Loading...
HomeMy WebLinkAboutPermit Electrical 1989-6-28 INFORJ1ATION LINt . 726-3753 Sq. Ftg. 1,Iain ~q. ~tg. Access. Sq. Ftg. Other flew Add A Iter Rep. Range -Fence Demo Change/Use Valu€ of Hark: Other- - ~':.....~ BUildint('permit Info: Describe Work(i.e.. Build Single Family nes;dence With Attached Garaae) I INSPECTION LINE 726-3769 -:z~t:> 'n.' .... ' Job Address_\ \~ ~ Legal Description . CITY OF SPRINGFIElO COMBINATION APPlICATION/PERMIT EIIERGY SOURCES: Heat Ha ter Hea ter \"v-. ~ r C>\-J.>-. J;?D . I\D\.I..."'-:~\<._ ~~IJ'\c.E, Owner \\\~N--\ ~t.~\.~S Phon~'tI1 \ Address . I :, ~ ~ C) - ~ Construction lender 5/rc- C~7?';'/~ ~A A?7/S~#'--'./A Ai'?_/-<'A'A'7'~ , ' , ~ Address Phone DES I GN T tAI1 (name) (address) flies. no. ) (exo; n~c;) Primary '2.o,;.,MP>...~-\<.I...f:I.~ ~<-'" roR.,\.,~~t"\ \\fi Structura 1 Electrical \'-\<;=\\'-.. ~6~ p()~\. !'\t-...\CJ 4~ ~f r1echan; ca 1 CONTRACTORS (namel (address) flies. no. ) (pxoirps) Genera 1 'L.'-O'-\.a~.'=\ \ ,:,->\ \'l\.~ v...\~'U ~~, ~'?::> Plumbina r4AB.IiE .J!lL...1 I furnace/burner to BTU's I Floor furnace and vent Recessed wall ~n~rp hp~tpr ~nrl vpnt Electrical ~\...E.~.::n:~..,-I='C"!:~ \0,,-0 ~'";\...p.,~ ~'L"> 'Cr{J-~ ~lechanical PlUllBI NG ElECTRICAl NO, FEF rHARr,E Nn "<> Each single fixture Residence of SQ. FT. Jr" it Relocated building (new fix. additional) New circuits alts. or extensions I ~~ 150 11/3 I I I I S.F. Residence (] bath 1 10uplex (1 bath) IAdditional bath ~Ia ter servi ce SERVICES each 6~ ITemporary Construction IChange in existing rps j dJmrp Imultifamily, COlTll1. or Tnrluc:trial I j Sewer Storm Sewer I 10f ICOMM,/IND. FEEDERS l'Install/alter/relocate I dic;"trih. fpprlprc: 10f amp~1 I I I I I ~3 U'J amps.1 TOTAl CHARGES TOTAl CHARGES WHERE STATE l,'I~ REQUIRES that tile Electrical work be done by an shall not be valid until the label has been signed by an Electrical (ohone no .~) (ohonp nn ) Pi}€>-~,-\,\ \a\\\p,q . \ \'"\\-6.~?'l MECHANICAl il ~cLl...c.HA.R.G.t ~. ~.$. . m I Appl lance vent seoaratp I Stationary evap. cooler I Vent fan with sinole durt I Vent system apart from I heating or A.C. I Mechanical exhaust hood and dud Wood stove/heater ISSUANCf OF PFRlllT TOTAl CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFULLY EXAtlINED the completed aprlication for permit, and do hereby certify that all infonnation hereon is true and correct, and I further certify that any and all work oerfonned shall be done in accordance with the Ordinances of the City of Spri ng fi e 1 d and the laws of the Sta te of Oregon pertai n i ng to the work descri bed herei n. and that HO OCCUPAUCY wi 11 be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s 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 compliance with OP.S 701.055 wi~~sed on ~ro:ect. NAI,IE(please print)~ \\~~o;;;::.~-? SIGfIATUR~~ DATE~pf\ FOR OFFICE USE'OlllY ( I . I Sq. Ftg. f-tain x Value Sq. Ftg. Access x Value Sq. Ftg. Other x Value Zone Fire Zone Flood Plain Type/Canst. Bedrooms Units Occy load Occy Group Stories BUIlDING PER~llT Charges and Surcharges Plan Ck. Comm/Ind 65%/Rldo P€'r Fpe ------------Pian Ck. Res 30%lBI do Per Fee I Fence ------------ I Demo ____:? .:?...,.>z:::>1 Sidewalk / . /;S I A/C Paving I Curb Cut I PlUt1BING PERMIT Charges and Surcha rges ELECTRICAL PERr~IT Cha rges and Surcharges 11ECHANICAl PERMIT Charges and Surcharges TOTAl VAlUATION Systems Development Charqe (!.5~) , ITotal Comb. Permit ,- IIOTAl ~ 2:?-cb,:5 . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. legal Description ..... 1. example- Tax lot 100, Lane County Map Reference 17 03 43 2. example. Lot 1, Block 3. 2nd Addition to sprl~gtield Estates . C. Name, 'etc.~ of owner and construction lender . D. Energy Sources, . 1. examDle~heal/erectrical ceiliilQ/or forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. ------ 1. examole- 1250 sq. foot house. 500 sq. foot garage 2. example- if new project. check:ruew - if addition, check add. etc. F. Building pennit information: 1. exam~le - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. OESIGN TEAM ANO CONTRACTORS To avoid design or construction delays. Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing. Mechanical. & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing. Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEOULES D. As noted on the CAP. the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical label. --- III. Applicant to sign and date Whenever possible, 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 signa ture. 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. I t.f;)-Y';? i , -= !?;, ~~\r' ~J: l (' \ . V. FOR OFFICE USE ONLY P,noit Cl'~'^-- G14a I PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date ,I