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HomeMy WebLinkAboutPermit Electrical 1988-07-10PECT I -3769 L eel /76 3< cor,tBI nATr 0N nppl r cnuoH/pERMI T N 726- Job Address 4 Legal Description Zae-t'n-o Vb, ,.2?j 1 Ranqe l.later Heater EIIERGY SOURCES Hea t Owner Value of llork: Sq. Ftg. Access.-- Sq. Ftg. 0ther Jlew_rqdd_A I Ier,a€-p . _Fence Demo Change/Use_other--- nSq. Fto Add ress Phone B F t Info ce tli .e., Build Single 4zrrr-e Ar; Construction Lender Z-z,"tuizZ 1-2,ioe &ao.{-t-ry Addres s Phone v DO D()s s.* t^l OES I GtI TEAI4 name addre s s cs. no.expr res phone no. l Pri ma Struc tura I L/Electrical Mechani cal ,CTORS name addrps s 'l i cs. no.exDt res (ohone no- Genera I El ectri ca l ELECTR I CAL MECHAN I CALPLUHBI NG THAPNFFFFFFFCHARGFNONOFEECHARGENO furnace/burner to BTU' S Residence of FTSQEach single fixture Floor furnace and vent New circuits alts. or extensions Relocated building (new fix. additional) 3n Recessed wal 1 Snace heater und venL'r,a')SERV I CESS. F. Residence ( I bath)/3Duplex (l bath) each Apol iance vent seDa ra te,.*tr*, const"uc(onAdditional bath Stationary evaP. coo l erge in existing dence Chan res il.later servi ce Vent fan with sinole ductmul t if ami ly, corm. or TndrrstrialSewer Vent systern aPart from heatinq or A.C.0f s. Storm Sewer stlCaex COHI"I,/IND. FEEDERS l,lood stove/heaterI nsta l I /a l ter/rel ocate distrib. feedersr\ 0f amp s.\.1 \vI ISSUANCT 0F pFRt{IT TOTAL CHARGESb3TOTAL CHARGESTOTAL CHARGES oxt 7 -/4SIGNA c t3IllAtlE(please print).ui te ,a , REQU unti l tsofth0npermectrcaportthetractorEectrcaCondonanworkbetricaEIecREthastltetV1onEsATELlI.I di Di sERHHtongtheBuandreturnedrvorsac bytriEEC Supenedansbybeenhatheabesbeva,ltnoha 0regon the Bui exemp 055 wi trueonreonsn+formatthaacertdandohetreb,yp(.,tca oneEDNhetcomp the Cl')apE FUL n an oces f tytheh0rdncdaWItccornaahdonebermedaworkndape rfohattndafurrthecert madbendarreccofyr{ct OCCUPA!.ICYthandarhe rebedkworscdenntothertagDC any ofheStetathndeofLawstead the Bu deroftvllonthSprn9srathatrfurthertmyregcefysnDdn9oof th atthetermsandructwlturethoupnsaoftednohereonyonbaSforsexemp tthettthatORS70505redndef,f tec sa requ byftnuforceaardBos tthonroj ecsuedpbe701w1anceOPSthreanwhocompandtorsonsutracempoyeesbconv TOTAL VALUATION Pl an an Y I Res FrI S q. Ftg. AcceLoad cy Group Sq. Ftg' Other x x ts Val 'I ue opmeflternsDeve 1.5% Fire Zone Bed BUILDING PERI.IIT Clrarges and Surcha rges Val ue Ftg . t'la iZone Tyoe/Const Flood Plain Stories- 0c Fence Dgmo PLUI4BING PERMIT Charges and Surcha rges St dewal k Tota'l Cornb. Permi tA/C Pavi ng p e.so r ,13 ELECTRICAL PERI!IT Curb Cut TOTAL I,IECHANICAL PERNIT Charges and Surcharges 2 3.b= Pl umbi nq .Q s Charges and Surcha rges CCI4BINATION APPLICATION/PER},IIT (CAP) I. Applicant to furnishA. Job Address8. Legal Descriptionl. ii+5ff Tax Lot 100, Lane County Map Reference Z. examDle_ tot.l. Block 3, Znd Addition toS[.Fffiielo LstatesL. name, etc. of rD. E;;;dy'i;;.;l.o'nt" and construction lender I ec tri ?c tr*]*E. Squa valuati or I examo I e- examo I e- check add 1250 sqif new on, 2 foot house,500 sq. foot gara ge etc, project, chec k new - if additi oDt F Buildi ng permit informa ti onIexamp I e a ttac hed -_construct single family house with angarage 2 exampl e examp I e res taura remodel existing 3 - convert si garage into fami ly room nt(ngl e fami ly residence i nto G. Value of work as change o def i ned f use) Structura I Special ty Code in Section 303 (a) of the H.OESIGN TEAI,I AND CONTRACTORSTo avoid cles l9l ff n or construction del aJs, Bui ldiDivision Sta must be able to contact a n9 pers on s rega rd i ng design info ppropri a te correc t i ons, et rmation or job siteII.Abbrev.ia ted PIumbi ng, lilechanica l, & ElectricalA.Excep port i t where b lank spaces Schedu l es on of the Mechan i ca I occur in the desc ri ption the appl icant need fi l l-in and Electricai Schedul es ,Eoxes adjacentto the a ppr0pr iate item(s Hechanical only theto be in No. B.Ful I Pl umb i ng,stalled are avaiiable , and Electrical Schedul es 1. To cons at the Buil ding the Division ha ve erve space on permit form the schedules 2. If been abbrevi a ted the the item(s) to be installed are not covered on ful I abbreviated sc hedules you shoul d consult theschedul esC. EUILDING DIVISION STAFF I.,ILL FILL OUT ALL FEES ANDCHARGESON THE SCHEDULESD. As noted on the CAp,I contractor the label mustfor signature be delivered to tel ectrica he supervi s or. The 9enera I contractor by his electrical to sign the el ectri ca l 'labe I rs.not authorizedIII. Appt icant-to si 9nle, and dateI'lhenever possib the initial applicat tlhere possible, Buil, ion will be useda worksheet only.ding Division Sta as wi l1 prepa re a type written copy and re ff appl i signa Fees cant at the time the turn it to the tu re.actual permit is issued for his Iy.and Cha rges PIan check fees are due and payable at the time of theapp I fees ication , and no plans wi 'll be processed unii I theseare paid Al I other fe es and c ha rges are due andPayable when the permi t is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION -[ tr ?-t,V Permit Clerk )lq vo PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: t applicant exempt from registration with the Builder's Board because:Permi Additional Projeit Information : PLANS REVIEWED BY: name si gnature date C{-.