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HomeMy WebLinkAboutPermit Plumbing 1985-01-14oo55 COHBI APPLI CATI TI NSPEC 726-37 Job Address /o4g %. e8'14- Lesal Description \-lfi72r^r r /\tan,/A llater Heater Ranqe. EIIERGY SOURCES Hea t 0wner Val ue of llork: l.'lai n_ Access._ Sq. Fto. 0ther_NewjddjlGIm- _Fence_Demo Change/Use 0ther Sq Sq Ftq Ftg .€., Build Singlenq Re Bui I cii Fami I y Permit Info: Describe Work(' rsidence llith Attached GaraqeAddress ' )o 1S Zt . AatfU Phone 0-U ffition t.na"" \l N o (^ Addres s Phone 'lcs- no-exD l res ohone no.DESIGN TEAI{name addres s Pri mary Structura I E l ectri ca i Mechan i ca I aq -no-pYnl rpq ohonp nn -CTORS name add res s Genera l o.l3.l B 7tlI U E l ectri ca l ca (t fl /6 35t,I KL r" 4 ?oa 5pt'lechani ca l ELECTR I CAL MECHAN I CALPLUI.IBI NG FFF CHARGF NN FFF .HA PCF I'10 FFF Residence of FTSQ furnace/burner to BTL|' s Each single fixture Relocated building (new fix. additional) New circuits alts or extensions Floor furnace and vent S. F. Residence ( l bath)SERV I CES Recessed wal l Snaap hPatpr and vpnt Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDa rate Llater service ge in existing dence Chan res i Stationary evap cool er Sewer multifamily, comm Industrial or Vent fan w'i th sinole duct 0f amps,Vent systern apart from heatino or A-C-Storm Sewer k>,/0.@ COMI'I./IND. FEEDERS hnnd and drrct Mechanical exhaust Instal I /al ter/rel ocate distrih. feeders l'lood stove/heater 0f amps. aq o .qo ISSUANCE OF PFRI.IIT TOTAL CHARGES f /o .4o TOTAL CHARGES TOTAL CHARGES WHERE STATE Li\W REQUIRES that the Electrical work be shall nor be vali'l untiI the label has been signed by an done by an Electrical Contractor, the electrical portion of this permit Electrical Supervisor and returned to the Building Division ?77l.lAt'lE(p lease pri nt)IGNA K permi ffect exemp 055 wi t natforontandodcerthatatn fo rma 0nc0mp trueDermitpaphereb.y fy dan fu rther cert tndarreccot a kwor rmed has donebe n eaccordanc twl h n fandthaaoerfothe0rdanceso cthefy ty e andd eth ofLaws Statheof thsprngfite rny of on art n tt0 workhe crides bed n and ta OCCUPANCYNC wl madebe0regpehere ing s tu retruc thoutwl hetofany s s 0n theof u d s on herfurt cert sngthat tr t o v|ln theth ulB der sfymyreg Board s fun fo rce nd e t bas s forredORS07055tthasfthe on s hereonnoted and thatrequbyexempt on subco 'acntr rsto nda who rea ,l n nca wl ht 7ot0r?s usvempoyeescomDbe ed th0n s ectrojp /. Ftg Ftg FtgGroup Sq x Up Fire Zone Bedrooms 0ccy Load x Val al 'I ue l'la i nZone--TYPe/ const.Uni ts Flood Plain Stori es . Access . Other Plan Ck. Corm/Ind 65%/81rlo Ppr Fpe Svstems Deve charqe (1.5c opmmtBUILDING PERI'IIT Charges and Su rcha rges Plan Ck. Res 30%/Bldo Per Fee FencePLUi4BING PERMIT Charges and Surcha rges Dgmo SidewalkELECTRICAL PERI,:IT Charges and Surcha rges A/C Paving Total Comb. Permit Curb CutI,IECHANICAL PEFJIIT Charges and Surc harges TOTAL 15 /o.-/ o v \Jq/[ I \-,r\-,\./\-,tY' au^anF tAtL / -f ToTAL VALUATI0N_-- \ COMBINATION APPLICATION/PERHIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. SCqElg.: Tax Lot 100, Lane County Map Reference17 03 432. example- Lot I. Block 3, 2nd Addition toS[FTffiietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1 exampi e- examp I e- uare footag heat/el ectrica ceil i forced air gas 2 wate e sol arE. sq e or valuation, 2 examo i e-1250 sqif new . foot house, 500 sq. foot garageprogect, check new - if addition,examp I e- check add , etc II F. Building permit information:l. example - construct singie family house with anattached garage ?. examp]e - remodel existing garage into family roomJ. exampte - convert s.ingle family residence intorestaurant (change of use)G. Value of work ai defined in Section 303 (a) of the.. Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contait appropriitepersons.regarding design information or job sitecorrections, etc. Abbreviated Piumbing, Mechanical, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion of the Mechanical and Electr.ical Schedules,the applicant need fill-in only the No. Boxes adjaient_ to the appropriate item(s) to Le instal]edB. Full Plumbing, Mechanical, and Eiectrical Schedulesare 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 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 electricalsupervisor. The general coniractor ii not authorizedto sign the electrical labelApplicant to sign and date Whenever possib)e, the initial application will be used asa.worksheet only. Where possibie, Building Division Staiiwill prepare a type written copy and returi it to theapplicant at the time the actual permit is issued for hissignature. 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. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III. IV v PERMIT VALIDATION Permit Cler (5 t{' -,} 3 \/ PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit app)icant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: na datesignature 1.