HomeMy WebLinkAboutPermit Plumbing 1985-01-24ON LI}IE
COHBI TI AP ERMIT 7?6-31
l-ega) Description
Job Address
tlater Heater
Hea t_
EIIERGY SOURCES:
/n/4^Value of l,lork
Sq. Ftg. Access._
Sq. Ftg. Other_
l{ew__,ld61l ter_Rep.
_Fence_Demo Change/Use
0ther
rkn 'e., Build SingleAddres s
,sb[ ld
tclf *-t.LQ '
aconstrucidn t*a..
\o
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0o
Address Phone
exDr rFsDES I GN TEAI.,I name addres s I ics. no
Pri ma ry
Structura I
El ectri cal
l'lechani cal
nhnnp nnaddres s lics. no.exD l resn amq
/%(i, t)o*I
-t$
El ectrical
Itlechani cal
ELECTR I CAL MECHAN I CALPLUi4BI NG
FFF .HAPGFFFFCHARG F NOFEECHARGENO
furnace/burner to
BTU' sEach single fixture Residence of
FTSQ
Floor furnace
and vent
New circuits alts.
or extens i ons
Relocated building
(new fix. additional )
SERV ICES
Recessed wal I
Soace heater and vent
S. F. Residence(l bat.h)
Duplex (l bath) each
Apol iance vent
seDa ra teTemporary Constructi onAdditional bath
Stationary evap
cooi er
in existingChange
res i de ncetJater servi ce
mul ti fam i ly, cornm
Tndrrqtrial
0r Vent fan with
sinole ductSewer
apart from
.c.
Vent systern ,
heatinq or Aimps.0fStorm Sewer .
Mechanical exhaust
hood and duct,/o u COMI.I./IND. FEEDERSI
I'Jood stove/heaterInstal I /al ter/re l ocate
distrib. feeders0
0f
ISSUANCF OF PFRI1IT
IOTAL CHARGESTOTAL CHARGESTOTAL CHARGES ry)6
WHERE STATE Llll REQUIRES that the E'lectricaj work be
shall not be valiC until the label has been signed by an
done by an Electrical Contractor, the electrical portion of this pernit
Electrical Supervisor and returned to the Building Division
l,lAt'lE ( p l ease pri nt)v
tru esrtcetthaaformantheonreonhereddoancatnrfotb.y fypermtheNEDeappcomp
n rdance thw1 0rdthe na nce rofthesat{o kr rformedpe hasa ac codonebendfuhertcertrthatndandacorrectanyfy
ma
ty
denthaandNCtwlOCCUPAHCYbertanl+to workhe d crles hebed reronofterfdndaLawsthetheoftaSfDEng0regSpng
re stra t n t1., 1 theh u1B der sdDisonfu rt rhe cert tha tftus truc w1re tthou het ss of0n Bthe u fy m.y spermng
dshereonnotedan thatron0557thatbassfoEXhetftBoasnfufoandrceffecatredORS0Iemptexemp
any
rd requ by
be sedu th0n sn17 projndwhorenwlance011sthntrsubcotoacarsonlvernployees
Val ue
Val ue
TOTAL VALUATION-
qq x ValFtg. Acce
Sq. Ftg . 0ther
nst. Units So' Ftq' l'lain
Fire Zone
Zone
Load
Flood Plain Stories Occ.Y GrouP
Svster:rs Devel opment
charqe (1.57)'Plan Ck. Conrn/Ind
65%/B1do Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERTIIT
Charges and
Surcharges
Fence
DEmo
PLUI4BING PERMIT
Charges and
Surcha rges 6
Sldewalk
Tota'l Cornb. Permi tA/C Paving
ELECTRICAL PERI|IT
Charges and
Surcharges
Curb Cut /0 4 0
TOTAL
},IECHANICAL PERMIT
Charges and
Surc harges
0wner
Phone tsur
Fam
]TOR S
[rorr/-?/'tC
I
II
1
comcl
6frrof
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description
i. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot l. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
6q/ b7
@ ,/ut/r,'/
1. exampl e-2. exampl e-E. Square foota
heat,/electricai cei 'I or fofced air gas
wa ter e ec or soJar
ge or valuat o[,
1 examp-le- 1?50 sq. foot house, 500 sq. foot garageelample-.if new project, check new - if addition,check add, etc.
2.
II
F. Building permit information:1. example - construct s.ingle family house with anattached garage?. examole - remodel existing garage into family room3. examFIE - convert single iafrity"iesioence into
- restaurant (change of use)G. Value of work ai defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, BuildingDivision Staff must be able to contalt appropriitepersons.regarding des.ign .information or job sitecorrecti ons , etc.
Abbreviated Piumbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur .in the descriptionportion of the Mechanical and Electrical Schedules,the appl icant need fi'H-in only the No. Boxes iajii.nt
_ to the appropriate item(s) to be installedB. Full P'lumbing, Mechanical, and Electrical Schedu.lesare available at the Building Division1. 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 thefu l I schedulesC. BUILDING DIVISION STAFF I^IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be de.livered to theelectricai contractor for signature by his e.lectricai -
supervisor. The general contractor ii not authorizedto sign the electrical IabelApplicant to sign and date
Hhenever possible, the .initial application wi.ll be used asa.worksheet only. Where possiblb, Building Division Staiiwill.prepare a type written copy and returi it to theapplicant at the time the actual permit is issued io" fris
s i gna ture.
Fees and Charges
Plan check fees are due and payable at the time of theapp'lication, and no plans will-be procesieA until thesetees are pa'id. Ajl other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY
III.
IV
V Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit appl i cant exempt from registration with the Builder,s Board because:
Additional Project Information:
PLANS REVIEWED BY:
name s't gnature date