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HomeMy WebLinkAboutPermit Building 1988-08-02m COI,IBI NATION APPLICATION/PERMIT 7 Job Address Legal Description 00 EIIERGY SOURCES: Heat l,later Heater Ran . I'la Sq. Ftg. Access.-- Sq. Ftg. 0ther__ _l'l er^r_Ad d-A I te r--Te p . _Fence_Demo_C ha n ge/ U se -other-[>St N) I value of vto"k, p,?fEOwner Address f 0 (n scr .e., Build Single Constructi Addre s s I name address 'lcs_ no-exD l res ohone no. Pri ma Structura I E I ectri ca I Mechanical rmme address I lics. no.exni rps I (ohone no. Genera I a-5 T Pi u4bi ng Itlechanical PLUHB I NG ELECTR I CAL MECHAN I CAL FFF CHARGE NO FFF CHARGF NO FEE CHARGF Each si ng1 e fi xture Residence of SQ. FT. furnace/burner to BTU' s Relocated building (new fix. additional ) New circuits alts or extensions Fl oor furnace and vent S. F. Residence ( I uattr )SERV I CES Recessed wal I Soace heatpr and vpnf Duplex (l bath) each Additional bath Temporary Construct'i on Apol iance vent separate tlater service Change in existing resi dence Stati onar.v evap coo I er Sewer multifamily, comm. or Industrial Vent fan with sinole duct Storm Sewer Vent systenr apart from heatinq or A.C. coMr{./rND. FEEDERS Mechan'ical exhaust hood and ductaInstal I /al terlrei ocate distrib. feeders I'Jood stove/heater ?,0f \ l/l ISSUANCF OF PFRI'IIT TOTAL CHARGTS TOTAL CHARGES TOTAL CHARGES WHERE STATE LAt.l shal I not be valid ' REQUIRES that theuntil the label has Electrical work be done by an Electrical Contractor, the electrical portion of this permit been signed by an Electrical supervisor and returned to the Building Division EXAMI N ED the comp e apr)ca ti on fo r DE rml t and hereb.y cer ti fy t ha t I I informa t o n he reon I s truandcorrec t nd I fu rthe r ce rt 'I fy t ha t any and a1 I te of 0reqon n of the BuiI work perfo rmed s ha I I be done I n accorda nc e t h the 0rd 'I nan ce S f the CityI be madeofSpr'l ng fi I d a nd the Laws 0 f th Sta pe rt a I n I ng to the wo rk d e s crl bed here i n and tha t NC OCCUPAN CY wl IofanysfructurewlthoULthepermrss'I di ng Di v1 s 'I on fu rt her cert 1 ty tha t m.y re g '|str,a t I on u/l t h the Bu 'I I sBoardIs'I n fu I I force a nd ef fect a S requ '|red by ORS 7 0 1 05 5 tha t I f exemp t the ba s 'I s for exempt 'I on no te d hereo n a nd tha tlybcononstractorsand empl lktTH oyee s who a re 'I n comD I I ance w1 th 0r?s 701 05s l|l 'I I be ed on th s p roj ect tlAt'lE(p1ease print)E Bilulvct(S I GNATURE a_TE 2 arF Zone Tyoe/Const tc Ftg. t,lain Val ue Fire Zone Bedrooms 0ccy Load Sq. Ftg Flood Plain Stories 0cc.y Group Sq. FtS Acce s s Val Value TOTAL VALUATION- 0ther BUILDING PERMIT Ctrarges and Su rc ha rge s ,50 Plan Ck. Comn/lnd 65%/81dq Per Fee terns 0pmen PIan Ck. Res 30%/81dq Per Fee PLU!4BING PERMIT Charges and Surcharges Fence Demo ELECTRICAL PERI|IT Charges and Surcha rges Sldewal k A/C Paving Total Comb. Permit TlECHANICAL PERI,IIT Charges and Surc ha rge s Curb Cut TOTAL /o = y's n 0f amps der' \ coMBrNATr0N AppLrcATi0N/pERMrT (CAp) i. Appiicant to furnishA. Job AddressB. Legal Description l. glaT?lg: Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. example- heat,/electrical ceilinq/or forced air oasz. example- waterheater/electr.icaj/or solai-E. Square footage or va'l uati6[lGTc.- 1. example- 1250 sq. foot house, 500 sq. foot garage?. example- if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house w.ith an attached garage 2. exanrple - remodel existing garage into fami)y room3. exemple - convert single iaili1y-resiaence inio restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI{ AND CONTRACTORS To avoid design or construction delays, Build.ing Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc.II. Abbreviated Piumbing, Mechanical, &. Electrica'l SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Scheduies, the appiicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be.installedB. Full Plumbing, Mechanical, and Electrical 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 insta'lled are not covered onthe abbreviated schedules you should consult theful l schedulesC. BUILDING DIVISION STAFF WILL 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 eiectricalsupervisor. The generai contractor is not authorizedto sign the electrical label.III. Applicant to sign and date Hhenever possibie, the initial application will be, used asa worksheet only. 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 gnatu re.IV. Fees and Charges P'lan 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, V. FOR OFFICE USE ONLY PERMIT VALIDATION (, ( b (' Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: Permit app'licant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name S1 gnature date