Loading...
HomeMy WebLinkAboutPermit Plumbing 1983-9-6 I I'ISPECTIO'/ LIr'E CITY OF SPRINGFIELD INFORrlATION LINt '7~6-3769 r , COMBINATION APPLICATION/PERMIT' , 726-3753 I ~ErlERGY SOURCES: Sq. Ftg. r'lai n \),) Job Address 2 12 'Q' -:j)"~'&'f!!!!r Heat :q. Ftg. Access: Legal Description I?<!:)Y"'=<:~":< ~&:>./$~I Hater Heater Sqiie~tgAd~th~~ter P.ep. WN . , Ranqe -Fence~mo Change/Use , ValuE of I'lork: AOther , ' v/Nc:f. ~ Owner ~ y cb~ J3~tI?HfC;,~ ,,~. ~ 0 . . .. ...... Address"..., ~ .,/.' 'I __ ~_.--:::>>~ BU11clna Pernllt Info: Descnbe Work(l.e., BU11d Slng1e 111 ..4/7< "WJIIC 'i:) 7RE'E,' '7Ijo~..:;7C:i'" Family P-esidence \1ith ft.ttached Garaae) "B ~jP~(.r ~Y/h4'" J?;;rH/N;IP&'-E Construction Lender ",;,I:-~ f'A--~A./~ ~C~ :::;'SI~,1jI1 Address Phone DESIGN TEAr-1 (name) (address) (lics. no.) Primary .1Ji1?A~ ~)y~N~""'.IY~ . -::?/-<. C:s:? 1677' , "/ (exnires) (phone no:) ?~"-o:a'" Structural , Electrical Mechanical , CONTRACTORS (name) (address) (lics. no.) (expires) (phone no.) , Genera 1 ' Plumbinq Electrical ~1echani cal PLUf1BING ELECTRICAL MECHANICAL NO. FEE CHARGE NO' I FFF rHARGF NO. SQ. FT. furnace/burner to BTLI',s FFF rHARGF: /~/ Each single fixture Residence of Relocated building (new fix.' additi~nal) New circuits alts. or extensions Fl oor fu rnace and vent' IS. !:.Residence (lbath) .. [Duplex (1 bath) each IAdditional bath, IHater service SERVICES Recessedwa 11 Soace heater ahd vent Of ' amps.1 Appliance vent seoa ra te Stationary. evap. cooler Vent fan with sinale duct Vent system apart from I heatinq or A.C. Mechanical exhaust I hood and duct Wood stove/heater I I I I i Sewer I I I I ~ Temporary Construction Change in existing residence multifamily, comm. or Industrial Of COMM./IND. FEEDERS Insta 11 /a 1 ter/relocate distrib. feeders amps.1 I I ;~~ Storm Sewer TOTAL CHARGES WHERE STATE L~W REQUIRES sha)l not be va1iJ ~ntil th~ ISSUANCE OF PFRMIT -2-S:~ TOTAL CHARGES TOTAL CHARGES thatlthe 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 EXNlINED thecomp 1 eted apflli cation for permit. and do hereby certify that all informati on hereon is true and corr!"ct. and I further certify that any and all \10rk oerformedshall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon oertaining to the work described herein. and that NO OCCUPAlKY \1il1 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 emp,l oyeeswho are in como 1 i ance with ORS-701. 055,\1i II be used on thi s oroject. , . ''''IE(,J"" ,""tl.Jb,N-"1L' a /l4'A~// SI'"ATURE~~~--r>L "OA>E9-tt-6'3!' FO~ OFFICE USE ONLY , Zone ;l<- ~' Tyoeli:onst.~'VI'~ Units' Sa. Ftq. rlain x. Va;lue Fire Zone ' Bedrooms Occy Load Sq. Fta. Access x Value Flood Plain Stories Occy Group Sq. Ft;. other~j;9~ Value_ 9 ",-- TOTAL VALUATION BUILDING PER~lIT Charges and Surcharges '1 Plan Ck. 65%/B1da -'-----------, Plan Ck. " l, . 30%/Bldq ::z s-: ~ I Fence ---~--/~-~o-I Dt;mo I Sidewalk I A/C Paving , , I Curb Cut - - - -,-- -,,,,,-, - --'-I 1 _ \1 . ' I CommlInd Per Fee Res Per Fee I s: ~t> rc:t ' 12"Z'.SZ ~ 60lS $'" I I' I I I I I 'Systems Development Charqe (1.5%) , PLur~BING PERMIT Charges and .Surcha~ges ELECTRICAL PERr~lT Cha rges and Surcha rges :zy. -- Total Comb. Permit S'"tf),4- MECHANICAL PERMIT Charges and Surcharges I TOTAL S<f), d.o .~, I. ~. . . "':;'J COMBINATION APPLICATION/PERMIT (CAP) _:'M' PERMIT VALIDATION I. Applicant to furnish " , A. Job Address B. Legal Description 1. examo1e- Tax Lot lOa, Lane County Map Reference 17 03 '43 2. ' examp1e- Lot ,I. B10c~ 3r 2nd Addition to" Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. examo1e- heat/electrical ceilinQ/orforced air gas 2. examole- waterheater/electrical/or solar E. Square footage or valuation, etc. 1. examo1e- 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 gar"ge 2. example - remodel existing garage into family room 3. examole - 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 TEAI~ Arm 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 sChedul es 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 ~sed 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. ~B5 ~~:(~L6 , ". ,. .;. V. FOR OFFICE USE ONLY Permit Clerk P , (;')VYJ--) PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: - 'H/JJ ;Z:>~ML.)'" /~ ~~ /~~E:Z>~/7)&>NA"(.<"'r 'Af.s .4~'/ ~~,' M7>> ~~.I.N~ #r.....~VAL. 6~ .7~ C:/7.,. ~~c..&>~ ~ ~AFr/< ~V/~..;C:'H5, /~.~/~' c:..:"1I-<'~?7f'~C:::~c:r~ /7--/5' P~~... J2!,--~~ T/:Mr /H#Z:>-e:-~CrJA'~ ~~ /~/>? 2c':"":--:~: :;:\:1~::r.~ ':'..:.rr.fi ~ur,l fCSl~btratig-. ,,~'L1, LI,t: E.u;lj~;":. 3vu.J L-=.:a:.:~ /~ ~Y/~. l'#&: L.t:>,- ~~.::~ vt5dF ~P/"~/~P Tnform8ti9R~ ~ f::ii'e:-'v/P~ c:; r<r' --:?,-, .. ';.;lY-:. ~~c.=-~S"'G ~S . ~/~b/ ~?-5 v . . 7~'M~__p ~~"/.5' , '. '..' / t. ", -. r Adcliti:r.:l r~jprt ','. I~~a;:- ..~.N/~~~/? h-~~/~ ,hC<.J~z::, "I' ~ """.;:::::> ~ PLANS REVIEWED BY: name t.~c.: rl~~~ ~,.~"~ signature ,;PI"::-r~' " ;- date 97..p'~