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HomeMy WebLinkAboutPermit Building 1988-6-29 "" r - Ranqe ValuE of Work $60,000 BU1]c,lnCJ Pel Fan11v nesld lNFORlIATION LJlk 726-3753 So Ftq rlaln ~CJ t"t!) Access Sq Ftq Other Hew AddX Alter nep --Fence Demo Change/Use Other - -- O\J 1(3 \ft r- I~ 11l1SP~CT101I L1I1E 726?1"9 Job Address 1800 CENTI:NNIAL. legal DmnPt,or\ ~()~ 'I ~ ~~ CI1Y UF SPRINGFIE,D COHBlIIATION APPLICATION/PERMIT EnERGY SOURCES Heat l~ater Heater Owner SPRINGFIELD ~'1N'\ Address MCKENZII:-WILLAMETTE HOSPITAL Phone Construction lender '\JJr~s UlS tGTl IE^" r Primy Str1Jrtural THE AMUNDSON ASSOCIATES (name) Phone (address) Electncal '1ectTanlcal COIlTRJ\CTORS Oescrlbe Work{l e . BUlld Stngle Lh ~ttached r.araoe) RENOVATION AS TENANT IMPROVEMENTS FOR CI:NTENNIAL SQUARE- OFFICE AND ADULT DAY CARE. (11C5 no) (exolresl (ohane no SPRINGFIELD. 200 S. MILL ST. P,UllBHlG fixture Relocated building (new f,X addlt1onal) S F Pesldence - (] b'thl -_. Ouplex (l bath) each ___ Additional bath (name) (addrp'ic;) 746-8231 _4 )), \ {,S-I~ (11r.0:; no) (p)'F)lrpC; \ (ohnn!' nn General MCKENZIE COMMERCIAL 865 W. 2ND EUGENE 45539 Pl~,no TWIN RIVERS 2050 W. BROADWAY, EUGENE 20-96PB Elie~m'l C & S ELEC. 2140 CENTENNIAL BLVD EUGENE 20-14C flecm'nical HARVEY & PRICE 2015 NUGGET WAY EUGENE 77 r.g:r ("\ Each single ~c , 1--- "'ater serVlce t ~ Sewer - Storm Sewer ELECTRICAL FFF CHARGI=' Nn 1 ";() q(iC Resldence of So FT New ctrcults alts or extenslons "- SERVICES 7-21-89 6-1-89 10-1-89 10-1-89 343-7143 683-1414 344-2236 746-1621 MECHANICAL :rLJ:tlAE!i.E ..1!O I furnace/burner to B1U's I 'IL 1.QlABJiE. 22.~ Floor furnace and vent Recessed wall ~o~rp hp~tpr ~n~ vpnt amps .,"6 V7V ApDllance vent seooarat~ Stat10nary evap cooler Vent fan W1t'" sin(]le duct Vent systeM apart from I heat1na or A C Mechan1cal exhaust hood tlnd duct. Temporary Construct1on Change 1n eX1stlng rps 1 tteJ'll"'P mult1famlly, comm or TndlJc;trlal Of COMII II NO FEEDERS Install/alter/relocate ri1c;trlh fppdpl"'C; Tyoe/Const Bedrooms Stones 'G\.\ Units Occy load Occy Group Of \Iood stove/heater /..;) 1 \ 1').~(,1 1..1)- ~,;f?, Yl1 I ISSOANCf OF PFR'lIT TOTA, CHARGES C\Cl I.d:) . TOTAL CHARGES ?? '8::> 1 TOTAL CHARGES~\h"\:),~U:-\ \ SGD WHErE STATE l ,\~ REQUIRES that the Electncal work be done by an Electncal Contractor, the electncal portlon of'thlS pem1t shalt not be val1J untll the label has been slgned by an Electr1cal Superv1sor and returned to the BU1ldlng DlvlSlon amps. I HAVE CAREFULLY EXN1IN[O t~e completed apnlication for ryermlt, and do herebY certify that all info~atlon hereon lS true and correct. and I further cert1fy that any and all work oerformed shall be done 1n accordance wlth the Ord1nances of the C1ty of Soringfleld and the laws of the State of Crenon oerta1nlng to the work descnbed hereln. and that no OCCllPArK'f wlll be made of any structure wlthout the pcrm1SS1on of the GUlldlng 01vision I further certify that my reqlstratlon wtth the BUllderts Goard ts in full force and effect as requlred by ORS 701 055, that if exempt the basts for exemptlon 1S noted hereon. and that only subcontractors and enployees who are in comollance wlth OPS 701 055 w1ll be used on thlS prOJect 1IA1-[(please print) Zone (' (' Ftre Zone Flood Plain - BUILDlIIG PERmT Charqes and ""\ Surcharges oJ... PLU'~B I NG PERMIT Charges and ~ Su~charges ::::> ELCCTRlcn PERl'n (' J r'Jes and u :: _ (. 