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Home My WebLink AboutPermit Building 1983-07-18HEL 'LAi1og 726-37COMBI Phone 247 q el3 Phone CATIO IT "IJob Address -egal Descriptionf o"- vner 'dless eOO struction Lender ^ess F/ 7u lry tura 1 "ical ical 'al PLUI1B I NG single fixture lted building 'ix. additional ) es i dence (i bath) each nal bath rrvi ce ,l.l REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permituntil the label has been signed by an Electrical Supervisor and returned to the Building Division t b.y certjfy that a I information hereon is truefurther certify that any and all work rmed shall be done in accordance with the 0rdinances of the Citythe Laws of the State of Oregon oertaining the Building Divis to the work described herein, and that NC 0CCUPANCY will be madethout the permission of ion. I further certify that m.y registration vrith the Builder's'ce and effect as requi red by oRs 701.055,that if exempt the basis for exemfition is noted hereon, and that and ernployees who are in comD I i ance wi th 0l?S 701.055 wilI be used on this Droject. INED the completed apnlication for pe perfo 4 E .)Ll I GNATURE -iDATE, / ) yoelCons t.ts So Ftg Ftg Ftg l4ain Acce Value rdrooms 0ccy Load a Val ue rA x xI..yc"orpF ? sq 0the r a,:?_ Val TOTAL VALUATION EIIERGY SOURCES Heat l,later Heater Ranqe 5ooValue of Uo*:ft Sq. Ftg. Access.-- Sq. Ftg. Other_ _l{ew_Add-Al Ter TEF:- _Fe nce_Demo_C han gel U se -other- scrn :e., Build Single tLr<ovlr& uer {S l ru. lot. (aus{ru./ tp Q mc ( l ics. no.exoi res ohone no- name ELECTR I CAL MECHAN I CAL FEE CHARGE NO FEF CHARGF NO FFF (.HAPG F Residence of sQ. FT. furnace/burner to BTU, s New circuits alts or extensions Floor furnace and vent SERV I CES Recessed wal l SDace hpatFr and vpnt Temporary Constructi on Apol iance vent seDa rate Change in existing res i dencp Stationary evap cool er multifamily, cornm. or Industrial Vent fan with sinole duct 0f amps.Vent systern apart from heatino or A.C. COMI.1./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocatedistrib. feeders l,Jood stove/heater -amps.0f ISSUANCE OF PFRt.IIT TOTAL CHARGES TOTAL CHARGES Plan Ck. Corm/Ind 65%/Bldq Per Fee 5 eD. l-rl-S v s terls Cha roe Deve r1. 5Z opment P'l an Ck. Res 30%/Bldq Per Fee (ntA44-J,,Q", I E3z Fence r\l Demo 5/Uau4r rr{ rq Y-t<,7rYrED7 g .D E,*e-.b>/7"@SidewaIk A/C Pavi ng Tota'l Comb. Permi t Curb Cut q 2./z ?3- ori es 2 ,/2 0c + o {-*,rd <d€<r(R *aa lQ >-^ TOTAL COMBINATION APPLICATION/PERMIT (CAP) L App'l i cant to furni shA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference I7-TT-:T:2. example- Lot 1. Block 3, 2nd Addition to Sin-!-fielo EstatesC. Name, etc. of owner and construct'ion lenderD. Energy Sources l. exampl e-2. example-E. Square foota hea t air gas ura te I ge or example- 1250 sq example- if new check add, etc. foot house, 50Q sq. foot 9ait ra ge 2 project, check new - if add ion, F. Building permit information:1. example - construct single family house with anattached garage ?. example - remodel existing garage into fami ly room3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Speciaity CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, BuildingDivision Staff must be able to contact appropriate persons regarding design information or job s.itecorrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrica'l SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the appiicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full PIumbing, Mechanical, and Electrical Schedules are avaiiable at the Building Divisioni. To conserve space on the permit 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 schedulesC. BUILDING DIVISION STAFF I,JILL 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.III. Applicant to sign and date l,lhenever possible, the initial application will be used asa worksheet only. Where possible, Building 0iv.ision Staffwill prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for hissignature.IV. Fees and Charges Plan check 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. V. FOR OFFICE USE ONLY PERMIT VALIDATION Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information PLANS REVIEWED BY: ndne L>F,at€ 7<& * signatu date V/*e