The URL can be used to link to this page

Home My WebLink AboutPermit Miscellaneous 1986-8-14 . . Valu, of I-Ior~: =< 6 & ""'- Builr;ina Permit Info: Describe I~ork(i~e," Build Single Far.1ilv nesidence l'llth JI.ttached (;araae) 6~~ ./7}:?-:;c.,-;"'?~ bJA-;~-' ~y~ f ~.;;i?iQ ~~,-~~' / - /l 6/ "J-:..~iL...~r ~11cs. no.) (exniresl I I I I TOTAL CHARGES J TOTAL CHARGES .1 TOTAL CHARGES WHERE STATE LAW REQUIRES that tile Electrical work be done by an Electrical Contractor. the electrical portion of shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division '1 jlflSPECTIOIl L1IIE 726-3769 . , CITY OF SPRIIlGFIELD CorlBI IIA II all APPLI CA IIONI PERMrT EflERGY SOURCES: Heat Ha tel'" Hea tel'" Ranqe legal 2/ '17 )'-4#//7 57: Dmription /7-O3-~(;" '7':< .e=?,)6'C!) , Job Address Owner 6/.Il/ I!!~:?f: Address 1?Oc-'h"=-X ":2'1867 Y~?7"'-~ W/;#. '7&'/~~ Constructinn lender Phone Address Ut~ 1 Gl1 f EArl fnamel Phone (address) Primary Structural Electrical r1echanical CONTRACTORS (name) (address) (1 ice;. no' Genera 1 ,tCb&::r.N.1<- ~__?:> '1 ~74 .v~..... . /' Plumbina Electrical 1,lechani ca 1 PLUIIB IIiG I rl-l.ARr:~. flO I I I I j -t I I ELECTRICAL 1m. FFE" rHARr.F r~n ccc Each Single fixture Residence of sq. FT. Relocated building (new fix. additional) S.F. Residence (J bathl Duplex (1 bath) New circuits alts. or extensions SERVICES each Additional bath Temporary Construction r- Change in existing I rp~ i rlJ"nrp I multifamily, COIl1:l. or Tnd,,<:.trlal I 10f I COI~'I.!IND. FEEDERS I Install/alter/relocate rli<:.trih fppdpr<:. I 10f I- I I ~!a ter servi ce Sewer Storm Sewer amps. amps. ~~ .fIArSG:;:, - I NfOf{JIA T ION L I ,It 726-3753 So. Ftq. 1.lain ~q. H!). Access. Sq. Ftq. Other Uew Add Alter ~ep. Fence_Demo _Change/Use _Other ~ \) ~ N {ohone no. ..It? - ,~ "1(~, ,', (PYFlirpc:' (ohnnp nn \ ~~-::5?q/ MECHAN I CAL I ~n:: rI-lAIU~~ furnace/burner to BTU's Floor furnace and vent Recessed wall ~n~rp hp~tpr ~nrl VP"t Appl iance vent "poaratp i Stationarv evap. cooler ~ Vent fan with sinole duct I Vent syster.1 apart heatino or A.C IMechanical exhaust : hood and dur:t from Wood stove/heater '1 I IS5UANCF OF PFR!IlT this perlilit I HAVE CAREFULLY EXN1IflED t),e completed application for ~ermit. 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 Orel)on pertaining to the work described herein. and that rlC OCCUPAI~CY 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 the sis for ex tion. noted hereon. and that only subcontractors and employees who are in compliance with OP.S 701.055 w 1 b sed on thi oje. 1IAf.IE(please Print)~I)~ 'Dm~ I 51f"IATURE FOr! OFF I C: USE Dill y. Sq. Ftg. r1ain ,)I' Sq. Ft!J. Access )I' Sq. Ftg. Other~~ .x Zone L <:::: Type/Canst. Bedrooms Stories Units Occy load Occy Group Fire Zone Flood Plain BUILDIIIG. PERI.lIT Charges anc Surcharges - Plan Ck. Corrm/lnd 65~/Rldo P~r Fpp Plan Ck. Res 30%/Bldo Per Fee I Fence I Demo I Sldewal~ I A/C Paving I Curb Cut I I TOTAL Value Value Value :7C"98.....". TOTAL VALUATlOlI Systems Development Charoe (1.5~) PLU'1BIIIG PERMIT Cha rges and Surcha rges ELECTRIUL PERI~IT Cha rges and Surcharges ~ S-o Total Comb. rermit ~ 11ECHANICAl PERMIT Charges and Surcharges jI~. 31?Sc>. . , ....i COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A, Job Address B. legal Description 1. examole~ Tax lot -lOa. lane County M'ap Reference 17 U3 43 2. examDle- Lot I. Block 3, 2nd Addition to -Spnngtield Estates C. 'Name~ etc. of owner and construction lendef- n Energy Sources . .1..' examole-' heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/electrlca'tlor 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. examole - construct single family house with an a ttached garage 2. examole - 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,' DES I GN TEAl.! 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. 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. - 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. 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. , II. III. IV. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPArJCY: - , . PERMIT VALIDATION ,- Permit Clerk , Permit appl icant exempt from registration with the Bui,lder' s Board .because: ,J. Additional Project Information: , , . , .. PLANS REVIEWED BY: name-.LtC>70U/~ ~t"'~ s'ignature 4- g-I'~~ 'I , .