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Home My WebLink AboutPermit Building 1984-10-10 ~lechanical PLUIIBING NO. 9 Each single fixture Relocated building (new fix. additional) S.F. Residence (1 bath] Duplex (I bath) each Additional bath Hater service 7iJIJ' Sewer Storm Sewer ELECTRICAL Fff rHI\RQL Jjfl 5":- ~S'... iqlc-0'c'./ J~U MECHANICAL Residence of I ~~~ 1 rUllliG.EtllQ..!-1 furnace/burner to SQ. FT, BTU's New circuits alts. ...... or extensions 1:):- 7~~~ I SERVICES I g !TempOrary Construction IChange in existing I rpsjrjp.,n('p 1/5- !multifamily, comm. or I r Inoustriill I IOf :Z~ amps.! I~"" ICOMM./IND. FEEDERS I IInstall/alter/relocate ! rli,trih fpprlpr, 10f amps.1 Floor furnace and vent Recessed wall SOil~P hpiltpr ilnrl vpnt #.:~r ~,.Pr Appliance'vent c:pr)i'!r;lt.,. Stati on'ary evap-:- rf'l('ller Vent fan with sinole duct Vent system apart from heating or A.C. Mechanical exhaust hood and nuct Wood stove/heater C)- ~ I~. 10 I~ i>Q (nhr'lne no .', ~n I ru~ 6+-- I l..-V<.- I I I I I I I ISSUANCf OF PFR!IIT TOTAL CHARGES /~ 0.:> TOTAL CHARGES 1ft), Pf' TOTAL CHARGES --:s".-:? - WHERE STATE l~W REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall 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 aprlication for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein, and that liD OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon,~d that only subcontractors and employees who are in compliance with OPS 7n1.055 Wi~/1_b,e__u, _sed ~ on thi~~~~t. I NAlIE(please pri~t) MACk l0o.9/( E SIGilATURE I/~ /r~ DATEl'tJPd/rk-: FOr. OfFICE USE OiILY Sa, Ftg, !Iain '2/I:/._~ Sq. Ft~Access Sq, Ftf~~ c'^" _ ~ Zone"R-L. ~.V,p. TYDe/Const. ";':'N Fire Zone. Bedrooms jY(~, Flood Plain Stories / BUILDING PERHIT Charges and Surcharges PLU'~BING PERMIT Charges and Surcharges ELECTRICAL PERI:IT Charges and Surcharges !1ECHAN I CAL PERMIT Cha rges and Surcharges / x Value 4I.J!): ~ - > x Value ..,ce- ./ --..c-_._ x "h.;1 Value ~ /,v"" TOTAL VALUATION -- fJ " / ., '/ r' IJ,""-" v .; i.L Systems Development /' S. "'" 18//I.8.D I1Ict/"I~.Charae t1.5~)' "-17' . .._.., /,'-.:_/''''~~d~ -1b,. t;."jlio?>~_:r- ~ ~~x ,17%J.~3ati::>...l. Units Occy Load Occy Group~-:? 4"C'l.- ITotal Comb. I I TOTAL j7.'? _ Plan Ck, Conm/lnd ~.. 65%/ijldo ppr ~PP --- --L -8.---- Plan Ck. Res 0. 8 ~9%/Bl rl~ _ p~~ F~_ _ I~"., ~ Fence ____L~':____ 6. yo D~mo _____Y.t2-"~ Sidewalk / .60 A/C Pavi n~7.f.q." 3J.i2. ,cw:::. I Curb Cut ,. ----- /-~';-I 'I5"'~ iPg ~/~~S Perm; t ~ . . . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to 'furnish A. Job Address B. Legal Oescription 1. example- Tax Lot 100. Lane County Map Reference II uj 43 2. exa~le- Lot I. Block 3. 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinQ/or forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - I. examole- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project. check-nfw - if addition; check: add, ete. .. F. Building permit information: 1. example - construct Single family house with an attached garage 2. example - remodel existing garage into family room 3. exam~le - 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 AND 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. 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 electrical supervisor. The general contractor is.not authorized to sign the electrical label. --- Ill, Applicant to sign and date Whenever possible, the initial application will be. used as a worksheet only. Where possible, Building ~ivision 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. V. FOR OFFICE USE ONLY " \1 . PERMIT VALIDATION . cti/ ~ \P~~ ~ \6- ~-\.o1JDq, 8rt:~ Permit Clerk rAO::tU . ,~ PROJECT CONDITIONS TO BE SATISFIEO BEFORE OCCUPANCY: /- ?.A:l7N/.Aeo. O~ --5~r /~iZH~v~Ei'Yr k-/T'<5-~-;,..-n~ 2-5/&Uv.n.,c::;. C>~ 5~WG";P In -4t!:tr~ ~~~hrf~~:; Permit applicant exempt from registration with the BuilQer's Board because: Additional Proje~t Information: -.'.. PLANS REVIEWED BY: -'name~ 7t~~ Signature~~ ~ #" ~ ' , .,L-~__.,date/~'Z"'~-e9' r' ./