HomeMy WebLinkAboutPermit Mechanical 1980-09-25L CITY OF SPRINGFIELD
COMBI iIATI ON APPLICATION/PERMIT 726
Job,': lress
l-ega1 Description q
Ran
l.later Heater
EIIERGY
Hea t
AP L
tg. l'lain_
Sq. Ftg. Access._
Sq. Ftg. 0ther_
J{ewJddrAl ter_ReP.
_Fence_Demo_C hange/ U se
0ther""i:u8b.ooOwner-fi:,c k€-1.'Rott scr
Att
tI ng e
Addres s Phone
lt )A')SnAU6 i Chtmn4tttLb)H3_-l
Constructi on Lender
so
O
-D
\
O
Addres s Phone
dre s
ll-/
El ectri cal
Structura l
Pri ma r
l''lec ha n i ca I
ohone no-'l i cs. no.'exoi res )addres sname
Genera l
Pl umbi nq
El ectri cal
I,lec ha n i ca I
MECHAN I CALELECTRICALPLUIIB I NG
FFF CHARCFFFFrHA RGF NOFFFCHARGFNOilo.
furnace/burner to
BTLI' s
Residence of
FTSQEach single fixture
Fl oor furnace
and vent
New ci rcui ts al ts
or extensions
Relocated bui1ding
(new fix. addjtional )
Recessed wal I
Soace heater and vent-SERV I CESS.F. Residence(l bath)
Duplex (1 bath) each
Apol iance vent
seDa rateTemporary ConstructionAddi ti onal bath
Stationary evap.
cool er
Change in existing
resi dence[.iater servi ce
Vent fan with
sinole duct-Tndrrstrial
multifamily, comm. orSewer
Vent system apart from
heatinq or A.C.amps.0fStorm Sewer
Mechanical exhaust
hood and ductCOMT.I,/IND. FEEDERS
Insta l I /al terlre1 ocate
di stri h- feedprs l'Jood stove/heater
amp s.0f
ISSUANCF OF PFRI1IT
TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES
WHERE STATE LAt,l REQUIRES that the Electrical work be done
shall not be valiI until the label has been signed by an Elec
bytri an Electrical Contractor, the electrical portion of this permit
cal Supervisor and returned to the Building Division
I HAVE CAREFULLY EXAIIINED the completed application for oermit, and do hereb.y certify that all infonnation 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 Oregon oertaining to the work described herein, and that NC 0CCUPAI'ICY will be made
of any structure without the permission of the Building Division. I further certify that my registration urith 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 employees who are in comcliance with 0l?S 701.055 wi'll be used on this nroject.
oor?25-fuI'lAl'lE( pl ease pri nt )S I GIIATURE a
Flood Plain _ Stories Occ.y Group Sq al ue
TOTAL VALUATION
x
Uni ts/Const
Bedrooms 0c cy Load
Val
!q
S o,. rtg.qlal
Val ueFire Zone
Zone
Ftg
Fts
Acces s
0ther
Plan Ck. Comm/Ind
65%/B1C'o Pcr Fee
Svs
Lna
terns Deve
rqe (1.52 opmentBUILDING PERMIT
Charges and
Surcharges
_5
Plan Ck. Res
30%/81dq Per Fee
FencePLUI4BING PERMIT
Charges and
Surc ha rges Demo
SidewaIkELECTRICP,L PERIlIT
Charges and
Surcha rges A/C -Paving Total Comb. Permit
Curb Cut
TlECHANICAL PERMIT
Charges and
Surcha rge s
_t
TOTAL e0.re
)e Work (
I Garaoe
rnnp nopYnt reqIFAtl
:TORS 0r
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. gf{p]g- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot I. Block 3, Znd Addition toSpringfieid Estatesq. Name, etc. of owner and construction lenderD. Energy Sources l
2
atr as
E. Squ
ga
dit
rage
i on,
II.
