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Home My WebLink AboutPermit Mechanical 1988-7-19 JINSPECTION LINE 726-3769 Job Address . CITY UF SPRINGFIECD COMBINATION APPLICATION/PERMIT EIIERGY SOURCES: Heat l~ater Heater . INFORllATlON CIN" 726-3753 Sq. Ftg. 1.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter Pep. --Fence Demo Change/Use Other- - ~ ~;).// m ti0v Legal Description Phone 72t 112/ BuiltiinQ Permit Info: Describe Work(i~e , Familv nesidence With Attached ~raoel 1 ~. .~/. J" "'.u _:I ..12lM / ,. ". (J . Build Single a;) ~ ::J \) Owner~/~ ~. Address :::Ld. I qJ rn (!I ,-: Range ValuE of Hark: Construct; ender /I - , _ t? A Addre. (}jml/nt/tMdJ- JMkd A9-t~ ) DESIGN iEAr1 I,;amel . . fddJssl primar~ ~p Lt.-. flies. no.) (exoiresl lohone no. l ~ v (- .... .... "/"1 II c' 1, n() J Structura 1 Electrical Mechanical CONTRACTORS lnamel (addrpss) (1 ;('11;,_ no.) (pxoirp~) (ohnnp no ,;,cy'V "* Genera 1 Plumbina Electrical / 01VI7#11/ Mechanical PLUIIBING ELECTRICAL MECHANICAL NO. Each single fixture FEF I-ClJARr.F Nn~1 FFF r"'IRG.E. NO I Residence of furnace/burner to SQ. FT. BTU's I ':.E.L 1.cHAllG.f.. Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (l bathl Ouplex (1 bath) each Additional bath ISERVICES I Recessed wall Sn~rp hp~tpr ~nrl vpnt Sewer ITemporary Construction IChange in existing rp~ j QPJlrp Imultifamily, conm. or lnduc:;trial IOf amps. ICO~1./1ND. FEEDERS I Install/alter/relocate di..trih. fppdpr.. Appliance vent c:;eoaratp Stationary evap. cooler Vent fan wi th ~inole duct Vent system apart from heatina or A.C. Mechanical exhaust hood and dlJrt. Water service Storm Sewer Wood stove/heater 4.0 IOf I I I amps. ISSUANCE OF PFRI1IT TOTAL CMARGES TOTAL CHARGES TOTAL CHARGES WMERE STATE L'H REQUIRES that the Electrical work be done by an'Electrical Contractor. the electrical portion of this permit shall not be valij until the label has been signed by an Electrical Supervisor 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 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 IlO 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 ons 701.055, that if exemp!~asis for exemption is noted hereon, and that :~::(:~::::t::~::~s a~\e~;~s w:a;~n~O:l~a~:th :::IIZ~/&;~ DATE7,/r-% FOP. OFFICE USE,orILY sot' Ftg. S:;. FtD. Sq. Ftg. Zone Fire Zone Flood Plain Type/Canst. Bedrooms Units Occy Load Dccy Group t1ain x Value Value Value Access x Stories Other x TOTAL VALUATION BUILDING PERf1IT Charges and Surcharges Plan Ck. Comm/Ind 65~/Bldn P~r Fpp Plan Ck. Res 30%/Bldo Per Fee Fence Syste.msDevelopment Charoe (L5~) PLUI1BING PERMIT Charges and Surcharges D~.o ELECTRICAL PERI~IT 'S1dewal k Charges and ------------ Surcharges A/C Paving Total Comb. Permit MECMANICAL PERMIT Charges and SurCharges 6 ____15_<_0_O"J Curb Cut .7::5 I TOTAL (~-'-7S' , '.' . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I, Applicant to furnish A. Job Address B. Legal Description I. example- Tax Lot 10D, Lane County Map Reference II oj 43 2. exam~le- Lot I. Block 3, 2nd Addition to Spr,ngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. example- heat/electrical ceilin...Cl/or forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation. etc. - 1. examole- 1250 sq. foot house. 500 sq. foot garage 2. exa~le- if new project, check-new - if addition, check add, etc. F. Building pennit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. examole - 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 schedul es 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, --- 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. (did 1- /(q~~f 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: name signature date