HomeMy WebLinkAboutPermit Electrical 1990-02-02Job Address
l-ega1 Description
LINE 7?6COMBI
Hea t
Ran
EITERGY SOURCES
t'later Heater
Sq. Ftg. Access.-
Sq. Ftg 0ther
Sq.
Use
n
V al ue of \'lork
Owner
ng ei€. ttn
tii thPhone
Constructi on
Addres s Phone
name
Pri ma
Structura I
E l ectri cal
l4echani ca I
MECHAN I CALELECTR I CALPLUI'{BI NG
I
furnace/burner to
BTLI' s
Residence of
FTSQEach single fixture
Floor furnace
and ventl,lew circuits alts
flextensions
Relocated building
(new fix. additional)
Recessed wal I
Soace heater and ventSERV I CESS. F. P.es idence(l bath)
Duplex (1 bath) each
Apol iance vent
sepa rateTemporary Constructi onAdditional bath
Stationary evap.
cool erge in
dence
exi sti ngChan
res iI,later servi ce
Vent fan with
sinole ducty, comn. or
Industrial
mul ti fam
Sewer
Vent systern aPart from
heatinq or A.C-0f imps.Storm Sewer l,lechanical exhaust
hood and ductCOMI,I./IND. FEEDERS
l,lood stove/heaterI nsta I I /a I ter/ rel ocate
)ilt010f(
ISSUANCF OF PFRI{17
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the Electrical work be done
has been signed bY an ElecWHERE STATE LAN REQUIRES
sha I I not be val i'l unti I the
tha t
Iabel
TOTAL CHARGESTOTAL CHARGES
SqGroup
Pl an
an
I
I Per
,0ccy Load Val
I
opmen
Zo n e_______-TYPe / Co n s t alue
TOTAL VALUATI
l'la i nFtg
Ftg
Ftg
BUILDING PERNIT
Charges and
Surcha rges
Uni ts Stt
Fire Zone Bedrooms.
F]ood Plain Stories
Access
0ther
Fence
Demo
PLUI4BING PERMIT
Charges and
Surcha rges
Sidewalk
Total Comb. Permit
ELECTRICA,L PERIIIT
Charges and
Surcha rges A/C Paving
Curb Cut
TOTAL
MECHANICAL PERMIT
Charges and
Surc harges
,01
(rft,\1t o hn\ )0n
Co
I
pxnt r(addressDESIGN TtAI.l
n
, TOTAL CHARGES
Superv i
s
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA, Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, Znd Addition to
SpFffifie1d EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. example- heat/2. exampIe- water
Square footage or
el ical cei I in or forced air gas
r e ec br soTar
L va l uat otl ,1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new - if addition,
check add, etc.F. Building permit information:1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family room3. example - convert single family residence into
restaurant (change of use)G. Value of work as defined in Section 303 (a) of the
Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Bui)d'ing
Division Staff must be able to contact appropriate
persons regarding design information or job site
correcti ons , etc.IL Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,
the appl'icant need fi'll-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF l^llLL 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 electrical
supervisor. The general contractor is not authorizedto sign the electrica l label .lII. Applicant to sign and date
llhenever possibie, the initial application will be used as
a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his
signature.IV. Fees and Charges
Plan check fees are due and payable at the time of theapplication, and no plans will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is 'issued.
V. FOR OFFICE USE ONLY
PERMIT VALIDATION
Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registration with the Bu'ilder's Board because:
Additjonal Project Informatjon :
PLANS REVIEWED BY:
name Si g nature date