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Home My WebLink AboutPermit Mechanical 1984-06-19ONL 0wner c0r,rB r 726- Value of lJork RMITLICAT Job Address Lega1 Descri ption l,Jater Heater Ranqe EIIERGY SOURCES Hea t Sq. Ftg. Access._-- Sq. Fto. 0ther_ _l'lew_Ad d_A1 ter_Pep . _Fence_Demo_C ha n ge/ U se 0ther . Ftg n_ PhoneAddres Bui lciir Famr"ly nq Pernrit Inf Res i dence l.li o: oescE'ue-woTt Cth Attached Garaoe' .e., Build Single S,pj.L DO Q-r+-t-1 r0nntatr Constructi on Lln#r Dutn n Addres s Phone /r ,+ (,,AJ C,\) DESIGN TEAH name addre s s 'I ics. no.FXO req ohone no. Pri ma ry Structura I E I ectri ca I Hechan i ca I ACTORS name add res s (l ics. no.exD I res (nhonp nn Pl umbi nq E I ectri ca I ical PLUt,lBI NG ELECTR I CAL MECHAN I CAL FEE CHARGF NN FFF CHA RG F lI FFF CHARG F Each single fixture Residence of FTSQ furnace/burner to BTLI' s Relocated bui ld ing (new fix. additional ) New ci rcui ts al ts or extensions Floor furnace and vent S. F. Residence ( l bath)SERV I CES Recessed wa'l I Snarp heaicr and vpnt Duplex (l bath) each I T't&tn./0F Additional bath Temporary Constructi on Apol iance vent seDarate l.later servi ce ge in existing dencp Chan res i Stati onar.v evap cool er Sewer multifamily, conm. or Indrrstrial Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatinq or A.C. COMI.I./IND. FEEDERS Mechanical exhaust hood and duct I nsta I I /a I ter/ re I ocate di<trih. fpedprs ['lood stove/heater 0f amps ISSUANCE OF PFRI'IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES /o,m WHERE STATE Lltl REQUIRES that the Electrical work be done by an Electrica1 Contractor, the electrical portion of this permitshall not be vali:l until the label has been signed by an Electrlcal Supervisor and returned to the Building Division llAl.lE (pl ease pri nt )I GIIATURE=rL DATE b 1 ,l any rd perm ffect exempt 055 wi l 'E c onLxAtlENEtDheat t nda heredo cert ttha a n rmatfo on hereon sappc0mpb.y truefy and correc t and certfu rther tha at a nd a ,kwor sha donebe n ccordancea thw1 t nfynypehe0rd a nces the cof tyofSr'l fi de dan Lawsthe theof Stapng te of on n thto worke descr bed and0regDe rta ng here th at NC wlOCCUPAHCY madebeofrutWIcturethethou ts s o0n th Bue d s o n CfLrther ertng th at tras 0nti thl,r'l het Bu de r sfym.y reg Boa fu afo rce endn red ORS 07 0s5 hat tas f sbatherequs for t 0n noteds tha tandhereonbyexemp u tracbcon rsto andsv awho 'Ire n ncea thw'l 7o0r?s tnothernp0yeescomc Ftg Ftg Ftg TOTAL VALUATION 0c cy Load Sq xr Val Rorl rooms xr Val Cons t Flood Plain Stories Occ.y Grou 0ther Zone ts So. Fire Zone al ue . l'lain .Ac PIan Ck. Conrn/Ind 65%/81dq Per Fee Svsterns Deve Charqe (i.57'opmentBUILDING PERNIT Charges and Su rc harges Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surc ha rges D6mo Sidewal kELECTRICP,L PERI1IT Charges and Surcharges A/C Paving Total Comb. Permit Curb CutI,IECHANICAL PERMIT Charges and Surc ha rges /0,oo------'-qo -,{ tr 4OTOTAL Genera l COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION Applicant to furnish A. Job AddressB. Legal Description 1, example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, ?nd Addition to SpiinlFie1d Estates C, Name, etc. of owner and construction IenderD. Energy Sources 1, example- heat,/electrical ceiling/or forced air gas 2. example- waterheater/electr.ical/or solar E. Square footage or valuation, etc.1. example- 1250 sq. foot house, 500 sq. foot garage 2. exampie- if new project, check new - if addition, check add, etc.F. Building permit information:1. exampie - construct single family house with an attached garage 2. example - remodel existing garage into family room3. examole - convert sinqle family residence into -re s ta u ra n t ( c ha n g e o f - u se )G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI4 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. Abbreviated Piumbing, Mechanical, & Electrical SchedulesA. Except where biank spaces occur in the descriptionportion of the Mechanical and Electrical Schedujes, the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full P'lumbing, 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 instal'led are not covered on the abbreviated schedu'les you should consult theful'l schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to thee1ectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label. Applicant to sign and date !'lhenever possible, the initial application wiII 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 si gnature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due and payable when the permit is issued. FOR OFFICE USE ONLY 6 3ct3 b-l?-il II III IV V Permit Clerk PROJECT CONDiTIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registratjon with the Builder's Board because: Additional Project Informat'ion : PLANS REVIEWED BY: name sig nature date