HomeMy WebLinkAboutPermit Building 1990-10-3
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225 FIFTH STREET
SPRINGFIELD. OR 97477
GATEWAY
BUILDING PERMIT. APPLlCATIOtj
MAL L TEN ANT IMP R OV E MEN T SON L y.
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.DEVELDPMENT SERVICES DEPARTMENT
City Hall Buildino
BUILDING 5AFETY
(503)
DIVISION
72.6-3759
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Nature of Work:
Value of Work:
Telephone: (618) 907-3400
Job Site: (503) 746-4707
Fax:r (816) 9.07-8641
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Application fee:
$200.00
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Owner:
General Growth of California
Addreaa:
15821 Ventura Blvd. Suite 525
Encino, California 91436
TENANT1MPROVEMENT
Name of Tenant Business:
Size of Tenant Space:
~ :-b~fu.j ~\<-~e\\~R..
Describe Business:
~E\P-.\L
Job Site Addreaa: ..
3], 0: 1
Mall Space No.
3000 GATEWAY STREET
SUITE:
loL
DESIGN TEAM
(Name)
PrimBr:JS.~\W ~IIS1...
Mech/Plumb: c:; A."^-.c
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(Aridresa)
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(Phone No.'
Electrical:
CONTRACTORS
Ge~er~~
(Name) (Address)
r-...\' I \. /~ t:J ...a ...".
'0\\\)'<.' ~l ~",(,~,h
(Lic."
(Exoires)
(Phone No.)
~rT" V",Y7
7V/-77fY~
p~~;.,<",
6.1 t:; V~
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Electrical :
*Suoervisor's Sionature
Plumbino: ~O-"\\)~, ... ~\'-Le ',:11;)\2> ~"?(fJt. \.J"i, ZlAi~"''L jO'l-. ~1l\Cl j
Hechanical:
7L1b-J (" 2 (
AGENT
(CONTACT PERSON)
(Name) (~ddresa)
(Phone No.)
. WHERE STATE LAW REQUIRES that electrical work be done by a licensed electrician, an electrical permit shall
not be issued without the name and signature of the Supervising Electrician and his/her valid license
information. FurtherlDo~9." _~~,~J.ectrlcal permit is issued, it shall not be valid until the electrical.
label has been ~d~l~'~gneij'by the Supervising Electrician and poated on the switching equipment for
the tenant 8oace. (See instructions O~ ~~V~~q~~~11~ f~r furthe~ ~or~~B~ion)
I have .ca~efully examined this completed ~l'rc8tibn for permit, and do hereby certify that all information
hereon. is,..lrue.. ,.",j ._.,....._ .'U;-al~.ftft'thft >i:er~tfY."that any and all work performed shall be done in accordance
..ith the Ordinancea of the City of t1!W!iiQnelil:8n~i the La..s of the State of Oregon pertaining to the ..ark
daacribad.here:. , .,...;, .".,j~C'{'llf"fHE 'PREMIStS WILL NOT 8Y UNDERTAKEN ..ithout the permiasion of the
Building Safety Oiviaion in the form of a GERtltftATE OF OCCUPANCt.
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Date
INSTRUCTIONS -: Hall perBit""DlicBtiDn
The tenant or his duly suthorized sgent must complete
all required spaces on this application form.
Incomplete forms will be held without further
procesaing until the required informstion is provided,
.resulting in unnecesssry delsys in issuing the permit.
THE APPLICATION MUST 8E ACCOMPANIED 8Y A $200.00
APPLICATION fEE WHICH WIll. BE APPLIED TOWARO THE
PROJECT PLAN REVIEW fEES.
Note: _ PLANS & SPECIfICATIONS and other construction
documents ahould not be included with this applicetion
(the construction documents should instead be
submitted to the mall owner for review snd
scceptance). The owner will forwsrd the sccepted
documents directly to the City for Plan Review and
Permits.
This application will be mstched with the sppropriste
plans when they are received from the owner. Plans
not having evidence of the owner's acceptance will not
be accepted for review by the City. Plsns which are -
received before the permit spplication will be held by
the City until the spplicstion is received, snd they
will be reviewed for Code complisnce in the order thst
the Aoollcations are received.'
The following informstion will assist in filling out
tha Applicstion form:
PERMIT # - will be sssigned by the City upon
scceptance of the spplicstion.
VALUE Of WORK - should include ell costs for msterisl
& lsbor (including contrsctor's OH & p) snd the cost
of sll sdditionsl instsllstions by the lsndlord which
are being chsrged to the tensnt (eg. sdditionsl roof
curbs, etc.).
NAME Of TENANT BUSINESS - Include the nsme of the
business 8S ~t will appear on the storefront, and the
name of the company, individual, partnership, etc., if
it is different from the business name being used.
SIZE Of TENANT SPACE - Indicete the totsl. floor sres
specified i~ the le8s8 for your business apace.
'.
DESCRI8E BUSINESS - Indicete the type of.merchandise
and/or service to be provided to customers/clients.
SUITE - this is the tensnt lease spsce number.
DESIGN TEAM - Include the requested informstion for
the design professionals who prepared or participated
in the preparation of construction documents. If all
or any.portion of the project is being designed by the
contractor(s), please so state in the appropriate
spaces.
CONTRACTORS - Include the requested informstion for
the general contractor & subcontractors.
Note: Effective January 1, 1990, the State of Oregon
requires all contractors to be licensed through the
Construction Contractors Board, In addition, persons
instslling or modifying electricsl or plumbing work
must hold a valid Journeyman's license for these
trsdes from the Stste.
.. AS Of JULY I, 1989, Oregon law requires that s
aupervising electricisn shsll sign the permit
spplicstion, or the electricel portion of this
combinstion building permit will. not be isaued.
TME--ElECTRICAL PERMIT HAY BE OBTAINED SEPARATELY BY
THE ElECTRICIAN..
AGENT - The spplicstion must be signed snd dsted by
the tensnt or. his/her duly suthorized representstive.
fOR
~ f ICE
,
USE
APPlICATIlJI RECEIVED:
VALUE Of WORK: - - - - - - - - $
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~1~Ia:.n DEV. DIARGE:
Cl.5~ of Vslue)
$
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BlIILDIN: PERIlIT:
Surcharge:
$
SUBTOTAL:
$
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PlAN REVIEII fEE:
less Application:
$
(-)
200.00
SUBTOTAL.
$
..
PlIIIIINC:
fixtures.
Surchsrge:
?-... CI ~cO
$ C:O.Q5
, :SO
$ . 31 .'E()..
SUBTOTAL:
ELECTRICAL:
feeders: _Gl_amps
" amps
Wiring: 2 or more cir.
Surcharge:
$
22.50
"
SUBTOTAL:
$
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IIDWllCAL:
Alc units or heaters:
less than 100 HIlH_1I$6.50 $_
Vent fsns (lductl_CI 3.00
Other vent eyat. or
exhsust hood _CI 4.50
fuel gas piping
Surcharge:
SUBTOTAL
$
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lIT1EIl: PERIIr IIIUAICI
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