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HomeMy WebLinkAboutPermit Electrical 1986-11-19 I INSPECTIon LINE 726-3769 . Job Address . ( ,<1-.t~ CITY Uf SPRHIGfIELD C011BIiIATION APPLICATION/PERMIT Legal Oe~cription ///I.::j' /f IJf flh1 ) l E1IERGY SOURCES: Heat t'Jater Heater Ran<1e ValUE of Hark: INFORltATIO:l Ui'it. 726-3753 Sq. Ftq. f.iain ~q. !='tg. Access. So. Ftg. Other flew' Add JI..1ter P.eD. --Fence Demo Change/Use Other - - g -:>0 J0 Address (U ,':/7 /J I ~ /LlaA~ ;;e-R~ /--1I/iA".L ~/ -:]-,1/ -I W~,c Phone t?37 ;?~5/ Builr:inQ Pennit Info: Describe ~Jorkli-.e.. Build Single Familv nesidence l'lith ".ttached (;araoe) Owner Construction Lender J1uw 1#700 --.. Address Ut~ J Grl fl:.A1t (name) Phone (address) /~tlr (1 ics. no. (exo; res) (ohone no. \ Primary Structura 1 I~. ; Electrical 11echanical CONTRACTORS InamE"'l (addrp.s,,) n il':<:;. no.) (pxr);rpc;) {nnnne nn.' Genera 1 Plumbina Electrical {)wfLV(../ t.1echanical PLUIIBI riG ELECTRICAL MECHANICAL ....J!JL..I I FFF I CHARr,F Each single fixture Relocated building (new fix. additional) I' S. F. Res i dence II bath) IOuPlex (1 bath) each Additional bath -.....llil.....1 i I=;:T i rliAflliE. ~Jn I Residence of SQ. FT. New circuits alts. or extensions '!IL' furnace/burner to BTlI's Floor furnace and vent SERVICES Recessed wall Sl'l~('tl kp~tt>.. ::Inri Ifpnt Sewer ITempOrary Construction Change in existing rpS; (tp~nr~ multifamily, comm. or InrllJ<:.trial Storm Sewer Of COMM./IND. FEEDERS Install/alter/relocate rli<:.rrih fpt>npr<:. amps. Appliance vent saoa ra tp Stationary evao. rnoler" . Vent fan wi th . s;nole durt Vent system apart from heating or A.C. j'lechanical exhaust hood and dud Wood stove/heater -I ~Iater servi ce Of amps. ISSUANCE OF PFRtHT TOTAL CHARGES TOTAL CHARGES WHERE STATE L.\I-I REQUIRES that the Electrical work be done by an shall not be vali1 until the label has been signed by an Electrical TOTAL CHARGES Electrical Contractor. the electrical portion of this permit Surervisor and returned to the Building Division I HAVE CAREFULLY EXM1INED 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 Soringfield and the laws of the State of Oreqon oertaining to the work described herein, and that rw 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 ORS 701.055. that if exempt the basis for exemotion is noted hereon. and that ~:I::(:~::::t:::::~S ~;~yS :~~C::;:._~ith:::I~~e ~~ om 1I-(q-f&J FOr. OFFICE USE OIIL Y Sq. Ftg. riain $Q. Ft!J. Access Sq. Ftg. Other Zone Tvpe/Const. Bedrooms Stories Units Occy load Occ.y Group x Value Val ue Fi re Zone x Flood Plain x Value v(o TOTAL VALUATION BUILDlIlG PERr.1!T Charges anc Surcharges Plan Ck. Comm/Ind Syste~s Development Charoe 0.5%) PLUt1BING PERMIT Charges and Surcha rges ____________ 65X1BldCl p_pr r",p Plan Ck. Res 30%/Bldq P~r Fee ____________1 Fence I O~mo ___~_.:?J_.~QI Sidewalk .90 A/C Paving Curb Cut I ~ I J<. I f~c LabdJ Total Comb. Permi t I I TOTAL I ;) 3/bV , ..ELECTRICP,L PERI~IT Cha rges and Surcharges 11ECHAN I CAL PERMIT Charges and Surcharges .zn ;. - . . '1 I , ., 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 1I oj 43 2. examole- Lot I. Block 3. 2nd Addition to sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/electrlca(/or solar. E. Square footage or valuation, etc. ------ 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project. check-new - if addition, cheCK add. etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. examole - 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. DESIGN TE~l 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 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. B01~~5 II ~ I q - f(P V. FOR OFFICE USE ONLY Permit Clerk cc/ ~ ,. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANC Permit applicant exempt from registration with the Bunder's Board because: Additional Project Information: PLANS REVIEWED BY: J , name signature date , ~l