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HomeMy WebLinkAboutPermit Electrical 1982-12-13 C./TAjV6--~ ., 0(\ rv '" 00 I~ BuilolnQ Permit Info: Descr1be \~ork{1.e" Build Single I Family l1esidence \Jith Attached Garaoe) s.<"V/C~J . fZsz.-,' -ti ;g(,dO~ 0 . ll1lSPECTIotl LINE. 726- 37 69 CITY OF SPRIIIGFIELD COMBInATIOII APPLlCATIOlI/PERMn EIIERGY SOURCES: Heat Hater Heater Job Address //'6 'i5 M A ) A.I <; ?"c.t=> I.egal Description n ~h&"\ ~ ()lJ!rrf)f)O .. - .- 0;0--- Range ValuE of Hork: INFORlIATION LINt 726-37S3 Sq. Ftq. 1.lain ~q. Ftg. Access. Sq. Ftg. Other flew Add A I ter Pep. -Fence Demo Change/Use -Other - - Owner E P B r /1/ AI ~ r r Address$5,;?o.sv.N'..5 G"T S'PFD Phone _~;' ~ Y." '" ",0 E,Lec..T Construction Lender Address DtSIGN ItAf1 (name) Phone f address 1 (l ics. no.) (exo; res) (ohone no. J Primary -~L AT- ., Structura 1 Electrical Mechanical CONTRACTORS (name) (address) (lies. no. \ (pxo;rec;.) (ohane no.) Genera 1 Plumbino Electrical < 1/ /\/ L n 7> DEL G" c. r- ;; b.J L (; V... L 5P"cEj dO -/..0..2 C. '7/?D/g-~ 7.ilit i'f!:OO ~lechan; ca 1 PLUIIBING ELECTRICAL MECHANICAL NO.1 lEaCh single fixture IRelocated building (new fix. additional) IS. F. Res i dence (1 bath) IDuplex (1 bath) each IAdditional bath ~Iater service I FEf7 I f.HARt;F Nn ' I r:n- I rI-lAR~J: NO. I I r:r:r I nlAR~r Residence of SQ. FT. furnace/burner to BTU's New circuits alts. or extensions Floor furnace and vent ISERVICES I ';'J: Recessed wall Snn~p hPntpr nnd vpnt Sewer I I I I I I I I I TOTAL CHARGES _2 In. l!)'U TOTAL CHARGES that the Electrical work be done by an.-[lectrical Contractor, the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the Building Division Iremporary Construction I'Change in existing rP5- i r!pnrp . Imultifamily, comm. or Indu"trial Storm Sewer 10f ICOf~1./IND. FEEDERS I Install/alter/relocate rlic:.trih fpprlprc:. 10f I I I amps. Appliance vent "FlOaratp Stationary evap. cooler Vent fan with s;nole duct Vent system apart heatinq or A.C. Mechanical exhaust hnnd and dud from Wood stove/heater amps. ISSUANCE OF PFR!IIT TOTAL CHARGES WHERE STATE L~H REQUIRES shall not be val;~ until the I HAVE CAREFUllY EXM11NED the completed aprl;cation for permit, and do hereby certify that all information hereon is true and correct. and I further certify that any and all work performed 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 NO OCCUPAHCY 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 subcontractors and employees who are in compliance with OP.S 7Ql.055 will be used on this project. I~AI.\E(please print) R .. 10-'1.. r" k \-..\ f) \'1 h. 4. Y) SIGIIATURE?~cr/'/ om /'L/J'<k."- FO~ OFFICE USE OI~L Y Zone Tyoe/Const. Units Sq. Ftg. 11ain Fire Zone Bedrooms Occy Load Sq. Ftg. Access Flood Plain Stories Dcc.y Group Sq_ Ftg. Other x Value Value Value x x TOTAL VALUATION BUILDING PERflIT Charges and Surcharges Plan Ck. Comm/Ind ____________....Q.2!/Bldo Per Fee Plan Ck. Res 30%lBlda Per Fee Fence Systems Development Charae (1.5%) PLU'1BING PERMIT Charges and Surcharges Demo I I I ITotal Comb. Permit I I TOTAL c%o~ ELECTRICAL PERI~IT Cha rges and Surcharges _ -.d_S_,~ _?._ ___Sidewalk 1.00 I A/C Paving Curb Cut f1ECHAN I CAL PERMIT Charges and Surcharges . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. lega 1 Oeser; pt i on 1. example. Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot I. Block 3, 2nd Addition to Springfield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinq/or forced air Qas 2. exa~le- waterheaterielectrical/or solar E. Square footage or valuation, etc. I. 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. example - construct single family house with an attached garage 2. example - 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. 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 schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOULES 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. --- Ill. 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. 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 ~ ~. ;..<..0<....__, '"~ ..:....--~...-~ .-. - ~'.._-- :