HomeMy WebLinkAboutPermit Building 1990-3-15
.(
.~
'.IINsPEcT"IONLINE
: 726-3769
t, ,
CITY OF SPRINGFIELD
COMBINATION APPlICATION/PERMIT
. ENERGY SOURCES:
Heat
04~)t~ater Heater
Range
INFORI1ATION UN!:.
726-3753
Sq. Ftc). r.1a i 0.
~q. Ftg'. Access.
Sq. Ftg. Other
New AdacXA 1 ter Rep.
--Fence Demo Change/Use
--Other -- --
Address
'"
MCKENZIE -WILLAMETTE
1460 "G" ST~EET,
ValUE of Hark:
HOSPiTAL $35,000
. Ph "";;'-4IlMn, Builtiinq Permit Info: Describe \~ork(i.e.,
. 0If~6-4 01 Family Residence ~~ith JI.ttached Garaqe)
Build Single
, '
Job Address 1621 CENTENNIAL.
Legal Description \(1 (Jj ~7)('"M
, Owner
~
OFFICE AREA REMODEL. CLINIC (600 SF)
Construction Lender
Address
DES I GN TEAr'1
(name)
Phone
(address) ,
(1 ics. no.)
(expires)
(phone 0.0.\
746-82]1
. Primary
: Structura 1
THE AMUNJ;>SON ASSOCIATES 200 SOUTH MILL
, El ectri cal "
, ,
, Mechanical
: CONTRACTORS
, ,
(name)
( address!
(lies. no.)
(exoi'res) ,
(ohone no. )
345-8100
; Genera 1
, I
Plumbinq
JOfiN'HY~ANDCONSTRUCTION 1941-A, LAURA ST.
,El ectri ca 1
. ~1echani ca 1
_ \ ,,' "r ,.
'..I~c''f,q&i1~i:1~ '~{Jdlk~~'_
J.f .~ J:;L - 9 (')
.PLur.1BI NG
\! ...
ELECTRICAL
MECHANICAL
NO. :i !
: 0 Each s i 0.9,1 e' .f.ixtpre-
'. '9 ~~"'~I>9<~'V .
i :!' CAPS
Relocated building
(new fix. additional)
IS. F. Res i dence .
(1 bath) .
IDuPlex {l batri) each ,~
IAdditional bath,: I' ,'1
I ~la ter servi ce
I Sewer
. FEE
CHARGE l ~n
FFF
rHAR(;F NO.
I FFF
rHAR(;F I
?S'o 7.'5'~
Residence of
SQ. FT.
furnace/burner to
BTlI's
y
New circuits alts.
or extensions '
~ CJ~ ?A6'R€ .'
ISERVICES
I
ITempOrary Construction ,I
Change in existing I
residence
multifamily, comm. or I
Industrial
:z=<St ·
Floor furnace
'and vent
':.
','
I
I
I
I
I
I
I
I
Of
ICOMM./IND. FEEDERS
I Install/alter/relocate
distrib. feeders
1/ 10f / 2~ amps.1 b.j2: v--'
~/r ~".6'~ d..o-~Jv~
~~/,:;"Al/~~ ~
-6"~c:.r ~7/?-~iC.. . ~A":":"J-', ISSUANCE nF PFRr1IT
~5-:~ TOTAL CHARGES rS'.~. TOTAL CHARGES ~#. /,-5": c:s-O
that the Electrical work be done by an,Electrical Contractor, the electrical' portion of this permit
,label has been signed by an Electrical Supervisor and returned to the Building Division
amps.1
Recessed wall I
Soace heater and vent '
~t..,~ &/-?75~:>')~
Appliance vent
separate
Stationarv evao.
cooler " ,
Vent fan with
sinale duct
Vent system apart from I
heating or A.C.
Mechanical exhaust
hood and duct
Wood stove/heater
I
I
I
'j I
~A2/7=? ,.r~1
r . - ~I I
I I
,I
Storm Sewer
I
'I
TOTAL CHARGES
WHERE STATE LAW REQUIRES
shall not be valid until ,the
DAT(15 MAR~H' 91;
Zone-.-C A4R,
Fire Zone
Flood Plain
Stari es
Units Sa. Ftg. Main x Value
Occy Load Sq. Ftg. Access x Value
Occy Group 7;1-2. Sq. Ftg. Other~~..P~~t:1z;zt Value~~~
. .~~X==' ~ . \csau \ IT>1iC(~ATION "
, Plan Ck. Comm/lnd \ ) l Jr') Is~stems bevelopment
_~'?/s.._:>~ 65%/Blda Per Fee . C arqe (1.5';) ,
Plan Ck. Res I
-/ C?-?~ 30%/BTdq Per Fee
~~~' Fence I
~---:z-~~?-I D~R1a I
<.1~SI (J] , ISidew'al k I
---- &~-I A/CPaving ITotal Comb. Permit
~--.J~~--I Cocb C", )OTAl.
/
BUILDING PERmT
Charges and "
Surcharges ..'
PLur~BING PERMIT
Charges and
Surcharges
ELECTRICII.L PERtHT
Charges arid
Su.~<:ha rges
MECHANICAL PERMIT
Charges and
Surcharges
-;2&7. -:28
.,11
'0> "
'.,
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant'to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 03 43,
2. ,,~,"example-Lot 1. Block 3, 2nd Addition to
~. Springfi~ld Estates
C~ Name, etc. of owner and construction lender'
D. Energy Sources
'I. example- heat/electrical ceilinq/or forced air qas
2. example- waterheater/electrical/or solar
E. Square footage or valuation, etc.
1. example- 1250 sq. foot house, 500 sq. foot garage
.2. example- if new project, check-new,-, if add,ition,
check add, etc.
F. Building permit information:
1. example - construct single,famiiy house with an
a ttached garage ' .
2. example - remodel existing garage into family room
3. 'exampl~ - 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. DES IGN TEA~1 AND CONTRACTORS
To avoid design ar construction delays, Building
Division Staff must be able to contact appropriate
persons regarding desig'n information or job site
corrections, etc.
II. Abbreviated Plumbing, Mechanical, & 'Electrical Schedules
A. Except where blank spaces ac'cur in the descriptian
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 sched~'es yo~ should consult the
, full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. ,Ai not~d on ,the CAP, the label must be delivered to. the
electrical contractor for signature by his electrical
supervisor. The general contractor isnat authorized
to sign the electrical label. ---
Applicant to sign and date
Whenever possible, the initial application will b~ 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
signature. '
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 ahd-,
payabl'e' wh'en the,permit is issued.... . .'
ir
III.
IV.
V. FOR OFFICE USE ONLY
",
'.... ;~ .
PROJECT CQNDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
.,; ,-~
PERMI~VALIDATION
'cyNB
';:\'
~ '?}:O
.,~-A:~~ ]b9.fJ.
......
~_~ :;)_C(O
zB-.~~1
, Permit
Clerk&rJJOu
Permit applicant exempt from registration with the' Builder1s Board because:
. Addi ti-'ona 1 ProJect Informat.i on:
PLANS REVIEWED BY:
h~ 1
t ..~
name
~A/~ ~_-::;- 6?\
-. ... --... ,
signature ~ ~~~da~e
r~~~ /,'
~-T::?-9~
~,