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HomeMy WebLinkAboutPermit Signage 1988-7-12 I INSPECTION LINE 726-3769 Job Address 5'125 . CITY Uf SPRINGFIELO COMBINATION APPLICATION/PERMIT E!lERGY SOURCES: Heat Hater Heater Range ValuE of Work.: . INFORltATION UNl 726-3753 Sq. Ftg. I.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. --Fence Demo Change/Use Other- - /YL~ Legal Description , 0\) ~ ~ ~ BuildinQ Permit Info: Oescribe Work(i-.e.. Build Single ............ Familv R.esidence l~ith...P.ttached Garaael , ~ ~ ~AfiJ\;)' ~ / ~ Owner lll~ Address . "5"9;;- ., f ~~ ~ Phone Construction Lender Address DESIGN TEAll (name) Phone (address) (1 ics. no.l (exoiresl I , I no. ) (ahOM Primary Mechanical CONTRACTORS (.....,1 (address) flics.no.) (pxnires) ~L ~y {",hOOP nn Structural __,...- $300 ...,.,.~ \ Electrical Genera 1 Electrical / /){.1 JVJO A./ r I J /}' , Plumbina ~lechan;cal PlmBIIlG ELECTRICAL MECHANICAL NO. FEF rHARr,F Nn rrr r~~Rr.r Nn rr~ ~ rl-ldQr..~ ~ Each single fixture Residence of SQ. FT. furnace/burner to BTU's Relocated building (new fix. additional) S.F. Residence (l bath) Duplex (1 bath) each Additional bath New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wall Sn~rp hp~tpr ~nrl vpnt Storm Sewer I I I I I I Of amps. Appliance vent ~POi'lrate Stationary evap. cooler Vent fan with <;;nolf:\ rluct Vent system apart from I h':'':ltinq 0f A.r Mechanical exhaust hood and rluc-t Sewer Temporary Construction Change in existing rpc;iQ.ent:p multifamily, corrrn. or Tnrlu<;triitl ~Iater service ~I ~ f) ()d \/1 I I COMM./INO. FEEDERS Install/alter/relocate c1i c:;tritL fpprlprc; Wood stove/heater Of amps.! TOTAL CHARGES WHERE STATE l~U REQUIRES shall not be vali-J until the TOTAL CHARGES ISSUANCE OF PFR!lIT TOTAL CHARGES that the Electrical work be done by an"Electrical Contrac ,or, the electrical portion of this perrilit label has been signed by an Electrical Surervisor and returned to the Building Division I HAVE CAREFUlLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed 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 rm OCCUPArKY 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 O~S 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. IWIE(please print) K.11/fE.N J ':bONNER.....> SIr,!IATUR~tJrn.~ ... ..---- . -- --- -.- .---- FO~ orFI CE USE O1~L Y DATELg/lJJ./f v v Zone Fire ZonE' Flood Plain Tvpe/Const. Bedrooms Stories Units Occy Load Occy Group Sq. Ftg. liain Sq. Ftg. Access Sq. Ftg. Other x Value Value Value x x TOTAL VALUATION BUILDING PERNIT Charges an~ Surcharges Plan Ck. Comm/lnd 65%/Blda Ppr Fpe ------------PTan Ck. Res 30%/Blda Per Fee Fence Systems Development Charoe (1.5%) . PLU'1BING PERMIT Charges and Surcharges I OeRlO 15, Cf'D I Sidewalk --------~75-1 A/C Pavin9 I Curb Cut leaU! I I I ")'" (EO( ~ I I ELECTRICAL PERI:IT Charges and ~ Surcha rges 1, .1ECHANICAL PERMIT Charges and Surcharges ITotal Comb. Permit -~ (.5 - r~ I --uD I TOTAL . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Oescription 1. example- Tax Lot 100, Lane County Map Reference II UJ 43 2. example- Lot I. Block 3, 2nd Addition to sprlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilin~/or forced air aas 2. examyle- waterheaterlelectrical/or solar E. Square footage or valuation, etc. , I. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check:ruew - if addition, checl< add. etc. F. Building pennit information: 1. example - construct single family house with an attached garage 2. examele - remodel existing garage into family room 3, exa~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. DESIGN TEM~ 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 0, 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 signature. 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. rr(j; 7{ 1-17/--11( V: FOR OFFICE USE ONLY Permit Clerk CfJ . 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