Loading...
HomeMy WebLinkAboutPermit Miscellaneous 1986-8-14 (2) . . ValuE of l'lor~: =<6<9 & ""'-=- Buildina Penn; t Info: Describe Hark( Le.. Far.lilv P-esidence l'lith fi,ttached r.araoel G~~ ;'!-,7qJ5:77??-?c? :p~r<-/ f);ryc= l' ch?i'~ /??-<i.-:._i~ /~/ 4~~. , ~d~~. no. i (exn; res) (onone no.' I ~ F -, iIlSPECTlOll LWE 716-3769 . Job Address Z/ If? )-.4/'///7 57: Legal De"ription /?-o3-~t:.. '1':? . t') :<,6(!) , Owner 0/)r...~ 6v~:_~I"~ Address 1?Or'h>=->r :?~B6/ ~';?7C~ ~d ""7&,/:::?q Construct inn lender Phone Address Ul:.~lull ltt\rl (name) Phone (address) Primary Structural Electrical r1echani ca 1 CONTRACTORS I name 1 (address) Genera I h.....:::;:,N~ :::;;'-vn t ~7'" J..-6?' Plumbino (1 its no.l /. Electrical '1eChani ca 1 PLUlIBlIIG I i-EIu~'n I I I j I I I r~o _ ELECTRICAL FFF CHARt;F t;n i Residence of sq. FT. New circuits alts. or extensions I SERVICES I I Temporary Construction I Change in existing rp'i- 'i riJ~nrp I jmultifam;ly, CQITr.l. or Tnnllc:.tri;11 I Of amps. I cor~'1. IIND. FEEDERS I IInstall/alter/relocate rli~tr1h fpprlpr~ I Of amps. I I I Each single fixture Relocated building (new fix, additional) S.F. Residence 11 bath\ IDuplex (1 bath) each IAdditional bath ~!ater service Sewer Storm Sewer JNfORl1ATION L~ltt. Ii 726-3753 So. Ftq. "lain ~q. ftg. Access. Sq, Ftg. Other r~e\<I Add Alter ~ep. Fence_Demo _Change/Use _Other ~ \} ~ N Build Single (px~\ (ohnnp nn )_ ~qr..s?~/ MECHANICAL 1 n'~ . rL4llB.G.E. furnace/burner to BTlI's Floor furnace and vent I Recessed wall ~n~rp hp~tp~-~nrl vpnt I Apol iance vent ~~Oilr~tr:a Stationary evap. cooler ~ Vent fan wi th s1nole duct Vent syste~ apart from heatina or A.c. Mecnanical exhaust hood and duo I Hood stove/heater I I I I ISSUANCE OF PFRtllT TOTAL CHARGES .1 TOTAL CHARGES .1 TOTAL CHARGES WHERE STATE L~W REQUIRES that the Electrical work be done by an Electrical Contractor. the electrical portion of this pe~it shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAr1WEO the completed application for lJermit. 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 ~ertaining to the work described herein, and that flC OCCUPAUCY wi 11 be made of any structure without the permission of the Building Division. I further certify that my re~istration 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 comoliance with OP.S 7Q1.055 w 1 b sed on thi oje IlAIlE(please print)~I)~ · DATE ~tl ~ S mlA TURF. FO~ OFFICE USE 61iLY' So. Ftg. Sq. Ft~. Sq. Ftg. Zone C. c.: Fi re Zone Flood Plain Tv~e/Const. Bedrooms Stories Units Occy load Occy Group riain Access Other r/91.~,-/ -, ", BU I LD IIIG PERI.IIT Charges an': Surcharges Plan C~. Comm/Ind 65%/Blda Ppr Fpp ------------"""fi"fan Ck. ROes 30%/Bldn Per Fee I Fence I O~mo I S1dewal~ I A/C Paving I Curb Cut I Value Value Value 7C"38.--=- TOTAL VAlUATlOII , , "--" Syste~s Development CharQe (1. 5~) PLU'1BWG PERMIT Charges and Surcharges ------------ ELECTRIC;.L PERr~IT Charges and Surcharges fI~. I1ECHAN I CAL PERMIT Charges and Surcharges ~~ ~~ Total Comb. Permit I TOTAL u 38-SC>' .. . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A, Job Address B, Legal Oescription 1. examole- Tax lot .100, lane County Map Reference 11 UJ 43 2. example- Lot 1. Block 3, 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender C. Energy Sources 1. examole- heat/electrical ceilinQ/or forced air Qas 2. examole- waterheater/electr;cal/or solar E. Square footage or v~luat;on, etc. ------ 1. example- 1250 sq. foot house, .500 sq, foot garage 2. example- if new project, check new - i.f addition, check add. etc. F. Building permit information: . 1. examole - construct single family house with an attached garage . , 2. examole - remodel existing garage into family room 3. examo I e - convert s; n9 1 e .family res; dence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specia,lty 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 8. 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 Z. 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 011 THE SCHEDULES D. As noted on the CAPy 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 possibley 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. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: ~ITY OF SPRINGFIELD . City Hall Sprlngftald, Dragon Depertment of Public Works OFFICIAL RECEIPT (I 'No. B Date At..Vi 1'1 19 ~. . (I Rec'd From ~.ElYt!= ~12..1~..4-.4 y~ 'R6..7:!C,JC l~7 Address Cc.-'CJ'C'~"" c:;; 7V 1'5 / . .. ( ( 669lC , <1 J~,7S Q::: &t;; d-:-'),h2 Received For: t ;1ZIY//'-I?' ~7/Y/<~ ?&:.s~ . ( ( ( q~, ( 3R.;YO Amount Received ( d p/"" //f~,' ,~?:1 tr;> ALJ'rHORlZED S1GNAT~FlE r - '1. ( . ~. ... Permit Clerk l , Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: . , PLANS REVIEWED BY: name Ltt>7U/Cf ~r~':;( signature ~~. y Pe .'. >' ,date &-/~-~ . .- . ,I