HomeMy WebLinkAboutPermit Electrical 1990-07-24I NSP
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INE C ITY
COMBI NATI ON
OF SPRI
APPL ICA
I ELD
ON/PERMIT 726
Job Address .
Il-egal 0escriPtion
EIIERGY SOURCES
Hea t
t^later Heater
Ran
Phone
__,
Address
Owne r
- l,laln
5q. Ftg. Access..---
Sq. Ftg. 0ther--'New ''Add AlTer-nep. -
] e n-c e-O emo-C h atg e / U s e
-other---
Sq
Val ue uo
.e- BultO SinglecribeIn
N
t
s
r\1Construct i on en
Addres s Phone
exDl resaddressnameDES I GN TEAI,,I
Pri mary
St ruc tura I
Electrical
Mechanical
exD l res (phone no.add res s (lics. no.
Genera I
Pl umbi nq
i lJofr u [_,ta2 - /q5L /0-/-fu,l
lLElectrical
\l'lechani cal
ELECTRICAL MECHAN I CALPLUt{B I NG
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furnace/burner to
BTll' sEach single fixture Residence of
FTSQ
Fl oor furnace
and vent
New ci rcui ts al ts.
or extensions
Relocated building
(new fix. additional)
Recessed wal I
Snacp hpatpr and vpntS ERV I CESS.F. Residence(l bath)
Duplex (1 bath) each
\Temporary Construct i on \S1 D Apol iance vent
seoa ra teAdditional bath
Stationary evap
cool er
Change in existing
res i dencel.later servi ce
I ndus tri a I
multifamily, conrn. or Vent fan with
sinqle ductSewer
Vent systenr apart from
heatino or A.C.0f s.Storm Sewer
Mechanical exhaust
hood and ductc0Mr'1./IND. FEEDERS
Instal I /al terlrel ocate
di cfri h fppdprs l'lood stove/heater
0f s.
ISSUANCE OF PFRIIIT
TOTAL CHARGES ra,pTOTAL CHARGES TOTAL CHARGES
WHERE STATE L.ltl REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be valiC until the label has been signed by an Electrical Supervisor and returned to the Buildin! Division
y.rZZ
0regon
the Bui
exempt
055 wi l
H FULL INEEXAI1 tD he c ta on dtrmian do he rtce ttha a forman t heon scompapppereb.y re0n t ruefy
and cco rre t nda fu hert cerr ti tha at nd a wor k foafyper srmed ha acn rdan wlce tth na ofdonbe0rdihences het c ty
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Boa rd s fun aforce efnd ctfe sa u red ORS 0s5701 tha t bathereqby th taandhereonnotedsforstexemp
on ubcons actrly rsto and o who reaempyees an wlce 0tlsth 0 no thc0m0 f /o7_3,3e s
NAI.I ea se tnppri GN DA.
Val ue
Iue
ToTAL VALUATIoN--._-
.x Value
Fto
\t. Units Sq. Ftg
Group Sq. Ftg
Zone
StoriesFlood Plai
l'la i n
Fire Zone Bedrooms 0ccy Load Acces
0ther
Plan Ck. Conrn/Ind
65%/81do Per Fee
Sy s tems
Cha rqe
Deve'
f1.5%
opmentBUILDING PERI'IIT
Charges and
Su rc ha rges PIan Ck. Res
30%/Bldq Per Fee
FencePLUI4BING PERMIT
Charges and
Surcha rges D6mo
SldewaIkELECTRICAL PERI|IT
Charges and
Surcha rges C
Total Comb. PermitA/C Paving
Curb CutHECHANICAL PERMIT
Charges and
Su rc ha rqes tt'15TOTAL
ru/tDnr
L_ttgS
PERMIT VALIDATION
Permi t Cl erk
147
Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot I. Block 3, 2nd Addition to
SpffiTield EstatesC. Name, etc. of owner and construction lenderD. Energy Sourcesl. example- heat,/electrical ceiling/o2. .rorEl.- water6eaETTel ectrJcllTor
Square, footage or valuatlon, etc.1. ex,ample- 1250 sq. foot house, 500?. example- if new project, check new
check add, etc.
F. Building permit information:
l. example - construct singie family house with an
attached garage
2. example - remodel existing garage into family room
3. exarTrplE - convert single family residence into
r-estaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections, etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant nqed fill-in only the No. Boxes adjacent
to the appropriate item(s) to be installed
B. Ful l Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
L To conserve space on the permit form the schedules
have been abbreviated
2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
ful I schedul es
C. BUILDING DIVISION STAFF t^lILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. 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 authorized
to sign the electrical label.
IIL Applicant to sign and date
!'lhenever possible, the initial app)ication wil1 be used as
a worksheet only. Where 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
payabie when the Permit is issued.
r forced air qas
solhr
sq. foot garage
- if addition,
E
COMBINATION APPLICATION/PERMIT (CAP)
V. FOR OFFICE USE ONLY
SpeciaIty Code
I AND CONTRACTORS
Structura IH. DESIGN TEAM
PRoJECTCoNDITIoNST0BESATISFIEDBEFoREOCCUPANCY
Permit applicant exempt from reg'istration with the Builder 's Board because:
Additional Proiect Information :
PLANS REVI EI,JED BY :
date
name atureSi9n
L