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Home My WebLink AboutPermit Building 1989-10-05"72 sc ri Farni I-/55?/22- Construction L E CO}18I AP e a> Wor i ld s ng e CATION ERMIT Ftg. l.la n 26-3753 Value of llork l-egal Descri ption Job Address Owne r Address Phone z t InNith A llater llcatcr Ranqe Sq. Ftg. Access.--EIIERGY SOURCES Hea t m t .0t ._ffi2-*ffi [)honeAdrlre s s NtrsTGN TEAM Pri ma Struc tura I El ectri cal i''lechani cal -bb7 7 PI afis I MICHAN I CALELTCTR I CALPLUl,lB I NG I)lo a tt 1 I ical FEENOFFFCHARGENNFEECHARGE .46e. furnace/burner to BTLI 'sResidence of FTSQEach single fixture Fl oor furnace and ventNew ci rcui ts al ts. or extensions Relocated bui Iding (new fix. additional ) ,o.4 ?/nRecessed wal i Snace heafer and ventq'SERV I CESS. F. Res i dence ( I bath) Duplex (l bath) each Apol iance vent seoa ra teTemporary Construct jonAddi tional bath Stati onary evap cool erChange in exi sting res i dence[,,later servi ce ?' -rEVent fan with sinole duct/I ndrrstria I multifamjly, comm. or Sewer Vent systern apart from heati nq or A. C.Storm Sewer Mechanical exhaust hood and duct lJood stove/heaterInstal I /al ter/rel ocate di qtri h- feeders t2*.r44fu,Zzznamp s.0f *f91zf;rff72r*a ba e72,, )41 ,z€, -/'42,. fuz/-v 7) Vz,./)1 lSSUANCF OF PFRIIIT4 Flood Plain stories ,/y'2G2?- 0cc.v aroup 2-? sq S I Gi,IATURI:I'lAl'lE(pl ease print)DA zSH.----=7- Fi re Zone Bedrooms--OccY Load 0regon the Bui ng st oncomp pe ,foDer t Type/Const.7$ Units_=-- Sa lue Iue Va Va :r Sq rmation hereon is truermit, and do herebv certif.y that all inEDteted appl i catY EXAI1I he Ordinances of the CitYrmed shall be done in accordance w'ith tand correct, and I further certif-v that any and all rvork the work described herein, and that I'lC 0CCUPANCY will be madeininq tofield and the Laws of the State of De rtaof Spri lding Division. i further certify thatructure without the permission ofof any Board i my reqistration vlith the Builder's ' exemption is noted hereon, and thats in full force and effect as required by ORS 701.0 55, that if exempt the basjs for hi s nrojectth OPS 701.055 vrilI beonly subcontractors and employees who are in comcljance wi Access 0the r. ilectric,rl Contractor, the electrical portion of this permit Supervisor ancl returned to the Building Divisionl^JllERE STATE LAl,l REQUIRES that tlte Electri' shall not be valiC until the label has been s cal work be done bY an igned by an Electrical ToTAL VALUATI0N=-- Zone aA TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES l'la i n Val ueFtq Ftg Ftg ,/\//Z -///2 -33 ?e4,VE 5l De 1. Plan Ck. Comm/lnd 65%/81do Per Fee Plan Ck. Res 30%/81dq Per Fee BUILDING PERI'iIT Charges and Surcharges __/5D Fence DOmo PLUI4BING PERMIT Charges and Surc ha rges Sidewalk Total Comb. Permit ELLCTRICAL PERI|IT Charges and Surcha rges A/C Paving Curb Cut z/r.7eI,IECHANICAL PERMIT Charges and Surc ha rges >,sI'o___3_TOTAL :€. t Add .0ther. Ftg FXn I rpq( addres s( name CIIAPGF c0r.1r.1./lND. FEEDTRS 1-4*. zz COMBINATION APPLICATION/PERMIT (CAP) I . Appl icant to furni shA. Job AddressB. Legal Description1. glaTplg- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition toSFIfnlTietd EstaresC. Name, etc. of owner and construction lenderD. Energy Sources r lolced air gas :ebt sq. foot garage - if addition, 1. gl-e11plq- heat/electrical cei I inq/o2. exampTfe- wa terfreaTEiTElEc trica lTor Square footage or valuation,-eTd-1. example-_ 1250 sq. foot house, 5002. example- if new project, check new check add, etc. E II III F. Bui lding permi t information:1. example - construct single fanrily house with anattached garage ?. examp]e - remodel existing garage into farnily room3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Bui ldingDivision Staff must be able to contact appropriitepersons regarding design informat.ion or job sitecorrectj ons , etc. Abbreviated Plunrbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installe<jB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Bui lding Division1. To conserve space on the permit form the schedules have been abbreviated2. If the itenr(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF I,JILL 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 electricalsupervisor. The general contractor is not authorized V to sign the electrical Iabel Applicant to sign and date Hhenever possible, the jnitial app)ication will be used asa worksheet only. I,Jhere possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actua) permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of the app l i cat i on, and no pl ans wi l l be processed unti l thesefees are paid. All other fees and charges are due andpayab)e when the permit is issued. FOR OFFICE USE ONLY IV. PERMIT VALIDATION /5o5V Permi t Cl erk r0 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Perm'it appl icant exempt from registratjon with the Builder's Board because: Addit'ional Project Information : PLANS REVIEWED BY: s i gnaturname Lan E n"==K date