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HomeMy WebLinkAboutPermit Mechanical 1989-6-15 " --~ ~ Job Address /C5/' ;';i?AY./Y ~T. legal omription Vi n ~ ~ (S' 7J \ (Y\Q...OU \. .... CITY Uf SPRINGFIELD ,. CDr1BIIIATlDN APPLICATiON/PERMIT EIIERGY SOURCES: Heat Hater Heater ,. NFORI1ATlON 726-3753 Sq, Ftg, 1.lain ~q. Ftg. Access. Sq. Ftg. Other New Add Alter P.ep. --Fence Demo Change/Use -Other- - ~ ~ ~ " 1 INSPECTlDll UN,C 726-37t-9" . 'p<?~ ~/Lr..stY. ~e; ~~~f"- >;'. v~,~ ,~/7?::A<~!'.!' , , . Address /&;5-/ ,,>;?"#nv ~7", _;.l/lOne'7/~ 7, ,..;,;, .59"'(2} p/5', Construction Lender Range ValuE of l'lark: ~.-- Buil(;ino"Permit Info: Fflmil y nes i dcnce IH th ~ <,fY:;> Oeser be Work(i.e.. Build Single Mtached r.araqe\ &~,,,,iz:>--I A/c"-; .::;-~ ~HZ=. !;-;/". C.;",j.,-~~ ~7'"Z=#C;Y, Addrc5S DESIGN rEM {namel Phone (addressl (1 ics. no.) (exnires) ([)hone no. I I. * Primary Structural Electrical f1echanical CONTRACTORS (namel Cilddress1 l1ies. no. \ (exnirpc;) (ohone no. \ Genera 1 Plumbinq Electrical ~lechani~aIIU~rE~.IY ffi-..!"""~-1'7/c.$ PLUIIB I NG ELECTRICAL MECHAN I CAl NO. FEF CHARGE Nn FFF rHARr.F NO. I FTF CHARGF SQ. FT. furnace/burner to BTlI's Each single fixture Res i dence of Relocated building (new fix, additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence (I hathl Duplex (1 bath) each Additional bath SERVICES Reces sed wa 11 ~n~r~ hp~tpr ?nrl vpnt Storm Sewer Of amps. Appliance vent seoarate Stationary evap. cooler Vent fan wi th sinale duct Vent system apart from heatiOCl or A.C. Mechanical exhaust hood ;lnd due t l Hood stove/heater lr - -I I "" CA'~"."./>~ ~ '9"........ . I I Sewer Temporary Construction Change in existing r~c;.id,,:ncf? multifamily, conm. or Indllc;trial Water service COI1l-I./lNO. FEEDERS Install/alter/relocate dic;trih. fppdpr" Of amps. ISSUANcr nF PFRtuT TOTAL CHARGES TOT^l CHARGES WHERE STATE L\l1 REQUIRES that the Electrical work be done by an Electrical shall not be vali~ until the label has been signed by an Electrical Supervisor TOTAL CHARGES ~.t". Contractor. the electrical rortion of and returned to the Building Division r5.- this penait I HAVE CAREFUllY EXNlINED the completed application for permit. <lnd do hereby certify that all information hereon is true and correct, and I further certify that any <lnd all work oerformed shall be done in accordance with the Ordinances of the City of Spri n9 fi e 1 d and the Laws of the S ta te of OrelJon rerta 1 n i ng to the work descri bed here in, and tha t IW OCCUPArKY wi 11 be made of any structure without the permission of the Ouilding Division. I further certify that my registration with the Ouilder's Ooard 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 comoliance with OP.S 701.~~~~~t~ IlAIIE(please print)'0tl~ 9').J? (j;o h fLY,.,...,) SIGII^TUR~ _:YCdf~OATEJ,,'~ IS-kl FOr. OrFICE IISE DrilY /./ Zone Fire Zone Flood Plain Type/Const. Bedrooms Stories' Uni ts Occy load Occy Group 51"!. Hfl. l1aio Sq. Ft~. Access S~. Ftg. Other x x Value Value Value x TOTAL VALUATION BUILDING PERfllT Charges and Surcharges Plan Ck. Carom/Ind 65%/Bldo Per Fee ------------ Plan Ck. Res 30%/Bl d~ Per Fee Fence Systems Development Char~e (1.5%) PLU'~BJNG PERMIT Charges and Surcharges O~mo ELECTRICAL PERIIIT Charges and Surcharges Sidewalk 11ECHANICAL PERMIT Charges and Surcharges !~~ 7' ------------ .75" A/C Paving I Curb Cut I Total Comb. rermit TOTAL I :):7~ l ';;-:, . ", I COMBINATION APPLICATION/PERMIT (CAP) 1. Appl icant to furnish A. Job Address B. legal Description 1. example- Tax Lot 100. lane County Map Reference 17 oj 43 2, example- Lot 1, Block 3, 2nd Addition to . 'Sprlngtjeld Estates' . ' C. Name. etc. of owner and construction lender O. . Energy Sources ~, . 1. example- heat/electrical ceil in~q/or forced air Qas 2. example- waterheater/electrlcal/or solar E. Square footage or valuation, etc. 1, examole- 1250 sq. foot house. 500 sq. foot garage 2. exarnple- if new project. check-new - if addition, check add. etc. . F. Building permit information: 1. examele - construct single family house with an attached garage 2. example - 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 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 SCHEDULES O. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is ~ 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'permi't is issued. V, FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Additional Project Information: PLANS REVIEWED BY: name signature :':i:;, '\.r:- - .'.;; . ,./'. I ~~; '. ~ 'i' .' , j( , \J~r ., II: ., " , ., ." ~ '. " t,'l , 'll .. \, i ,l:~~\' , .., PERMIT VALIDATION (.~"l" '; ~'ld' "1 .~,!II:' II"," " ~ ,',' .,' l<~ ' . 1-'1' . .1 , , ,. f'J Vu. Ir'l \ ,,' i' I, ~~ lo ,\~,~A ! :1 " '.' I" I .' , " il'll' ,~: ..' r '. j> ' , :1 ' ,.1 lit, I:, .Q0 , , ::!Ii Permit Clerk 1'!1 \!;. ,. . ," ", ':~I, .,'" I'. ::t1j " '''f Builder's ',' H.t, i:;f. ,'II, Ii," If,'.), ~rit~ '~jil , "I" '.,A'li. "1" 'i' '.1 " , '.. ;tH' Board be.c.ause: Il~.. . :lli'ti II I-I' .!\I;-', , =1' ~ .' I ,I:: i" , ,,. loll " ~ ; " ,',,' d,~ , , , l:~.' p' ~~~ I i, " '. da:te , , " 'i:!:' .'