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HomeMy WebLinkAboutPermit Electrical 1990-1-30 \ INSPECTION LINE 726-3769 Job Address \ I\~l) t\'{\ ~'(\ ~ Legal Description f1Q.38lo3 r 6I/..o()() Ow\er ~ h J,J. O. ~ CITY UF SPRINGFIELD COMBINATION APPLICATION/PERMIT . INFORI1ATlON LINE 726-3753 Sq. Ftg. Hain ~q. Ftg. Access. Sq. Ftg. Other. lIew Add Alter Rep. -Fence Demo Change/Use Other - - .J) EIIERGY SOURCES: Heat l~ater Heater lJ j. tri I) OC) .J\ f aJ-- Phonf~\()\ In f , U.:-V\\I ,1.11'1- Range _ valu,\\f\r\j . BUlltiina~ermlt Info: Oeser be Work{i.e., Build Single Familv R s;dence W~1h_ A~ta:~ed Garaael l:' \ )U.Jy.J$1flf1d1rfYmp \ (I) f) (1});n::;- Construct v Address DESIGN rEM (name) Phone (address' (l its. no. \ {exniresl {ohone no. Primar.v ~~ ~ Structura 1 Electrical 11echan;cal CONTRACTORS (namel {address \ (lies. no, \ (pxnir~s\ (ohane n~. 1 Genera 1 Pll,lm~ino Electrical. G-0,( ,G.lo. \I'\~. EloJltnl"C' " PLUMBING ELECTRICAL 7)lo~ 1.I.)gct1 hB 4-"K '5-2b~ (~RLP()rT ) I IfJVq J , MECHANICAL ~'echanical NO. . FEE CH~RGE NO "FF . CH'lRliE. NO. FFF rH~ SQ. FT. furnace/burner to BTU's Each single fixture Residence of Relocated building (new fix. additional) f\\' .New circuits alts. ('j or extensions r ~QsJ Floor furnace and vent S.F. Residence (j bath' Duplex (1 bath) each Additional bath SERVICES Recessed wall Sn~rp "PAtpr And vp~t amps. Appliance vent ~t:o~r;:'l~,p Stationary evap. conl@r Vent fan wi th sin91e duct Vent system apart from I heatinq or A.C. Mechanical exhaust hnl'Jd and dud. Sewer Temporary Construction Change in existing reos j <te.nee multifamlly, corran. or lndustl"'ial Water service Storm Sewer Of COMfI./lND. FEEDERS Install/alter/relocate di~trib. frpder~ o~mps. Wood stove/heater ()!J.~ TOTAL CHARGES WIlEnE STATE LAII REQUIRES shall not be vali1 until the \ TOTAL CHARGES that the Electrical work be done by an. label has been signed by an Electrical I SSUANCF OF PFRIlIT ~f)CJ, TOTAL CHARGES Electrical Contractor, the electrical rartlon of this penmit 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 nerformed 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 HO OCCUPArlCY 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 exemption is noted hereon, and that only sUbcontraci~l~~~ Wi~S 7~1.DS " 1 be use on this project. ~nt) SI~UR FOP. orFICE USE'EfOl~ ' Zone Tvpe/Canst. Units SI1. J . l-\ain Fire Zone Bedrooms Occy load Sq. tlJ. Access Flood Plain Stories Occy Group Sq. Ftg. Other DATE . Value Value . x Value TOTAL VALUATION BUILDING PERfIlT Charges and Surcharges Plan Ck, Comm/lnd ____________ ~'Rldo P.l'r Fpp Plan Ck. Res 3D~'Bldo Per Fee Fence 'syste.r.1s Development I Charoe (1. 5~ '" PLU'~BING PERMIT Charges and Surcha rges D~o __~S-"C!?___ 'Sldewalk A .!1 ~ A/C Paving Curb Cut Tota' Comb. Permit EL[CTR I CAL PERIH T Cha rges and Surcharges IIECHANICAL PERHIT Charges and Sure ha rge s TOTAL ~'l ~Q~ I ~ ,~ COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description I. example- Tax Lot 100, Lane County Map Reference 11 oj 4J 2, example- Lot 1. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examole. heat/electrical ceilinQ/or forced air Qas 2. examyle- waterheaterjelectrical/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 permit information: 1. examole - construct single family house with an attached garage 2. exa~le - remodel existing garage into family room 3. examjple - 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. B~;lding Division Staff must be able to contact appropriate persons regarding design information or job site corrections. etc. ' , t 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 b~ 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. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . . .. PERMIT VALIDATION " I cfJ-YrJ Permi t Cl erk ciD~ Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name , signature date