HomeMy WebLinkAboutPermit Building 1987-06-05EN
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726-IT I
37
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COI'18I IIATION APPLI
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l-egal Description -o
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Address P, o. Box
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PLUIlB I NG EL ECTR I CAL I,4ECHAN I CAL
v Each single fixture 7tu ??5a
Res idence of
SQ. FT I
furnace/ouinEi-to
--BTLI' S 6."'Relocated uuildrnq
(new fix. additional )ur'New circuits altsor extensions2 aP ) 6.8€??.s"
Fl oor furnace
and vent
. Residence
SERV I CES Recessed wa'l I
Dupiex (1 bath) each
Additional bath Temporary Constructi oJr Apol iance vent
l,later servi ce Change i n exi sti ng
ro< i danao er
tationa r-v evap.
Sewer multifami1y, comm. orIndustrial Vent fan rvith
sinole duct20Storm Seurer ?o.*of
-%--q*pr.7o1,75+Vent systern apart fromheatinq or A.C./fur*z.arySra '27)7.5>
2
c0l{r1./lND. FEEDERS illechan ical axhar/st
hood and duct
I nstal I /a I ter/rel ocate
d i str i b. feeders l'lood stove/heater
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ISSUAIICF OF PFRI,lIT{e
STA
ALTOT CHA eRGES
IcTOTALGESHAR @PTOTCALGEHARS
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ICE
Uni ts
Flood Piain Stories
TOTAL VALUATION
Load
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q.E.IG rou Val
Tone ,tV Cons t
Fire Zone Bedrooms occv
Valu
Val ue
Fto. llain
Ftg. Access x
F tg. Other /21rd>E s__)<
Plan Ck. Comm/ind
65%/B1dq Per Fee &,Q3 bN3?7 Systems Deve
Charoe ( 1.5r.
o pmen t /v4BUILDING PERI,lIT
Ctrarges and
Surcharqes
__!_/_ ___}.Plan Ck. Res
30%/81dq Per Fee
Fence t6t f,-oPLUI4BING PERMIT
Charges and
Surc ha rges -42C--5-a aa
Demo
Sidewal k ?3' ,'/6, ?tr
"t
. ELECTRICAL PERIlIT
Charqes and
Su rcha rges A/C Paving Total Cornb. Permit
Curb Cut 30'/.so
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NECHAN I CAL PERI,I IT
Charqes and
Surc ha rges TOTAL 2,5-/.23
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Address phone
seoa rate
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PERMIT VALIDATION
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Permi t Cl erk
coMBINATI0N AppL ICATI0N/pERMIT ( CAp)
I . App l i cant to furni shA. Job AddressB. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. B]ock 3, Znd Addition to
SpTlngTield Estates
C. Name, etc. of owner and construction lenderD. Energy Sources
1. examp l e- heat/2. example- waterE. Square-ilotage or
electricai cei I i or forced air qas
a ter CC CA or sol ar
valuation,c.
II
III
IV
l. examole- 1250- sq. foot house, 500 sq. foot garage2. g1eqSi* if new project, check new - if aOOit.i on,cnEEFi-ad, etc.F. Building permit information:t. examole - construct single family house with an;ttached garage
2. q lrple - remodel existing garage into family room3. example - convert single iamity-resiOence intorestaurant (change of use)G. Value of work as defined.in Section 303 (a) of theStructural Speciaity CodeH. DESIGN TEAI,I AND CONTRACTORS
To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriatepersons re-oarding design information or job s.i tecorrections, etc.
Abbreviated Plumbing, l,lechanical, & Electrical SchedulesA. Except where blank spaces occur in the descript.ionportion of the Mecnanical and Electrical Schedules,the appl icant need fill-in oniy the No. Boxes adjacentt0 the appropriate item(s) to be.installedB. Full Plumbing, I'lechanical, and Electrical Schedulesare available at the Building Div.ision1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful 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 s.iqnature by his electrica.lsugervisor. The general contractor is not authorizedto sign the electrical label.Applicant to sign and date
Hhenever oossible, the.initial application will be used asa.rvorksheet only. l,lhere possible, Building D.i vision Staffwill preoare a type written copy and return it to theapplicant at the time the actuai permit is issued for hissignature.
Fees ano Charges
Plan cneck 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 andpayable when the permit is .issued.
FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFiED BEFORE OCCUPAIICY:
Perm'it applicant exempt from registratjon with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY
name s'i 9na tu re da te