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Home My WebLink AboutPermit Plumbing 1987-07-06L riE-3 69 c0t,lBI APPLT I II 6-3Job Address Legal Description s/0o 70oI EIIERGY SOURCE- Hea t l{ater Heater Owner Vaiue of t.Jork Addres s Phone Att n C be den Bu Fai e., Bu ng e /6lr nstruction Lender Addres s Phone OA D c\s N name ss no Primary Structura I L EI ectri cal ) l'4ec ha n i ca I n ame Gene i cal RS c I'1ec ha n i ca I PLUIlB I NG ELECTR I CAL MECHAN I CAL FFF CHARGE NO FFF CHARGF NO FFF C HARG F Each single fixture furnace/burner to BTU' S Relocated building (new fix. additional)New ci rcui ts al ts or extensions Floor furnace and vent S . F. R.cs i dence(t natn)SERVICES Recessed wa l I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Construction Apol iance vent seDa ra te [,Jater serv ice Cha nge i n exi sti ng i dencp Stati onar.v evap coo I er sewer lt/2//o.oo multifamily, comm. or Industrial Vent fan with si nol e duct .amp s.0fStorm Sewer Vent system apart from heatinq or A.C, COI,II.1./]ND. FEEDERS Mechan i cal exhaust hood and duct J 1.50 Instal I /al ter/re1 ocate d'i st-r'i b. feeders l'lood stove/ heater amp s.0f /g*d l 14 ISSUANCF OF PFRI'IIT,75 IOTAL CHARGESTOTAL CHARGES q *#re TOTAL CHARGES XHERE STATE LAli REQUIRES that the Electrical work shall not be vali:l until the label has been signed by be done an Elec by an Electrical Contractor, the electrical portion of this permit trical Supervisor and returned to the Building Division and correct, and I further certif-v that any and all r"rorkof Soringfield and the Laws of the State of Oregon oerta of any structure without the permission of the Building Board is in full force and effect as required by ORS 701 only subcontractors and employees who are in comcliance for oermit, and do hereb.y certify that all information hereon is true rrerformed shall be done in accordance with the Ordinances of the City ining to the work described herein, and that NC 0CCUPANCY will be made Division. I further certify that m.y registration r,rith the Builder's .055, that if exempt the basis for exemptjon is noted hereon, and that with 0l1S 701.055 wilI be used on this pro,ject. 7-tr*lDATES IGiIATUREt,lAl.lE(please print) I HAVE CAREFULLY EXAMINED the completed apn I i cati on fritrt/ l,,t/ itl r'21 g G^ /ilru;.* Ftg Ftg Ftg Val ue al ue Value ToTAL VALUATI0N_ x XSq -0ccy Load Group l4ainZone.Tyoe/ Cons t ni ts Acces s 0the r Fire Zone Bedrooms Flood Plain Stories terirs e (1 ve 5/. opmentPlan Ck. Comm/Ind 65%/B1dq Per Fee Plan Ck. Res 30%/81do Per Fee BUILDING PERTIIT Charges and Su rc harges eb Fence U--------.rD5rmo PLUI4BING PERMIT Char.ges and Surc ha rges { Sidewal k Total Cornb. lermit TLECTRICAL PERI,IIT Charges and Surcharges A/C Pavi ng Curb Cut TOTAL I,IECHANICAL PERMIT Charges and Surc ha rqes I sq.Fts.-H;T;-- I sq. rts. Acceiil--_-I so. rto. ottrer _t.lew_Add_Ar IEF-IEE. - r _Fence_Demo_Change,/Use I0ther I 7H /rfu kbnat u-/ pxnt rpq ( ohone no -- Residence of sQ. FT. COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION I Applicant to furnish A. Job Address B. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addition to SplingTieta Estates C. Name, etc. of owner and construct.ion .lender D. Energy Sources 1. exampl e-?, exampl e- Square foota heat/el ectri ca cer I or forced air gas wa terhea ter e e ca 0r sol ar E ge 0r va luation, etc. . foot house, 500 sq. foot garage project, check new - if addition, 1. examol e-1250 sq ?examp I e- check ad i f newd, etc.F. Bui lding permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into rEtauiant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc.IL Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportjon of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and E)ectrical 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 the ful I schedul esC. BUILDING DIVISION STAFF WILL 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 III to sign the electrical label 1V. Applicant to sign and date Whenever possible, the initial application will be used asa worksheet on1y. Where possible, Building Division Staffwili prepare a type written copy and return it to theapplicant at the time the actual perm'it is .issued for his s i gnature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wi1) be processed unt.il thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: name SI g na tu re date