HomeMy WebLinkAboutPermit Electrical 1986-07-31APPLICOHBI I 53
Job Address
Legal Description
Ranqe
EIIERGY SOURCES:
l,later Heater
Owner
Value of tlork:
Sq. Fto. l.tain _-
tg. Access.
Sq. Fto. 0ther
_l{ewiddrAf Eem$:-
_Fence_Demo Chii-qe/Use
0ther
Sq. F
aAddress /i&scriUn
c
t
dence .e., Build Single
7 |'/ rr, u;Constructinn Lender
Addre s s Phone
Nbl.n
t}'.i
l..,}'.)
name addre s s exoi res phone no.
Pri ma ry
Structura I
E l ectri cal
l,lechanical
:TORS name addres s PXn'rps ohone no.
Genera I
Pl umbi nq
ilechanicaI
PLUI{B I NG ELECTRICAL MECHAN ICAL
FEE CHARGF NN FFF CHARGF NO FFF CHA PCF
Each single fixture Residence of
FTsQ
furnace/burner to
BTL!' s
Relocated bui ldino
(new fix. additiona'l)New circuits alts.or extensions
Floor furnace
and vent
S.F. Residence(1 bath)SERV I CES Recessed wal I
Soace heater and vent
Duplex (1 bath) each
Additional bath Temporary Constructi on Apol iance vent
seoa rate
[,later servi ce Change in existing
res i dence
Stationary evap.
coo I er
Sewer multifamily, conrn. or
I ndustri a I
Vent fan with
sinole duct
Storm Sewer 0f s.Vent systenr apart from
heatinq or A.C.
COI.lI.!./IND. FEEDERS l4echanical exhaust
hood and ductInstal I /a l ter/rel ocate
distrih. fppdpr<l'lood stove/heater
(0O a.n,r2 Szuuk!-2,,o
0
ISSUANCF OF PFRI{IT
TOTAL CHARGES TOTAL CHARGES -) sodaa.TOTAL CHARGES
STATE LAN REQUIRES that the Electrical work be done bybe vali.l until the label has been signed by an Electri,
an Electrical
cal Supervisor
Contractor, the electrical portion of th.is Dermitand returned to the Building Division
I.'HERE
shaI I not
llAl.lE(please print)SI porL.al KLELfrrsA I\^tffo N
EDN the c lat foronapl')comp ce rtanddot that Ii nI forma ont hereon s'I truehereb.ycondatrrecandIcertfurther'I tha at nd Ia worI kafy has I1 donebe 'I a ccordance thWI the I0rd na nces 0 cthe IIf'|anddsprn9 fi Lawsthe thof q ta
ny
ofte n1IDe rta to workthe esd bedcrr0regonnq '|here n dan hat ilct wlOCCUPAHCY iI mabe
ty
defsturetrucwlthoutthesSiofnpermiBuithedI'I D I '|'I IngsonhefurtcerrtiIathtsttraon'Ifym_y req i thvn Buthe I'I derany
rdBoa '|s nI Ifu fo andrce aeffect s '|u red ORS 05501 freqbythat t basthe 'I'I exemp s rfo t 0n'I '|exemp henoted reon tha tandIonbcSUontractondvrsaiernpwhoreanI'I anceI wloyeescomc th 7010r?s t{l055 'II usbe oned '|th s ecproj t
Flood Plain Stories 0ccy Group Sq
Ftg
Ftg
Ftg
Load . Access x Val
x ValUni ts So .l'lain
ToIAL VALUATI0N_
0ther Value
Zone______Typel Cons t.
Fire Zone Bedrooms
PIan Ck. Conrn/Ind
65%/8ldo Per Fee
teris
rge 57
BUILDING PERNIT
Charges and
Surcha rges Plan Ck. Res
30%/Bldq Per Fee
FencePLUI,IB ING PERMI T
Charges and
Surcha rges Dgno
Sldewa l kELECTRICP.L PERI:IT
Charges and
Surcha rges
____g;F_q_qo Tota'l Conrb. Permi tA/C Paving
Curb Cut ?7tBCI1ECHANICAL PERMIT
Charges and
Surcha rges *48bR " ZO TOTAL )3 ,6[0
7L7. K
of
-amps
s
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. example- Tax Lot .100, Lane County Hap Reference
17 03 432. ellample- Lot 1. Block 3, Znd Addition toSpriffiield EstatesC. Name, etc. of owner and construction IenderD. Energy Sources
PERMIT VALIDATION
l. exampl e-2. examo I e-
E. Square footag
heat/electricql ceiling/or forced air gas
wa terhea ter/ e IEcTiJ ca7or
'e or valuatid, etc.
solar
II.
1. example- 1250_ sq. foot house, 500 sq. foot garage2. effiple- lT-new project, check-i6w - if aoOition,
check add, etc.F. Building permit information:1. elqmllq - construct single family house with an
Ettaclea garage
2. example - remodel existing garage into family room3. examole - convert singie family res.idence into
iEsTi-urant ( change of -use
)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. OESIGN TEAI{ AND CONTRACTORS
To avoid design or construction deiays, BuildingDivision Staff must be able to contact appropr.iitepersons regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes adjacentt0 the appropriate item(s) to be instailedB. Full Plumbing, Mechanical, and Electr.ical Schedu'lesare available at the Building Divisionl. To conserve space on the permit form the schedules
have been abbreviatedZ. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF I,IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES0. As noted on the CAP, the Iabel must be delivered to theelectrical contractor for signature by his electricalsupervisor. The generai contractor is not authorizedto sign the electrical label.Applicant to sign and date
Hhenever possible, the.initial appl.ication will be used asa worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for hissignature.
Fees and Charges
Plan check fees are due and payable at the t.ime of theapplication, and no plans will be processed unt.il thesefees are paid. All other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY
Rtrbrlo
r"l -s0
III
IV.
v Perm'it Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name s'l gnature date