Loading...
HomeMy WebLinkAboutPermit Miscellaneous 1981-2-6 . s'....~c..,,~..... e, ,; "''' Fo'-'l.<..< Add"" :;l.14~ NDr~V+ L" &..,." ~ INSPECTION LINE 726-3769 Job Addreu legal Description l r I' ~. Conl.ruclion lender Address DESIGN TEAM Primary _Structural t:ledricol Me-cho:-:1tnl .s9!.nRACYQn~ GenoroL Pl....mbin~ Electrica. M~ch(]ni":<:I1 NQI-"-~'''- I I I I I I I I Each $in~le fixture Rcl(lcotod building (now fix. additional) S.F. Ruidence (l bath) , I Duplex (1 both) each Additional both Water Jorviee Sewer Storm Sewer ~,..... ..s~~....~ed~1t. ot- CITY OF SPRINGFIELD . INFORMATION LINE COMBINATION APPLICATION/PERMIT 'Q\ cl~ jUo::::' 726-.3753 ENERGY SOURCES: i Sq. fIg. Main 10'12 Hoc" ~- \ P C Sq. Fig. Acc.on. Woter Heoter ~ I G ~ Sq. Fig. Other , ,oC)+-" ,~" Ronqe ~ I ~_c.... _New_Add_AlhH_Rep. Value of Work: _pnce_Demo_Change/UslJ ~~ 2 00;:) ~O'h" t'>".ohlio" f<>.t. "'~.I'.'" ,_,) \.o....ov~ Building P~r;i't-Inf~;. Describe W-;;~k. (i.e., Build Single Phone Li8S-1 ~ <..Z Fomily Residence With Attach"d Gara'!!) I J2. /. .. . .(f:.. p,p., At J.IJ(yJ:tL ;;:O/YU I 11- O:S" 2 7 - Lj 2 .2'-/00 o 9 t-o I O.r..... '1"1'-1":>1 ~~ YY1fll LO(jL; - ~ Phone (name) (oddreu) (lin, no.) (phone no.) (expires) o ~ 'i"SL("" / P IJJ" c...- h.<>. ,........ (.lam!)) (addrlln) (phort& no,) (Iin. nc.) (expires) ~0 ~ __,I"h<>" <A" ... ~;"'-\... ...........,,~.J 0!- Il S '-.J '2. 7rr'\-. "!''-1Y- 'h'&j>a 3~",p I s..""", #- ?,<.o <."'/ 2JZDJ" I _.:,::,::- --..----. - --1-- - ,. -'-Fu'TCHARGE INO: ,-- I I ElECTRICAL MECHANICAL 'TFeE I CHARGE NO. FEl r';-ARG, I furnoce/burnl'lr to ItTU's Applionc3 vent separate Stationory ovop. coolor V..nt fan with singlo duct Vent sy5f6m aport from hoatinQ or A.C. Mechanical exhaust hood ond duct Rosidence d _s9:ft. New circuits, alterQtiora or extensions SERVICES Temporary Construction Amps. 'Wood stove/heater I I I I I I I -0- FEEDERS Heat Pump Air handler to 10.000 CFM Air handler over 10,000 CFM P lMA.lI;:\ (\ .Mill orfuix I t2&aco.'6.d PMQ o --- " I TOTAL CHARGES I /5,02 I I I I Amos. r: hr k.la~ it>arvxd ~ Rdcrffihd &~ /5,O!:! ISSUANCE OF PERMIT 15.o.~ WHERE STATE LAW REQUIRES that the Electrical work b. done by the Electrical Contractor, the C1lectrical portion of this permit..shall not be valid until.a laboi has b_n signod by on Electrical Contractor and attached -to the electrical panel. 15. Oft TOTAL CHARGES TOTAL CHARGES I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is trup. and currect~ and I further certify that any and all work performed sholl be done in accordance with the Ordinances of thtJ City 'of .Springfield and the laws of the State of Orogon pertaining to lhe work. described herin, and that NO OCCUPANCY will be mode of any structure without tho permission of the Building Divilian. I further certify that my r&gistTation with.the Builder's Board is in full force and effect ns required by ORS 701.0S5, rhat if exempt the bcuis for.,xemption is noted heron, and that only subcontractors and employees who ore in compliance with ORS 701.055 will bo used on this project. NAME (please print) Basis for Builder's Board exemption' 'P1 W"; c.. "" DATE t<A Zone Fire Zone Flood Plain ~ SUILDING PERMIT Charges and Surcharges PLUMBING PERMIT Charges and Surcharges ELEORICAl PERMIT Charges and Surcharges MECHANICAL PERMIT Charges and ,." Fr-.L..i W ~ zIt, J E'>I . . .