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Home My WebLink AboutPermit Mechanical 1984-05-09INS tzb It COMBI AP CA ERMIT 7?-3 l-egal Descri ption Job Address EilERGY SotRCESHeat_LT Ra l,later Heater -J Owne r Xtlttf-)varue of K7n l,leur . Access ,_C hange/Use ller. [et. - Sq. Ftg Sq. Ftq tg. l.la Addres s Phone Ga ra Bu 'I n h Attache scr ..e., Build Single 0 rIP)a >A Construct'ion Lend$( Addres s Phone p DESIGN TEAI{name addre s s 'I ics . no.exDl res ohone no. Pri mary Structura I E l ectri cal Mechanical name addres s (ernires)lics. no.)ohone no. Genera l Pl umbi nq EI ectri I )l ffi[ \\PLUHB I NG ELECTRI CAL I'4ECHAN I CAL FF CHARGF NN FFF CHARGF NO FFF CHARGF Each single fixture Res idence of FTSQ furnace/burner to BTLI' s Relocated bui lding (new fix. additional) New circuits alts. or extensions Floor furnace and vent S. F. Residence(l bath)SERV I CES Recessed wal I Soace heater and vent Duplex (l bath) each ;wbu#trMb 3 ( Additional bath Temporary Constructi on Apol iance vent seDarat-e [^la ter servi ce ge in existing dence Chan res i Stationary evap coo l er Sewer Tndustrial multifamily, comm. or Vent fan with sinole duct Storm Sewer 0f s.Vent system heatino or A apart from .c. c0t1r.t./IND. FEEDERS Mechanical exhaust hood and duct- Instal i /al ter/re1 ocatedistrih- feeders l'Jood stove/heater 0f S L,rnLn efin-/, U ISSUANCI OF PFRI,IIT @ TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES )90 WHERE STATE LIN REQUIRES that tlte Electrical work be done by an Electrical Contractor, the electrical portion of this permit shall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Building Division tlAl'lE(please pri SIGNA 0regon the Buiof any Boa rd I t anatnoforca ce rt t atha trma hereonon s truepr)comp and nda a t^/0 krcorrectandfurrtheticerthaaL nhadonebe ncaccordas 0rd n cesan 0 tf ChethetheWIpefy tyrlof ny offiedandtheofLawshettas nlSpn9terta to het dwork c r'lCS hereibed n and th at NC 0cc ,AI,ICYUP wl be madengDC rut c retu thouwl thet SS ofnspermi d n D s on hefurt r cer t tha t re s ttra 0 vJln theth UI de rIfymyg force and asnS the bas s for on s hereonnoted and thateffectexempt Proj ectonly subcontractors and ernployees used on required by ORS 701.055, that if exempt are in comcliance with 0l?S 701.055 wil Flood Plain Stories 0cc.v Group Sq Ftg Ftg Ftg Val ue TOTAL VALUATION- x x st its l{a iZone 0ther Val ue Val ueFire Zone Bedrooms 0ccy Load Acces s Plan Ck. Conrn/lnd 65%/81dq Per Fee Svsterxs Develooment charqe (1.5q)BUILDING PERNIT Charges and Surcharges ee Plan Ck. Re 30%/Bldq Pe srF FencePLUI4BING PERMIT Charges and Surcha rges Dgmo Sidewal kELECTRICP.L PERI1IT Charges and Surcharges A/C Paving Tota'l Cornb. Permi t Curb CutI1ECHANICAL PERMIT Charges and Surc harges 1D---TOTAL ,g\ l^lork o0fr-nfi,[) llnt, \1s \.c tN 1 40 COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 43 PERMIT VALIDATION 2.exampl e- Spri ngfi Lot 1. Block 3, 2nd Addition to eld EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. exampl e-2. examol e- E. Square footag air gas te?fiq51example- 1250 sq. foot house, 500 sq. foot garage example- if new project, check new - if addition, check acid , etc. 2. F BuiIding perm i. example - attached rit information: construct single family house with an garage II 2, example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. 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 sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Eiectrical Schedules are available at the Building Division1, To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF I.IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDUI.ESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical iabel Applicant to sign and date l,Jhenever possibie, the init'ial application wil] be used asa worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture. Fees and Charges PIan check fees are due and payable at the t'ime of theapplication, and no plans will be processed until thesefees are paid. Ail other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III IV. V Permit Cler PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Informat'ion : PLANS REVIEWED BY: name S'I gnature date q M I (