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Home My WebLink AboutPermit Electrical 1990-07-11b3 cc> COMB I ON Phone L TI 726-3t53 b Address ON ,s-t- -'gal Descri ption Owner Address ,{t NECHANICAL PERMIT Charges and Suncharges Sq Sq tI l.lo r k'IDe ra (rBu I ng ReFanr'|s ng e Val ue Uo hange/ Use l,Jater Heater Ranqe ntq Ftg. Access Ftg I ter llep. EIIERGY SOURCES Hea t 4tw-7 )tl '/ConstrJction Ednder -s)\-)G{ 6 \/Address Phone DES I GN TEAI{name address lics. no.exDl res Pri mary Structura I E.rectricar @6h Mechan i ca I ACTORS name addrcs<)(lics- no-)pYnt rpq nhonp no-CONI Genera I Pl umbi nq Erectricar J(C f'troJvic Z-15? Don Sf U5 rz? t/"2,1-qt )dL 4ts, r^ f'lechani cal ELECTR I CAL MECHAN I CALPLUI.lBI NG FEE CHARGE NO FFF CHARGF NO FFF CHARGF Each single fixture Res idence of FTSQ furnace/burner to BTU' s Relocated bui lding (new fix. additional) New circuits alts or extensions FIoor furnace and vent S. F. Residence(l bath)S ERV I CES Recessed wal I Soace heatpr end vent Ouplex (l bath) each Temporary Constructi onAdditional bath Apol iance vent seDa ra te tlater service in existingChange res i de nce Stationary evap coo l er Sewer mul ti fami ly, I ndustri a I corm. or Vent fan with sinole duct 0f s.Vent system apart from heatino or A.C.Storm Sewer c0r,lr.r. /IND. FEEDERS l''lechan ical exhaust hood and duct Instal I /al ter/re1 ocate di stri b. feeders llood stove/heater amps0f ISSUANCF OF PFRIIIT TOTAL CHARGES loD.G)TOTAL CHARGESTOTAL CHARGES WHERE STATE L{tl REQUIRES that the Electrical work be done by an EGitrical Contractor, the electrical portion of this permit shall not be vali'l until the Iabel has been signed by an Electrical Supervisor and returned to the Building Division rrect, and I further certify that any and all work performed shall be done in accordance with the 0rdinances of the Cityingfield and the Laws of the State of Oregon pertaining to the work described herein, and that NC 0CCUPANCY will be made ission of the Building Division. I further certify that my reqistration vrith the Builder's as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that l,lAl.lE ( pl ease pri nt )ICNATU L perm ffect \ of any structure without the Board is in full force and e only subcontractors and er,'rployees who are in comcliance with OPS 70i.will be used on this nroject.5r45s D the completed application for oermit, and do hereb.y cert s truefy that a I information hereonI and coof Spr Ftt: Ftg Ftg Val ue Val ue Group Sq TOTAL VALUATION t o x x S q Val up 0ccy Load Zone Tyoe/Const Stori esFlood Plain llain BedroomsFire Zone Acce s s 0ther Plan Ck. Conm/lnd 65%/8Ido Ppr Fec Svstems Deve Charoe (1.5r. opmentBUILDING PERNIT Charges anC Surcha rges Plan Ck. Res 30%/81dq Per Fee FencePLUI,IBING PERMIT Charges and Su rcha rges Dgmo Si dewa I kELECTRICP,L PERI1IT Charges and Surcha rges -oo--- A/C Paving Total Comb. Permit Curb Cut TOTAL (oSoo i I c0MBINATI0N AppLICATIoN/pERMrT (CAp) I. Applicant to furnishA. Job AddressB. Legal Descriptionl. gpIpfg- Tax Lot 100, Lane County Map Reference17 03 432. example- Lot I. Block 3, ?nd Addition toSpringfield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources1. example- he^ +l. examDle- wa square-T6oEage a t,/ ei ectri ca I teror valuati on, 1250 s q. foot lF-new project , etc. or forced air qas or sol ar I E I 2 exampl e- examp I e- check add house, 500 sq. foot garage , check new - if addition, cal, & Electrical Schedules occur in the description and Electrical Schedules, n only the No. Boxes adjacent ) to be installed , and Electrical Schedules II III. IV. F. Building permit information:1. example - construct s.ingle famity house with anattached garage ?. example - remodel existing garage into family roomJ. exampte - convert single family residence into - restaurant (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, BuildingDivision Staff must be able to contact appropriitepersons.regarding design infonnation or job sitecorrections, etc. Abbreviated Pl umbing, MechaniA. Except where blink spacesportion of the Mechanical the applicant need fil l-i _ to the appropriate item(sB. Full Plumbing, Mechanical are available at the Build.ing Divisioni. 