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Home My WebLink AboutPermit Building 1991-02-04E P I l-ega1 Description Job Adciress Ranqe-- llater Heater EIIERGY SOURCES Hea t 0wner Value of llork:/4*-* Ftg. Access._ Sq. Fto. 0ther-- l,leul Add Al ter--PeP. - _f e n c e-Oe-mo-C h aln g e / U s e 0ther Sq 9q Ftq llain Builciinq Pernlit Info: Descrit Family Residence t'lith Attacher ng.e ekAddress Due 4zzqar eEaz>#ats Construction Lender Addre s s Phone resaddressexDname Pri mary Structura I El ectrical Hec han i ca I I 'I E l ectri cal l'lechani cal ELECTR I CAL MECHAN I CALPLUHBI NG IHA ANFC HA RCF NN FFF CHARGF NO FFFFEE Residence of FTSQ furnace/burner to BTLI' sEach singie fixture New circuits alts. or extensions Floor furnace and vent Relocated building (new fix. additional ) SERV I C ES Recessed wal I Soace heater and vent S. F. Residence ( l bat-h ) Duplex (1 bath) each Temporary Constructi on Apol iance vent seDarateAdditional bath Change in existing rec i dpncp Stationary evap cool er[^later serv ice Vent fan with sinole duct multifamily, conm. or I ndu stri a ISewer )Dt *0f amps.Vent system apart from heatino or A.C.Storm Sewer COMI.I./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate distrih fppdprs l,Jood stove/heater 0f s. ISSUANCE OF PFRI1IT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES *e,t1 t). WHERE STATE IAI,I REQU shall not be valiC until IRES that the Electrical work the label has been signed by be done by an Electri ' an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division I HAVE CAREFULLY EXA|IINED the completed apnlication for.oermit, and do hereb.y certify that all information hereon is true and correct, and I further certif-v that any and all work performed shall be done in accordance with the Ordinances of the Cityof Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that ilC 0CCUPAI'ICY will be madeof any structure without the perm'ission of the Building Division. I further certify that my registration vrith the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and ernployees who are in comoliance with 0l?S 7n1.055 will be used on this rrroject. cl.lAt'lE ( p1 ease pri nt S I GNATURE DATE }-,1-J I1,1 Lrno Fire Zone Bedrooms Flood Plain 5tories TOTAL VALUATION an llPzone 4t/, tyr"/con't.htg?/26.-ln its llP Load Sq.Ft!lue Ftg. l'lain x Val Group Sq. Ftg.0ther______x Val Acces s Plan Ck. Conrn/Ind 65%/Bldq Per Fee ZO.QtZVfi.0 pmenterns Devel.5z /5d,eBUILDING PERNIT Charges and Surcha rges PIan Ck. Res 30%/BIdq Per Fee FencePLUi4BING PERMIT Charges and Surcha rges rr.CeO____4.2 r___ Demo Sidewal k ./zzfELECTRICAL PERI,:IT Charges and Surcha rges A/C Paving fu-9 Total Comb. Permit Curb CutI,IECHANICAL PERMIT Charges and Surcharges zg?.-"TOTAL N \ 1?6-3 t- 53C(.)IIB I iIAT I APPL I CAT I Phone 7/rA I LAI.1 )nnp no - 5\ CI coMBTNATI0N AppLICATI0N/PERMIT (CAp) I. Applicant to furnishA. Job AddressB. Legal Description1. gg1El_g_- Tax Lot 100, Lane County Map Reference17 03 43?. example- Lot 1. Block 3, 2nd Addition toSprinqfield Estatesq. Name, etc. of owner and construction .lender D. Energy Sources PERMIT VALIDATION /7r*,f ?*7-A/ 1. examol e-2. examol e-E. Square foota hea t/trical c I or forced air qas wa e or solarge or valuat o[tIexampl e- examp l e- ch-ec[--add 1250 sqif new . foot house, 500 sq. foot garageproject, check new - if addition,L etc II F. Building permit information:1. example - construct single family house with anattached garage ?. examp_le - remodel existing garage into family room3. example - convert single iamily-resiaence iniorestaurant (change of use)G. Value of work ai defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Build.ingDivision Staff must be able to contalt appropriitepersons.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 adjaient _ !0-lhg appropriate item(s) to Le installedB. Ful'l Plumbing, Mechanical, and Electrical Schedulesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated?. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful 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 theeiectrical contractor for signature by his electricalsupervisor. The general contractor ii not authorizedto sfgn the electrical iabelApplicant to sign and date lrlhenever possible, the initial app)ication wil.l be used asa.worksheet only. Where possible, Buitding Division Staffwill.prepare a type written copy and returi it to theapplicant at the time the actual permit is issued for hissignature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wiil be processed until thesefees are paid, All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY %f 78t III IV V Permit Cler PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from regjstration with the Builder's Board because: Additional Project Informat'ion: PLANS REVIEWED BY: name s i gnatu date ?- 7€f