HomeMy WebLinkAboutPermit Building 1989-04-26IN
72 COMBI IIATION APPLICATION/PERMIT 726-3753
Job Address 700 l.lor th I s t . Avenue
EIIERGY SOURCES
Hea t
Sq. Ftg. I'lain.
I 5q. Ftg. Access.-'--
Sq. Ftg. Other__
_l'lew_Ad d_A I te r_P.ep .
_Fe n ce_Demo_Cha n ge,/ U s e
0ther
l-eqal Descri ption 2 two
Rangeccrrplexes.
Va lue of l,lork:
$7,483.000wner PARKSIm, II\C.
Acrdress P.o. Box 17489 Phonc t scr n9 e
Farni I s Ni Ga ra
Salon, Oregon (503) 555-5366 SUNCREST APARTMENTS
Construction Lender
Addrcss l'lront.
ndilte
Pri ma Ear ly Roof ing Service, Inc. 1322 trlorth 30th St. #6003 l-90 (503)746-967
Structura I
Electrical
i{echanical
CONTRACTORS n anle (lics. no.exDl res ohone no.
General Earl
P l umbi
Electrical
l.lechanical
PLUIIB I NG ELECTRICAL MICHAN I CAL
FFF CI]ARGF NO FFF l^ HA ANF NO FFF CHARGF
Each single fixture Residence of
SO. FT
furnace/burner to
BTLI ' s
Relocated buildi
(new fix. additi
n9
on a I )
S. F. Res i dence(l bath)
New ci rcui ts al ts
or extensions
Floor furnace
and vent
SERV I CES
Recessed wal I
Soace heater and vent
Duplex (l bath) each
Additional bath Temporary Construction Apol iance vent
spoa ra t-e
I^later service Change i n exi sti ng
rpc i dpncp
Stationary evap.
cool er
Sewer multifami1y, conrn. or
Industrial
Vent fan with
sinole duct
Storm Sewer 0f _.-.-- amps.Vent system a part from
C.heatino or A
c0r4r!./tND. FEEDERS Mechanical exhaust
hood and duct
Insta l I /al terlre locatedistrib. feeders l,ood stove/heater
0f ,amps.
ISSUANCF OF PFRtlIT
TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES
WllEnE STATE L\N RTQUIRES that the Electrical work be done
shall not be valil until the label has been siqned by an Elect
by an [lectrical Contractor, the electrical portion of this permitrical Supervisor and returned to the Building Division
I IIAVE CAREFULLY {.XAlllNtD the conrpleted apnlication for oermit, and do hereb.y certif.y that all information hereon is true
and correct, and I further certif.v that any and all work Derformed shall be done in accordance with the 0rdinances of the Cityof Soringfield and the Laws of the State of 0reoon nertaining to the work described herein, and that I'lC OCCUPANCY will be madeof any structure without the permission of the Buildinq Division. I further certify that m.y registration r,lith the Builder's
Board is in full force and effect as required b.y ORS 701.055, that if exempt the basis for exemption is noted hereon, and thatonly subcontractors and ennloyees rvho are in comcliance wjth 0lls 7n1.055 uill be used on this Dro.ject.
I'lAr,!E(pleasep.int)_E_qIEJ_E_LELrjrSsCrEI4sr/T_REA_SIIRBGN^TI]RE 1EAPR. 26, 19
r0
Zone____ TynelConst tjni ts So Ftg
Ftg
Ft9
f'la i Value
Fi re Zone-.-.---__Bedrooms_-
Flood Plain Stories
0ccy Load_ -_ Sq Access
0ther
xi VaI llp
'0c c.y Group .===_----Sq x Val
ToTAL VALUATI0N--
BUILDING PERl'lIT
Charges anC
Surc ha rges
PLUI4BING PERMIT
Charges and
Surc ha rges
_-50__Plan Ck, Connr/lnd
65%/81do Ppr Fec
Systems Deve
Charqe (1.57.opment
Plan Ck. Res
30%/Bldq Per Fee
Fence
D6mo
SidewalkELTCTRICAL PERI,:IT
Charges and
Surcha rge s A/C Pavi ng
Curb Cut
Total Comb. Permit
MECHANICAL PERMIT
Charges and
Surc ha rges TOTAL
rl,rater lleater_-
rtl l Ll\11 pvn I rpq rnnF no
PTRMIT VALIDATION
U\L
Perm'i t Cl erk
\3\rc4
COMBINATION APPLICATION/PERMIT (CAP)
Applicant to furnish
A. Job Address
B. Lega
l.
I Description
example- Tax Lot 100, Lane County Map Reference
17 03 43
example- Lot 1. Block 3, 2nd Addition to
SpTingTield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
2E. S
I
2
. example- heat/electrical ceiling/or
. example- waterheater/electrical/or
quare footage or valuation, etc.
example- 1250 sq. foot house, 500 sq
example- if new project, check new -
check add, etc.
forced a llr 9q!
sofa r
foot garagejf addition,
Building perm1. example -
a t tac hed
it information:
construct single family house with an
garage
2. example - remodel existing garage into family room
3. examilE - convert single family residence into
iEETaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAI'I AND CONTRACTORS
To avoid design or construction delays' Building
Division Staff must be able to contact appropriate
persons regarding design information or iob site
corrections, etc,
II. Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occurin the description
portion of the Mechanical and Electrical Schedules'
the applicant need fill-in only the No. Boxes adiacent
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
l. To conserve space on the permit form the schedules
have been abbreviated
?. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
ful I schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP' the label must be de'livered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is not authorized
to sign the electrical label.
IIL Applicant to sign and date
l,Jhenever possible, the initial application will be used as
a worksheet only. l^lhere possible, Building Division Staff
will 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 time of the
application, and no plans will be processed until these
fees are paid. AIl other fees and charges are due and
payable when the Permit is issued.
V. FOR OFFICE USE ONLY
F
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI'ICY:
Permit applicant exempt from registration with the Builder's Boar d because:
Additional Proiect Information:
PLANS REVIEWED BY:
date
name natureSig
4El sq