HomeMy WebLinkAboutPermit Electrical 1989-06-29Owne r
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COIIB I IIAT I NAP I CAI I ON RI,lI T
l-ega1 Descri ption
Job Address
tla ter llea ter
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726-37
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EIIERGY SOURCES
Hea t
e., Build SingleBu i I tii n.r Pefar:rily llesi
rnrit Info; Describe t'/ork(
dence l'li th Attached Gatqiel'lroncAtltl rc s s
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QL.,cor,rt.r.ti or\ Le\oei- I
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Pri ma
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Structura l
E I ectri ca I
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I-4[CHAN I CALELTCTRICAI-
tri ca
PLUIlBI NG
I
furnace/burner to
BTLI, S
Residence of
SQ. TTEach sinqle fixt.ure
Fl oor furnace
and ventNew ci rcui ts al Ls
or extensions
Relocated building
(new fix. additional )
Recessed wa'l I
Soace heatet and ventSERV I CESS. F. Res i dence
( l bath)
Duplex (l bath) each
Apol iance vent
seoa ra teTenrporary ConstructionAdditionaI bath
Stati onar.v evaP
coo l erblater servi ce
Vent fan with
sinole duct
Change in existing
_resl-dcn.cl--_-
mul ti f ami 1y, conm. or
IndustrialSewer
Vent systern aPart from
heatino or A.C,0fStorm Sewer Mechanical exhaust
hood and ductc0r4t1./lND. FTEDERS
Instal I /al ter/rel ocate
dist.rib. feeders
l'lood stove/heater
amp s.0f--
ISSUANCF OF PFRIlIT
I
r
Con
and
thi s permi trk be done by an [lectrica
by an Electrical SuPervisoWHERE STATE Llt.l REQUiRES
shal l not be vali,l untiI the
that the Electrical wo
label has been signed
TOTAL CHARGESTOTAL CHARGESTOTAL CHARGTS tractor, the electrical Portion of
returned to the Building Division
tjni ts
.Occy Load
Per Fee
xSo
XSq
xSq
terxs
l,lAtlE (pl ease pri nt )
0cc.y Group Val
7o
(1.5
Total Comb. Permit
f.v
fy0reg
the Bany
rd
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any
of arton nrlpetof,he S tetafor1f1dIndaLawstheSpn!J Iu()1 n t1 th BheS1atrtertcItthaf'IS on rthe r reqnlyr,lIIu(JI i Din{ltheISonIosructretul. houw't permo I noted hereononIsthetba'I s exemptforatht'I eIOR701055 xempeecffatsredS'I nI fu II rceo and requ b.yBoa ec tUSonedrhs'I ro.jIbepI0557o1'II cean th ORSWIIltreilrvlioscompntCrat'sto nda InoISUbcoemp o.yeev
,TEISGiiRII,Ttl
A/C Pav i ng
Val ue
TOTAL VALUATION
l4ainTyrle/ Cons t
Bedrooms
Stori eFlood Plain
Fire Zo
SidewaIk
Dento
Fence
Plan C
P lan e
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BUiLDING PERI.lIT
Charges and
Surc ha rges
PLUi4BING PERMIT
Charges and
Su rc ha rges
TLECTRICT.L PERIlIT
Charges and
Surcha rges
Vai ue
Access
0ther
i s true
the Ci ty
be made
I der' s
and that
Curb Cut (1/)TOTAL
I,IECHANICAL PERMIT
Charges and
Surc ha rges
J\\oral , o\
CONTRACTORS
oIl
OCCI.IPAHCY
,/
COMBINATION APPLICATION/PERMIT (CAP)
I Applicant to furnish
A. Job Address
B. Legal Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 43
2. example- Lot 1. Block 3, 2nd Addition to
SdFiilTieto Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
1. exampl e- heat/2. Exam6'Te- water
E. Square footage or
el ectri al ceili or forced air ilas
e or sol ar
valuat On, e
1. example- 1250 sq. foot house, 500 sq. foot garage
2. examp'le- if new project, check new - if addition,
check add, etc.
F. Building permit informat'ion:1. examplg - construct single family house with an
attached garage
2. example - renrodel existing garage into fanrily room
3. example - convert single fantily residence into
restaLrrant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Special ty CodeH. DESIGN TEAM AND CONTRACTORS
To avoid des ign or construction delays, Bui lding
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections, etc.
II. Abbreviated P)umbing, Mechanical, & Electrical SchedulesA, Except where blank spaces occur in the description
portion of the Mechanjcal and Electrical Schedules,
the appl icant need fill-in only the No. Boxes adjacent
to the appropriate item(s) to be installed
B. 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 installed are not covered on
the abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF t.JILL 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 authorjzed
to sign the electrical label.
I I I. Appl icant to sign and date
Whenever possible, the initial application wil'l be used as
a worksheet only. l,lhere possible, Building Division Staffwill prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
s i gna ture.IV. Fees and Charges
Plan check fees are due and payable at the tirne 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 pernrit is issued.
V. FOR OFFICE USE ONLY
PERMIT VALIDATION
lo
7-1
Perrni t Cl er
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit appl icant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name signature da te
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