HomeMy WebLinkAboutPermit Plumbing 1986-11-18tiq€ ,u t NDJ
I IIE u I TY 0F SPR I llGF I tLD
COIIBI iIATION APPL ICATION/PERHIT
NL 1,rL
726-37 5:
I
C
L(
Pri ma
S tructura I
E l ectri cal
l'1echanica l
Genera
Plumbin
Job Address 5rFt
l-egal Description
Ran OP
llater Heater
EIIERGY SOURCES:
Hea t
n A
Owner
Val ue of l,lork
Sq. Ftg. Access._
Sq. Ftq. Other__
ller.r Add Al ter Pep.
_f ence_Oerno_Change/ U se
0ther
So.q.
.\ddres s 3 Descr l.io rk
Fami I lr
ng etn
sidence lli h
O,
Construction tendetd t
Addre s s Phone
name I ics. no.exo i res phone no.DES I GN TEAI.I ( addres s
MECHAN I CALELECTR I CALPLUTlB I NG
furnace/burner to
BTLI' sEach single fixture
Fl oor furnace
and vent
New circuits alts
or extensions
Relocated building
(new fix. additional )
Recessed wa l I
SERV I CESS. F. Resi dence
Duplex (l bath) each
Apol iance ventTemporary Constructi onAdditional bath
tat onary evap.Change i n exi sti ngflater servi ce
Ven t n withmultifamily, comm. orSewer
Vent system apart from
he0frm
i{echan i ca au st@c0r"1r.!./lND. FEEDERS
I'lood stove/heaterInstal I /al ter/relocate
amps.0f@
ISSIJANCE OF PFRI'IIT
TOTAL CHARGESTOTAL CHARGESTOIAL CHARGES
IRES that the Electrical work be
the label has been signed bY an
an Electrical Contractor' the e
cal Supervisor and returned to t lectrical Port'ion of this Permit
.he Building Divisiondr
E
one by
I ectriI,IHERE STATE LAN REQU
sha I I not be val i 'l unti l
r-l 6{
S IGiIATURE0-t /l-=I'iAl.lE(please print)
TE
s truethereononnrrnafotthaahertrmianddoeb.vonrfoacLDEhee tedDINEtcomp !-)ap the LInasnceof tyULLCAP.EF 0rdththeanordcew1nedonccashaberkrmedar"l0 perfotthaandrfuctherertany be madendcotrrecaf"vnd AI.I l.r 1athaOCCUPtilcrenandhebeddescriworkenthtoo0nSteta0ofoe rta ngreawsLfothe ui rdeneandthedthethoriofSsatrtvll0nsfitthare-qfuhertfyrn.yrnoBuidD ha ttofnethngandsSthewlhottupermirenhereontscturuaoft0nsotednyexemr)fo rhetbasSfetthaxempts5701ORSredeffatrequbySandrcefofu tnsrdBoaothnsnro.jusedbenwi5057()RS 1cew1anreancomcwhorsndaontractosubcoemDoyeesv
?ob
Uni tsTyoe/ Con s t
TOTAL VALUATI
xSo
Zone
x
l'la i n
Fire Zone Bedrooms 0ccY Load
Flood Plain Stories -0cc.v GrouP
Val ue
Ftg
Ftg
Fts
Value
Access
0ther Val ue
opment
1. 5ttems
rgeanCI
lan
1d
Res
BUILDING PERI''IIT
Charges and
Surc harges
Fence
Demo(dC-L5.PLUI4BING PERMIT
Charges and
Surcha rqes
Sidewalk
Total Cornb. lermitA/C Pavi ng
ELECTR I CAL PERI'IIT
Charges and
Surcha rges
Curb Cut /5"bcr 0TALI,IECHANI CAL PERMIT
Charges and
Surc ha rges
z) rr L/
(
|. H AACFFFFat.tA0cFFFFNN
Residence of
sQ. FT.
(nena ha:ian and vFnt
cpnaretp
e nol pr
c'inolp drtctTndrcl-ria
,*^kn 0 "*f
rli ctri h fppdprc\
I
SIcerti1SI
II 'IthI
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, 2nd Addition to
SpFr'is'Fi el d EstatesC. Name, etc. of owner and construct.ion lenderD. Energy Sources
1. example- l?50 sq. foot house, !!0 sq. foot garagez. "I.;p]C. Tf !.w project, irrecr<-new - ii ijaiiioi,check add, etc,F. Building permit informat.ion:1. example - construct single fam.ily house with anattached garage2. examole. - remodel existing garage .into family room3. exarblE - convert single iufiily res.idence intorestaurant (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 de.lays, Bui)dingDivision Staff must be able to contatt appropriitepersons.regarding design .information or 3ob sitecorrections, etc.II. Abbreviated plumbing, Mechanica.l, & Electrical SchedulesA. Except where blink ,pu.., o..r" in the a"sc"iption--portion of the Mechanical and Electrical Schedulei,the applicant need fiil_in only the to. aoi.r-ijjii.nt_ to the appropriate item(s) to -be .installed
B. Full Plumbing, Mechanical, and Electrical Schedulesare avai lable at the Building Divisionl. To conserve space on the permit form the schedu.leshave been abbreviated2. If the item(s) to be instal.led are not covered onthe abbreviated schedules you should .onruit-tn.ful I schedulesC. BUILDING DIVISION STAFF I.JILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectricar contractor for signature by his .i.iiri.ui ''
supervisor. The general coniractor .ii not urih;;i;;;- to sign the eiectrical labeilII. Applicant to sign and datel,lhenever possible, the.i nit.ial application wil.l be used asa worksheet ontv. Where possibr!', euifuing oivili";.;;.;iwill.prepare u iV?9 written copy-anA-return it to theappticant at the time the u.irii pl.rit is iiiuei io,^ ni,s i gna ture.IV. Fees and CharoesPlan check feis are due and payab)e at the time of theappiication, and^no ptans wiii"b;;.;;...ed unt.il thesefees are paid. ett btirer i.", uro".ilrges are due andpayable when the permit is iiiueJ. -""
V. FOR OFFICE USE ONLY
forced air qas
oEr----
or
ewat
1 ceili
ec tr ca ors
hea t/ e
e or valuation, e
1. examol e-
^+-t. examp I e-E. Square footag
PERMIT VALIDATION
Permit Clerk
(t
gb
(-
b(,1 1
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Pe rm ti a I anC tpp ex t femp rom re si t ra .Itg no wi th t he un
D 1 ed r S Boa rd beca su e
Additional project Inf ormation:
PLANS REVIEWED BY:
da te
name s'l gnature
U/
i
I