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HomeMy WebLinkAboutPermit Building 1980-09-23COMBI AP ERMIT 726-3753 Job Address I L/a€79b l-ega1 Description #z EIIERGY SOURCES: Hea Range)ozz Access._ 0ther lence-oemo-Chan ge/U se 0ther Sq I ter Repl.ler^r Add A Sq. Ftg Sq. Fto Value of l.lork Owner .e., Build SingletJo rkn GaFani I Bu C€.E Address Construction Lender P t ?nu -O N o0 5/74Addres s Phone nocs Struc tura.l Pri ma El ectri ca I l'lec ha n i ca I -2 , tr6PIbin Genera l l'lec ha n i Ele MECHAN 1 CALELECTR I CALPLUTlB I NG l'10 rrr CHARGFFFF{:HARGEFEECHARGENOr10. Residence of SQ. FT furnace/burner to BTU' sEach single fixture Fl oor furnace and vent New ci rcui ts al ts or extens i ons Relocated building (new fi x. addi tionai ) Recessed wal I Snacp hcatpr and vpntSERV ICESS. F. Residence(l bath) Duplex (1 bath) each Apol iance vent seoa rateTemporary ConstructionAdditional bath Chan rp< 1 ge i n exi sti ng dencp Stationary evap coo l ertqol^Jater service c Vent fan with sinole duct,4 .S "a 0rmultifami ly, comrn Industrial6fsewer/h 6?.t< 77et Vent systenr apart from heatino or A.C.0f an ps.Storm Sewer Mechanical exhaust hood and duct-col.il.r./rND. FEEDERS l'lood stove/heaterInstal I /al terlrel ocatedistrib. feeders atGIAberce /rbna *,-P.- ISSUANCF OF PFRI'IIT TOTAL CHARGESTOTAL CHARGES p.*TOTAL CHARGES 2.* WHERE STATE Llll REQUIRES that the Electrical work be done by a shall not be valil until the label has been signed by an Electrica nEIS lectrical Contractor, the electrical portion of this permit upervisor and returned to the Building Division completed apnlication for oermit, and do hereb-y certify that all information hereon is true and correct, and I further certif_v that any and all r.rork performed.shall be done in accordance with the 0rdinances of the City of Springfield and the Laws of the State of 0regon oertaining to the.work described herein, and that NC OCCUPAI,ICY will be made of any structure without the permission of the Building Division, I further certify that my registration vrith 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 ernployees who are in comcliance with 0i?S 7n1.055 vlill be used on this project. liAl'tE(please print)DATES I GIIATU 7 o I HAVE CAREFULLY EXAI1INED the t?bOt<e t/ome $ryt<€ &/<? Fire Zone Val ue Val ue Val ue ToTAL VALUATI0N_ x x X Zon F d 5 q -Typel Con s t Uni ts So Bedrooms 0ccy Loa Flood Plain S to r.i es Group. Ftg. Acces Ftg.0ther Itd- t4ain Plan Ck. Comm/lnd 65%/B1do Per Fee tems Deve rqe (1.52 Svs Cha opmentBUILDING PERI'1IT Charges and Surcha rges Plan Ck. Res 30%/81dq Per Fee FencePLUI4BING PERMIT Charges and Su rcha rges oeza flo Dgmo SidewalkELECTRICAL PERIlIT Charges and Surcha rges L 6aD I Vo A/C Pavi ng Total Cornb. Permit Curb Cut14ECHANICAL PET Charges and Surc harges TOTAL fl gt.?o l.later Heater lf*, C^fr )vld l , H^ /,,'/ 0f amps. COMBINATION APPLICAT1ON/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description 1. glample- Tax Lot 100, Lane County 17 03 432. example- Lot l. Block 3, 2nd AdditSpringfield EstatesC. Name, etc. of owner and construction ID. Energy Sources Map Reference ion to ender r lqrced air gas1. example- heat/2. examp)e- waterE. SquarEEotage or e ctrical cei I in r e ec or soTar valuat OIl' II 1. example- 1?50 sq. foot house, 500 sq. foot garagez. example-.if new project, checkl-ew _ if addition,check add, etc.F. Building permit