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 consu.lt theful I schedul esC. BUILDING DIVISION STAFF WILL FILL OUI 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 coniractor ii not authorizedto sign the electrical labelApplicant to sign and date l'lhenever possible, the initiai application will be used asa.worksheet only. Where poss.ible, Building Division SiaiiwiIl.prepare a type written copy and returi.it to theapplicant at the time the actual permit is issued for h.is s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesetees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLYV tl -v-q) #t1 bgz PERMIT VALIDATION Permit Cler t PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Informat'ion : PLANS REVIEWED BY: name da teSigna tu re qp {.zo:i7.s-" ""' ,nru,,,iillroir;i?il?[Jfii8ror,,-37 53 Job Address 4ccO Fl. [@TH eo. otr\ l-ega1 Description I'later lleater Ranqe EI]ER(]Y St)URCES Heat 6ulTE#@tenT) 12*-41\eowner QV, JftSfi Lpreer+a Val ue of i.Jork:*tzo,ooe q.Ftg.llain_ Builciinq Pernrit Info: Describe i,lork( i.e., Build SingieFarrily flesidence lJi th lttached Garaqe)Address Phone Constructi on Lender Addre s s Phone name addres s I ics. no exoi res phone no.I)t51GN ItAt.1 S t ruc tura I Pni ma El ectri cal l"4echani cal name addres s lics. no.exoi res ohone no. CIrGenera I I-\r:r-rr-l Jl-tr-c.Jo ( ax\Ataia,?rG.f,o-T-i, ^ A \{.tu,6, f- Pl umbi nq Electrical T K(r Fll.p,,ttan { m<r.Bl'lechani cal PLUI,IBI NG ELECTRICAL MEC HAN I CAL N0.FFF CHARGF NO FTF CHARG F NO FTF CIiARGF t+Each single fixture 'agD /ba Residence of SQ. FT furnace/burner to BTU' s ng on a l ) Relocated bui ldi (new fix. additi u New c'i rcui ts al ts or extensions 259 Fl oor furnace and vent S. F. Residence(l bath)SERV I C ES Recessed wal I Soace heater and vent Duplex (l bath) each AWilmAnol)boa Addi ti onal ba th Temporary Constructi on spDa ra tP Apol iance vent Change in existing rpc i dpncpl,later servi ce Stationary evap cool er Sewer Industrial multifamily, conrm. or Vent fan rvith s inole duct-300 /200 Storm Sewer amp s.0f Vent systern apart from heatinq or A.C. cor,lr.r. / rND. FEEDERYID A 37 fe i"lechanical exhaust hood and duct Instal I /al ter/rel ocatedistrib. feeders l'Jood stove/heater 0f amp s. fo M lvzVZzt,t ,La 9/tu7P-tw+/ (ISSI]ANCT OF PFRIlIT WHERE STATE LAl.l REQUIRES that tlre Electrical work be done by an Electrishall not be valil until the label has been signed by an Electricai Supervi 60 sor and returned to the Buiiding Division n ctor, the electrical portion of this permit TOTAL CHARGESTOTAL CHARGES TOTAL CHARGES I HAVE CAREFULLY EXAIIINtD the completed apnlication for oermit, and do here and correct, and I further certif-v that any and all work performed shall be don n oertaininq to the r^rork described herein, and that NC 0CCUPAHCY rvill be madeDivisjon. I further certify that my registration vrith the Builder's llAl.'lE (pl ease pri nt )IGiIA 0rego the Bu b.y certify that all information hereon is true e in accordance r^rith the Ordinances of the Cityof Sorinqfield and the Laws of the State ofof any structure without the permission