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HomeMy WebLinkAboutPermit Building 1989-07-03l-eja I Description 776-175i/o, t\ A llea Y 0il rAT . _:t t coilB I ilA lilSt)tcit0ll 126-37 <,9 tLll Job Address 4 Z r ERHII l[L 0N/ ilu CA t/a ter llea tcr Ra nqe EIIERGY SOURCESloc 5t L ct,> Owne r Va lue of l.lork:8l Z cto o-e 5q. rt9. Acceil- 5q. Ftq.0ther llew_Add_Al G;-T;t- _t ence_Demo_Change/Use 0 ther 5o. F tq. l.ia i n .\rld rcss /P lron c H rkno I' lle s (tuI e rnl 11 lllF d ce ild Sing eh nttac dlJi Desc r r bet Info Constructlon LGiaer / ,\dd re s s l)hotrc rlante s I Structura l Electrical nera l ectri PLUIIB I IIC ELECTNICAL Each single fixture Residence of SO. FT f urnace/burner to _- BTtt' s Re oc a de bu d n9 new x dda on a r''or ex ten I ons New circuits alts.F'l oor f urnace and vent Pes encet a SERV I CI5 Recessed wai I Duplex (l bath) each Additional bath Temporary Construction Apol iance vent l,later service Cha nqe in existin !tat'ionary evao Sewe r nrultifarrri y , conlm. or I an t,J thVen t torm S 0f Vent systern apart rom c0r4il./lND. rEt0[RS i ca I exhaus t t',lood s tove/hea ter .amp s.0f I ns ta I I /a I ter/rel oca Ce ISSUANCF nF pFnrtlT TOTAL CHARGTS TOTAL CIIARGES sa TOTAL CIIARGES Sl,ilEnE AT T E 1l,r Snt hatREQU t re E ec rt CA rkt.Jo donbe be an I ec rty C r'l raCon t c rshato he e tecbetno r ac no ftUNporo rh tbeahepe rnbench.r s ned a nI t e c r abyc Su r rope reand rntU toed he Bu d 5 onn9 ItA!tE(please print) I NiIATURE TE ctlPA CAI?t t_xAl !re c (:oilrl)ted d c r'l nnp o r)r rilt IC a nri do he re cc raLrv tha atndan n o rnta ond he reon sUr erUr the cer hat t-V a nd a t./oany DCrk sr f o rnred ha be done n a cco rd cen t horf 0he rd naada nce o hen9ndeth cLows vShetaoef0reoonrpanntotheworkdICesrbedhterenndahaoilctOCYtrucuilctvlmadbenyrehouehermDCsonohell tr (l t1 D one rBourthe C re t hdrdsnfuv my tra on thoccndreq the uB rdeecct)rc(l red c0ll 7 05 5 ha eon xeil[)he sba for ex telnDvbconcril s no edtornd he reon a th anderxprvhooyeesraecoflrDnnceths0lrl()05 5 U5 onedbe h s tccro.jt) Value TOTAL VALUATIOII Sq xf,-/r ts. otnurfurVe-ry2E< vu 0c cy Load Iue Gr| Value Group Zone T ynelCons t Flood Plain..-.stories tjni ts Acces s llainFtt Ftn F i re Tone_Bed rooms P lan Conm/ I nd rqe 1 .51 stems 0eve opnlen tBUILOIIIG PERI.IIT Charges anC Surcha rges I Plan BI Ile s Fee FencePLUt4B IN6 PERI,lI T Charqes and Surcha rqes Dcrno SidewalkTLTCTRICT.L PINI:IT Charqes and Surcha rge s Total llornb. lermi t 38A/C Pavinq Curb Cut IrtcltAlilcAL PtRtltT Charges and Su rc ha rqe s T0ThL 4?. /v Pri ma llechanica I Pl anl al NICIIAN I CAL T e., ri tco rrec t .tof s s s sastron ---Z?rF-?- COMBINATION APPL ICATION/PERI,IIT (CAP) I. Applicant to furnishA. Job AddressB. Legal 0escriptionI. example- Tax Lot 100, Lane County Hap ReferenceTTll-[r' 2. exanrple- Lot l. B.lock 3, ?nd Addition tor Sprlrffield EstatesC, Name, etc. of owner and construction lenrjer0. Energy Sources Pernrit Cler PERMIT VALI DATION I . exarnole-Z. examo I e-E. squaiE-?6oG examo I e- ex a.rpie- cFdaf-add 2 Buil hea t/ectrical ceili /or forced air gas wa Ier e tr ca solarge or valuati orlr e 1250 s q. foot house, 500 s q . foot g.r ra 9eTT-ri'ew project. check new - if additi oo', etc F d i ng permi t crgr!_lg - c attached g,l examole - exarrriiie - information: onstruct single farnily house with anrd ge rcrlodel existi n9 fa nri ly 9a rage res idence into 2 3 convert s i n gle into fanri ly roorn res taurant (change of useG. Value of rvorli a s defined in Section 303 (a) of rheStructural Spec ia I ty CodeltDES I GN TEAI.I ANO COI'ITRACTORS To avoid design0ivision Staff i or construction dcla ys, tluildingnlust be able to conta ct appropriatepersons regardin g design jntorrnation or job sitecorrec t i ons etc.II. Abbreviated pl unrb i ng , I'lechan.ica I E Electrical SchedulesA. Except rvhe re blank spaces lonportion of the Mechanica occur in the descrrpt and E lectrical Schedu les,the appl icant need fi I l-in only the No. Boxes adjacentto the a ppropriate i tern(s) to be installedB. FulI Pl unrbing, l'lechanica are avai lable at the Bui I, and Electrical Scheduleslding 0ivisionJ. To conserve space have been abbrevi ,on the permit fornr the schedules a ted2. If the item(s) to be installed are not cov ered onthe abbreviated schedules you should consu It thel'ul I schedulesC. BUI LDING DIVISION STAFF I.IILL FI LL OUT ALL FEES ANOCHARGES ON TIIE sCH TOUL ES0. As notetl on the CAP, the label rrrust be deliv ered to theelectrical con tractor for si gnature by his electricalsupervi sor.The general con tractor is not authorizedto sign the e lectrical labelIII. Appl icant to sign and da te !'lhe never oossible, the ini tia l appl ication wi I I be used asa worksheet onlvwill prepare a t Hhere pos sible, Building 0ivisi on Staffype wri t tenapplicant at the time the ac s i gna ture PLANS REV I tI^/[D BY : Fees and CharoesPIan check feis are due arrd payable at the time of lheapplication, and no plans,riii'tre p."."rruo until thesetees are paid. All orher fees antl.;;;;;;'are <Jue andpayable when the permi t is issuea. ,rvr rLJ FOR OFFICI USE OIILY copy and return it to thetual pernrit is issued for h.i s IV PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY Board l-:ecause: P e rm t a cI na tpp e eill t f ronl erp i tS r a jt wong tj Ir t he uB ed r S Additjonal project Information name signature da te I I.l