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Home My WebLink AboutPermit Mechanical 1983-5-2 Job Address S /2-,- M aJS, legal De,criptlon J')-02.-11~12.-_ 06101 I INSPECTION lINE. 726- 37 69 Owner .. - ..,Jel.j., PC) Address Construction lender Address DES I GN TEAI~ Primary Structural Electrical Mechanical CONTRACTORS Genera 1 Plumbino I Electrical ~lechanical NO. I 1...1&';> C;""" 7 jCZ;>,OOO . ').5-0 1,0= laOoCl G./X> . CITY UF SPRINGFIELD COMBIIIATION APPLICATION/PERMIT EIIERr,y SOURCES: Heat t~ater Heater Range c!J JJ E) ~ INFDR/IATiON liNt I 726-3753 Sq. Ftg. I.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. -Fence Demo Change/Use -Other - - 1fO'>'(JCG/" Uo< 770 ValuE 1 ~6 s-: BuiltiinQ Pernlit Info: Describe Work(i.e., Familv nesidence With Attached Garaae) Build Single Phone !Jc,6 -BTBI (name) Phone (address) (ohone no. (1 ics. no.) (exo; res) ~y,6,/ (name) ~- (ohnne no. \ (address) fl ies. no. l (pxoirps) ~..I.Jl.oJ~.... PlUJIBING ELECTRICAL MECHANICAL FEE 'rHARr,E Nn 'I.L 'J:HARliE. _llih.: Res i dence of furnace/burner to SQ. FT. 1<0=0 BTU's '~~~ 'rl:lARG.E. ~ Each single fixture 7,Stl ; Relocated building (new fix. additional) S.F. Residence (] bath) Duplex (1 bath) each Additional bath \olatf;:r ser'vice Sewer Storm Sewer New circuits alts. or extensions Floor furnace and vent SERVICES Recessed wa 11 Sn~~p hp~tpr ~nQ vpnt ~~nc~l s€!oarate . ,Stationary evap. cooler Vent fan with sinole duct Vent system apart from heat;na or A.C. Mechanical exhaust hood and duct. Wood stove/heater 3.00 ITempOrary Construction IChange in existing rps i dJ.ncp . Imultifamily, COI1111. or tndu<;.trial IOf ICO~~./IND. FEEDERS I Install/alter/relocate dic;.trih. fppdpr<;. IOf amp~1 I I I amps. ISSUANCE OF PFRIIIT /O.QO 2(),SO TOTAL CHARGES . WHERE STATE L'I/ REQUIRES shall not be vali1 until the I TOTAL CHARGES that the Electrical work be done by an. label has been signed by an Electrical TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFULLY EXM1INED 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 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 NO OCCUPAIKY will 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 will be used on this project. SIGrlATURE dJ~/#..L4cJL t"/ IWIE(pl.ase print) d()hn ,\0 VlP{,;O k Zone Fire Zone Flood Plain BUILDING PER/lIT Charges and Surcharges PlUt1BING PERMIT Charges and Surcha rges ELECTRICAL PERJiIT Cha rges and Surcharges /IECHANICAl PERMIT Charges and Surcharges DATE Diz/ff~ Tvpe/Const. Bedrooms Stories FOr. OFFICE USE O.ur Sq. Ftg. Sq. Ftg. Sq. Ftg. x Units Occy load Occy Group r1ain Access Other .x x Value Value Value TOTAL VAlUATiOrl Plan Ck. Comm/lnd ____________~/R'dQ Ppr F~e Plan Ck. R-es 30%/BldQ Per Fee Fence Systems Development CharQe tI.5%1 . I I I DB!l10 Sidewalk ------------ I AIC Paving ______2Q~1 Curb Cut , qy" .e4J ITotal Comb. Permit 1- IIOTAl ;~ 1cf-1. ~~ ~ . . 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 sprlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. examole- heat/electrical ceilinQ/or forced air Qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. ------ 1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project. check new - if addition, chee k add. ete. F. Building pennit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3;" examyle - 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 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 OIVISION 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. --- 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. ~D ~31-- .~ QoY V. FOR OFFICE USE ONLY Permit Clerk r~ . ] 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 _ _ .,' .................,_...._<__,. _.'_'._~ '_.U~__ ..-._",-.". ._, ,".. .~_....--" _:.'-"--'- -<- ."*"'---- '