'arges -, .: ~ANICAL PEPMIT Charges and ( Surchar~es ~ S I GilA TURf FOP OFFICE USE DIlLY So Ftg l1aln Sq Ft9 Access Sq Ftg Other \ ~~- ni Con'nr1I nd PJ'r Fpp Res Per Fee "':l.. \ r CJ:::) Plan Ck _y~lC2_______ 65tlBldo \ '" '1>C;J Plan Ck oJ. 30ttBl do __:\.Q_~~___ Fence "-\ ~3 r'(. '1 So ----\-\~----I AlC Paving ___~'9-,.??___-' Curb Cut 4 /5 I I Demo I Sidewalk DATE x Value x Value x Value TOTAL VALUATlDrI '20 3 <.fs /t()5' '-2 ,..JSystens Development I <0 "" O~Charoe (J 5<) I I I I ITotal Co~b rermit I I TOTAL \.)l~ I I ~ (k. ~ \ _ I ~-~ 1. 115 ~ II 1 - 1 , , , '\ _.!.t' COMBINATION APPLICATIONIPERMIT (CAP) III Appl1cant to furn1sh A Job Address B legal Descrlpt10n 1 example- Tax lot lOa, lane County Map Reference 1/ 03 43 2 example- lot 1 Block 3, 2nd Addlt10n to springtleld Estates C Name, etc of owner and constructlon lender o Energy Sources 1 example- heat/electr1cal ce1l1nq/or forced a1r Qa5 2 examole- waterheater/electrlcal/or 501ar E Square footage or valuatlon, etc ----- I examole- 1250 sq foot house. 500 sq foot garage 2 example- 1f'l1ew proJect, check-n€w - lf add1t1on, check add, etc F BUlldlng perm1t 1nformat10n 1 example - construct slngle fam11y house w1th an a ttached garage 2 examyle - remodel eX1st1ng garage 1nto famlly room 3 examyle - convert slngle famlly resldence lnto restaurant (change of use) G Value of work as deflned 1n Sectlon 303 (a) of the Structural Speclalty Code H DESIGN TEAM ANO CONTRACTORS To avo1d des1gn or construct1on delays, BUlldlng 01vlslon Staff must be able to contact approprlate persons regardlng deslgn lnformat1on or Job slte correct1ons, etc Abbrev1ated Plumb1ng, Mechanlcal, & Electrlca1 Schedules A Except where blank spaces occur ln the descrlptlon port1on of the Mechanlcal and Electrlca1 Schedules, the appl1cant need f111-1n only the No Boxes adJacent to the approprlate ,tem(s) to be lnstalled B Full P1umb1ng, Mechanlcal, and Electrlca1 Schedules are avallable at the BUlldlng Dlv1510n 1 To conserve space on the permlt form the schedules have been abbrevlated 2 If the 1tem(s) to be 1nsta11ed are not covered on the abbrevlated schedules you should consult the fu 11 schedu I es C BUILDING OIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEOULES D As noted on the CAP, the label must be del,vered to the e1ectrlca1 contractor for slgnature by hlS electrlcal supervlsor The general contractor 15 not authorlzed to 51gn the electncal label - Appllcant to slgn and date Whenever posslble. the lnltlal appllcatlon wlll be used as a worksheet only Where posslble. BUlld1ng D1vlslon Staff wlll prepare a type wrltten copy and return It to the appllcant at the tlme the actual permlt 15 lssued for hlS slgnature Fees and Charges Plan check fees are due and payable at the tlme of the appllcat10n, and no plans w1l1 be processed untll these fees are pald All other fees and charges are due and payable when the permlt 1S lssued IV V FOR DFFICE USE ONLY PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY. " . ~ ~~ '- I -"'if ~ /,('rj J . PERMIT VALIDATION \' : ~ "cr 1 ., d, ,- >,' r ,t -' ~T# PermIt Clerk . , , 7" " , ", 1''i5~~ d KJ_____ ~ -.;t 'J - '&"<. Permlt appllcant exempt from reglstratlon wlth the BUIlder's Board because AddItIonal ProJect InformatIon PLANS REVIEWED BY -'- na~ ~ ~) \ \-c> slgnature~ ~>~~ " ,.,.-..- dateC")-?--:J-~~