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Home My WebLink AboutPermit Mechanical 1986-7-8 Builc;ina Permit Info: Describe Hork(i,.e., Build Familv Residence With Attached Garaae) #n;JZ;:!/p;~ " f I I I I I I I I I I I I TOTAL CHARGES Electrical Contractor, the electrical portion of Supervisor and returned to the Building Division -. r-I I NSPECTI ON LINE 726-3769 ' CITY OF SPRIrIGFI ELD CO/IBIrlATION APPLICATION/PERMIT E!IERGY SOURCES: Heat ()00D '2- ' t~ater Heater 533 (Q St-. Legal Description J 11 0 .3 r:::l t, L/;2 Job Address Owner ~n fL.~(:> Address .C)33 ~ , I t1,.ueA-~ s:r. Range ValuE of \,Iork: Phone 1'-/1- 19c;~ Constructinn Lender Address DES I GN TEAll Phone (address) (name) (lics. no.) , Primary Structural Electrical l1echani ca 1 CONTRACTORS (name) (address) ( 1 i cs. no.) General Plumbina Electrical , n' ~lechani ca 1 ,. .I,ll (.t.tl}...... ( ) PLUr1B rrffi-/ ~ccb ~ A- ~~ rvlj~ ELECTRICAL NO. FEE I CHARGE NO I FFF I rHARr;F NO. Each single fixture Residence of SQ. FT. Relocated building (new fix. additional) New circuits alts. or extensions IS.F. Residence (] bath) , IDuPlex (1 bath) IAdditional bath I ~!ater service Sewer each ISERVICES I ITempOrary Construction IChange in existing residence Imultifamily, comm. or Industrial Storm Sewer I I I I I I Of amps, , COMM./IND. FEEDERS I I Install/alter/relocate distrib. feeders ~IOf I I I I TOTAL CHARGES J TOTAL CHARGES WHERE STATE L.'\\~ REQUIRES that tile Electrical work be done by an shall not be valid until the label has been signed by an Electrical amps. I I l~~@ . INFOR/1ATION uik 726-3753 Sq. Ftc!. r'lain ~q. !"tg. Access. Sq. Ftc!. Other New Add Alter ~,ep. -Fence Demo Change/Use -Other - - 00 ~ -t:: -:::r -........ Single (exnires) (ohone no.) (exoires) (ohone no.) MECHANICAL furnace/burner to BTU's I FFF rHARr;F I Floor furnace' and vent I Recessed wall Soace hentpr nnd I vpnt I Apo 1 i ance vent seoa ra te I Stationary evap. cooler I Vent fan with sinale duct I Vent system apart from I heating or A.C. ' I Mechanica I exhaust hood and duct 1I'}OOd stove/heater l~ciT Por"r I t/?o I I I I I (,S',cC) I ~O ISSUANCE OF PFR11IT IS- ,&:.'0 this permit I HAVE CAREFULLY EXAf1INED 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 performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Orellon pertaining to the work described herein, and that NO OCCUPAfKY 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 comoliance with OP.S 701.055 will be used on this project. ' S-tf\ ~ER. SIGNATURE U/b//~.e~ FO~ OFFICE USE OilL Y /" . Sa. Ftg. rlain Sq. Ftg. Access Sq. Ftg. Other NAME(please print) T t\ ek. Zone Fire Zone Flood Plain Type/Canst. Bedrooms Stori es Units Occy Load Occy Group BUILDING PER~1IT Charges and Surcharges PLU/1B ING PERMIT Charges and Surcha rges Plan Ck. ____________ 65%/Blda I Plan Ck. 30%/Blda I Fence I Demo ____________, Sidewalk I AlC Pavi ng '(s. ~ I Curb Cut --------.-~O-, Comm/Ind Per Fee Res Per Fee ELECTRICt,L PERr~IT Charges and Surcharges r1ECHANICAL PERMIT Charges and Surcharges DIm 7-.?-J?6 x Value Value Value x x TOTAL VALUATION Systems Development Charqe (1.5r,) ITotal Comb. rermit I TOTAL /5.00 .jj COMBINATION APPLICATION/PERMIT (CAP) PERMIT'VALIDATION I. Applicant to furnish A. Job Address B. Legal Description I. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender n Energy Sources 1. examole- heat/electrical ceilinq/or forced air qas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. 1. 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 i. 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 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. ~ ~h~ qO 1-%-00 V. FOR OFFICE USE ,ONLY Permit Cl erk Cc PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applic~nt exempt from registration with the Builde~'s Board because: Additional Project Information: PLANS REVIEWED BY: name signature date