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Home My WebLink AboutPermit Building 1990-04-13I 7 COMBI APPL I CAT IT Job Address Legal Descri ption '0a Hea Ranqe EIIERGY SOURCES: l.Jater Heater ('- tP r)rsnr a2Value of tlork: 3 SOp So. Ftq. I'lain-- Sq. Ftg. Access._ Sq. Ftg. 0ther_ I'lew Add A'l ter Pep. lence_OEto_C ha n ge/ U s e 0ther PhoneAddress L Bui I q,i no Pernri t I nfo: Descri be l^lork ( Family Residence I,lith Attached Garaqe :e., BuiId Single 7 SL tlfrg- - Constructi on Lender U Addre s s Phone DESIGN TEAI.I name tcs. no exDr res Pri mary Structura l E l ectri cal Mechanical C name ( a ddres s (lic< no exDl res ohone no. ) l0 t E llrl I 12, El ectri ca l f'lechani cal ELECTR I CALPLUHBI NG MECHAN ICAL .HAPG F0FEECHARGEN0-FFF CHARGF NO FEE Each single fixture Residence of SQ. FT furnace/burner to BTLI, S New circuits alts or extensions Floor furnace and vent Relocated building (new fix. additional) SERV I CES Recessed wal l Snacp hpatpr and vcnt S. F. Res i dence ( l bath) Duplex (1 bath) each Temporary Construction Apol iance vent seoa rateAdditional bath Change in existing rpc i dpncp Stationary evap cool erl,later servi ce Vent fan with sinole ductSewerI ndus tri a I multifamily, conm. or 0f Vent systern apart from heatinq or A.C.Storm Sewer COI,II.I./IND. FEEDERS Mechan ical exhaust hood and duct Insta l I /al ter/rel ocate disfrih. fppders l,Jood stove/heater 0f amp s" ISSUANCF OF PFRIlIT TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES WHERE STATE Lltr,l REQUIRES that tlte Electrical work be done shall not be vali:l until the label has been signed by an Elec bytri an Electrical Contractor, the electrical portion of this permit cal Supervisor and returned to the Building Division of Soringfield and the Laws of the State of 0reqon oertaining to the work described herein, and that HC OCCUPAI{CY will be made of any structure without the permission of the Bui)ding Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and enployees who are in comcliance with 0lls 701.055 r'lill be used on this oro.ject. 1:r-g"tot,lAtlE (pl ease pri Val ueZone ToTAL VALUATIoil_----- x xOcc.y Gro up sq 0c cy Load I l'lain , fy rtce 'I hat at 'I I 'I forman 'It he0n 1reon trueshedodannoatcetIedIhetDreb.v fycompap!') Iha I nccorda e t'I theh 'I0rd snance f IthenIedonsac tybendarrecc0tdanfuIcerrther'It ttha a a nd 'Ia tJoI r DCkny IGiIATU Bed rooms Sto ri esFlood Plain Fire Zone Value Value Acces s 0ther Ftg Ftg Ftg oelConst. Uni ts So Systems Deve Charqe (1.5q opmextPl an Ck. Conrn/Ind 65%/Blda Per Fee Plan Ck. Res 30%/Bldq Per Fee BUILDING PERT'IIT Charges anC Surcha rges 44,5:_-) 23 Fence Dgmo PLUI4BING PERMIT Charges and Surc ha rges Sldewal k A/C Pavi ng Total Comb. Permit TLECTRICAL PERI,IIT Charges and Surcha rges Curb CutI,IECHANICAL PERMIT Charges and Surc ha rge s TOTAL 4e 73 (r )nnp no - :TORS t COMBiNATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. glaTplg: 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 PERMIT VALIDATION 1 exampie- heat/ EIam'p'Ie- water uare footage or arr qas 2.E. sq examp i e- examp I e- check add 1250 s q. foot house, 500 sq. foot ga it rage 2 JT-i-ew project, check new - if add ion, etc. II. F. Building permit information:1. exampie - construct single family house with an attached garage ?. example - remodel existing garage into family room3. example - convert sing'l e fam.i ly res.idence.i ntorElTalFant (change of-use)G. Vaiue of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Build.ingDivision Staff must be able to contact appropriitepersons regarding design information or job sitecorrections, etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descr.iptionportion of the Mechanical and Electrical Schedules,the applicant need fil'l-in only the No. Boxes adjaientto the appropriate item(s) to be installed8. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Build.ing Division1. To conserve space on the permit form the schedules have been abbreviated2, If the item(s) to be instal led are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the labe'l must be delivered to theelectrical contractor for signature by his electricalsupervisor. The generai contractor is not authorizedto sign the electrical labelApplicant to sign and date Whenever possible, the initial application will be used asa.worksheet only. Where possibie, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is.issued for h.is s i gna ture. Fees and Charges PIan 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.