information:1. example - construct singie family house with anattached garage ?. examp]e - remodei existing garage into family roomJ. exampte - convert s.ingle family residence into . restaurant (change of use)G. Value of work ai defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI4 AND CONTRACTORS To avoid Cesign or construction detays, Bui)dingDivision Staff must be able to contalt appropriitepersons.regarding design information or job sitecorrections, etc. Abbreviated Plumblng, Mechanical, & Eiectrical SchedulesA. Except vrhere blank spaces occur .in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacent _ t0 the appropriate item(s) to be installedB. 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 I schedulesC. BUILDING DIVISION STAFF t,llLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As noted on the CAp, the label must be delivered to theeiectrical contractor for signature by his electrical - supervisor. The general contractor is not authorizedto sign the electrical label Appi icant to sign and date l/henever possibie, the initial application wilI be used asa.worksheet only. Hhere possible, Building Division Staffwill 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 p)ans w.ii1 be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is .issued. FoR oFFTCE USE oNLY III. IV V PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY 74o b(a 1 ,a € Permit applicant exempt from registration with the Builder's Board because Additional Project Information : PLANS REVIEWED BY name da te -BoSIgnature C c0r!81ilA O!.I APPL I ERI4I T (t 72.6-53iloil L -e., BU -/r,Fani I ,\Jd re s s rre nar n3 niUi'hon ,-/q O 5 Hea ter Sq. Ftq. 0 llew Add ther Al ter-P.eP € nn\J -0 nf, Do UJ ng1 e a q * -->Y1 lr I nfo Sq. Ftq. l'la 'I 0therYaiue of l'iork t.e,:rl Cercrigtion AJdrc5r Drner L/ <- Descri be ed LEConstruction Lender Phone addre Prirna S truc tu ra I EIec:rical l'!echanicai Oii i RA Ge ,= dence ili EiIERGY SOURCES: Hea t :later Ranoe -i..* Dilmo Change/Use Sq. 5tg. Access'-.-- iob Address i 'tC6 ,')' //J= MECHAN i CALELECTR I CALPLUIlB I IIG NOFFFCHARG FCHARGFu0.furnace/burner to BTLI ' s Residence of FTcnEach single fixture Fl oor furnace and ventNew ci rcui ts al ts or extensions Relocated building (new fix. additjonal ) Recessed wal I Snacp heat-er and vent)LKV ILL)S . F. Res i dence(1 bath) Duplex (l bath) each Apol iance vent seoarateTemporary Constructi onAdditional baLh Stationary evap. cool erres i dence Chan.oe i n exi sti ngl.later servi ce ,/?D Vent fan with <i nol e ductmu1 ti fami 1 y, lndustrial comrn, or-asSewerr,, ti+n< t7t'i$r/Vent systerx apart front heatinq or A.C.-amp s.0fStorm Sewer Mechanical exhaust hood and ductCOI4I'1./IND. FEEDERS flood stove/heaterInstal I /al ter/rel ocate distrib. feeders amp s.0f -/€.dt/WB/.-€ />bma 5; iSSUAIICF NF PFP,IlIT TOTAL CI1ARGESTOTAL CHARGES i.o,*TOTAL CHA,RGES by an Electrical Contractor, the electrical portion.of this oermit rical Supervisor and returned to the Bu'ilding Division 27I'lAl'lE ( p.l ease pr j nt)TE o(ICiIAT llHEnE STATE Ll',J REQUIRES that the Electrica I r,rork be done the for ne oerfo fy 1 it n reonhe S rui ecrte.l ath a II n f orrnactaonirmitanddohereetIedb.y fyHcompapPI nan'I oCES thf ce 1lanrdceanth0rd tythe.Srmed h I.t dobe cc0neIandrreoctndafuIhertcrerItthaaanoIar{orkcny CYAil I!,/l bI m aden'I CUPt.tc 0cLthaandnIn'I to worthe descrk bed'I reheireIdIndathLavrstheoftStaofon0reortaoeofgSoncl