HomeMy WebLinkAboutPermit Plumbing 1986-09-04q ii
Itl
7?
TI
69
C
coHB I ilA IONICATI726-IT
3
ONL ilE
Job Address JKrl
l-egal 0escription 0e-o60
Hea
Ranqe
EIIERGY SOURCES
l,later Heater
Owner
Val ue of l.lork
rtg. Acc"--
Sq
5q
Sq
I ter llep.
' Change/Use
Ftg. l.lajn
. Ftg. 0ther
Add res s Phone n
F
n
I'|
Descr
tac .e., Bui I ng e
Constructi nn Lender
Addre s s Phone
ca
o
o
6-
Ns
name add
Pri ma
St ruc tura I
E I ectri ca I
l'lechanical
S
E lec
PLUIlB I NG ELECTR I CAL MECHAN I CAL
Each single fixture Residence of
SQ. FT
furnace/burner to
BTLI' S
Relocated bui ldinq
(new fix. additional )
New ci rcui ts al ts.or extensions Floor furnace
and vent
S.F. Residence(1 uatn)SERV I C ES Recessed wal 1
Duplex (1 bath) each
Additional bath Temporary Construct ion pol i ance vent
llater servi ce Change i n exi sti ng
res i denee
Statjonary evap.
coo I er
Sewer multifamily, conrn, or
I ndustlli a I
Vent fan with
sinole duct
Storryr Sewer 0f Vent systern apart from
ieating or A.C.l,il V-a"rM-COI,II'!. /IND. FEEDERS Mecnanica l exniulT-
_hood and ductAtuoD/b -n"
Instal 1 /al ter/rel ocate
di stri b. feeders t'Jood stove/heater
0f
/ .zo
ISSUANCF OF PFRI'lIT
(ALTOT HARGESC LTOTA CHA RGES
)e EI triec Ica kw0r be done Ian Con rat rcto the I ect rl ca '|'It on of ht sIpor '|thaperms1nednbeesEanecIIby
bytri ac SuI 1perv andsor turnre toed Buthe d'I'|1 n 'iD Is 1s on
TOTAL CHARGES
HHERE STATE LAt,, REQUIRES that tshail not be valiC until the label
l.lAl.lE ( pl ease pr.i nt )S IGiIATURE.Db\D
DA'
0reqron
the Bui
XAIl N e ted Lcompap a onti forl')trmi a rehe ceDEb.v rt tha atfy n rrnafo onti reonheandtcorreca truendcefu rther rt t tha a nd aaf-v ny wor k Der rmedfo ash be done n cordaac enc wl th het 0rd ifo na nc ofrfed the cSPandth tyngwsLaftheStetaofDErtanltheLUwokngrdescrbednhere i and th at NCof ,AIICOCCUP wtruta madeberectut houwlny tt he Dermi ss o ofn d n Dg on fu certrther tthafy s ttra nBordare9m.y v/l ht Bthe u rnfude sf,rceo dan ffece at s u redrecl 7ORS 05501by t tha f t ba sheexemDt fors e xempt on n0on ted he reon andubconstr hat tlyacantorsdsemr)oyee who rea n comD an wlce 0r?sth 701 0 55 be u sed no th s ectoroj
Ev BESr
USE
Ftt-:
Ftg
Ftg
Zone its
Value
ToTAL VALUATI0N_
x
x
I up
ValFi re Zo
Const. Un
Flood Plain Stories Occv
.l'lain
Acces s.
0ther
Load (n<t.
Group So.
Plan Ck..onmmd
65%/B)dq Per Fee
Svs
Cha
pment
rqe )
tems Develoi. 5z
BUILOING PERI'IiT
Charges and
Surcha rge s Plan Ck. Res
3A./s1dq Per Fee
FencePLUI4BING PERMIT
Charges and
Surcha rges
' //)
-----.2 O,Y
/ ,20 Deno
Sidewa l k
ELECTRICAL PERI:IT
Charges and
Surcha rqes A/C Pavinq Total Comb. permit
Curb Cut
I,IECHANICAL PERHIT
Charges and
Surc ha rges TOTAL 7l.za
q
seDaratP
/7-
El ectri ca e
t
si
coilBrNATI0N AppLrCATIoN/pERMrT (CAp)
I. Applicant to furnishA. Job AddressB. Legal Description
l. example- Tax Lot .l00, Lane County Map Reference
T7-03-432. examole- Lot 1. Block 3, Znd Addition toS[fingTie1d EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
1. examol e-2. Examtle-E. Squa re Tio-ota
heat/e l tri ca cei Ii r forced air qas
wa ea e or solar
ge or valuation,etcl. examole- 1250- sq. foot house, 500 sq. foot garage2. examEiEr if new project, check-iEw - if additio;,
check add, etc.F. Building permit information:l. elamo1e - construct single family house with anattaclea garage2. example - remodel existing garage into fam.ily room3. glqfnpfE - convert single iaiily-resiaence intoiEETiIFant (change of-use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI.I AND CONTRACTORS
To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriatepersons regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the l'lechan'ical and Electrica) Schedules,the applicant need fil l-in oniy the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare avai lable at the Bui lding Division1. 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 labei must be delivered to theeiectrical contractor for signature by his electricalsuoervisor. The general contractor is not authorizedto sign the electrical iabel,
Applicant to sign and date
l,lhenever possible, the initial application will be used as
a worksheet only. tlJhere possible, Bui lding 0ivision Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his
si gnature.
Fees and Charges
Plan check fees are due and payable at the time of the
appi ication, and no plans wil l be processed until thesefees are paid. All other fees and charges are due andpayable vrhen the permit is issued.
FOR OFFICE USE ONLY
aroll
II il
III.
IV
v Permit Clerk
trr ca
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project information :
PLANS REVIEWED BY:
datenamenaturesig