HomeMy WebLinkAboutPermit Electrical 1990-03-06v
INSPECTION L
7?6-37 69
ilE ffi[D
CO},IBI i.IATION APPL IcATION/PERMIT 7
Job Address
l-ega1 Description )' )fAI
Ran
Hea
EIIERGY SOURCES
Value of l,lork
Ftg. Hain_
Sq. Ftg. Access.---
Sq. Ftg. 0ther_
__Jlew Add AlfetREE-
_Fence_Demo_C ha nge/ U se
-other-Owne r
Builrlinq Pernrit Info: Describe t^iork('
Far:rily Residence I'lith Attached Garaqe
.e., BUild SingleAddress
Construction Lender
u
v^)
ca
\Addres s Phone
name exo t res ohone no.
Structura I
Pri ma
El ectri ca I
Mec han i ca I
n ame lics. no.'exoires)(nhonp no
EI ectri cal ^0.6"o
l'lecha n i
PLUI.IB I NG ELECTRI CAL MECHAN I CAL
FEE CHARGF NN FFF rHA PG F NO FFF CHARGF
Each single fixture Res idence of
FTSQ
furnace/burner to
BTLI ' s
Relocated buildinq
(new fix. additioial)New c i rcui ts al tsor extensions
Floor furnace
and vent
S. F. Residence(l bath)2_SERV I C ES Recessed wal I
Soace heatpr end vanl
Duplex (1 bath) each n6.)15 D
Additional bath Temporary Constrrlti on Apol iance vent
seoa rate
[^!ater' servi ce ge in existing
dencp
Chan
res i Stationary evap.
cool er
Sewer'multifamily, coffin. or
Lttdlstri a I
Vent fan with
!inqle duct
Storm Sewer 0f s Vent systern apart from
heatinq or A.C.
c0[,il.1./IND. FEEDERS Mechanical exhaust
hood and duct
I n sta I I /a l ter/ rel ocate
d i st-r'i b. f pedprc l'lood stove/heater
ISSUANCF OF PFRI1IT
I'lAllE(please print
IGNATURE DA
F
IRES that the Electrical work be done by an Electricalthe label has been signed by an Electrical Supervisor
Contractor, the electrical port.ion of this permit
and returned to the Building Division
formaany
of
perm
ffect exempt
055 wi l
I UL L NE XAI1 I eIcomp ca onti rfo rmtapp t dand o tcer I hat athereb.y n'I .It nfy reonhe s'I rutrcodanrec t dn fuI erth r Icert t tha danfy a II Derwo rk
DE
fo srmed Iha beI ond 'Ie acn th'I 0rdthe na'Ic o rdance snce 0 cthe 'ISof tyefidIdanngpriLatheofwstheStateartn'I Ion0e tto workhe0regng crtdes hebed 'Ire n dan hat NCt OC CU wlPANCY II be madeaoftsureructwlnytht0uhetIss0nIftheB'iu dI n'I D I 1 1qs 0 furt r IIheceirtthattstraonIfyregim.y thv/1 het IBu deI r ss'|rdBoa fu IIn fo andrce u r,las 'edreq 0 RS 7 10 055by hat t 'I f ba 'Is forSthe t on'I sexemr)ednot reonhe haandt tnoIntsubcoctorarsvand1ernpsarewho,l noyee il cean wlcomD th 700t?s be sedu nI s t'I projec
TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES
WHERE STATE LAt,l REQUshall not be vali:l until
Value
Zone
x
xsq
its
!q
l'la iConst
Load Val ue
TOTAL VALUATION-
Fire Zone Bedrooms
a lue
Ftg
Ft9
Ftg
. Access
. 0therFlood Plain Stories 0cc.y Group
Plan Ck. Comm/Ind
65%/B1dq Per Fee
Svs
Cha
terns Deverce (1.52 opmetrtBUILDING PERMIT
Charges and
Surcharges Plan Ck. Res
30%/B1dq Per Fee
FencePLUI4BING PERMIT
Charges and
Su rc ha rge s D6mo
Sidewal k
ELECTRICAL PERI1IT
Charges and
Surcha rges
au-
3.75 Total Cornb, PermitA/C Pavi ng
Curb Cut
MECHANICAL PERMIT
Charges and
Surc harges TOTAL n5
)n4"lr-llater Heater
\./
DES I GN TEAI.I
0f ampr
,r,(lu/,.a
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl' example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot I. Block 3, 2nd Addition toSIFiis'f,ieto EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
,w
l. example- heat/electrical ceiI ing/2. example- waterhealer/electricaT-/oE, Square footage or vaiuation, etc.
or forced air gas
r sol ar
3(,$1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new - if addition,
check add, etc.F. Building permit information:1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family room3. example - convert single family residence into
restaurant (change of use)G. Value of work as defined in Section 303 (a) of the
#1bgl
Structural SH. DESIGN TEAM
'pecialty Code
AND CONTRACTORS
II.
III.
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, & Electricai SchedulesA. Except where blank spaces occur in the description
portion of the Mechanical and E'lectrical Schedules,
the appl icant need fill-in only the No. Boxes adjacent
to the appropriate item(s) to be instal ledB. Full Plumbing, Mechanical, and Eiectrical 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 installed are not covered on
the abbreviated schedules you should consult the
ful I schedul es
C. BUILDING DIVISiON STAFF I,IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the labei 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
Hhenever possible, the initial application wiII be used as
a worksheet only. Where possible, Building 0ivision Staff
will prepare a type written copy
applicant at the time the actual
s i gna ture.IV. Fees and Charges
and return it to the
permit is issued for his
Plan check fees are due and payable at the time of the
application, and no plans will be processed until these
fees are paid. Al'l other fees and charges are due and
payable when the permit is issued.
FOR OFFICE USE ONLY Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
permit appljcant exempt from registration with the Builder's Board because:
Add'itional Proiect Information :
PLANS REVI EI,JED BY :
name s i gnat te