# tbotr z IV V Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration r^rith the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name S1 gnatu re date Lo,L a ntro r UI'{ AP ERMiT Job Address l-egal Description Address Phone EIIERCY SOURCES Hea l,later Heater Ran q. Ftg. l'lai Sq. Ftq. Access._ Val ue of l,lork Des be Work Farri I ;e., Bui1d Single Construction Lender \,I Addre s s Phone DL5IGN ILAI.I name addres s 'r cs. no exDr res phone no. Pri Structura I El ectri cal Mechanica l name addres s lics. no-exnl res ohone no. EI crKr han i PLUtlB I NG ELECTRI CAL MECHAN ICAL NQ.,FEE CHARGE NN FFF CHARGF NO FFF CHARGE Each single fixture Residence of furnace/burner to BTU' s Relocated bui lding (new fix. additional)A New I.i 'circuits alts extensions Floor furnace and vent S. F. P.es i dence ( I bath)SERV I CES Recessed wal I Snace heatpr and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDarate hlater service Change in existing res i dence Stationary evap. cool er Sewer mult'ifami ly, comm. or Tndrrstrial Vent fan with sinole duct Storm Sewer 0f Vent systern apart from heatinq or A.C. COMI'I./IND. FEEDERS Mechan i cal exhaust hood and duct Instal I /al ter/re1 ocate di stri b. feeders tJood stove/heater 0f S ISSUANCE OF PFRI'IIT TOTAL CHARGES <r TOTAL CHARGES TOTAL CHARGES WHERE STATE LAI,I REQU shaiI not be valiC untiI IRES that the Electrical work be done by an E the label has been signed by an Electrical S lectrical Contractor, the electrical portion of this permit upervisor and returned to the Building Division INE D t he comp a pp c at n fo r Derm l t do here by cert 'I fy th a +a I rmat 1 on hereon 'I s L rue and and i further certify rd the Laws of the without the permis force and effect a tha t a ny a nd a I I wo r k pe rfo rme d s ha I I be done I n acco rdan ce wl th t he 0rdi na nces of the ci ty f Sp r1 ng f 'I e I d an Sta te of 0reg on oe rta 'l nt ng to th e work descri bed he re 'I n an d +ha t t,lc 0ccu PAI,ICY wl I I be made of any structu Board is in fu re s 'I on of the u 'I I d 'I ng D 'I 'I S 'I on furt he r cert 'I fy tha t my regi s tra t 'I on v|l t h the Bu 1 I der S I I s requ '|red by ORS 7 01 .E 5 tha t 'I f exemp t the bas 'I S for exempt 'I 0n 'I s no ted hereo n and tha t on I v subcont ractors an d emp 'I 0ye ES who 'I n comD I I ance wl th 0r?s 7nl 055 vJl 'I I be u sed 0n th 'I s p roj ect 2(fi,5 t'lAliE(please print S DATE *27 Zone Type/Const. Uni ts So Ftg Ftg Ftg l4a i x Val llp Fire Zone Bedrooms 0ccy Load Acce x Val Ip Flood Plain Stories 0cc.Y GrouP x.Va lue TOTAL VALUATION- 0ther BUILDING PERI'lIT Charges and Surc harges Plan Ck. Comm/Ind 65"1/B1do Per Fee s terns 7.5% Plan Ck. Res 30%/81dq Per Fee PLUMBING PERMIT Charges and Surc ha rges Fence D6mo ELECTRICAL PERIlIT Charges and Surcharges SidewaIk A/C Paving Tota'l Comb. Permit I4ECHANICAL PERMIT Charges and Surcha rge s Curb Cut TOTAL JA ,b3 . Ftg. SQ. FT. correc t, PERMIT VALIDATION Permit Clerk ( q+-L3 \("nE COMBINATION APPLICATION/PERMIT (CAP) i. Applicant to furnish A. Job Address B. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference i7 03 43 ?. example- Lot L Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction Iender D air gas E ga, dit rage lon, F. Bui lding permit informatjon examp I e a ttac hed - construct single family house with an garage 1I II III IV 2. example - remode'l existing garage into family room 3. eiample - convert single family residence into EETIIFant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact a persons regarding design information or corrections, etc. pj propri a te ob site Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanjcal and Electrical Schedu'les, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. FulI Plumbing, Mechanical, and Electrical Schedules are avai lable at the Building Division 1. To conserve space on the permit form the schedules . have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF l.llLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff wi'I1 prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnature. Fees and Charges Plan check fees are due and payable at the t'ime 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. FOR OFFICE USE ONLYV PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permi t app'l i cant exempt f rom reg i strat'ion wi th the Bui I der' s Board because : Additional Project Information: PLANS REViEWED BY: datenameS1gnature \K-