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HomeMy WebLinkAboutPermit Electrical 1988-12-9 ; OLfi..H->.f~ 1'. 63 t;tB <II . CITY OF SPRINGFIELD COtIBIIIATION APPLICATION/PERMIT E!lERGY SOURCES: Heat t~a ter Hea ler . INFORI1ATION LINt 726-3753 Sq. Ftg. '.Iain ~q. Ft9. Access. Sq. Ftg. Other lie" Add A Her P.ep. -Fence Demo Change/Use Other - - ~ ........ () ....0 (] I INSPECTION LINE 726-3769 Job Address;J .1, 03 Legal Description 1'7 ..s+. DI / 0 6 Ran!"]e ValUE of Hark: IiwnerT",.x N "-.7') J). ,_..4- Address ~~ J/ t() .:'iT h/s;T~ ,$ ~tJ, ()f2 '77,;)./, Phone BuildinQ Permit Info: Describe Wor~:.(i.e.. Build Single Family nesidence l'Ii th P.ttached r.araqe) 10 /7.eW eI ec..-h- /C:e' Q - &('~~ Construction lender Address DESIGN TEA11 (nameJ I'hone {address \ Hechanical CONTRACTORS (namel (addrl~SS , . fl ics. no. \ (exnires) (nhonP. no. l // I? I /l"- _ CI., 'D C 11/ IJ - I -, ..> (1 i cs. no. ) (exoiresl (ohane no. \ Primary Structural Electrical Genera 1 PlumbinQ Electrical ? ;::;- ~ I' /) PDEoy }/5'{~q Ol>~""r{ ~b-..6,g)(c.. ;;} 5< ;5;>-'7 :>:0.. \ ~lechanical PLUI1BlNG ELECTRICAL FEF cllARGF ~n Residence of SQ. FT. .b New circuits alts. or extensions SERVICES MECIlANICAL NO.1 -----lEach single fixture Relocated building (new fix, additional) S,F. Residence (1 bath1 Duplex (1 bath) each FFF 1..c.HARliE.-1IP. FeF nJARGJ: furnace/burner to BTlI's dB Floor furnace and vent Reces sed wa 11 ~n~rp hp~tpr ~nrl vpnt \)V'\ Temporary Construction IChange in existing rP."J rl!i:nce Imultifamily, ConIn, or TnrllJ"tri~l I Of amps. ICOffij./IND. FEEDERS I Install/alter/relocate rli"trio^ fpprlpr" fOf amps. I Appliance vent "po~ r~ te Sta'tionaryevap. cooler Vent fan with sinnle duct Vent system apart from heatina or A.C. Mechanical exhaust hood ~nd r1urt Additional bath ~/ater service Sewer Storm Sewer Vood stove/heater ISSUANCF nF PFRlHT TOTAL CHARGES TOTAL CHARGES WHERE STATE L\l/ REQUIRES that the Electrical 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 Supervisor and returned to the Building Division I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work nerformed shall be done in accordance with the Ordinances of the City of Spri ng fie 1 d and the Laws of the Sta te of Oregon pe rta i n i n9 to the work descri bed herei n. and tha t He OCCUPAUCY wi 11 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 7111.055 will be used on this rro,ject. H~(~::;r:t~ 1--<1.1--01 "-"'- --s- Fk..sL 01';J,^. SIGI1ATlIRE.a.._~..-..:>~-- ll~.!EL2.':::3- '6 R FOr. OFFICE USE bilLY l./ Zone Fire Zone Flood Plain Type/Canst. Bedrooms Stories Units Occy Load Occ,v Group Sf!. Ftg. riain Sq, Ft9, Access Sq, Ftg, Other x Value Value Value , x TOTAL VALUATIOtI BUILDING PERfIIT Charges anc Surcharges Plan Ck. Comm/lnd 65t/Rldo Ppr Fpp ------------ Plan Ck. R'es 30t/Bldn Per Fee Fence Syste~s Development Cha rQe (1. 5%) PLU'1BING PERMIT Charges and Surcharges Demo ___X.:.Sit:.~_Sldewalk /. 13 A/C Paving Total Comb. Permit ELECTR I CAL PERIHT Charges and Surcharges '-'\ /lECIlANICAL PERMIT Charges and Surcharges Curb Cut TOTAL cQ3. Go3 1---. . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1, example~ Tax Lot 100, Lane County Map Reference 11 03 43 2. example- Lot 1. Block 3, 2nd Addition to Sprlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. example- heat/electrical ceilinq/or forced air Qas 2. examole- waterheater/electrlcal/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. examele - remodel existing garage into family room 3. exam~le - 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. 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 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. --- 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. 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. II. I I I. IV. V, FOR OFFICE USE ONLY . ~ III ~ PERMIT VALIDATION ";'.' ...-E,ermi t Cl erk .' f(p /l, ~aJ-: d- r:J.J~ lA. f~q~l' 1Z.-/3-~-r; PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: DAVE KIMMEL PRES/OENT PLANS REVIEWED BY: name signature PERMIT CONSULTING SERVICES INC. 122 S.E. 27111 Portland. OR 97214 (503) 236-6000 date