HomeMy WebLinkAboutPermit Electrical 1985-10-29IN
72 LIIIE
COIIBINATI ICA
3753IT
Job Address ?sz Stunr.r)/
l-eqai Description
l€. t i ng'l eFami I Work
A
l,later Heater
Value of l,lork
Ranqe
Permi t
i den
EIIERGY SOURCES
Hea t q.
Sq. Ftg
Sq. Ftg
llainAcceill--
0ther
Phone525
Owner
Address
Construction Lender (
Address Phone
n
Pd ,/22
y'/eal
PLUIIBI NG ELECTR I CAL 14ECHANICAL
Ca)
El o
eo/a-c
Leo.
Hechan i ca l
El ectri ca l
Structura I
Pri ma
At
NO FEE CHAR6F NO FFF CHARGF NO FFF CHAAGF
Each singie fixture Residence of
FTsQ BTU' S
furnace/burner to
Relocated buildino
(new fix. additional)New circuits altsor extensions
Floor furnace
and vent
S. F. Residence
( l bath)SERV i CES Recessed wal I
Soace heater and vcnt
Duplex (1 bath) each
Additional bath Temporary Constructi on Apol iance vent
seDa rat-e
l.later service Change i n exi sti ng
res i dence
Stationary evap.
coo i er
Sewer multifamily, corm. or
Industrial Vent fan with
sinole duct
Storm Sewer 0f *Vent systern apart from
heatinq or A.C.
c0r4r.1./IND. FEEDERS Mechanical exhaust
hood and duct
Instal I /a.l ter/rel ocatedist-rih. feeders ['Jood stove/heater
0f a
9,,"),4",e- -t-4 160 AS oo
atwpn 47"I do
u
ISSUANCE OF PERI1IT
TOTAL CHARGES TOTAL CHARGES Zl" 60 TOTAL CHARGES
l,lAl'lE ( pl ease pri nt)-2?-&5l^IGNA
REQUIRES that tlre Electricai work be done by an Electrintil the label has been signed by an Electr.ical Supervi
cal Contractor, the electrical portion of this permit
sor and returned to the Building Division
and
of
of
Boa
onl
any
ofng
stany
rd empt
wi'l
YL IEXAI1 e ca onti for trmt anI rtddo 1t on reonhe sI ruetn,ltac0mpapl-)DE ceherebycorrectandIerertcIhatLfurthdaIIworkrmedfohasII'I nedonbeanfyper ac cecordan thwt Ordithe ncena ofs Cithe tyrl'It 1 anddSp Lawsthe theof Sta te on rt nat t tto workhe crtdes 't n ha0regoehebedredant NCt CUPANCYOC IWI beI madeng
cturu WIre thethout s 'Is ofonpermi the 'I dI I Di sI on1 furt r 'IIn9hecert f tha tras 1t-vlion theth 'IBu deI r Sfyreg imy
sI nI Ifu I fo arce nd affect s '|red ORS 07 05 5 itha 1 f ex 'Itherequbys s for 0'I Tn noteds and tthabaexemp t
s bconv totrac rs a nd I who Iempre n I a'I nc tw1 h 0r?s 70t 0 55 IoyeescomD be 0nused sthi ectproj
I.JHERE STATE LtrIishall not be vali.J u
Fire Zone Bedrooms Occy Load Sq
Ftg
Ftg
Ftg
Uni ts
Valuex
TOTAL VALUATI nil
I llp
1
Zone____Type/Cons t l4a'i n
Flood Plain Stories Group Sq.
Acces
0ther
P l an Ck . Cornm/ I nd
65%/Bldo Per Fee
tems De
rqe tlSys
Cha
ve
5/.
opmmtBUILDING PERIIIT
Charges and
S u rc ha rges Plan Ck. Res
30%/Bldo Per Fee
FencePLUI4EING PERMIT
Charges and
Surcha rges Demo
Si dewal kELECTRICAL PERTIIT
Charges and
Surc ha rges
5,
/ .6D Total Comb. PermitA/C Paving
Curb CutHECHANICAL PERHIT
Charges and
Surc ha rges dD,7_bTOTAL
J^trwd
\q
D
t^)
e)
A
Nechanical
hereon,
COMBINATION APPLICATION/PERMIT ( CAP)
I. Applicant to furnishA. Job AddressB. Legal Description
l. !S_!P!C: Tax Lot 100, Lane County Map Referencei7 03 432. example- Lot t. Block 3, Znd Addition toSEn'igFietd Estates
PERMIT VALIDATION
C. Name, etc. of owner and cons truction lenderD. Energy Sources
c
I. example- heat/electrical cei I inq/or
?. exa[pt e- waterhEiTETTEiEcrriEi-j7or
Square footage or valuation,-eEdI-
l. example- 1250 sq. foot house, 500 s2. example- if new project, check-newcheck add, etc.
' forced air oas
solar
q. foot garage'if addition,
(r055FBui l ding perm
example -
attached
it information:I construct single family house with an
2.
garage
example -
example -
res ta uran
remodel existi ng ga
fami
rage into family room3.convert si ngl e Iy residence into
G. Value of work
t (change o
as defined
f use)
Structura l Specia I
in Section 303 (a) of the
(
ty Code x{H. DESIGN TEAM AND CONTRACTORS
II
To avoid desig-n or construction delays, BuildingDivision Staff must be able to contact appropriitepersons-regarding des.ign information or job s.itecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical Schedu,lesA. txcept where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fijl-.in only the No. Boxes iOji6ent_ to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedu.lesare available at the Build.ing 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 l schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by his electricai -
supervisor, The general contractor ii.not authorizedto sign the electricai labelApplicant to sign and date
l,lhenever possible, the initial apptication wilI be used asa.worksheet only. Hhere possible, Building D.ivis.ion 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 payabie 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
6/>l
D
III
IV
V Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registration with the Builder's Board because:
PLANS REVIEWED BY:
name sig nature date
j(
Additional Project Information :