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
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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
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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
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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