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Home My WebLink AboutPermit Mechanical 1984-10-4 I INSPECTION LIIIE 726-3769 . . JC;o....,? ~ Legal Description / ~),~~ Owner ~ .......,.-10 V - ta . .' 1'. ./<~ t4Jp,/ Address ~"". \-'q3~ ~t!lnr"lf4. Phone 7q~- eU tlllAIP ,t''IfJ 9'1</6 ~ 8;;.97 Construction le~der IHfORllATIOH UNc . 726-3753 Sq. Ftq, I,lain ~q. Ftg. Access. Sq. Ftg, Other Ilew Add AI ter Rep, --Fence Oemo ChangelUse Other -- -- ValJJl/of l'lork: ..p. ~ r~o . crU' Buildinq-Permit Info: Describe Work(Le., Familv Ilesidence Hith ,a,ttached Garaae) ~~~~ Build Single \ ~)' rl) 0 \. 3 t- ::J J )C Job Address Address Ut~ lliNI tAr1 (name) Phone (address) . (li....o:._ no.) (exoirpc;l ~ I (nhone no .') Primary Mechanical CONTRACTORS (name) (address) (lies. no.' ~ ~ (pxoirp~) ~ lahonp no.) Structura 1 Electrical General P1umbino ~.PA Electrical ~'echanical PLUIIBI NG ELECTRICAL MECHANICAL NO, FFF r."^Rr,F Nn..l...-I Residence of I r:r:r: 1 ru~ _Nn I I ~r:!:' , I r 1-1 ARG.E. Each single fixture furnace/burner to SQ, FT. BTU's Relocated building '(new fix, additional) New circuits alts. or extensions Floor fu rnace and vent S.F. Residence (1 bathl 10uplex (1 bath) each IAdditional bath 1 ~Iater service I Sewer SERVICES Recessed wall Sn~rp hp~tpr ~"rl vpnt Storm Sewer ITemporary Construction IChange in existing rpc:-; rLe>nrp Imultifamily, comm. or Tnrlllc;t.rhl 10f amps,l ICOMM,/INO, FEEDERS I Install/alter/relocate rlic;t.rih_ fpprlprc; Of amps.l I Appl iance vent sp.oa ra te I Stationary evap. cooler I Vent fan with ... . sinnlp duct I Vent system apart heatino or A,C. I Mechanical exhaust hoorl and dud. I Hood stove/heater I '1~ I I from / I~' t.D I I .IS bE TOTAL CHARGES TOTAL CHARGES WHERE STATE L\H REQUIRES that the Electrical work be done by an, shall not be vali1 until the label has been signed by an Electrical ISSUANCE OF PFRllIT TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFULLY EXffi1INED the completed aprlication for permit, and do hereby certify that all information hereon is true and correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Spri ngfi e 1 d and the Laws of the Sta te of Oregon perta i n i ng to the work descri bed herei n. and that 1m OCCUPAIlCY wi 11 be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s Board is in full force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon. and that only subcontractors and employees who are in compliance with OP.S 7Q1.055 will be used on this project. Zone Fire Zone Flood Plain Type/Const. Bedrooms Stori es Units Occy Load Occy Group S1GIIATURE /?};j ~ FO~ OFFICE USE DIlLY Sq. Ftg. Sq. Ft9, Sq, Ftg. Jrl( .f' r DATE IW'IE(please print) fr1ltrJiW'rh1,., riain Access Other x Value Value Value x x TOTAL VALUATION BUILOING PERmT Charges and Surcharges Plan Ck. Commllnd 65%/Blda Per Fpp ------------PTiin Ck, Res 30%/Bl do Per Fee Fence Systems Development Charqe (1.5~) " {q w-i ~fOY'€ C/rrfo /, C C/t? ,(pe;, PLUI~BlNG PERMIT Charges and Surcha rges O/jlllO I'Sidewalk I AIC Paving I Curb Cut I ITotal Comb. Permit ELECTRICAL PERI~IT Cha rges and Su.rcharges 11ECHAN I CAL PERMIT Charges and Surcharges I I TOTAL .. ~\ /.( 6.::.... . . " COMBINATION APPLICATION/PERMIT (CAP) I I I. I. Applicant to furnish A, Job Address B. legal Description I. example- Tax Lot 100, Lane County Map Reference I! U3 43 2. example- Lot I. Block 3, 2nd Addition to sprlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examole- heat/electrical ceilinqjor forced air qas 2. examyle- waterheater/electrlcalior ~ E. Square footage or valuation, etc. I, examole- 1250 sq. foot house, 500 sq, foot garage 2. example- if new project, check-nfw - if addition, check add, etc. F. Building pennit information: 1. examole - construct single family house with an attached garage 2. examEle. remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. OESIGN TEM4 ANO CONTRACTORS To avoid design or construction delays. Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II, Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2_ If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules ' C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES 0, 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 possible. the initial application will be. used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his signa ture. IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. \ , PERMIT VALIDATION 12-# 63'-J~ fJllofr/J'<I ~ , , V, FOR OFFICE USE ONLY Permit Clerk~~ ] PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature date J ]