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HomeMy WebLinkAboutPermit Plumbing 1981-6-15 I TRS, TL 13 ~z- 5 -.II> 20 I Idne; county" '.. &RESS 49'b2 ~ed.~( CH ECKLIST ~(. PLUMBING/ MECHANICAL OFFICIAL USE ONLY Appli./ \2.oq-'8\ Pen11l t # ".,) APPLICANf INFORMATION: . · 1\ tA' , 'I I"lrrr.l1./Yl.~ Qd)oo UXLJYU. ~ame or~irm-Please Prlnt) . PLUMBING CONTRACTOR o Yes Firm ~o:}j ~) T:2fo-oQ2b '\,Mallmg AddreSS) (t'lty or Town) (Zlp Code) rn- b83- 3bZZ Cont. OSRT' Address o No o Self ~1ECHANICAL CONTRACTOR 0 Yes Firm Cont. OSR# \ Address , ~ N~1f DIRECTIONS TO SITE CflDP'J\., ed ' ~ ~ 0Yl (~(hQO-fu6. _Co. _ ~f}2~NJ J.) / ~ l) .-/:rtJm. Type of Fixture Number of Each Fee On Each Total Sink Lavato!" [Wash Basin] Tub (with or without shower) Shower. separate Water Closet [toilet/urinal] Dishwasher Disposer (garbage grinder) Washing Machine Water Heater Floor Drain Sewer--lst 50ft. each additional 100 ft. Water Service--lst 100 ft. each adclitional 100 ft. Storm and Rain Drain--lst 100 ft. each additional 100 ft. Special Waste Connection Sewage and Sump Pump [eiector] ~bbiie Horne Sewer and Water Other (specify) SUB-TOTAL (Minimum $10.00) ,I r I J $ 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 15.00 10.00 15.00 10.00 15.00 10.00 5.00 5.00 10.00 I TOTAL FEE 'ZJ),O IO.CO .-10 ~O /K) ~ Type of Equipment MECHANICAL Nwnber of Each Fee on Each Total Mechanical Permit Base Fee Furnace UP to 100,000 BTU/H Furnace over 100.000 BTU/H Clothes Dryer Vent Bathroom Ventilation Fan & Duct Range Hood with Mechanical Exhaust Wood Stove Air Conditioner Only Heat Ptmm Floor Furnace Gas Piping System 1 to 4 Outlets Per Outlet $ 10.00 $ 6.00 7.50 3.00 3.00 4.50 6.00 6.ob 6.00 6.00 .50 Other (specify) . SUB-TOTAL I 1 certlty tnat all Plu..," '''~ WOrK WIll U~ UUII~ '" I accordance with applicabl& provisions of Oregon TOTAL FEE Revised Statutes Chps. 447 & 693 and applicable codes. and tha t no help wi 11 be employed unless Permi t l~censed unPerj>RS 693._ ~ J_ ~ issued bv Slgnature " r;;j,.b:1Jz ~ l t. (LkJ -' _. J Date i5~o ,'BQ. C~ ((-)"-15-~1 f LANE COUNTY "APPLICANT AKIN~ LORRAINE ,~u~ 1802050~00201 SUBDIV ~EW BLDG TY~E USE R NO BDRMS 4tCODE APPL NO , ACTION DESCRIPTION BP BP . BP BP . PL LC 1~0981 PL PLUMBING EL NO. FIXTURES: 4 NO. ,_CH \.I,:)'ltR , r PCK .. EST. COMPL~TION DATE 061581 .. CATG: "1;111: TAI<r,N APP .('1 RY CAn RA FP ..' "I ' .. . .. , , f' n~ ..,:' f . ~ I, . :~ f ~ i ;1 " " .17 [. i; ..; '1 1 'ifl " p ..!-> " '" " '" :", ~ , "J:! ~ ex: .r tc a: ..'"'I:. II 'i'~ .. . . DEPT ENV MGT RECEIPT ~ 130981 DATE 061581 ADDR 4982 JASPER RD., SPFD., OREGON .. LOT BLK 00 NO UNITS 001 NO STORIES NO BLDGS 001 SQ FT UNIT COST VALUATION FEE' DAYS" .. .. 1'1 ONLY CONNECTORS: MECHANICAL FEE STATE SURCHARGE PLAN CHECK FEE .. 15.00 EACH = 47- . 507- 20.00 .. 0.80 10.00 " .. SDS .. 1 " .. SI PCK OTH IS'S o TOTAL FEE** 30.80 CK .. r ..: , ,