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Home My WebLink AboutPermit Mechanical 1988-12-27E COHBINATI ON APPLICATION/PERMIT 7 26-37 53 Job Address 6 ,{ l-ega1 Description EIIERGY SOURCES Hea t t,Jater Heater -Val ue of l,lork Ran Sq. Ftg. Access._ Sq. Fta. Other__ _l{ew-q66 A'l ter_P.ep. _Fence_Demo_C han ge/ U s e 0ther n 0wner M /( t/,, Z C Gara 'e., Build Singletr,inq Pernrit In Farni I o: DescrPhoneAddress Sz rq C Ots /r,/c ro j czs 72;, ', 4 uc.r77Constructi on Lender 4 o0 ()tr PhoneAddre s s exor resaddre s s lics. noDES I GN TEAI.I name Pri mary Structura I ElectricaI 2 {\ou Hechanical ohone no.I i cs. no.'exoi res )address )n ame Genera I zltr/) st,6zt'lecha n i 'I 3oq/'325/ / 2-/- MECHAN I CALELECTRICALPLUIIB I NG FFF C IlARGFFFFNHARGFNO(.I]ARGF NOFEENO furnace/burner to BTU' s Residence of FTSQ Fl oor furnace and ventRelocated bui lding (new fix. additional ) Recessed wal I Soace heater and veniSERV I CESS. F. Res i dence(l bath) Duplex (l bath) each Apol iance vent seoa rateTemporary Constructi onAddi ti onal bath Stati onar,v evap coo l er ge i n exi sti ng dence Chan rps il^later servi ce Vent fan with sinole duct multifamily, conm. or IndustrialSewer Vent systern apart from heatino or A.C.0f SStorm Sewer Mechanical exhaust hood and ductcor.il.!./lND. FEEDERS l'lood stove/heaterInstal l /al ter/rel ocate di stri b. feeders E,*.&ro'-0-,".,r-t- *athamp s.0f =L) ) ISSUANCF OF PFRI1IT I TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES WHERE STATE LAt'l REQUIRES that shaII not be valiI untiI the Iabel the Electrical work be done has been siqned bY an Elect by an Electrical Contractor, the electrical portion.of this perrlit rical Supervisor and returned to the Bui lding Division S I GiIATU REa"l,lAl.lE(please print Qrtr/,ra,rrS ? empt w.iI0tls t erusntformaonreonhedoerehcertfathatandctaforonrmrtetaedb-y vDE!")pFULEXAIlcorilp t 0rd na snce of Cithedonencc0aanrdwlcerhhermedhsabetandaworkrrerfoafrcertrhatnycrrecotdanrthUendafy ty deW1maberehenantdthaOCNCCUPAI.ICYnntoethkworrbeddeschettaSetfonrDEtaof0reoILa tJsherfieanddtfSpnq t thh Bue der sthasttraonfurt h cr rte ts0nfy regm.yBudDihetfonnrlsructUtrehottUethsfpermoany n nda ath tnotednohereobasforstheexexempttthaared0n701S550rdfnUfo rce na efd tfecBoas requ by tUSedthsroecpceanthwt7n7055dansarvhorecomDnnoubconSto rstrac,v emp oyee E OiIL TOTAL VALUATION Fi re Zone-Bedrooms OccY .0ther Ftq . t'la iUnits Sto ri esFlood Plain Access ValueZoneTyoe/ Cons t Load Sq.Ftg Group Sq. Ftg x Val ue x Value opmentSysterns Deve charqe ( 1.5% an Ck. Comm/l Plan Ck. Res 30%/Bldq Per Fee BUILDING PERNIT Clrarges anC S u rc ha rges Fence Derno PLUI4BING PERMIT Charges and Surcha rges Sidewalk Tota'l Cornb. PermitA/C Pavi ng ELECTRICA,L PERIlIT Charges and Surcha rges Curb Cut t5,rl5TOTALCharges and Surc ha rge s l5,co l.p ,14 },IECHANICAL PERHIT ]TORS Each sinqle fixture New ci rcui ts al ts. or extensions i/\ COMBINATION APPLICATION/PERMIT (CAP) I. Appl i cant to furni sh A. Job Address B. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 1f-0-tT3 ?. example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources1. gr3rp.lc- 2, exampl e- E. Square foota heat/electrical ceilinq/ 'heater/eIectricaI/o val uati onl-GTil- or forced air ggs water r solar 9e or foot house, 500 sq. foot garage c -qI_q_ry]_L 1250 sq er!mp-l_9- if new check add, etc. project, check new - if addition, F. Building permit information: i. gIg[!]S- - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into iElTiIFant (change of use) G. Value of work as defined in Section 303 (a) of the Structura'l Special ty H. DESIGN TEAI.I AND CONT ' Code RACTORS II To avoid design or construction delays, Bui )ding Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where bJank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fil l-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full PIumbing, Mechanical, and Electrical Schedules are available at the Bui lding Division 1. To conserve space on the permit fornr the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedul esC. BUILDING DIVISION STAFF t,JILL 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. Applicant to sign and date Whenever possibie, the initial application will be used as a worksheet only, l,lhere possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signature. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans r,ri11 be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. III T\/ V. FOR OFFICE USE ONLY PERMIT VALI DATION 4 lZqoo Permi t clerk d) /4 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: Perm'it applicant exempt from registration wjth the Builder's Board because: Addi ti onal Project Informati on : PLANS REVIEWED BY: name Si gn ature date