HomeMy WebLinkAboutPermit Plumbing 1989-08-23IT 726-37COMBIL
Job Address
l-egal Description
EIIERGY SOURCES:
Ran
l,later Heater
So-- Fto. Access.
Ftg.n-
Va lue of t'lork:
0wner
ng eDesc
tacAddress
Cons t
Addres s Phone
Pri ma
Struc tura I
E l ectri ca l
Mechani ca l
Pl umb
rical
MECHANICALELECTR I CALPLUIIBI NG
furnace/burner to
BTLI' s
Residence of
FTSQEach single fixture
Floor furnace
and ventNew ci rcui ts al ts.
or extensionsRelocated building
(new fix. additional )
Recessed wal I
SDace heater and tven-tSERV I CESceF. P,es
Duplex (| bath) each
Apol iance vent
se0arateTemporary ConstructionAdditional bath
Stationary evap
cool erge in existing
dpnce
Chan
rpc iI,later servi ce
Vent fan with
sinqle ductIndrrst-ria l
mul ti f ami ly, cornm, or
Sewer
Vent system aPart from
heatinq or A.e-0f amPs.
Storm Sewer Mechan.ica l exhaust
hood and ductcoMr'r./IND. FEEDERS
tlood stove/heaterInstal l /al ter/rel ocate
distrib. feeders
amps.0f
ISSUANCE OF PFRI,IIT
TOTAL CHARGES)P TOTAL CHARGESTOTAL CHARGES
llAt"lE(please print)I
ectrical Contractor, the electrical portion of this permit
pervisor and returned to the Building DivisionWHERE STATE LAN REQUIRES thAt
shaII not be val i'l untiI the Iabel
the Electrical work be done by an El
has been signed bY an Electrical Su
permi t
rformed
0reqon
the Bui
nI tforma on.I hereonrertce'I +tha aandodheb,y fy1Iac,]t noatheppELFULcomp +na0rdi'ESnc of t'I acn cecordan wl th heIhaIdonebendaIawoIperktaIrthefucertrIhatndarreccondfytNO CUPAHC0c wlY
'IItthaandhenrelntoworkthecrldesbed
any
of 1 'I ngoe rtafIadthendsLawtheoftaSte1ertSofngp
1onIthvrl'ItheBu1tthatstraI'I on I hefurt cert regim.yrdI'I ,l sD fy0nIofngwltthouthess'IsruLrectupermaofny tedno re0nhe asIforon'|sIthaItftbasexempttheexempIORS0705I5tanforcedfecfatreds1Board'Is fun I requ byI
n s'I ectbesuthrojed055'I I'l
1I wiance 0th 70us p1Isawho'|nreIonsuonbcand c0mptractorsemp0yeev
s true
he City
be made
der' s
nd that
ToTAL VALUATI0N-.---
lue'
IFi re Zone-Pedrooms 0ccy I nad
. Other
l,la i n
x Va
Ftg. Access
I ue.---Const. Uni ts
-Sq.
Ftg
q. FtsFlood Plain Stories.
Zone
0cc.y Group
opmentSvsterns Deve
charqe (t.srPlan Ck. Comm/lnd
65%/8ldo Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERI'IIT
Charges and
Su rc ha rges
Fence
Demo
PLUI4BING PERMIT
Charges and
Surcha rges
Sldewal k
Total Comb. PermitA/C Paving
ELECTRICAL PERIlIT
Charges and
Surcha rges
Curb Cut 52 5cTOTAL
I,IECHANICAL PERMIT
Charges and
Surc ha rges
-7
So. Fto. 0ther'l,lew Add Alter--nAp.
--TenEe-oEfro
ChEEge/Use
0ther
a !lA onF ECE .HADNFNNFFF I
PERMIT VALIDATION
L3 )
41\L
\
Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY:
Permit applicant exempt from registration with the Bu'ilder's Board because:
Additjonal Project Information:
PLANS REVIEWED BY:
Si gn ature date
,---*
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legai Descriptionl. example- Tax Lot 100, Lane County Map Reference
17 03 432, example- Lot 1. Bjock 3, Znd Addition toS[iffiField EstaresC. Name, etc. of owner and construction lenderD. Energy Sourcesl. example- heat/electltcf ceiling,/or forced air gas2. e!am[i"- waterhEITErTEEc[Fi ci-j7or soTli-_--E. SquaiiTto:ootage or valuation, TTE. -
1. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition,
check add, etc.F. Building permit information:1. examp]e - construct single family house with an
attached garage?, example - remodel existing garage into family room3. example - convert single family residence into
restaurant (change of-use)G. Vaiue of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job sitecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrica'l SchedulesA. Except where blank spaces occulin the descriptionportion of the Mechanical and Electrical Schedules,the appiicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Fujl PIumbing, Mechanical, and Electrical Schedules
are avaiiable 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 I,IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label.III. Appiicant to sign and date
Whenever possible, the initiai applicat.ion wilI be used asa worksheet only. Where possible, Buiiding Division Staffwill prepare a type written copy and return it to theapplicant 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 theapplication, and no plans wili be processed until thesefees are paid, Al'l other fees and charges are due andpayable when the permit is issued.
V. FOR OFFICE USE ONLY
name