Loading...
HomeMy WebLinkAboutPermit Miscellaneous 1987-1-28 .' '. CITY UF SPRINGFIELD CD/IBIIIATION APPLlCATION/PERMrT EilERGY SOURCES: Heat t'Jater Heater . INFORt1ATION L!1'it 726-3753 Sq. Ftq. f.lain ~q. !='ta. Access. Sq, Ftg. Other Ilew Add Alter P.eD. --Fence Demo Change/Use Other - - ~ ~ ~ I INSPECTION LINE 726-3769 , Job Address 1001 Main Street l.egaIOe,cript;on 17-03-35 4.1 Lots 5300, 5400 & 5500 Springfield Utility Board POB 300 Springfield, OR 97477 . RaMe ValUE of Hark: ~ $30,000 Ph 746-84~lBullGlnq Pennlt Info: Describe l~ork{Le., Build Single l/r;-- .. Famil'( nesldence \lith f\.ttached r,araoe) .,,- 35,300 square foot asphalt overlay 5,360 square foot new paving Owner Address Construction Lender Address UI:.)IGf{ TE.m1 lname) Phone (address) (1 ics. no.) (pxn; res) (ohane no. Primary Virgil Alonso, SUB ~46-8451 ,,' 402 V Structural t1echanical CONTRACTORS (name 1 per bid process (ilddress) (1 ics. no. \ (pxoir~s' {~hOf\P nn \ I I \ I I 1 I Electrical Genera 1 Plumbino Electrical ~lechani ca 1 PLUlIBING ELECTRICAL MECHANICAL NO,I -----lEach single fixture Relocated building (new fix. additional) FFF I rHllR(;F I ~I Il=.:n. I Res i dence of SQ. FT. !New circu~ts alts. or extenSlons I SERVICES I rl-lll&.G..E ~ tl() I I ~~~ I r\fAB..G.E. I furnace/burner to BTU's Floor furnace and vent S.F. Residence II bathl Duplex (1 bath) each Recessed wall ~n~rp hp~tpr ~nrl vpnt Storm Sewer Of amps Appliance vent c;.poarate Stationarv evao. cooler ~ . Vent fan with sinnle duct Vent system apart from I heatino or A.C. Mechanical exhaust hnnd ilnd dll'"'" Additional bath Sewer Temporary Construction IChange in existing residencp Imul.ti-familY, COITDTI. or Tnduc;t.rial ~!a ter servi ce com\. II NO. FEEDERS Install/alter/relocate rlic;trih fppdprc; Wood stove/heater Of amps.1 ISSUANC, OF PFR'lIT TOTAL CHARG,S J TOTAL CHARGES ImERE STATE L,\I~ REQUIRES that tile Electr;cal work be done by an shall not be vali1 until the label has been signed by an Electrical TOTAL CHARGES Electrical Contractor, the electrical portion of this pe~it Surervisor and returned to the Building Division 1 HAVE CAREFULLY EXMlINED 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 oerformed shall be done in accordance with the.Ordinances of the City of Soringfield and the laws of the State of OreC]on pertaining to the work described herein, and that 1m OCCUPAIlCY \.,.i11 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 exempt the basis for exemntion is noted hereon, and that only subcontractors and employees who are in comoliance with OP.S 701.055 will be used on this project. IIAI-IE(please print) KICI-IIU:'T"c> 7"2=L.i./NA SIr,IIATURE~~:z:f!.. ,_ FO~ OFFICE USE OilL Y " Zone_ C:C TYOe/constjJIv,,~ Units Sn. Ftg. Ila;n x Value Fire Zone Bedrooms Occy load Sa. Ft~. Accessj\/E"W _~Jr/~ Value ~~~ Flood Plain Stories Occ,V Group Sq, ng. Other OV~~ Value~,~ !i6Te ~ F~ ~ ~N' pk'Y /ili~o/~ O#~ '7" TOTAL VALUATlml~--- BUILDING PER~IIT Plan Ck. CommlI.nd ~~.o3" syste.ms Development /'''. QC> Charges an~ 65'.l:/Rldo Ppr Fpp -<~, ,. CharQe 0.5%) ~ Surcharges ------------""""i5"fan Ck. Res 30%/Bldo Per Fee I Fence om / /ZQ/87 PLU'1BING PERMIT Charges and Surcha rges Demo ELECTR ICAL PERI~IT Cha rges and Surcharges IIECHAN I CAL PERMIT Charges and Surcharges Sidewalk ------------ I A/e Pav; ng ________.____, Curb Cut I 'Ii/. 5"t:J ITota, Comb. rermi t LI'I, =>~ /33. 'tB . I I TOTAL . . iii iI COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax Lot 100, lane County Map Reference 11 oj 43 2, ' example- Lot 1. Block 3. 2nd Addition to Sprlngtleld Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceiling/or forced air Qas 2. examole- waterheater/electrlcal/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. example -'construct single family house with an a ttached garage 2. examole - remodel existing garage into family room 3. examyle - 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. OESIGN 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 schedules C. BUILDING OIVISION 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. g0~0J--~ ({ /~0 \ ",z,'b I V. FOR OFFICE USE ONLY ~ Permit Clerk C0 '1 1 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPMlCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: - 1 PLANS REVIEWED BY: V ./2 ?-J- name L..e.Jl?nE /L~g;;:p signatur"" //,1I.4e-('~=;; -- r date /-/9-.87