B Iu dI re SreSjatr,1+n ttri rhh eIhefurtCrrtItthafSonirnyqsuctrretuthLouhetermsi500nothe3uoDin9 h ha tdtanIon'I tedno e reonhaiIc I bathe i forS exemDtts any rd i n'i 1fu IBoa fo erc effecand at res ou red ORS 70i exemotby th 5'I r0onedus70550IlrlbeIo jnISoubcantrtocarsndIawho.1re n II cean thwi ORSernDoyeescomcv shall not be valil until the label has been signed by an Elect FIF SE ftlcare r/o*te 5q'7'rro€ '{;4<? SoTy cel Con s t 0cc.v Group TOTAL VALUATION S q x x its x Val Value Val ueBedro oms Stori esFlood Plain 0ccy LoadFire Zone Zone Ftg - Acces Ftg.0ther Plan Ck. Comm/Ind 65"/ /?,1rlo Per Fpe Svstens Develocment Charqe (1.51)BUILDING PERI'IiT Charges anC Su rc ha rge s Plan Ck. Res 30rllBldq Per Fee Fence DBmo PLUI4BINC PERMIT Charges and Surcha rges fo --\ *.<.-. SidewalkELECTRICAL PERI1IT Charges and Surcha rges L I . eyc *e/.n Total Comb. PermitA/C Pavi ng Curb CutCharqes and Surcharrles I4ECHANICAL PE[tr gt.?aTOTAL n ) --\ ddz 055, 1 COMBINATION APPLICATiON/PERMIT (CAP) Applicant to furnish A. Job Address B. Legal Description 1. ellllple- Tax Lot 100, Lane County Map Reference l7T3-T32. example- Lot 1. Block 3, Znd Addition toSliifrgTietd EstatesC. Ilame, etc. of owner and construction ienderD. Energy Sources ;1. exarnol e- he2. examilE- waE. squaiETGTase atlelectrical lin or forced air qa or valuation, etc PERMIT VALIDATION CITY OF SPRINGFIELD City Holl Springfield, Oregon Deporlment of Public Works OFFICIAT RECEIPT No. B 546f ( ( e EC ca or sblar-Dote Received For 9 1. exarnole- 1250 sq. foot house, 50q sq. foot garage?. exa,rple- JT-new project, check-new - if additio;, ch-EE t-add , etc .F. Buiiding permit information:i. exanDle - construct single fami ly house r^lith anattaclA garage 2. exancle - remodel existing garage into famj'ly root3. efiffile - convert single iafri1y-resioence inioiestilrant (change of-use)G. Value of work as defined in Section 303 (a) of the II. III. IV. V. StructuralH. DESiGii TEAI,I Specia l ty Code AND COI,ITRACTORS To avoid Cesign or construction delays, Building Division Staif must be able to contact appropriate persons re-oarding design information or job site correcti ons. etc, Abbreviateci Plunbing, i,lechanical, & Electrical SchedulesA. Excect 'irhere blank sDaces cccur in the descriptionporlion of the l4echanical and Elect.rjcal Schedu.les, the applicant need fill-in only the lio. Boxes adjacenito the aopropriate item(s) io be installedB. Full P'lunbinE, llechanical, and Electrical Schedules are avaiIable at the Building Division1. To conserve space on the permit form the schedule: have been abb!-eviated?. If ihe it.em(s) to be installed are not covered on the abbreviateo schedules you shoulC consult the ful I scheoulesC. BUILDIiiG DI'JISIOi.I STAFF l,JILL FILL OUT ALL FEES AND CiiARGiS Oii THE SCHEDULES0. As noted cn the CAP, the label must be delivered to thelectrical contractor for signature by his electrical supervisor. The general contractor is not authorizedto sign the eiectrical Iabel. Applicant to sign and date l,Jhenever possibie, the initial appl ication wi II be used as a uiorksneet onl-v. Ilhere possible, Bui lding Division Staffwill preoare a type written copy and return it to the applicant al the time the actual permit is issued for his signature. