HomeMy WebLinkAboutPermit Building 1990-08-03-IN
72
ONL 6-3753
ng leDescr
ami I
Phone
I
rknnPhoneJ
{
Sq. Ftg. Other__-__--Hew "Add Al ter-A;E:-
-FencE De-mo Chlnge/Use
-Otn..---
Hea t
l,later llea ter
Ftg
Ran
,8;ao'd
t''la n
c
EIIERGY SOURCES:
Val ue of llork
Legal DescriPtion
Job Address
Owner
Address
LenderCons truct'i
Addre s s
Sq. Ftg. Access.-.--*$bD
-E\DA
tq
I
Pri ma
Structura I 0
El ectri ca I
Mechani cal
MECHANICALELECTR I CALPLUTTB I NG
furnace/burner to
BTLI' S
Residence of
FTSQEach single fixture
Floor furnace
and ventNew c'i rcui ts al ts
or extens i onsRelocated bui1ding
(new fix. additional)
Recessed wal I
Snace heater and ventSERV I CE SS. F. Residence(l bath)
Duplex (1 bath) each
Apol iance vent
seoa rateTemporary Constructi onAdditional bath
Stationary evaP.
cool erChange in existing
res i dencetnlater servi ce
Vent fan with
sinqle ductI ndus tri a I
multifamily, comm' or
Sewer
Vent systern apart from
heatino or A.C.0f
Sto Mechanical exhaust
hood and ductcoMr.t./IND. FEEDERS
l,lood stove/heaterI n s ta'l I /a I ter/ rel ocate
distrib. feeders-
0f amp s.
ISSUANCE OF PFRI1IT
Flood plain Stories Occ.y Group Sq
S IGNATUREt{AtlE(please pri nt)
Ftg
Ftg
Ftg
TOTAL VALUATION-
fl-3- o.l
DATE
Zone
!q
t 1
Val
Load
its l'la i
Val ue
exemp
055 wi
n s trueIfo'Irmat hereoonIc'Iert f ttha andaheredocaontrfo'|vb-ytted0ernlIEDNhetappcomp 0 f a 'Ithe0rdnances'I tythenardancew1thIhabeIIdonecco1rkw05rformedaInda1hattr)I efu rth cer rtand anyfyc0ecrrtnda '|II madebeNCOCCUPAI{CIrendanthatkbeddescrihe'Inta 'In to eth w0rng0reStetaofpe00nfid'I tand Lawshe theoffoSengpri I r sIthttiButheIdettt0nrahefurtcer1rtthareg iIfym.y1dD1s1onI'Iss theof 'IBuiutwlthhout ngeofatsctrepermiru nd tha tnytedhereonanofor0nIs1tba'Is sfthe05517 exemptttha1redIORS0Iandforceefecas+byBordasIn11furequ ect1s'I beI su on thht7010r?sat'II ncare wleandIswhousonbc0rstrac t 0yee c0mpIonempv
an Electrical Contractor, the electrical port
cal Supervisor and returned to the Building Di
'ion of this permit
visionWHERE STATE LAt'l REQUIRES
shall not be valiC unti'l the
that the Electrical work be done bY
label has been signed by an Electri
TOTAL CHARGESTOTAL CHARGESTOTAL CHARGES
Acce s s.
0ther
Fi re Zone-$edrooms OccY
opmentSvstems Deve
charge (t.51Plan Ck. Comm/lnd
65%/8ldq Per Fee
Plan Ck. Res
30%/Bldq Per Fee
BUILDING PERI'IIT
Charges and
S u rc ha rges
,DD
Fence
DEmo
PLUI4BING PERMIT
Charges and
Surcha rges
Sldewalk
Tota'l Comb. Permit
ELECTRICAL PERI,IIT
Charges and
Surcha rges A/C Paving
Curb Cut /S'7Y-TOTAL uMECHANICAL PERHIT
Charges and
Surc ha rge s
COMBI
COMBINATION APPLICATION/PERMIT (CAP)
I Applicant to furnishA. Job AddressB. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 03 43?. example- Lot 1. Block 3, Znd Addition to
SpTTn--qfield EstatesC. Name, ett. of owner and construction lenderD. Energy Sources
1. examp-le- heat/electric?l ceiling/or forced air gas2. exampIe- waterheater/electr-lca[or soTarE. Square; rootage or va'l uationl-EE.-
l. example- 1250 sq. foot house, 500 sq. foot garage2. exampie- if new project, check n1w - if addition,
check add, etc.F. Bui lding permi t information:i. examp'le - construct single family house with an
attached garage
2, example - remodel existing garage into fami)y room3. g&!p-Le - convert single l"anrily residence intoiei[SIFant (change of'use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanical, E Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,
the applicant nqed fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be jnstalled are not covered on
the abbreviated schedules you should consult thefull schedulesC. BUILOING 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 signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label.
Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet on1y. Where 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
s i gna ture.
Fees and Charges
Plan check fees are due and payable at the time of theappiication, and no plans wi li be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
FOR OFFICE USE ONLY
tttl
III.
IV,
V
PERMIT VALIDATION
'funol3^
0,w
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPA}.ICY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information :
PLANS REVIEWED BY:
name Si g nature date