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HomeMy WebLinkAboutPermit Building 1987-06-05EN L Ii]EIIISP 726-IT I 37 DJob Address I COI'18I IIATION APPLI 7\ s;T'. l-egal Description -o Val ue of C 1fe. me re c? -zr*23- oz Yo 5q. Ftg. Acc ess .e., Euild S ngtnDecSr di cen e l.l At ta (, IPhone o. Ftg. Iiain Ilo rk ra Construction Lender Owner r€ \sc-I t*l O P*t.^r (, ki c<- -, Convzrf €,(f JTO ^ Sq. Ftq. Other _Hew _Addxp I tEF-TEo . - _Fence DemoJChange/Use 0 ther Address P, o. Box 'lc Pri ma (7'L 8..a:rr S truc tura I ,b Electricai llechanical .CTORS name )(lics. no.(exo i res Dhone n.) Genera l ui ^Q ( . ffeQ'I umbi D e (,se {acTc Iq-cal Vaa-+6 x3- 6'LG2? o. ?. x S-locc< crf?-€oC ( 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 0f . f;.1-\- " - ISSUAIICF OF PFRI,lIT{e STA ALTOT CHA eRGES IcTOTALGESHAR @PTOTCALGEHARS l.iH ERE TE ANL RE SRE athQUI thet IE t r Ica be dowor"k ne a n E eI rct 'Iby ConI rat ctor eth eI ,lctr ac l rto oni thof 'Isp s fhaIItnoDern tVA'II un,J 'Ibet theI aI Ibe bhas een ,|s an EIg ned by ec catri I s0I andr tureSupe rv torned t he Bu I'I d ,l Di i Is 0nng I NiIATURE (-l=,.,-llAilE(please p.tnt) e-c vL/,16ls f-yfy fyany rd xemDt 5 wil H VE Y ehet ted tca ncompap!')rfo tDerm dan hedo re rtce t tha a frb.v n 0rma t n reonhe s rut eandctco rre a nd fu cerrther t ttha a t^/oaand oe rformedrkny sha be nedo n ca rdco an ht 0rdthe nao snce theof CiDSr1fednda tytheofLawsngsthettafoeon0reqrtanntoDCworthekrscgbedrehenandtthaOCIICwlCUPAI.ICY madebeofrutuctrewIhotLuthesnpermoftheUdDisonnqfutherrcertatthrattvJt0nregm.y tth Buhe rde sBoaSnufrceforndafecefasturedreq7ORS0055bytthafebaSfosrtexemDt0nsnnootedreonheandhat tSntru bcov toac andrs o r^rhoernp are comDn nca wi th 0 7PS 0 05 be sedU n th s CCnro,j ICE Uni ts Flood Piain Stories TOTAL VALUATION Load u"--ZZDF 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 .6,0 ao v ??.sa z NECHAN I CAL PERI,I IT Charqes and Surc ha rges TOTAL 2,5-/.23 e Address phone seoa rate #a PERMIT VALIDATION n v \\f 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