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable vrhen the permit is issued. FoR 0F F r CE USE 0r'rLY {col I BY Amount Received Permit Clerk ZEO SIGNATIJRE 5HELION.TURXBULL PiINT€RS EU6EH€ OR 97tOI rI PROJECT CONDiTiONS TO BE SATISFIED BEFORE OCCUPAIiCY: ,Va--*.*b/'r?8 G*.*'EGfc# M*ryfts.34 Permit applicant exempt from registration t^J'ith the Builder's Board because: Additional Project Information: PLANS REV I E!./ED BY : name Si gna tu re -Eeda te 1 ( ( ( ( l. +- f4e@ -IIISPECTION PROCEDURES FOR THE CiTY ^tr SPRINGFIELD BUILDING DIVISi0N 346 ll":il STREET INyPECTiONS 726-3769 IllFORI,IATION 726-3753 The fol I orv d in pections are required for your construction at€7 It is the responsjbilj tyte permt t holder to iee that a r nspec ons are made at the pro per time,tthat each address is readable from t he street , and that the permit c ard islocated at the front of the property. 1. SITE INSPECTION: To be made after excavation, but prior to setup of forms 2. UIIDERSLAB PLUI4BING ELECTRI CAL & o ma e ore any work is covered. 3. FOOTINGS & FOUI,IDATION: T 11. FRAMI NG INSPECTI0II : lrlust be requested @ouqh olumbinq, elec-trical & mechanical. All roofinq, bracing & chimneys, etc. must be com-pleted. llo work is to be concealeduntil this inspection has been made and approved 72. DRYhTALL INSPECTIQN: To be made after Wace, but prior to any taping. 13. SEI,,IER WATER & DRAINAGE LINES or to rng 'rn trenches. after trenches are excava forrns are erected, but pr pouring concrete. ob ted ior e made and to tr a4. MAS0NRY WALLS: Steel location , bond beams, grout r ng. 0r ver tical s in ac- cordance wi th U. B . C. Secti on Z4l5 . 5. UNDERFLOOR PLUIlBING & MECHANICAL: e made prior to jnstallation loor insulation or deck'ing. 6. POST & BEA|I: To be made prior toinstallation of floor insulationor decking. 7. ROUGH PLUI1BING ELECTRiCAL & )il t^/or sto e covered unti I these inspect'ions have been made and approved. 8. FiREPLACE: Prior to p1 aci ng faclnqrnaterial s. 9. FIRE & SEPARATION I,IALL: Located & constructed acCordr'ng to pi ans 0.._I NS ULATI ON VAPOR BARRIER INSPECTIOIi: obema e after a NSU at lon a 14. SIDENALK & DRIVET^JAY: Re quired for all concre pav ngw t jn street right- of-way; to be made after all excavat- ing complete & form work & sub-base material in p1ace. 15. I^JO0DSTOVES: After instal lation is cor,rpl eteE. 1.6. SPECIAL INSPECTI0IIS: t^Jhen required byteutnge, special inspector to be pr esent when work is in proqress. A copy of the speclal testinq report to be furnished to the Buildjnq t'ljvisjon. = Structural Concrete: In excess of 3000P.S.I. --r Structural l^lelds: Performed on the job:- Glu-Lam Beams: Inspectjon certificate(by approved agency) suppljed to Bujld-ing Division before beams are placed.,l-] Fjre Retardant Roofing: Before 'instal- I ation. r bfTo of lequired vapor barriers are in piacebut before any 'lath, gypsum board orwall coverjng is applied, and beforeany insulation is concealed. 7 . OTHER INSPECTiONS:May be requ'ired in accordance wi t}- Bui I di nq Code, to beindicated in plans or by notice frogrBuilding Inspector. _lfloi /<e tb<aa 4-<<<- 7,?