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HomeMy WebLinkAboutPermit Mechanical 1990-8-14 ---- I INSPECTION LINE 726-3769 J.;!, Address Pf)J Q-\.~ \\ ~ m0(1:1,1 Legal Description \fln~~S4Q ()8.w(l.' ( .. Owner \ \\ "''(. 9 . 1=\ i- (' \rL Address<p{'){ n- ~ \1"\ < A ~\(1 ~ construc~on ~en'de~ l - , TY SPR NIELD COMBINATION APPLICATION/PERMIT EIIERGY SOURCES: Heat Hater Heater Ranqe ValuE of ~Jork: NFORllAT ON 726-3753 Sq, Ftg, ',lain ~q. FtlJ. Access. Sq, Ftg, Other New Add Alter Pep, --Fence Demo Change/Use -Other- - .-1) D - ~ Phone BuildinQ Pe~lit Info: Describe Work(i.e.. Build Single Family nesidence With Attached Gara~e) Address UI:.SlliN II:.Af1 lnamel r F4VJ~3~&1 V \. '\ JlQJ) ~ l ~c \Q fUll A1Yl 11 ) I \ \ r (ohane 00.\ Phone (address 1 (lies. no.) (exoires1 Primary Structural Electrical Mechanical CONTRACTORS {name} (address) (1 ice:;, no_ lexoirf'<;'\ (nhonp no. \ Genera 1 Plumbina ~lechanical ~C9Jl\).~ Q 9 C\- 6nY\ ~ PLUI,IBING ':)~?:,L. /J ,1{)Ulqz- 4\.0<61', \f(]'Q..j\ #C.~\C1 OCJ' 'l~lw'Ilr1)' J ELECTRICAL \ I MECHANICAL E1 ectr1ca 1 NO, HE CHARGE ~tn FFF r~ARr,F NO Fn~ rH~ ,SQ, FT, furnace/burner to BTlI's Each single fixture Resldence of Relocated building (new fix, additional) New circuits a1t5. or extensions Floor furnace and vent S.F. Residence (] bath) Duplex (1 bath) each SERVICES Recessed wall Scarp heater and vent Storm Sewer I Of amps. Appliance vent c;eoaratp Stationary evap. cooler Vent fan wi th sinole duct Vent system apart from heatina or A.C. Mechanical exhaust hnnrl and dud Sewer Temporary Construction Change in existing res.; rt~ncr. multffamily, camm. or Industrial Additional bath Water service CO~1,/IND, FEEDERS Install/alter/relocate ni<;.trib_ fpprlers Wood stove/heater Of amps. TOTAL CHARGES WHERE STATE L~W REQUIRES shall not be valid until the ISSUANCE OF PFRt1lT \ TOTAL CHARGES " TOTAL CHARGES that the Electrical work be done by an.'Electrical Contractor, the electrical portion of this label has been signed by an Electrical Supervisor and returned to the Building Division penilit I HAVE CAREFULLY EXAMINED 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 Spri ngfi e 1 d and the Laws of the Sta te of Oregon perta i ni ng to the work descri bed herei n. and that NO OCCUPAIKY will be made of any structure without the permiSSion of the ~uilding 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 iEt th basis for exemption is noted hereon, and that only subcontractors and employees who are in compllance with DP.S 7nl 55 w 11 used on this project. /, IWIE(please print) I!l?rl/.Gy ,z:/I?,v.o SIGtl^TURE DATEOBJ/~/ 7'CJ FOP. OfFICE USE O~LY ~ ' $q, Ftg, tiain Sq. Ft!). Access Sq, Ftg, Other Fi re Zone Type/Const, Bedrooms Units Occy Load Dccy Group x Value Zo~e x Value Flood Plain Stories x Value TOT^L VALUATlOtl ! BUILDING PERflIT Charges and Surcharges , Pl an Ck, COIlll1/lnd ____________~/Rldo P.er Fee Plan Ck, Res 3D%/Bldo Per Fee Fence 'Systems. Development I Charqe tl,5~) " , PLUI~BING PERMIT Charges and Surcha rges D~mo 'Sidewalk ELECTRICAL PERI1IT Cha rges and Surcharges A/C Paving __J~~-_ Curb Cut ,'l~ Total Comb. rermit MECHANICAL PERMIT Charges and Surcharges TOTAL j (~,~, . COMBINATION APPLICATION/PERMIT (CAP) 1. Applicant to furnish A. Job Address B. Legal Description 1. examp.le- Tax Lot 100, Lane County Map Reference 1/ 03 43 2, example- Lot 1. Block 3. 2nd Addition to ~prlngtield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinq/or forced air Qas 2. example- waterheater/etectrical/or solar E. Square. f~otage or valuation, etc. 1. examole- 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 a ttached garage 2. examele - remodel existing garage into family room 3. exa~le - 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. I II. "Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant n~ed 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 fu 11 schedu 1 es C, BUILOING DIVISION STAFF WILL FILL OUT ALL FEES ANO CHARGES ON THE SCHEOULES 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 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. V, FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: . PERMIT VALIDATION ~~,\41\qqO ;jf \ ~05~ Permit' Cl erk !:d1DQ) Permit applicant exempt' from registration with the Builder's Board becaus,e: Additional Project Information: PLANS REVIEWED BY: name signature date