HomeMy WebLinkAboutPermit Electrical 1990-06-21I
7 ERMITCt)HBI
Job Address 1490 North Bth
)l nAl-ega1 Description
Ranqe
EIIERGY SOURCES:
Hea t
llater lleater
Sq. Ftq. Access._
Sq. Ftg. Othe
I'lew Add A
-Fence DerTto
-0ther-
r
ller--EeL
,_Change/Use
Sq . Ftq . I'la i
Value of llork
Owner Jackie B 1n er r€., Build SingleBui l tii nqt Farni Iy lle
Pernrit Info: Descrlt
sidence l,li th AttachetAddres s rhonfl l$ - J14
Springfield,0R 97477
Construction Lender Family residence - servjce change.
Phone
name address exDrres
Pri ma
4'lS-,Struc tura I I
qrlE l ectri cal a
l'lechani ca I
name addres s (l ics. no. ) (exoires ohone no.
Genera l
Pl umbi
L. R. Brabham Spf1d, 0R 97477 20-B7C 10I 0-D il il I 90
PLUI.IBI NG ELECTR I CAL MECHAN I CAL
FEE CI{ARGF NN FFF NHARG F NO FFF CIlAPCF
Each single fixture Residence of
rTSQ
furnace/burner to
BTII' S
Relocated building
(new fix. additional)
New ci rcui ts ai ts
or extensions
Floor furnace
and vent
S. F. Residence(l bath)SERV I CES Recessed wal I
SDace heater and vpnt
Duplex (1 bath) each
Additional bath Temporary Constructi on Apof iance vent
seDa ra te
[,later service Change in existing
rpsidpncc .75 .l5.00 Stationary evap.
cool er
Sewer Industrial
multifamily, conm. or Vent fan with
sinqle duct
Storm Sewer 0f a mps.Vent system apart from
heatinq or A.C.
COMI.I./IND. FEEDERS Mechanical exhaust
hood and duct
Instal I /al ter/re l ocate
distrih. fppdprq l'lood stove/heater
amps.0f
ISSUANCF OF PFRI1IT
TOTAL CHARGES TOTAL CHARGES 15.75 TOTAL CHARGES
I,IHERE STATE LAl.lshall not be valii u
REQU I
nti I
RES that tlte Electrical work be done by an ilectricai Contractor, the electrical portion of this perm.itthe label has been signed by an Electricai Supervisor and returned to the Building Division
S IGNATURE t rE 6/21/90 _
{
E NTI tD he c ta on'I for t anappDerm rcomp tcer I hat at II I rma 'Ihereb.y f.y t on 'Ihe reon truesndarrectIandrtherfuftcer'I tha at nd Iav'|a wor k fo rmedr has IIrle donbe Ie acn nccorda tvre t h rd n'Ithe0 cesan f0 het Ic tyofSedIndaethwsLa
ny
ofpring fi theof taS te 'Irta nl tope the deswork bedcrt relhe n nda0regonng ttha 0cct,lc CYUPAI,I Iwl beI mad et0stutrucwtretthoueth'I Iss no ofperm the 1Bui 'Id D I s,l 'I Ing hfurt r rtce I hat t '|rrest ta o'I n tl theh UI d'I er sfymyIany
rdBoa 'I s n1 Ifu forceI a nd feef tc sa u 1 red 0Rs 05570t th 'I treqbyat t ba 'Is for5theexemp e 0I In noS dte reohe n ndaxempt ath tnlsuonbctracdvtorsanIESawhoemp0yeIren'II an wlce th 70l?s 0 05 5 t,l II becomD used n0 'Ith s tecpro,j
rlAtlE(please print) LARRY R. BRABHAM
na6
Flood Plain Stories
Zone x
Fire Zone Bedrooms x
x al u
its FtttConst
Load Sq. Ftg
TOTAL VALUATION
Access
al ue
Val ue
Group Sq. Ftg. Other
Plan Ck. Corm/Ind
65%/81do Per Fee
Svs
Cha
tems Deverqe (1.51 opmentBUILDING PERI'IIT
Charges and
Surcharges Plan Ck. Res
30%/Bldq Per Fee
FencePLUT,IBING PERMIT
Charges and
Surcha rge s Demo
SldewaIkELECTRICAL PERIIIT
Charges and
Surcha rges 11
(90__:5_
A/C Paving Total Comb. fermit
Curb CutI,IECHAN I CAL PERMIT
Charges and
Surcha rges TOTAL € ls-rs
Address
b\
PERMIT VALIDATION
Permit Clerk
6
n
l 1+
"?l
COMBINATION APPLICATION/PERMIT (CAP)
App'l i cant to furni shA. Job AddressB. Legal Descriptionl. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot l. Block 3, 2nd Addition to
SEFTiITield EstatesC. Name, etc. of owner and construction lender
D. Energy Sources1. examole- heat/electrjcal cei I inq/or forced air gas
2. "raAi-t e- wa terhE terT-e l-ec t r-i c a lTor 1E@--E. Square footage or valuation, etc.
l. glsqp-l3: 1250 sq. foot house, -10-9" sC. foot garage
2. e*urrpte- lFnew proiect, check new - if addition,
check add, etc.
II
F. Building permit information:
L exampje - construct single farnily house with an
attached garage
?. g1egLlg - remodel existing garage into family room
3. Eilmple - convert single fantily residence into
resti-IFant (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 deiays' Building
Division Staff must be able to contact appropriate
persons regarding design information or iob site
corrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
port'ion of the l'lechanical and Electrical Schedules'
the applicant need fill-in only the No. Boxes adjacent
to the appropriate itenr(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the perrnit form the schedules
have been abbrev'i a ted
?. If the itenr(s) to be installed are not covered on
the abbreviated schedules you should consult the
full schedules
C. BUILDING DIVISION STAFF l^IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULTS
O. As noted on the CAP, the label nrust be delivered to the
electrical contractor for signature by his electrical
supervisor, The general contractoris not authorized
to sign the electrical label.
Applicant to sign and date
Whenever possibie, the initial appljcation will be used as
a worksheet oniy. Where possjble, Bui)ding Division Staff
will prepare a type written copy and return it to the
applitant at the time the actual permit is issued for his
signature.
Fees and Charges
Plan check feis are due and payable at the time of the
application, and no plans will be processed until these
fbbs are paid. All other fees and changes are due and
payable when the Permit is jssued.
III
IV
V. FOR OFFICE USE ONLY
PRoJECTCONDITIoNST0BESATISFIEDBEF0RE0CCUPAI{CY:
Permi t appl i cant exempt f rom reg'i strat j on w'ith the Bui I der's Board because:
Additional Proiect Informat'ion :
PLANS REVIEWED BY:
date
name sig na tu re
i