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HomeMy WebLinkAboutPermit Plumbing 1987-07-187 ECTION LINE 37 69 726-3753 Job Address EIIERGY SOURCES Hea t l,later Heater Ran Fto. l.lain_ Sq. Ftg. Access.-- Sq. Ftq 0ther _f{ew_AddrAlter Rep. _Fence_Demo_C han gel U se 0ther to -l C) (r] u t1 Legal Description 03 1 Vaiue of l,lork Owner Address 2 c Phone BuiIci'in Farni I y q Permit Info: Describe llork(' llesidence I'li th Attached Garaqel .e., Build Single //On / rt/ffl) Q-z,tut) co n s tru c t i orrllerfalr 4) Addre s s Phone / DESIGN TEAI.{name addres s l.ics. no.pxni res 'Dhone no. Pri ma ry Structura I E I ectri ca I l''lec han i ca I name addres s )Iics- no-exD l res ohone no. Gen Plumbin o 0 PLUI.IB I NG ELECTR I CAL MECHAN I CAL FEE CHARGE NN FFF CHARGF NO FFF CHARGF Each single fixture furnace/burner to BTU' S Relocated building (new fix. additional) New ci rcui ts a'l ts or extensions Floor furnace and vent S. F. Residence(l bat-h)SERV I CES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seDa rate l,later servi ce Change in existing res i dence Stationary evap cool er Sewer multifamily, comm. or T ndus tri a I Vent fan with sinole duct Storm Sewer 0f amps. Vent systern apart from heatinq or A.C. c0Mt'1./rND. FEEDERS Mechani cal exhaust hood and duct I n sta I I /a I terl rel ocate di stri h^ feeders I'Jood stove/heater 0f -ampa aq ISSUANCE OF PFRIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE Lltl REQUIRES that the Electrical work be done by an shall not be valil until the label has been si-qned by an Electrical Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division EXAI1INED the comp ete ap!')ca on for oermit, and do hereb.v certify that all information hereon is true oerformed shall be done in accordance with the Ordinances of the City ining to the work described herein, and that NC OCCUPAHCY will be made Division. I further certify that m.y registration r,rith the Builder's .055, that if exempt the basis for exemption is noted hereon, and that wi th 0l1S 701 .055 r.r.il I be used on th is pro.ject. and correct, and I further certify that any and all work of Springfiejd and the Laws of the State of 0regon oerta of any structure without the permission of the Building Board is in full force and effect as required by ORS 701 only subcontractors and ernployees who are in comcliance t'lAt'lE( p1 ease pri nt)o\^IGiIAT DATE 1 7 SE Zon 'yoe/ Con s t.Uni ts Fttt Fto Ftg l'lain x Value Fi re Zone Be d ro oms Occy Load Sq Acces s. 0the r lue Flood Plain Group Val ue ToTAL VALUATI0N_ Sto ri es BUILDING PERNIT Charges and Surcharges Plan Ck. Comm/lnd 65%/8ldo Per Fee Svstems Deve Charqe (1.5c opment Plan Ck. Res 30%/81do Per Fee PLUI4BING PERMIT Charges and /Surcharges b 6f..50 q,-az Fence DEmo ELECTRICA,L PERIlIT Charges and Surcha rges 5idewalk A/C Pavi ng Total Comb. Permit IlECHAI'IICAL PERMIT Charges and S urc ha rge s Curb Cut TOTAL 8L.u2- c0r,!Br ilATr 0N AppL I cATr0N/pERMIT A(: I0RS Res idence of sQ. FT. coMBINATT0N AppLICATT0N/PERMrT (CAp) I. Appl icant to furnish A. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to Spri ngfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources PERMIT VALIDATION 1. examp_le- heat/electrical ceiling/oZ. example- waterheater/electrical/orE. Square fooGge or valuationl-ETdI- r forced air gase@- 1. examp.le- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check-new - if addition, check add, etc.F. Bui lding permit information:1. example - construct single family house with anattached garage ?. example - remodel existing garage into family room3. exampje - convert single famiiy residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI'I AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriitepersons regarding design informat.ion 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 adjaientto the appropriate item(s) to be .installed B. Full Plumbing, Mechanicaj, and Electrical Schedulesare available at the Building Divis.ioni. 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. BU]LDING DIVISION STAFF l^IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The general contractor ii not authorizedto sign the electrical iabel.Applicant to sign and date lJhenever possible, the initial application will be used asa.worksheet only. Where possible, Bu.ilding Division Staffwill prepare a type written copy and return it to theappiicant 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. Al l other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY PGraqT 1-2-r'r1 II. III. IV Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Perm'it appl i cant exempt from registration with the Bujlder's Board because: Additional Project Information : PLANS REVIEWED BY name Si gnature da te