/< 6€avt< € FINAL MECHANICAL E FINAL FIRE DEPT. ROVED PLANS SHALL REMAIN ON THE BUILDING SITE AT ALL TII,4ES, AND ALLD IN ACCORDANCE WITH THOSE APPROVED PLAI'IS FINAL PLUMBING FINAL ELECTRI CAL All proiect conditions, such as the installation of street trees, cornplet'ion of therequired landscaping, etc., must be staisf.ied before the BUILDII{G FINALcan be requested. FINAL BUILDING The Final Building Inspection must be requested after the Final Plumbjng, Electrical andMechan'ical Inpsections have been made and approved. No occupancy of tfle premises canbe made until the F'inal Building Inspection has been made and approved, and a CERTIFI- CATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DIVISION AND POSTEo oru THe pnilllsEs. Name of perm'it holder Phone TrfG - /? zor S'ignature Da te z BUILDING D WORK MUST N0TE: Al I SION BE COMPLETE manholes and cleanouts are to be adjusted at no cost to the city. 'l ta/ ,\/o / )-/ (II Zjs,\ - ----i .: ,;. - I tt 7{. 7s' l1-i to,i- 7a' 2"mas f?.C 1 70 i T li ii I l; ll tl L tiIrl I I I I i I I I : 'S t3 "/" ,.r"L bo' 4 q. ?{ o 6\ 'J'r i b 1/'. t3.L l U /\.) ,\./) \A)l tA, r'I -+ /st? -'-/t\- e..\ $ Pr I +, 4s0\-.\ t\ I rrl.\ n qAg io' t1 ','. . ',' V .r'"-.=Jf M ,lF 'i J 1ll s *.- .".- f8 ".-. ,-**, l. ."- l'{ 70 '4o' ;o,c ,L ,Y'\,o''),n2,, I t3, no? I I I I l_l I . r, r rJ, ,ri-,r,1!Ut-.lELD, tJI.lEGUl{.r c0NTrrfis HERror H( ,i IIIIE-V|EWEO A'{0 Appnovl0, uilTH At?lLttRAItoNS tNotcArED i, llQftrt) q-tdil;fifrL6rucffi 0s'ARTMINIS AS ttitiiA$n Daie Received.... 'r.PE DEPI. CHEUI :l{GR. OEPf. CHECXEO: Uaie ... 7*i??-8o .'.........*,.*.*ry- ry_ By D mtI00. 0EPI. CntCXtD: Date.. *r k, r,,',, , .^ i TI L i(t) PERM I T It 726-53iC 37 0il L llit5t a aIS l :lAT OIi AP I CAI I {]iI Jb ..iddreis I "7rai3 ,'i'3,i b 5r t*-i.e.trl le(crlptton .d(/t ng1 e <?{€ Ien 4. -E c' i Use escr be c hed Ftq 'in .€= dence lli thFrnilJU 2anae Va !q. Ftg. Access.-.---EiIERGY SOURCES: Hea t :later lleater lhonc -,t- I I na irner .\JrJ re s r ConS!ructron Lender €-, -0 rc Do I'hone.\.ii.i rc s s phone noadcire s s Pri rna Structural n ii'e Elec|-rical l'1ec na n i ca 1 Genera I ,,1 Electrical tn tr6a v -t Itlechan i PLUtlB i IiG ELECTTI I CAL MECHAN I CAL it0 I FEi CHARTtF un FFF ftO -FFF I l.}]ARGF Each single fixture Residence of FTSQ furnace,rburner to BTLI'S Relocated building (new fix. addi tiona i ) I I I New ci rcui ts al ts or,.extensions Fl oor furnace and vent 5.F. Residence(l bath)SERVICES Recessed wal I SBaee heater and vent Dup lex (.1 bath ) each Addi ti ona l bath Temporary Constructi on Apol iance vent separate/qo'l,later service f ge i n exi sti ng dence Chan res i Stationar-v evap cool er .ad 5ewe r -*#multifamjly, comrn Industrial or Vent fan with s inole duct Storm Sewer 0f Vent syster:r apart frorn heatinq o[ A.C, coMt1./IND. FEEDERS itlechaniciI eihausL- hood and ductInstal I /al ter/rel ocatedistrib. feeders l'Jood stove/heater 0f 74;EIYbgt<c ;rbtrz - <-fo.* I I iSSUAIICE OF PFRiIIT S IGiIATUR DATE 2) lue C*<y Pl an cI a Deve1 F,qan 0cc .y Load 6rou XI Val ue x Va Iue itsoe,, Con s t L. i;i ALTOT SCHARGE .taCHARGETOTALS ALTOT HARC SLrI ERi,JH ST,E T E R U D1 ihaISEQ tlret EI CC rt ca'I r{0I berk do na ILneby Ce Ctri IashI Co tra torcIn eth Ie eL ctr I I rt iIIntU'ibe 0n of thIihp 'I S eIbIShair rnt tbeenISnedansbytIEIECs'I orSuoe retand durne to the uio dI ,i Di I 0nng any ofany rd YCAR F hetID etedI acomp I c1 tia 0npp fo rm i t nd dDE do henda tcer icorrectreb.y ttha Ia InCaIfyrUther n.I tfo ri-na 0njcrte.I t ireo nhehata erusfyndIaIl^/0 r oe rfok rme0 h Ia I donDCfo 1e acnifiIed NCcorda wlSorandt tth 0rd iheshenq ncna 0estheo tState jhe0 tyregonIrta,]npe to henq ri^/O dek rofsc bI heed 1tutru cs re n andret,l th ta CrlUhothte UPOCC IWI ISSiI bepermon0ft rnaciheIidBuiDIn9SiBofuherrtIiicertfunisthtoIIfofytraItdendfreq