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HomeMy WebLinkAboutPermit Plumbing 1982-12-281?6-3L 1NE ERMITCOMBIiIATICATI Job Address Lega1 Descri ption U )Ranqe- Hea EIIERGY SOURCES: lJater Heater n Val ue of llork Owner Ks.* Sq. Ftg. Access.--- Sq. Ftg. 0ther_ J{ ew_Ad d_A 1 te r_Re p . _Fence_Demo_C han gel U se 0ther Sq. Fto.n AddrG s s PhoneC Builriinq Pernrit Info: Describe Work( Farnily llesidence l,lith Attached Garaqd ng e T Cons tructi r Addre s s Phone DES I GN TEAI.I name addres s l ics. no.exoi res ohone no. Pri ma ry Structura l i"'lec ha n i ca l CONTRACTORS n ame add res s I ics. no. )exDI res (ohone no-' era I PLUI,lB i NG ELECTR I CAL MECHAN I CAL Each single fixture Residence of SQ. FT furnace/burner to BTU' S Rel ocated bui l d (new fix. addit ng onal ) New ci rcui ts al ts. on extensions Floor furnace and vent i dence SERV I C ES Recessed wal I Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent [^later servi ce Cha in existing tati onar-v eva p Sewer multifam i1y, comm. or Vent fan wit Storm r 0f rt fromVent systernti COI,lI.l, / IND. FEEDERS han i ca exhau s t Install/al ter/re'l ocate tr'lood stove/heater 0f ISSUANCF OF NgB1111TOTAL CHARGES TOTAL CHARGES TOTAL CHARGESREQU nti 1 r/H EER TESTA LAL,J RES th a t the ecE'I tri a berkwohas do ne LI ecnaotn t crt abea,j ntraCou ttocrthea he e ecbeha tr L abeen rtp0 0n ofgnedan th SbyEIec t bytri ac c permis0rupeandreturnedttoheudiDisvlonng I'lAl,lE(please print IGiIA fyoermi t rfo rmedof any Boa rd that m.y regis tor exemDtexemp 55 vri E FULL D the e tedcomp ca ontindaapp rfocomectand an dodfu herther rtcecertreb.y thatLha tfyand nanya forma L 0nkl^/Or h ereonto 'I +spe ruesprfieadshabengdtdonenheWSLaacc0theofrda nce w1Sta th tteof he 0rd n a nces0reqonn 0 fDe rta n toSrut the LgthurectkwordethouI^l l sc r bedtthe hereerm n a ndpssn0 th taof Ctt 0cctheBud UPANCYD lrllsnngson be mafufu ty deforcert herand cer tieffectas fyredu1 sreqORS tra t nby701 thy/ton055 Buthesubcovthatf derntrac t storsdanthebasesefirp0yeawhonrennheotedcomDNCawlreonhtnda7070r?s ttha0beused0thnectproj Zone Fire Zone Ftg Ftg Ftg, 0c cy Load Bedro oms Val u e xFlood plain Stories Group Iue Value Type/Cons t llain TOTAL VALUATION - . Access . 0ther an nd terns DeVe 5% BUILDING PERI,IIT Charges and Su rcha rges opmen tanP5 B F Fence PLUI4BING PERMIT Charges and Surcha rges Dgmo Sidewalk ELECTRICAL PERI|ITunarqes and Su rcha rges Total Cornb fermi t A/C Paving Curb Cut IOTAL o0 to El ectri cal I,IECHAN ICAL PERIIITs and rges \1()s,2.lst.St- -l U FFF .HA PNF NN FFF .HA DNF Irn FEF CHAPNF lr I L-\0f'r\-Xh t,,r 0 1 s PERMIT VALIDATION Permit Clerk d& ? htotM COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descr.iption1. example- Tax Lot 100, Lane County l"lap Reference]7TTT32. ggru]e; Lot_l. Btock 3,Znd Addition tosprrngfieid EstatesC. Name, etc. of owner and constructjon lenderD. Energy Sources1. exampl e-2. exarnple- E. Square footag hea t/e i trica i wat ea e ec r forced air gas or solar e or vaiuat O[, l. examp'le- 1250 sq. foot house, 500 sq. foot garage2. examp'le- if new project, check new - if addition, check add, etc.F. Building permit information:1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room3. example - convert single family residence into restaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS To avoid design or construction de'lays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc.IL Abbrevjated PIumbing, l4echanical, & Electrical SchedulesA. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Div'ision L To conserve space on the perm'it form the schedules have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult theful'l schedul es C. BUILDING DIVISION STAFF l^llLL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label. IIL Applicant to sign and date Whenever possible, the 'initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnatu re . IV. Fees and Charges Plan check feis are due and payable at the time of the application, and no plans will be processed unt'il these fles are paid. All other fees and charges are due and payab1e when the permit is issued. V. FOR OFFICE USE ONLY PROJECTC0NDiTIONST0BESATISFIEDBEFoRE0CCUPANCY Su ebecaaBordI.I erd sButthheon1WS1rattfromreg'iI anc exempttarmPetpp Addi t'io nal Proiect Information: PLANS REVIEI^IED BY: s i gnature name date