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HomeMy WebLinkAboutPermit Electrical 1990-5-22 } Owner ~ Idl...l) 3-11.tor\....J Address 32 '11. () I J..it-lll\ \ 'if (\ f{t 6 .~ Iu..J(\~M rJ.. Construction lender 0 U .. CITY UF SPRINGFIE~D . INFDRllATlDN LINt CmmlllATlON APPLICATION/PERMIT .... 726-3753 EIIERGY SOURCES, Sq. Ftg. I~ain Heat ~q. Ftg. Access. Hater Heater Sq. Ftg. Other lIew Add Alter Rep. Range Fence_Demo_change/Use valU~ wo.rl<: ,.~_ _Other () (l(J(? ~-P!'~ Builriinci Pernlit Info: Describe Work(i.e.. Build Single Family rlesidence Hith Attached Garaqe' /bjJl F".ek t .f~ r;Ah~ f-' ~M~-"~ Phone I ~ ~ I~ \) 'INSPECTlOII litlE " i 726-3769 , Job Address 1114- ~lUl ~f\U I) '-f f"l-A{J I legal Description J7.t:J3'~";?.jjO, .c>2~"""'~' / Address DESIliN IEAf1 (namel Phone (address \ (lics.no.l {exoiresl (ohone no.) Primary Structura 1 Electrical Mechanical CONTRACTORS (name) (address' (1 ics. no. \ {exniresl (ohone no.\ Genera 1 Plumbinq Electrical ~t.c:: .-'lb^(\'hLI'" firM" , ' '1II-/.J",,-qThI;~~'7 2..0 - /4C- lo-,.qo '14/-1-.1..% ~lechanical PlUlm ltIG ELECTRICAL MECHANICAL NO. I FEf r:HARGF: NO CFF r:HARr.F NO_ FTC r~IARGF SQ. FT. furnace/burner to BTU's Each single fixture Residence of Relocated building (new fix. additional) New circuits alts. ~'or extensions ,),Y - Floor furnace and vent S.F. Residence (l bath\ Duplex (1 bath) each Additional bath SERVICES Recessed wall ~n~~p hetter ~nrl vent Storm Sewer Of COI~I'1. /I NO. FEEDERS amps. Appl iance vent seoarate Stationary evap. cooler Vent fan wi th sin9:le duct Vent system apart from heatina or A.C. Mechanical exhaust hood and duct Wood stove/heater Sewer Temporary Construction Change in existing res i rl_eflcc multifamily, COlTlll. or Industrial ~Jater service I Install/alter/relocate distrih, feeders (,0 amps. If-~ Of TOTAL CHARGES WHERE STATE l~H REQUIRES shall not be valii until the TOTAL OIARGES ISSUANCE OF PFRf1lT ~... TOTAL CHARGES that tile Electrical work be done by an. Electrical Contractor. the electrical portion of this permit label has been signed by an Electrical Supervisor and returned to the BUilding Division I HAVE CAREFUllY EXAMINED the comrleted apr1ication 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 Springfield and the laws of the State of Orel]on pertaining to the work described herein, and that NO OCCUPAUCY will be made of any structure without the permission of the Bullding Division. I further certify that my registration \'lith 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 OP.S 7n1.055 will be used on this project. SIGrlATURE f2~q!)~~ ~E ~h ~l . -. I FOr. OfFICE USE OI~l Y ,r " I / ,Sq. Ftg. t1ain x Value Sq. Fta. Access x Value 7;;;-7 Sq. Ftg. OtherCC,<:2;T. c?L/? r Value:::? - -..;.. TOTAL VALUATION NAI.IE(please print) Onl; II e. A .Tha YO Zone r"/ Fire Zone Tyoe/Const. Bedrooms ,,-/9' Uni ts Occy load f)ccy Grouf1 Flood Plain Stories ? BUILDING PERMIT Charges ane: Surcharges Plan Ck. Comm/lnd ____________....2.21/R1da P.er Fee Plan Ck. Res 3D%/Bldo Per Fee Fence syste.ms Development Charee tl.5~ . PlUI~BING PERMIT Charges and Surcharges D/IIllo ELECTRICAL PERr\lT Charges and Surcha rges MECHANICAL PERMIT Charges and Surcharges LJ5' ~_ Sidewalk :<: _ 2...> A/C Paving Curb Cut Tota' Comb. Permit TOTAL '7'7- 2S- 1 . .. ~. "I ~ COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION I. Applicant to furnish A. Job Address B. legal Description 1. examp'le- Tax lot 100, lane County Map Reference II OJ 43 2: ' example- Lot I. Block 3. 2nd Addition to Sprlngfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examt'le- heat/electrical ceilinc:/or forced air Qas 2. examDle- waterheater/electrical/or solar E. Square footage or valuation, etc. - t. example- t250 sq. foot house. 500 sq. foot garage 2. example- if new project. check-new - if addition, cneck add, etc. F. Building pennit information: 1. examele - construct single family house with an attached garllge 2. example - remodel existing garage into family room 3. exa~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. OESIGN TEAM ANO 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. BOILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO 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 .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 signa ture. 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 OCCUPAtICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: name ,,/~~ date '5' -77--;7i?> CITY Of SPHINGFIElD corm IliA 1I ON APPLI CAlI ON/PERM IT EIIERGY SOURCES: Heat l~ater Iieater Ranqc__.____;-. 'J IrISPECT IOU 1I UE 726-3769 Job Address 1114- Jd.cu'lli%l,1.j} iN'\fu legal Description J7.~'3'~"2..jJO .c>?~"-O' / ~~~ J-utOJU Address :=\9,'1-1. j.)j'rlll1' tfl\rflO ~p /ll.J(\q.L..