HomeMy WebLinkAboutPermit Building 1989-04-18c0rlD I ERMI T 6-3
Job Address EIIERGY SOURCES:
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[,,ater Hea ter
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ange/ Use
Ftq. Otherl-eqal Description
Owner
.e., Build SingleBuilriinq4ermit Info: Describe t,lork(
Fami I y Res i dence I'li th Attached GaragleU11,).\Arr<rress \StO!j
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Primary
Structura I
E l ectri ca l
l'lec ha n i ca I
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Genera I
PI I
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MECHAN I CALELECTR I CALPLUI1B I NG
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furnace/burner to
BTtl' s
Residence of
FTSQEach si ng1 e fi xture
Floor furnace
and ventL.'New ci rcui ts al ts.
or extensions2 .aR rPaa$€
Relocated bui lding
(new fix. additjonal )
SERV I CE S
Recessed wal l
Soace heater and vent
S . F. [1es i dence(l bath)
Duplex ('l bath) each
Apol iance vent
spDa ra tPTemporary ConstructionAddi tional bath
Stationary evap.
cool er
Change i n exi sti ng
res i dence["later servi ce
Vent fan with
si nole duct
mul ti farni ly, conun. or
IndustrialSewer
t system apart from
tinq or A.C.
Ven
hea0f -__=---- amps.Storm Sewer
Mechanical exhaust
hood and ductCOMI.I./INT]. FEEDERS,4e,beZ,*z
ljood stove/heaterI nstal I /a I ter/rel ocate
distrih. fceders
?74.4m E-76*"0f amp s.
ISSUANCF OF PFRTIIT
ioror- ,nnoo, s ,fr;zy - r'g *??-SOTOTAI CHARGESTOTAL CHARGFS -+Ht*. /2
IRfS that tlre Electrical work be done by an Electrical Contractor, the electrical portion of this permit
the label has been signed by an ilectrical Supervisor and returned to the Building Division
J GIIATLIRT:I'lAl,lE (pl ease pri nt )
City
made
ny
of 0rer-r
the B
Ireon ts erUheonrehecrte1tthaIa1IformanItrrlaYNthe'I edet a I c'I a on o I tr by fyrULCARELXAIltDDEIconlppl-)fo theIIdonenIccoaanrdw1CCtth0rdhenaIsncenda
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bebedIrenIantdtha0cIICwlCUPANCY1Ikddoa u,ls tf She tetaf tr ia 1n n thto wore desc r heon,lr j I ane t Lheo ISPngfDE
II1der srIttstraonItv/1 theh BusiInoIudiIDISIon,i furt he c rte thaIfoat ruc uret I hot theul nq fy re-o im.ynyperm
a nd th taforsInsttednonhereo'It f bathe 15thfa10RS011550Sexempt exemptIfunlIL!forc nda e fec t reds'IrdBoa requ by
ec505ItlbeIonused'Ith sth0nsaajwince p ro,jnIbcoSUtnrtocsrndoISowhrenenr!-)yee-v
I"'IIERE STATE L 1N REQU
shal I not be val i I unti.l
1.57,
TOTAL
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Load Sq. ttg. Access x , Val
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croupd/-7 sq. Fts. otner&? ,/2{7 7 - uat
TOTAL VALUATI
___,0ccy
Occ.y
Total Cornb. Permit
.2{
opment
C
I
Fl ood Pl ai n
_./3
0emo
Fence
3
Sidewalk
Curb Cut
A/C Pavi ng /6{%
5z/ 36
l'la i n
Pl an Ck. Cornm/ Ind
Res
Per Fee
BUILDING PERI.lIT
Charges anC
Surc ha rges
PLUI,IBING PERMIT
Charges and
Surcha rge s
TLICTRICAL PERIlIT
Charges and
Surcha rges
I,IECHANICAL PERMIT
Charges and
Surc ha rge s
at)
zone_--11_
Fi re Tone
vaIue---=------__Uni ts __ __-_- -_ Sq. Ftq- -,_ ___ Tyne/Const
lied r0onrs
Stories
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B., Legal Description
1. example- Tax Lot 100, Lane County Map Reference
I7-T3-j[3
2. example- Lot l. Block 3, Znd Addition to
SFiingTield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
I
2E. S
, example-. example-
quare foota
air gas
II.
l. example- 1250 sq. foot house, 500 sq. foot garage
?. example- if new project, check new - if addition,
check add, etc.
F. Building permit information:
l. example - construct singie family house with an
. attached garage
2. example - remodel existing garage into fami ly room
3. example - convert single family residence into
FElEIFant (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 site
corrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacent
to the appropriate item(s) to be instalied
B. Full Plumbing, Mechanical, and Electricai Schedules
are available at the Building Division
l. To conserve space on the permit form the schedules
have been abbreviated
?. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
ful l schedulesC. BUILDING DIVISION STAFF I,JILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to the
eiectrical contractor for signature by his electnical
supervisor, The general contractor is not authorized
to sign the electrical iabel.
Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to the
applicant at the time the actual permit is issued for h'is
signature.
Fees and Charges
Plan check fees are due and payable at the time of the
application, and no plans will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
III,
IV.
V. FOR OFFICE USE ONLY
PERMIT VALIDATION
4lg -s'1
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY
Permit applicant exempt from registration wjth the Builder's Board because:
Additional Project Inf,ormation:
PLANS REVIEWED BY:
name /,aAEZ4R sisnatu date lrg-n
rmi t Cl erk