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HomeMy WebLinkAboutPermit Mechanical 1985-03-28CATI 53ITONLCOHBIN SPE ?6-3 ,lob Address a Ua ter Heater. EIIERGY SOURCES Heat l-ega1 DescriPtion 5q. Ftg. Access.-.- Sq. Ftg. Other-- tlew Add Al ter-Pep ' -F e ni-e-DE-mo-C h a n g e / u s e -0ther tg tia n :€. r I ng e Owner Addres s Phone 7?o/ Constructi on r Addre s s Phone n Structura I E l ectri cal Mechani cal MECHANICAL FI- FPLUHBI NG ELECTRI CAL NO N0.furnace/ burner to BTU' sResidence of FTSQEach single fixture = I Floor furnace and vent Recessed wa t'l l{ew ci rcui ts al ts ' or extensions SERV I CES di ng tional ) Relocated bui (new fix. addi i denceF, Duplex (l bath) each Additional bath Apol iance vent seDa ratqTemporarY Constructi on StationarY evaP cool er'i n exi sti ng nce Change res i dellater servi ce sinole drrct lent fan wittr T ndu stri a lnrultifamilY, comm' or Sewer apart fromVent systern heatinq or Aamps.0f Sto Mechan cal exhaust hood and ductcoMtt./IND. FEEDERS t'lood stove/heaterInstal I /al ter/re I ocate distrib. feqde-rs- 0f T a rssuANcE oF PFRllIr /O bytriREQU nti I 'I on'I f0 Sthi ttractoretheec,l t car1 permiEectrIca'I Con tI portan'I E 1ectr be doneIworkcathethatRESIATESTLlI.II.IHERE I 'I Is 0nrnedtutheto'Iu1 d 'I Drengandac'I i orsEIecSupean1beahaIbeenS .IsashIIbenotIVA,l'I u the bygned TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES only subcontractors and employees who are in comcliance with 0l?S 701.0 3-2Y-FrllAtlE(please print)IGNA Ci ty made any of fyng 70 trma on'I hereon truscertitthaanfo.Idoherec'Iat foron I t b.y fyDermIEDNtheapl-)c0mp f thewl0rdn10anceshetthIIkworsIhabe'I tdone an ordanceccandndtcorrecaIndrtfurhertce,l hatta afy performed th NCat wiOCCUPAI'ICY '|I bea1rttntoworkthebeddescniereh'I andfonIIdIndaLawstheoStatheiafo0reg0engsprngf IIttrlthehder 5BuiIfD'I SI I n'I 'Id I rfu rthe rtce '|th at ,l trat onsotustrucwlrethethou t rmt ss 0n'I theof u IB m.y reqpe and thatba1sforstiI0nnotedshereonthethaItf0551I any .rd exemps'I n1 Ifu force'I nda cteffe sa red ORSBoarequby be on Flood Plain Stories 0cc.y Group Sq Ftg Ftg Ftg l'la i n Load its Val I ue- Access 0ther ToTAL VALUATI0N_ Fire Zone Bedrooms Zone x Value Plan Ck. Comm/Ind 65%/81do Ppr Fcp Svstems Deve charqe (1.57 opmentBUILDING PERIIIT Charges and Su rcha rges Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Surc ha rges Dgmo Sidewa I kELECTRICAL PERI,IIT Charges and Surcha rges Total Comb. PermitA/C Paving Curb Cut I,'ECHANICAL PERI,lIT Charges and Surc harges 4a /a_ IITAL )04: zla-^>/0 lr^) f. t4 a \d\ //u /' I I a-:/ COMBINATION APPLICATION/PERNIT (CAP) I. Appl icant to furnishA, Job AddressB. Lega l Descriptionl. example_ Tl7_Tj_uS ax Lot 100, Lane County Map Reference Z. example_ tot_l. BIock 3,2nd Addition toSffiffiie.lo Lstatesr,. name, etc. of rD. E;;;;y'i;;.;lr"nu" and construction lender E F G H I I. Abbrevia ted Plumbin g, Mechanical & Electrical ScExcept where bl ank spaces hedul es portion of the Mechan i ca I occur in the descri ption the app 1 i cant n eed fi l l-in and Eiectrical Sc hedu i es to the a ppropriate item only the No.Boxes adj a cen tB. Futl pl umbing, Mechani (s)to be install ed are available atl. To conserve cal,and Electrical Schedulesng Divisionthe Bui Idi have been a space on the permit form the schedules 2. If the i bbreviated tem(s) to be instaljedted schedules you are not covered onthe a bbrevi a should consul tful I schedul ES theC. BUIL DING DIVISION STAFF I^JILL FI LL OUT ALL FEES ANOCHARGES ON THE S CHEDULES D.As noted on the CAP, ths label must be deelectricai cont ractor for si livered to the supervi sor.The genera l co gnature by his electricai to sign the e lectrical labe ntractor is not a uthori zed I I I. Appt icant to sign and date Hhen ever possible, the initia.l apprksheet only. l.Jhere possiblb,lication will be usedawoBui Iding Division Sta AS wi lt prepare a type written c ff appl i cant at the time the ac opy and return it to the signa tu re.tuai permit is issued for his IV.Fees and Charqes Plan.check feis are due and payable at the time of theapplication,,and-!g ptans wiit-oe proieisla until thesetees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLYV lA # 6qqqL PERMIT VALiDATION Permit Clerk 3y PROJECT CONDITIONS IO BE SATISFiED BEFORE OCCUPAI,ICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: datenamesignature