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HomeMy WebLinkAboutPermit Building 1986-09-29\0 q ECTION LINE 37 69 coilBI LICAT RMIT 72 Job Address q Legal Description Hea EIIERGY SOURCES: llater Heater Sq. Ftg. Access._ Sq. Ftg. Other_ J,lewJddJlIEEAep. _Fence_Demo_Chan ge/ Use -other- tg n Jo*,t dEzn*Owne r vatue of ,,o"r,1 *70r DesPerntt Info [,lork .e., Build SingleAddress ?r7 S &* y,Phone ,e?'fr< caaAdi { u*at to aD/75 ftira .fu?4r6,(E r*ffiConstruction Lender \ \.-- \ $.\ \ \ Address Phone lcs. no.exDl res phone no.IJt5l GN I LAI.'I name address Pri mary Structura I El ectri ca l Mechanical 'b )3075Genera l 7 4 ad ,7 L D- Plumbinq l'lechan i 1 -e e MECHAN I CALELECTR I CALPLUI{B I NG FFF CHAAGFFFFCHAAGFNOFEECHARGEN0- furnace/burner to BTU' sEach single fixture Residence of FTSQ New circuits alts. or extensions Floor furnace and vent Relocated building (new fix. additional) Recessed wal I Snace heatpr and vent S. F. Res idence ( I bat-h )SERV I CES Duplex (l bath) each Apol iance vent sPna ratPTemporary Constructi onAdditional bath Change in existing resi dence Statjonary evap cool erl^later servi ce multifamily, comm Tndrrstrial or Vent fan with sinole ductSewer Vent system apart from heatino or A.C..amps.0fStorm Sewer Mechani cal exhaust hood and ductCOMH./IND. FEEDERS Instal I /al ter/rel ocate dictrih- feedprs l,Jood stove/heater qmpi0f ISSUANCF OF PFRtlIT TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES WHERE STATE LAt,l REQUIRES that the Electrical work be done by an Electrical shall not be valiC until the label has been signed by an Electrical Supervisor Contractor, the electrical portion of this permit and returned to the Building Division only subcontractors and employees who are in comoliance wlth 0l1S 701 nformation hereon is true the Ordinances of the City . NC OCCUPAI,ICY wi I I be made 'ation r.rith the Builder'sis noted hereon, and that t. oere ?834 ktlAllE(please print)i GNATUREa 0reg the Bany rd ng IU perm ffect aHcatn0fortandodhertcehattapermreb.y fycomppp hawokrndrmedrfohasatecordancacnedonbeandandfucerrthertitthaatcorrecpefyny offrefidndathofwsStheta tthaandhedesworkbedcrlhenrerttortanl0nLafpeSpngngpe D s on fu hert certr tha t re strofudftuttfym.y gsonstrucrewlthoue Boa n fu fo and bas S orfr onhettthaf+ORS 5nrasrcee exemptexempredbyrequ 'l I be used on this jec FOll OFFICI Fire Zone Bedrooms Occy Load Sq. Ftg. Access x Val ue TOTAL VALUATION Zone ilpUni t Val UFS0ther e/Cons t Group q. FtgFlood Plain Stories s S9. Ftg. l'lain x Val terils De rqe (1 Svs Cha ve 57 opmentPlan Ck. Corm/Ind 65%/B1dq Per Fee BUILDING PERI'IIT Charges and Surcharges ?5 00 l*Plan Ck. Res 30%/Bldo Per Fee FencePLUI,IBING PERMIT Charges and Surcha rges D6mo Sidewal k Charges and Surcha rges 27fo ,80 ELECTRICAL PERtlIT Total Comb. PermitA/C Pavi ng Curb Cut 4r*.TOTAL I,IECHANICAL PERMIT Charges and Surc harges lur :am nhnne nn.AI]TORS -xA I I 'I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot l. Block 3, 2nd Addition toSpTiffiield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. examol e-2. exampl e-E. squaiE-TioTas heat/el ca iti or forced air qas wa gr ea or sol aror valuati on, etc II. 1. examp_le- ]3!9 sq. foot house, 500 sq. foot garagez. elample-.if new project, check new _ if addition, check add, etc.F. Building permit information:1. example - construct single family house with anattached garage ?. exampje - remodel existing garage into family room3. example - convert single family-residence inio - restaurant (change of use)G. Value of work as def.ined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construct.ion delays, BuildingDivision Staff must be able to contalt appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechan.ical, & Electrica'l SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacent _ to the appropriate item(s) to be instailedB. Ful l Plumbing, Mechanical, and Electrical Schedulesare available at the Building Div.ision1. To conserve space on the permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labei must be delivered to theeiectrical contractor for signature by h.is electricalsupervisor. The general contractor ii not authorizedto sign the electrical label.Applicant to sign and date llhenever possible, the initial appl.ication will be. used asa.worksheet only. Where possibie, Building Division Staffwili prepare a type written copy and returi it to theapplicant at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is .issued. FOR OFFICE USE ONLY + bo7/7c" III. IV. V Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name s'l g nature date