHIRGE NO FFF CHA RGF Irl0 Each siagle f,ixture Residence of SQ. FT _ BTU, s to Relocated fuilding (new fir. additimal)New circuits alts.or extensions Floor furnace and vent F SERV ICES Recessed wal I Dupler (l barh) each Additional bath Temporary Constructi on iance vent Uater servr'ce ge in existing dence Chan Ies i ti onar.v evap. Sewer multifamity, conrn. or lndu stni a l fan th Storm Serer '\lent system apart fromheatinq or A.C. col4l.l./IND. FEEDERS Hechanical exhaust hood and ductocateInstalI/alter/reidistrib. feeders l'lood stove/heater 0f TOTAL CHARGE TOTAL CHARGES PIan Ck. Conm/InZ- 65%/8ldo Per Fee Systems Deve Charqe fI.51 0pmeotBUILDING PERI'IIT Charges and Surcha rges PIan Ck Re Pe S r10%/Bldg Fee Fence DEmo SldewalkELECTRICAL PERI:IT Charges and Surcha rges A/C Paving Total Comb. Permit Curb CutHECHAIIICAL PERHIT Charges and Surcharges TOTAL yoft€ - 0therFtg. se0a ra te 0f amDs PLUI,ISING PERMIT Charges and Surcha rges a !.i ,t at I COMBINATION APPLI CATION/PERMIT ( CAP ) I. Applicant to furnishA. Job AddressB. Legal DescriPtionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SE7insf,iela Estates' C. Name, etc. of owner and construction 'lender D. Energy Sources PERI'IIT VALI DATION l. example-2. exampie- E. Square foota a!r gas l. example- 1250 sq. foot house, 500 sq. foot garage- 2. EiainplFIf,new proJect, check newl-'jf atldition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage2. example - remodel existing garage into family room3. exanrplE - convert single family residence into iEiTiriFant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building 0ivision Staff must be able to contact appropriate . persons regarding design information or iob site. corrections, etc. Abbreviated Plumbing, Mechanical,'& Electrica'l Schedules- -A. Except where blink spaces occur in'the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. FuIl 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 theful I schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AI{D CHARGES ON THE SCHEDULES0. 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 labe'l. Applicant to sign and date llhenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staffri'|1 prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for his si 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 It III. IV v Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: I nature da te ?-tz€a 1 t nu^"La.< 724* ,i