of Board is in full force and effect as requi ilding Ons 701red by 055, that if exenrpt the basis for ex ti hereon, and thatonly subcontractors and ernployees rvho are i n comcl i ance wi th ORS 7n1.055 r,ii l l be $sed on th i s ct DA.IE Zl,-\rf Oho T Value Val ue Val ue AL VALUATION 0cc.y Grou D S Type/const. Y-lilJ, JF(.Units so){q 50ccy Load X x # \-t<r"tc G-d( qf5 Bed roomsFi re Zone Zo ne l'1a i n q. Ftg q.FtsFlood Plain Stories. Acce s i 0the r Plan Ck. Comm/Ind 65%/81do Per Fee 3tn,r\f)Svs Cha tems Deve rqe ( t. sZ o pmen t /hoD,ooBUILDING PERNIT Charges and Su rc ha rge s 7o P l an Ck. Res 30'l/B1dq Per Fee FencePLUI'48]NG PERMIT Charges and Surcharges A oo .Ele Dgmo SidewaIkELECTRICAL PERIlIT Charges and Surcharges Total Cornb. PermitA/C Pav i ng Curb CutIlECHANICAL PERMIT Charges and S urc ha rqe s ao__/_ ,70 TOTAL z/3 /,os r\Sq . 5tg. Acces s .-- So. Ftq. Other _ _ilerv Addr(Al ter P.eo.- ren{o6t_change/use 0ther s 0a U ]TO RS {J(,I \ \ \f COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Lega) Descriptionl. examole- Tax Lot 100, Lane County Map Referencer-olas2. example_ I ot_1. Block 3, 2nd Addition toSpfifufietd Estates ! Name, etc] of owner and construction lenderD. Energy Sources 2 examp I e- examo I e-re footag heat,/el trica cer .tn i.,ff#e{s:rscrE. Squa wa ter e t oe or valuati o[,examp I e- examo I e- check add 1250 sq.if new p foot house, 500roject, check*new sq. foot garage etc if addition, F. Buil d ing permi t i nforrna ti onexample - attached _construct single fam.ily house vrith anga ra ge 2 exampl e - examp I e - restauran remodel e,xisti 3 convert s i ng garage into famiiy room mr Iy residence intongl e fa G. Valu e of work t (change of use) Structural S as defin ed in Section 303 (a) of the H DES I GN TEAI,I pecialty Code To avoid des AND CONTRACTORS Divisjon Std igff n or construction del ays, Buildi ngmust be able to contact appro priatepersons regardi ng desi gn info rmation or job siteiI. Abb corrections, e tc A reviated Plumbino Except where b1J nk l"lechanical, & Electrical Sc hedul es portion of the l'1ec . spaces occur in thanical and Electr he descri ption the appl icant need fill-in onl ical Sc hedu I es ,to the aooB. Fult ptumt ropriate item(s) to y the No. Bo xes adjacent i ng, t'lec hanical, and be installed are available at1. To conserve the Bui ld.ing D Electrical Schedules'tvtston have been space on the permit form the schedules2. If the ir abbreviated em (s) to be installedated schedules you are not coveredthe abbr-evi should consul t on ful I schedu theC, BU] L DING DIVISION STAFF I^/I LL FI LLCHARGES ON THED. As noted on thr SCHEDULES OUT ALL FEES AND electrical con e CAP, the labei mus t be delivered to thetractor for s i gna tu re by his electri calsupervi sor The genera) c ontractor is notto sign the e lectrical la bel authori zedIII. Appt 'icant to s ign and datel,/hen ever possib)e, rksheet oniy. the initial a Ppl ication wi I Iawo|^/here poss.ib)be used aswillprepare a type wri tten e, Building and return Division Staff appl i cant at the time the acture. c0py it to the signa tual permit is i ssued for his IV Fees and .Charqes Plan check feis are due and.payabre at the time of theapptrcation, and no plans wiif"O. p.o.ursla unill thesetees are paid. All other iuu, ura".il.ril'u." due andPayable when the perm.t r rs rssued. FOR OFFICE USE ONLY PERMIT VALI DATION +/(ve ," b5= Permit Clerk A ALQr. ,h0 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: eP rm at I Cp a tn Xep em ft mrop I S t ar treg no i t h t h h6e u d re S Bo a rd beca Su e Additional project Informa tion PLANS REVIEl{ED BY: name da tesignature i i j I