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Home My WebLink AboutPermit Mechanical 1991-3-1 o/9~t') CITY Of SPRINGfIELD COIIBHIATlON APPLICATION/PERMIT I. E!IERGY SOURCES: Heat I Hater,.Heater 'I'~' . Range . Valu€ of Hark: X $7,Q9}.OQ BuiltiinQ Permit Info: Describe Work(i.e,. Familv nesidence With Attached Garaael . 1 HISFECTlON LINE 726-3769 Job Address 42 '-- ~ Le9al De,cription /702 . ?< 'I- Owner W.C.' Wood Construction Address ,On - 12th St.. Oreeon ~\P( INFORltATlON LINe 726-3753 Sq. Ftg. 1.lain ~q. FtlJ. Access. Sq. Ftg. Other rlew Add Alter ~ep, Fence_Demo _Change/Use _Other n1k/A_) :s 2-- .32 c!tv. ollhone Build Single S) 10 ~ 1(; " " " . Construction Lender ,h/~7;1:ytL P///J L/"//T/r0,7~:S f .b<Tl9U?l'})(It"}-r" . Address DESIGfr TEAli (name) Phone (address) flies. no.) (exoires) (ohone no.' Structural ------ tl.. -d.\f/r' -11~ i~ Primary Electrical ------ ---- r1echan;cal CONTRACTORS (name) (address I t 1 i.-c;;. no.' (pxoirpc:\ (ohnnp nn. 1 General Plumbina Electrical ;>( Mechanical Salem Heating P.O. Box 12005. Salem. OR 97309 1505 5/19/91 581-1536 PLUlIBI NG ELECTRICAL MECHANICAL --BQ." FEF 'CHARGE .JJn r:r:r: ru~.....HQ..... SQ. FT. furnace/burner to 2- BTlI.' s Floor furnace and vent CCL..c1iAR.G.E.- Each single fixture Residence of 61!JO )2#0 Relocated building (new fix. additional) I'S.F. Residence (l bath] louplex (1 bath) IAdditional bath I Water service I Sewer I Storm Sewer I I I I I I New circuits alts. or extensions SERVICES Recessed wa 11 Sn~rp hp~tp~ ~"rl upnt each ITempOrary Construction IChange in existing rp$ i dJ'}l~p Imultifamily. comm. or TndlJc:trial 10f ICOMM./IND. FEEDERS I Install/alter/relocate dic:trih. fppdPrC: 10f 1 1 I amps. Appl iance- vent seoa ra tp Stationary evap, cooler Vent fan with sinole duct Vent system apart from heatina or A.C. I Mechanical exhaust hood and dur. t. I I.lood s tove/hea ter I~a :J)Hc-T I -I :r~ amps. TOTAL CHARGES TOTAL CHARGES WHERE STATE Ul~ REQUIRES that the Electrical work be done by an shall not be vali1 until the label has been signed by an Electrical I I I TOTAL CHARGES Electrical Contractor. the electrical rortion of Surervisor and returned to the Building Division I SSUANCf OF pm/lIT If') 110 '2..5(70 thi s pemit 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 Spri ngfi e 1 d and the laws of the Sta te of Oregon perta i ni ng to the work descri bed herei n. and tha t rm OCCUPAr~CY wi 11 be made of any structure without the permission of the Building Division. T 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 OP.S 7nl,055 will be used on this project. Zone Fi re Zone Flood Plain Tyoe/Const. Bedrooms' Stories Units Occy load Occy Group SIGII^TURE ~n"'-""-~ FO~ OFFICE USE OriL'y- u Sn. Ftg. 11ain Sq, Ft9. Access Sq. Ftg. Other , f,-l,j,-..., DATE 3/1/91 I- IW.IE(please print) Kathy Fitch x Value Value Value x x TOTAL VALUATlDr' BUILDING PERfllT Charges anc Surcharges , Plan Ck. ConmlInd 65%/81do Ppr Fpp ------------ Plan Ck. Res 30%lBI do Per Fee Fence Systems Development CharQe (I.Sn PLUl1BING PERMIT Cha rges and Surcha rges Demo ELECTRICAL PERIIIT Charges and Surcharges Sidewalk A/C Pavi ng 25"0 Curb Cut n--;-is---- Total Comb. rermit 11ECHANICAL PERMIT Charges and Surcharges TOTAL ~~>t 2- 5 . . . -- , . '. ,I COMBINATION APPGICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot laO, Lane County Map Reference II 03 43 2. examp]e- Lot 1. Block 3, 2nd Addition to ~prl,ngtield Estates . ' C: Name. etc, of~owner and construction' lender D. Energy Sources 1. examl,?le- -heat/electrical ceilinqjor forced air qas 2, exampJe- 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, check add, etc. ' F, Building pennit information: 1. cXJmD1e - construct Singlp. f~mily h0use with an attached garage 2, . exam~le - 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 TEAM AND CONTRACTORS To avoid, design or construction delays. Sui lding 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 appl,icant 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 fu 11 schedu 1 es C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As notedllon 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, Appii~ant 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 at1lthe time the actual permit is issued for his signature, i: 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, ..),., ... '.. ,. . J . I V. FOR OFFICE USE ONLY Permit Clerk ~~ . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: 'Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: "'. PLANS REVIEWED BY: I name signature date ,