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HomeMy WebLinkAboutPermit Plumbing 1988-9-8 'I INSPECTION LINE 726-3769 Job Address ~~~ Legal Description FEV~c( 7' CITY OF SPRINGFIELD COMBINATION APPLICATION/PERMIT ,ENERGY SOURCES: Heat l~ater Heater Range ValuE of Hork: ~~/';:1t"'"J~ ~ Buildinq Permit Info: Describe Work(;.,e., Family Residence With Attached Garaqe) INFORt1ATION L1N~ 726-3753 Sq. Ftg. r.1a i n :q. Ftg. Access. Sq. Ftg. Other New Add Alter Rep. ' --Fence Demo Change/Use --Other -- -- Address Phone Build Single ~ t}' ~ '\J \:b ~ Owner',~~~ &.?6\oY"TH ~C:-AtL/r. Construction Lender 457?~ ~~/-:? ~ _5c~/~ h ~~ ~7h".cn::7~..,..p- ~/Z" C=-/? Address DES I GN TEAr-l (name) Phone (address) (1 ics. no.) (expires) (phone no. ) Primary Electrical OlA/ :./ ./'\ "TJ J ~~()O yo Structural Mechanical CONTRACTORS (name) (address) (1 i cs. no.) (exDires) (ohone no. ) General P1umbinq 1.04:) ~V~~~_ ... - , "; .7?e>.2bx :</$>9. cz;..r-c;.-c=-~ ~ /'7&>2 r ~~-o~/ Electrical ~lechani ca 1 PLUI1B I NG ELECTRICAL MECHANICAL NO. FEE CHARGE NO. FFF rHARr,F NO. FFF rHARGF Each single fixture Residence of SQ. FT. furnace/burner 'to BTlI's Relocated building (new fix. additional) New circuits a1ts. or extensions Floor furnace and vent S.F. Residence (1 bath) Duplex (1 bath) each Additional bath SERVICES Recessed wall SDace henter nnd vent Storm Sewer Temporary Construction I (~.p.p Change in existing I .) . res i dence 2-""'\. pe> I multifamily, comm. or I ~ Industrial I 10f amps.1 I I ICOMM./IND. FEEDERS I I I I Install/alter/relocate I distrib. feeders , I ' I 0 f amp s. I I I I I I I I I I I I ISSUANCE OF PFmm ~-;r: &9 TOTAL CHARGES I TOTAL CHARGES that the Electrical work be done by an, Electrical Contractor, the electrical rortion'of this permit label has been signed by an Electrical Surervisor and returned to the Building Division Appliance vent seoarate Stationarv evao. cooler" , Vent fan with sina1e duct Vent system apart heating or A.C. Mechanical exhaust hood and duct from . '2$'1 \-later servi ce ?G>' Sewer Wood stove/beater TOTAL CHARGES , WHERE STATE LAW REQUIRES shall not be valid until the I HAVE CAREFULLY EXAtlINED 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 Oregon pertaining to the work described herein, and that NO OCCUPAfJCY 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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 70.1.055 wi_~ e ed o~n this Qr.,oject. , ~,d """'(p''''' pd,') ~ I M F. /J CJ S SI'''A,"' " ~ ~ DAT'?' ft~~ FOR OFFICE USE/or~L Y Zone Fire Zone Flood Plain TYDe/Const. Bedrooms Stori es Units Occy Load Occy Group Sq. Ftg. 11ain Sq. Ftg. Access Sq. Ftg. Other x x Value Value Value x TOTAL VALUATION Plan Ck. 65%/B1da Plan Ck. ,.' 30%/B1 dq PL1Ir1BING PERMII.S" ,.. . d~ -- Fence Charges and_....- -____J_d..:..___ Surcharges . ::(~ :< 51, D~mo ELECTRICAL PERrmSidewal k Charges and ---------___ Sur~~~rg~s, , BUILDING PER~1IT Charges and Surcharges Comm/Ind Per Fee Res Per Fee Systems Development Charge tl.5%) " MECHANICAL PERMIT Charges and Surcharges A/C Paving I Curb Cut I I. ,!rotal Co.mb. Permit I TOTAL ; C/? 2.:>:J - " ' COMBINATION APPLICATION/PERMIT (CAP)' PERMIT VAll DATION IV. I. Applicant to furnish A. Job Address B. Legal Description 1. exam~le- 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 constructi'6~"lender 'D. Energy Sources 1. . 'example- heat/electricai ceil ingjor forced air qas 2. example- 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 2. 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 oy:>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 schedul es 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 b~ 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. ", 7'0. ,- . . " . . '.... . I I I. V. FOR OFFICE USE ONLY ~(l". ~~ it, 12-.278, Permit Clerk d. (ji ~ q-15- ~' PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from regis~ration with the Builder's Board oecause: Additional Project Information: -" .... " - .~. PLANS REVIEWED BY: namec't?i9u~ Rz~~? signatured~;2~- date ;7~E-:g""l!!;.. /' ,/ '( ,. "-' , -.t'