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HomeMy WebLinkAboutPermit Curb Cut 1984-7-13 . I IrISPECTIDN L1IIE 726-3769 Job Address / d-. I S- 1'1 A I M Legal Dmription \ 'I ()~ 7'1~ ~ \ Owner ) D h N /\1 I f.. f1 / L L 1= IL-- Address / (L/. / 1-0 ft. / /\/ Construction lender Address Ul:.~lliU ItAr1 (name) Primary Structura 1 Electrical Meehan; ca 1 CONTRACTORS Genera I R 0 I) (name) C;-r-O u 14...-,0 I'M Plumbina Electrical f..lechanical PLUIIBHIG .....llih , FEE 'CHARGE NO Each single fixture , Relocated building (new fix. additional) S.F. Residence (J bathl IDuplex (1 bath) each IAdditional bath .Iwater service ISewer I Storm Sewer \ ISYl'X,", ~\\) \:;: I I , , , \~co 1 . CITY OF SPRHlliflELD INFORlIATION liNt I' COIIBIrlATION APPLICATION/PERMIT 726-3753 ~ E!lERGY SOURCES: Sq. Ftg. 1,Iain ,,,- Hea t S:q. Ftg. Access. ~ C'l,",..-.." !-Iater Heater Sq. Ftg, Other ~ 7\0. lL) flew Add Alter ~ep. Ranqe -Fence Demo Change/Use -c:::.. valup;r&6 ~ _, Other- - c.o Ph ""',~OfC,Builc;ino Pennit Info: Describe Work(;.e., Build Single 1-.....0 one/ Trcbl Familv nesidence With Attached Garaqe) ~~ ~'4..L4rI. I ...l (!,,~. 1{A-/+,WilIc. -rPl/J~. Phone (address) (exoires) " (ohone no.) (l ics. no.) _Yr(1)~ * (addrpSJ; ) ~~ (lies. no.) ~"1)B- (pxn;re<:;) (nhonp nfl. ) (!J$!. ,Tc+i- ~ f?S'}. (9~.~ qt..-J ELECTRICAL MECHANICAL ccc f'lARGE. NO. 'FCC 'f'lARGE. ,/ Residence of furnace/burner to BTU's SQ. FT. New circuits alts. or extensions Floor furnace and vent ISERVICES I Recessed wall Sn~rp np~tpr ~nrl vpnt ITempOrary Construction IChange in existing res i dence . I mUlti-family. COIl1Tl. or Industrial IOf amps.1 ICOMfI./IND, FEEDERS 'Install/alter/relocate, d;<:;trib. feeders IOf amps. I I I Appliance vent <;eoaratp Stationary evap. cooler Vent fan with sinole duct Vent system apart from I heatinq or A.C. I Mechanical exhaust , hood and duct Ilload stove/heater , , I I , , , I I I I I I ISSUANCf OF PFRlllT I TOTAL CHARGES Contractor, the electrical portion of this permit and returned to the Building Division TOTAL CHARGES TOTAL CHARGES WHERE STATE L'H REQUIRES that the Electrical work be done by an-Electrical shall not be valiJ until the label has been signed by an Electrical Supervisor I HAVE CAREFULLY EXAMINED the completed apr1ication 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 OCCUPArKY 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 exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 7Q1.055 will be used on this project. IlAl,IE(please print)~"- sQ~Q _ SI('11ATU~tt'\ c::; clv.t~~ FO~ OFF I CE USE OIIL Y Sq, Ftg. rlain Sq. Ftg. Access Sq. Ftg, Other 20ne r r . TYDe/Const, Bedrooms Stories Fire Zone Flood Plain BUILDING PERI.J1T Charges an~ Surcharges --~~~~---- \.0.'2.. ---"-~,-~~---- (,,0 PLU'~BING PERMIT Charges and Surcharges ELECTRICAL PERlm Cha rges and Surcharges 11ECHAN I CAL PERM IT Charges and Surcharges DATE 7-:13-lJS':- Units Occy Load Occy Group x Value Value Value x x TOTAL VALUATION Plan Ck. Comm/Ind 6~~/81do Ppr Fpp Plan Ck. Res 30%/BldD Per Fee Fence ~\ ' '2.0 Systems Development Charqe (1.5~) , I I I "l. Ct:l I I \ '-\, ~8 I CoO I Demo I Sldewalk\\\~~~, I AIC Paving I Curb Cut I Irotal Comb. Permit 1- I'DTAL \ \ <6 - - .. COMBINATION APPLICATION/PE~1IT (CAP) PERMIT VALIDATION .-/ (It/; 0 3 ~ i/ J I. Applicant to furnish A. Job Address B. legal Description 1. example. Tax lot 100. ~lane County Map Referen~e II OJ 4J 2. examole- Lot I. Block J, 2nd Addition to :>pnngtleld Estates. . . '.. ,", Name, etc. of' owner and construction lender' Energy Sources' . ',' , '-1.. ".exainole-' heat/electrical ceilin"q/or forced 'air OdS 2: examole- waterheater/electrlcal/or SOlar E. Square footage or valuation, etc. - I. examole- 1250 sq. foot house, 500 sq, foot garage 2. example- if new pr.oject.~check-new - if addition, check add, etc. \ F. .Building permit information: 1. examole - construct single family house with an a ttach€:d garllge 2. examole - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section J03 (a) of the ' Structural Specialty Code ,U,. ,..., " H. DESIGN TEAfl AND CONTRACTORS 6. ,,' 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. BOILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOOLES , 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. C. . ,0, \ ....\'. '~ Qor /1 .' T I I:,. . ~ '6~ q; I I Permit Clerk ~ ~~ V. FOR OFFICE OSE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: i ~ermit appl i cant 'exempt 'Trom reg,i s~ration with ,the-Builder' 5 .~oard becaus:e: _..... Additional Project Information: PLANS REVIEWED BY: namD ~)~'" )~ AM\.1\'- Signatu~M...I"'\.~ \f'A \( \.. d~te 'l-\~94-\