F. Bui lding permit information:1, example - construct single family house w.ith anattached garage
?. examp]e - remodel existing garage into fami.ly roomr. exampte - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Speciaity CodeH. OESIGN TEAI.I AND CONTRACTORS
To avoid design or construction delays, Bu.ildingDivision Staff must be able to contalt appropriitepersons.regarding design information or job sitecorrect'ions , etc,
Abbreviated Plumbing, Mechanical, & Electrica.l Schedu.lesA. Lxcept where b)ank spaces occur in the descriptionportion of the Mechan.ical and Electrical Schedu.les,the applicant need fill-in only the No. Boxes adjacent
- to the appropriate item(s) to be .insta'lled
B. Full Plumbing, Mechanicai, and Electrical Schedu.lesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF I^JILL 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 electr.icaisupervisor. The general coniractor ii not authorizedto sign the electrical labelApplicant to sign and date
Hhenever possible, the initial application will be used asa.worksheet oniy. !,lhere possib)e, Building Division Staffwill.prepare a type written copy and returi it to theapplicant at the time the actua) perm.it is issued for his
s i gna ture.
Fees and Charges
Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. Al l other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONIY
III.
IV.
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
PERMIT VALIDATION
Permi t Cl erk
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information :
PLANS REVIEWED BY:
datenameSigna tu re
PECTION
-37 69
I,IECHANiCAL PERIlIT
Charges and
Su nc na r^ges
COIIBIiIATI ON APPL ICATION/PERMIT 726-31s3
)JFt
ql-ega l Descri pti on
Job /- -rs5 5
Ran
Hea
l.later Heater
EIIERGY
Owner C Vai of rilork eo
Sq. Fto. l4ain.--
Sq. Ftg. Access.--_--
Sq. Ftq. 0ther_
_l{ew ,Add--_rAl ter TEp.
_Fence_Demo_Chan ge/ Use
_other-_=---
F il nq Pernit Info: Descr
Resi dence t'li th Attach
i1d SingleeAddres s Phone
L1
Construction Lender
Addres s Phone
\Jc
-c
N\)
\)U'
a s
Pri ma
n0
Structura I lJ
Electrica.l
i'lec han i ca I
Genera I
Pl um n
r
hani I
PLUIlB I I]G ELECTR I CAL MECHAN I CAL
F
Each single fixture Residence of
SQ. FT
furnace/burner to
BTLI' 5
Relocated bui ldinq
(new fi x. addi ti onal )
New ci rcui ts al ts
or extens'ions
Fl oor furnace
and vent
S . F. Res i dence
SERVICES Recessed wal I
Duplex (l bath) each
Additional bath Temporary Construct'i on Apol iance vent
l,later service Change in existing Stati onar,v evap
Sewer multifamily, comm. or
I I
ent fan with
Storm S r 0f .amp s orA
Vent system apart from
COI4I.,!. /IND. FEEDERS exhaustnca
Insta I I /al terlre1 ocate llood stove/heater
amp s.0f
ISSUANCE OF PFRI,iIT
TOTAL CHARGTS TOTAL CHARGES TOTAL CHARGIS
hIHERE STATE L1I,Ishall not be valil REQUIRES that the Slectrical work be doneuntil the label has been signed by an Elect
by an Electrical Contractor, thericai Supervisor and returned to
electrical portion of this permit
the Building Divis.ion
I HAVE
and correctof Soringfiof any stru
Board is in
onl,y subcon
I.lAl'lE( pl ease pri nt)I GiiAT o
Derm i
fo rme
Y EXLL t CO tede a c ap t o fornpp t an d do he rt hat atreb.y tfo rna nfy0 he nreo rt uefundahertcerrtf+tha a nd-V ny t^/o r roe d has AC rdc0 ceanndonbe ht he 0rd nan ce 0S f rh C tyadndtheofLawsStheteta0OTre00nrta0enntothkilo rq |^des c b heed re n dan hat ilct OC CUP AI w1CY b dematu!/tre hot tU th rmlpe s o ofn Buthe d ng s on fu r rthe rte ttha rat tfym.y v/t0n theth Bu der SIuforcendaeeffLLasudrereclORS070t55bythaexetbahemptfosrtonexempnsheoted0nreathand ttrtoracndemDawhoreoyeesnanc0mDcethtliT.J0 07 05 5 be sedu n th ec tDTo.j
A-z cr-er-,
DATE / C' -t Lt'-'
Ftg
Ftg
Ftg
llni ts So
c.7 Group
TOTAL VALUATION
X
X
Ine/Const.