~ J Construction Lender 0 U Owner Address DE~lliN II:.Ari Primary Structural Electrical Mechanical CONTRACTORS General INfORl1AlIDN LINt 726-37S3 Sq. Ftg. Hafn ~q. Ftg. Access. Sq. Ftg. Other Uew Add Alter Rep. -Fence Demo Change/Use Other- - ~ ~ ~ \) Phone Valu' '19 flork: ~ I ...-If;) ,} (Jr) . . BuildinQ Permit Info: Describe Work( Le., Build Single Family nesidence With Attached Garaoel /€/,fj} P",JL t (l~vo.<'/" 0.lfjA.J, h-, .')" ".~ j.f?~Xcr7 I (name) Phone {addressl (lies. no.l (exnires) (ohone no. enamel (address1 (1 i~". no.1 (pxnirpc:.l (ol1nne no.l PlumbinQ 1.10rtrfcol (i.~.s Ph~bi., n \ {J111~,. 1.14-~. I~ ~1echani ea 1 Relocated building (new fix. additional) S.F. Residence (1 bathl Duplex (1 bath) each Additfonal bath NO. . Each single fixture ~Ia ter servi ce Sewer Storm Sewer 2-.0-/4.(', lo-/-Qo '14/-1..1.% PlUIIBING ElECTRICAl MECHANICAl , FEF 'r.lIM~r.F .JW qr fWI[)r..~ NO nr fU!B!i.E. Residence of furnace/burner to STU's SQ. FT. New circuits alts. ~ or extensions Floor furnace and vent '))J/.~ \ Recessed wall Sn~~p hp~tpr ~nrl vpnt SERVICES Temporary Construction Change in existing r(>'lirlp_n~E: multifamily, COI11ll. or Inrlustrial Appliance'vent seoaratp Stationary evap. cooler Vent fan with sinole rluct Vent system apart from heatino or A.C. Mechanical exhaust hoorl and dud Wood stove/heater Of amps. / COI~.1. /I NO. FEEDERS Install/alter/relocate rlistrih. fpprlprs (,a n.~ Of amps. ISSUANCF OF PFRl1lT ,(,15:- I TOTAl CIlJ\RGES Electrical Contractor, the electrfcal portion of this Supervisor and returned to the Ouilding Division TOTAL CHARGES . TOTAl CIIARGES WIIERE STATE L\H REQUIRES that tile Electrfcal work be done by.an. shall not be vali1 until the label has been signed by an Electrical I IlAVE CAREFULLY EXAt'lINCD the completed application for permit, and do hereby certify that all infonnation 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 Sprfngffeld and the laws of the State of Ore~on pertafning to the work descrfbed herefn, and that 110 OCCUPAIICY wfll be made of any structure without the permission of the Ouildinl] Division. I further certify that my registration \-lith the Ouilder's Ooard 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 Or.S 7Ql.055 will be used on this project. SIGIIATURE f2~q/~/.dddJE sh ~ f permit IWfE(please prfnt) On; II e. A .Tllayp Zone r ./ Fi re Zone Flood Plafn BUIlDING PERflIT Charges and Surcharges PlUt~BING PERMIT Charges and Surcharges ElECTRICAl PERllIT Cha rges and Surcharges MECHANICAl PERMIT Charges and Surcharges FOr. OfFICE / 'f USE mIL Y S~. Ftg. Sq. Ft~. Sq. Ftg. Type/Cons t. Oedrooms Stories ")"-/9' Units Occy load Occy Group "B~L .', t1ain x Value Access x Value DtherC=-C,cz;T. t:7B'? r Value TOTAl VAlUATION :::;?c...-_"":- "2 Plan Ck. Conm/Ind ____________ ~fRldo p.or Foe Plan Ck. Res 30%fBldo Per Fee Fence Systems Development Charqe tl.5~l . D/jlI1O ____~~- Sfdewalk . :<: _ 2.5"' A/C Paving ____ ____ __ Curb Cut Total Comb. Permit ~TOTAl '17-:ZS-- , . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish 'A. Job Address B. Legal Oescription 1. 'example- Tax Lot 100. Lane County Map Reference 17 03 43 2: 'example- Lot 1. Block 3. 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examDle- heat/electrical ceilinQ/or forced air I 2. example- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - 1. example- t250 sq. foot house. SOO sq. foot gara! 2. exa~le- if new project. check new - if additioJ check add. etc. 'F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family rc 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 infonmation or jOb site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedule~ 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 adjac! 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 schedul have been abbreviated 2. If the item(s) to be installed are not covered c 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 electrical contractor for signature by his electrica, 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 signa ture. 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 cha.rges are due and payable when the penmit is issued. V. FOR OFFICE USE ONLY ,:TV OF SPRINGFIELD Clly Hon Sprlngftold, Orogon Development Services OFFICIAL RECEIPT \ \ I .' 17136 0010 M~ 2'2., '9 9D r Rec'd From ~ S eC(7'C-./ ... Address :<'~ .~~~~ r- RocoivodFor: ",J..:,1"r/'9~c,i/6 k,.~. , 7!' ,_ /' . ~. C'2? ~ t./c;.. ~ v- <' :2..'5>-"'" )/7. 2:;::' - ,L/~7/Y/ Amount Received - y /_ -zS . .!!:!.... ~~ . r~ AUTHORlZEDSlGNATUREP Frantler BUSINESS fOAI,tS. INC. 4!0031:M2.'''' '"'' Permit Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAtICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project ,Information: PLANS REVIEWED BY: I name t!...o8~ ~~..:;:?signature~~,.-? date '7'-77-"'7P I.