~ SIGNA TURC: FOR OFFICE USE ONLY Typel ConH. Bedrooms C;torieil- \J/J x Volue Value Valul _Units ""ccy Load . - Occy Group_.R '3> Sq. Ftg. Moin Sq. Ftg. Access Sq. Ftg. Orher_ x x TOTAL VALUATION. .!l,aQO.~ Q.o,op ,~ 15,05- ,(pC __--15.0,9 ___ ,"'.9 Plan Ck. Camm/lnd 65%/Slda Per Fee Plan Ck. Res 30%/ Bldq Per Fee I,:::>" al1ouu. ,; Systems Development Charae O.5%) 0,00 PD2-'h-'lJ ~ 6 r=;)//"~ 36C),0,9 Fence Demo Total Comb. Pormit J~. ''d-iD Sidewalk. lAIC Povino o I ---------1 Curb Cut 052..;;).2 TOTAL '~I Addilional Projecl Inlormotion, L0;,.., ~nA1>> D1 j:J.(p() /J /,. .."p. fJ-P, f'Jf'.I~ri r::U/}/Y trZkr/ rLUIVl A:/) /..M /)fJpf' .1/ rm.J . I J . A ' ~ addA1//7VJ/J} /-/)f'Y(jp,(/;,' ~..r:b./L/1'O. t - pt-.. -~ I '::-- ~,-' ppJ.J.JrY1 (~) ~DL/lifJMJ,N" ~ / g:!I &..DJjJl1'g ~.1 H .Pfl ./11> g..llll D~ ariP)iJ,,/fYYJM ~. I COMBINATION APPlICATlON/AIT (CAP) I. Applicant 19 furnish A, Job Address B. Legal Description 1. example-tax lot 100, Lane County Map Relerence 17 03 43 2. example-Lot 1. Black 3, 2nd Addition to Springfield Estales C. Nome, etc. of owner ond construction lender D. Energy Sources 1. example-heat/electrical ceiling/or forced air g05 2. exomple-woter heater/electrical/or solar E. Square footage or valuotion, etc. 1. example.1250 sq. loot house, 500 sq. loot garage 2. example-if new project, check new.if addition, check odd, etc. F. Building permit information: 1. example-construct single family ho',se with an attached garage 2. example.remodel existing 90r0ge into family room 3. example-convert single family residence into restauront (~hange of use) G. Value of work as defined in Section 303 (a) 01 the Structural Spedalty Code H. DESIGN TEAM AND CONTRACTORS To ovoid design or construction delays, Building Division Stoff must be aple to contoct appropriate persons regarding design information or job site corrections, etc. II. Abbrevialed 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, Me<:hanical, and Electrical Schedules are available ot the Building Division 1. To conserve 5pace on the permit form the schedules have been abbreviated 2. If the item(s} to be installed are not covered on the abbrevi- ated schedules you should consult the full schedules C, BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES 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 typewritten copy ond return it to the applicant at the time the actual permit is issued for his signoture. IV, Fees and Charges Plan check lees are due and payable at the time of the application, and no plans will be processed until these fees ore paid. All other fees and chorges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY . PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: PLANS REVIEWED BY, ~^-" Pl:1lMIT VALIDATION I I I II <. Permit Cler~ ~ I tV. !}87!;t rf~P A" name -r- ()'")I.L 5kC1.llr m IA signature ~~~ date :;}.-(",/q& I I -i/, ,(< i