Loa dBed roomsF i re Zone
Zone
al ue
Flccd Plain_stories : Val ue
Val ue
Acces s
0ther
an Ck omm/ Jnd
6 o roe 1.5q
Svs
Cha
S opmen tBUILDING PERI.IIT
Charges anC
Su rcha rges an C
Btd
Res
Per
FencePLUI4BING PERi4IT
Charges and
Su rcha rges D6mo
SidewalkELECTRICAL PERI,IIT
Charges and
Surcha rges
fotal Conb. permitA/C Pavi ng
Curb Cut
ec.8cTOTAL
ul
arn
re l,lork
Garao
lt)ffiD1Tfit )F; | (
j
1t
]Ttj RS n amP taq nn
C HA PGF iin FFF r.HAPT:F T]FFF
Snacp hpatan:nd vanf
sPDa ra tp
s
-=-ruilce44
COMBINATIOI'I APPLI CATION/PERMIT ( CAP)
Applicant to furnish
A. Job Address
B. Legal Description
1. examole- Tax Lot 100, Lane County Map Referr
l7-T:-?3
2. examole- Lot 1. Block 3, 2nd Addition to
Spifngfield Estates
C. llame, etc. of owner and constructjon Iender
D. Energy Sources i
1. exancl e- heat/el ec trical ceiIi /or forced
e- r^ra te ea er,
CITY OF SPRI${GFIEtD
Ciry Ho[
Springfield, Oregon
Deportment of pubtic WorksOFFICIAT RECEIPT
c
PERI4IT VALIDATION
No. B
l9
54700
{
E
6
0r so ar
t. Square-Tootag e or valuation, e
1250 sq. foot house, 500 sq. foot
if new project, check new - if add
, etc.
L. e e
1
2
e a,qol e-
ex an e-
ec k aCdF. Bui lding permi t informat'ion : (
l. exaiple - construct sing'le famiiy house wit
a -ttei"€d garage
?. era::le - remodel existing garage into fami
3. axar'.51E - convert single family residence ' r
r'"-s tl,.lrant (change of use)
5. Talue of r.rork as defined in Section 303 (a) of
5:ruc:'..;r-al Specia I ty CodeiJ. ::5;G:. T:ii.'i AIID COIITRACTORS
l::vc;c cesign or construction deiays, Buildir
:i.,i::.r 5taff must be able to contact appropr
:,.1r:cns ra;:rding design information or job si
:crri:'-ions, etc.-'.'1.i.r.:'-:: ili,--cine, i'lechanical, & Electrical Sch t^
:.:'r:r:.."ii.e Dldnk spaces occur in the descrip':.::.n :i:r:e llecn..rn'i cal and E'l ectlical Sched
'":.? ii) i:c:ni need fill-in only the No. Boxes" "'r jilr'c:r'jate jtern(s) to be installed
.' : . :. : r'r1, :''rch.tni ca l , and El ectri ca i Sche
:r,. ri.r:l rtle :t the 3uilding Division
'ti.rr-ve soace on Lhe permi t form the s
:-.'rn rcbr?v'i aied,.::.:r{si to be installed are not cor. ..vr,rtec scnedules you should consr
:re4,lleS::.'::IC:i STIFF ilILL FILL OUT ALL FEE:
r ,.L jLr:iL"JLt)
::r'.:r. CiP. the label must be deliver _.:r.lctcr for signature by his el
.,r:n5.1 I ggpg;actor is not au:.: .:i l:bei.
:i rl ,rpplicatjon will b,.:rlie. Euiiding Divis' '.r:; .rnd return it tc'-' ..r i lerr:it is issuec
::lr, ,ri. ihe time,. ; rnlg<5e{ g;1lj
:r tr:8s are due and
d rom
For:
Amounl Received
HORIZED SIGNATURE
H
E
t
E
hE
,F
;^rdL
:dt
'rn
r"lr
6i.
)
(,
\s
(i_
I inese
BY
ro(-TURNAUL! pRrilrERS - EUGENE OR 974Ot 56!fi.a :
it
tl1+ : .
tttt +.g r
ilrrt. jr --r-
()
Perm'it Cl erk
l-) Li'\
r'r(UJLLi L-'r.,r .. - rr ; : .: ]!;:OF.E OCCUPAI{CY :
permi t appl icant exempt from regi strat.i cn it i;h the 3ui I der's Board because
Additional Proiect Informatjon:
PLANS REV I EI^IED BY :
date
name Si gna tu re
(l
(
l