Loading...
HomeMy WebLinkAboutPermit Building 1989-6-16 (2) 1 U/,I'ECllOll Llilf. 726-3709 . LIlY ufo SI'IHilliFjUU COI\BIIIMION APPLICATION/PERMIT E!IERGY SOURCES: "eat I-later Heater Ranne_ . IIlfORllM;..'1 lid:' II 726-37,) So. Ftq. /.ld in ~q. :tlJ. Access. SQ. Hq. Other rlCh' Add lI,lter [I.eo. --rence Oemo Change/Use Other- - ~ ~ II 111] II I JOb Mdress I / / 7 _<;' a ' le~d] De~criptjon J'A .. ...s;- r- Phone Valuf of Hod:: $/3,/5/ Bui It;inQ Permi t Info: family Residence With Describe 1.lor~{ i.e.. Oui Id Single f\t tached r.araQc) Owner ~j' ~ t:.dJ;.) ,\ddrC5~A ,-,d ):/p I2OLJC-r.s l_rD, 726 -j q --7/ ;::< /J " J;" TT7.tO J-..HJ .<: ;:=;. / /_L os<.l4't:=- I5 L--owti=12 Construction lender ..\LlJress OE,llJil Tl^ll {/ldme} I'hone {address} (I ic<;. /10. \ {exniresl (nhnne no. J Primary 1--7 A .q k L 0 tJ.,r7 00 Structural ~ -1, f--h L- '-- t:;:,.J4/ Jr:i-CP'uJL Electrical !1echanicd 1 CONTRACTORS {name} (addreH 1 (1;('<;. no.\ ((>)(01rp" \ (nh(\f\p no ) Genera 1 }....//r_K":=kJrl."'::- /~~_/ tc:=y t:17^-_LSr: PlumbinCl Electrical t1echiH1'Ci\' rJ IA/. I~,<) PLUIIflI IlG ELECTRICAL MECHANICAL '" r1Ii\RGE IIf) 1...f.ELIJ:1JAIlliL furnace/burner to OHl's ;;u. , -----lEach 'ingl. fixture IRe\OColed building (new fix. addit iona I) IS.F. P.esidence r I bath I Duplex (1 bath) each f'f (IIARG' JIlL. Residence of SQ, CT, New circuits alts. or' extensions Floor furnace and vent !SERVICES Recessed wall Snarp hpa tpl'"' -'nrl ItPnt Storm Se\'/er or amps, Apoliance vent seoaratl'> Stationarv evao, coo 1 cr ~ ' I Vent fan \'1ith sinoJe duct Vent syster.l apart from I heatino or A.C. Nechanical exhaust hnnrl <'lna alJrt Additional bath Sewer Temporary Construction Cllanqe in existing res i d(>nc(> 'mult{filmi"ly, conl!l. or Indu<;tri;d ~!ater service CoI'IL lIND, FEEDERS Ilf,stall/al tel'/relocate rli<;trih. f(>(>t1pr<; IOf amps. \'load stove/heater ISSIJANCF nF P'P.lllT I TOTAt CHARGES Contractor, the electrical portion of this peri.\lt and return('d to the Building Division Zone M-.L,/ Tyne/ConH, Fire Jane Bedrooms ~, Units Occy load Occ.Y Group SIGlIATVRE /.z,1 /i hi /' __~ rop. OfFICE USE Oitty S~. rt~. 11ain x SQ. Ftl]. Access x Sq. Ftg. Other x omi12/L-_1 A''l IIM1E(pleilse flrint) I'--7A~.I< Lr:::lA..L.l.-,."J#t,./ Flood Plain Stories Value Value Value VALUATIOII /~, /S / TOT^L BUltolllG PERnlT Charges an~ Surcharges I Plan Ck. . __-I-~r'-~-:?__....Q5%/fildO Plan 0, ~.-;2." 30%fBldn ____________1 Fence I O,emo 1 Conm/lnd Ppr Ff>f> Ifes PI;' r Fer 16?-q.~ I I I I I Syste~5 Oe~elopment CharGe (1.5') PLU'1BING PERMIT C~arges clnd SurCharges . (lECTRICf..L PERI~IT CharQes and SurCharges I1ECIlANICAL PERlilT Char9~c:. and SurcharfJes Itota) (omb. rermit 1- j'OTAl /77GrP , . . COMBINATION APPLICATION/PERMIT (CAI') PERMIT VALIDATION /" / flY- 'j I. Appl ieant to furnish .A. Job Address B. legal Description 1. example- Tax Lot 100. lane Counly Map Reference II UJ 4J 2. examnle- lot 1. Clock J. 2nd Addition to 5,Prlllgf ield (states L. Name. etc. of owner and construction IcnJcr O. Energy Sources 1. exarnple- heat/electrical cell inCJ/or forced air oas 2. examole- waterheater/eleC(rlcar/or solar (. Square footage or valuation. etc. - 1. examole- 1250 sq. foot house. 500 SQ. foot garage 2. example- lfi)cw project, checkflCw - if addition. cheCk add. etc. F. Building pcmdt information: 1. example - construct sinyle farnily tlouse with an attached g"lr4ge 2. examole - remodel existing garage into family room 3. eXdlllole - convert single family residence into restaurant (change of use) G. Value of \",ork. as defined in Section 303 (3) of tlH? Structural Specialty Code II. DESIGN TEN! AND COIHRACTORS To avoid deS\<]1l or consll'ucliun delays. Uuihtiflg Division Staff must be able to contact appropriate persons regarding des ign inforlllat ion or job site corrections. etc. II. Abbreviated Plumbi(lg. Nechanical. & Electrical Schedules A. Except to/here blank spaces occur in the description portion of the Mechanical and Electrical Schedules. the applicant need fi\1~in only the No. Boy.es adjacent to the appropriate ltem(s} to be installed 8. full Plumbing. Nechanical. and Electrical Schedules are available at the Building Division 1. To conserve space on the permit (ann 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. BUILOING DIVISION STAFF WILL FILL OUT ALL FEES AIW CIIARGES ON TIlE SCHEUULES O. As noted on the CI\P. th~ \a.bel must be delivered to the electrical contractor for signature by his electrlcal supervisor. The general contractor is !!.2..!. author.ized to sign the electrica1 label. III. Applicant to sign and date Whenever posslble, the initial application will be used as cl worksheet only. Where possible, Bui lding Division Staff ."i 11 prepare a type wri t ten copy and re tUl'n it to the applicant at the time the actual permit is issued for his signature. IV. Fees and Charges Plan check rees are due and payable at the time of lhe application, and tlO plans \1ill be processed until these fees are paid. All otber fees anti chdrqes are due and payable when the permit is issued. V, FOR OFFICE USE Or/LY P,mit CI"t~ IYfIi.eflfJ .. PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAiICY: Permit applicant exempt from registration with the Builder's Board because: Add i ti ona 1 Project Informa t ion: PLANS REVIEWED BY: name_/ AV-?/91"- h.cz;~".l? signature ~~r?'~ d ate t::::- //, .:;;'7 . ..._1