irny no I ht eth i.lfeascti_1 Ij d rri sed0Rsreqby701550tthaf.I ex tnoIuSemp the b i sbcon fo rvtracoLarSnd It n0 ierDIexemD s on ted hereo n a ndoyee s drvho '1re thnIIacomDncwithCNSn5lIIbeedU5thon'I s ro,j ecD t I,lAl,IE (p lease pri nt) 0pmen r'la i n Zone TOTAL VALUATION Flood plain Stories Fire Zone rocms rL Coirm/ I n Res s tems rqe BUILDING PERT1IT Charges and Surcharges Acce s s 0the r thl>erc€ d*rve $avyTaa, Ftg Ftg PLUI4BING PERMIT Charges and Surcha rges ffe --, it6<i-'.Fence D6mo Sidewa l k ELECTRICAL PERI:ITunarqes and Surcha rges .?c Total Conb. permit A/C Paving Curb Cut IOTAL 3/.70 I{ECHAN I CAL PERI{iarges andrc ha rge s T Ch . Ftg | . H. /,,'/ Plunhino 9'L,- - /-,:r1',2 a--. C r;a I tr I I r e COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description l. example- Tax Lot 100, Lane County Map ReferenceI7T3-4-32. gxar,nplq- Lot l. Biock 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lender0. Energy Sources ; PERMIT VALIDATION CITY OF SPRINGFIELD City Holl Springfield, Oregon Deportment ol public Works OFFICIAT RECEIPT E (a,'r I 2 exampl e- exa;pl e: Fe-Toota examo I e- examp 1 e- ch-eakTdd heat,/eiectricai cei I in wa ter ec CA or forced air oa - olar No. B 5466 2 r 0rs foot house, 500 sq. foot ga rage , etc project, check-new -if addition,Rec'd F. Building permit information:1. exanple - construct singie family house with analtaaned garage2. exanole - remodel existing garage into famjiy rooi3. exampTA - convert single iam.ity-"esiJ"n.u jnto -- restaurant (change of use)G. Value of work as defjned in Section 303 (a) of theStructural Speciaity CodeH. DESIGi.I TEAI.I AND CO|..ITRACTORS To avoid Cesign or construct.ion delays, BuildingDivisicn Staff rnust be able to contatt approprjitepersons regardi ng design information or job si tecorrections, etc.il. Abbreviated Piunbing, i,lechanical, & ilectrjcal SchedulesA. Except vrnere blank spaces occur in the descriot:onportjon of the i4echanicai and Electrical Schedules,the appl icant need fill-in only the No. Boxes adjacentto the aoprocriate item(s) to be instajleciB. Full Plunbing, l,lechanical, and Electr-ical Schedulesare available at the Building Division1. To conserve space on the permit form the schedule: have been abbreviated2- If the item(s) to be installed are not covered on the abbreyiated schedules you ihould coniult thefull schedulesC. BUILCIIIG DIYISION STAFF WILL FILL OUT ALL FEES AND CHARCES OII THE SCHEDULES0. As noted on the CAP, the label must be delivered to thelectricai contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label.III. Applicant to sign and date l,ihenever possible, the injtiai app)ication will be used as a rvorksheet oniy. l.Jhere possible, Building Division Staff will prepare a type written copy and return it to the applicant al the time the actuai permit is issued for his s i gna tu re.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paiC. Ail other fees and charges are due and payable vrhen the permit is issued. ge or valuat on, etc. 1250 sqif new ( D ress Receiveci ( f m Amount Received AY ZEO SIGNA'URE 5s€LroN ruakssLL r L V. FOR OFFI CI USE O}II,Y Perm'it Cl erk PROJECT CONDITIOI'IS TO BE SATISFIED BEFORE OCCUPANCY rveI ,t*P# -.t*A i;r f# ud esCbeaArS'lu d reD l-Jhtcht BoItlt0sir+L ar0m+ I reet I1ac+Un xemp:eP 'lrm t L pp Add'itional Project Information : PLANS REViE','IED BY -g.edate i:-s i gnature name nAn qr-., ( II