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HomeMy WebLinkAboutPermit Signage 1987-11-13 CITY Of SPRINGfiELD COMBIIIATION APPLICATION/PERMIT EilERG'LSOURCE5..:. A Heat Elec. L . Ilater Heater --21"",,- Ran~e 'J tt.' I INSPECTION LINE 726-3769 Job Address ~-;J75 Gateway St. Lega 1 Deseri pt i on See attached l~r5_ ~"'7'44.N L:;h.t,W7~<::/A1-I!:.~Ar.. Owner Chevron U.S.A. Address 1301 5th Ave.. R=m 2900 Seattle. WA 98101 Phone Construction Lender Address Ut:.~l(jN II:.Ar.' {nameJ Phone (address) .. INfORlIATION LI'," ' 726-3753 Sq. ftg. 1.lain 90B ~q. Ftg. Access.~A Sq. Ftg. Other X flew Add Alter ~ep, -Fence Demo Change/Use -Other- - \)() 'J ~ ~ I~ I ValUE of Hork: $500,000 Builoina Permit Info: Descr,be Work(i~e.. Build Single Familv I'lesidence Hith I".ttached Garaae\ ConstIuct a new autorrobile fuelina facilitv with a ronvenience store (lics. nn. I (ohane no. ( exo;res) Structural Primary Billy Ray Strite, Architect P.A. 2660 Grover Court Boise, ID 83705 6-30-88 Temporary Cons~ruct;on ~~:i~:~~~~J~~!~~~?~~~ mult;fami'y~or Tnrl,,"triitl COffi1./IND. FEEDERS Install/alter/relocate" rlic:.trih fpprlpl"c' Electrical Mechanical CONTRACTORS Inane' (address) Genera 1 Plumbina Electrical Hechanical PlUllBlNG -.llih . Each single fixture 17 Relocated building (new fix~ additional) FEF CHARr.F Nn Residence of 7.:)~ t27.~ New circuits alts. or extensions S, F. Resideme (] bath) Duplex (1 bath) each SERVICES Additional bath g;r:/ Water service 75.'. ~ Sewer 7'~~ , q'f.j Storm Sewer ~- / /;3?J~A-7/""N'~";'~' 7.5<::: /gAC.....~'o~.../CF7.">& I I Of t.,<'t:>O I / Of -;;::'2:5" (:2S TOTAL CHARGES :::33''7. Sa TOTAL CHARGES ;;t6 y 58 WHERE STATE L'\~ REQUIRES that tile Electrical work be done by an.'Electrical Contractor, the electrical portion of this pemit shall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division 1983 (208-336-8370 l1ies. no.) (~xnirp,,) (ohon~ nn ) " ELECTRICAL MECHANICAL I:IL J:HARIiE. NO I furnace/burner to '-;;>4.= BTU's , ~. c>C ccc ru'JlG.E. SQ, FT. ( Floor furnace and vent Recessed wall Sn~rp hp~tp~ ~nrl vpnt amps. Appliance vent seoarate Stationary evap. cooler /' Vent fan wi th (L) sinolp rlu("t Vent system apart from heatina or A.C. I Mechanical exhaust hoorl ~nrl rjll(.t: I I Hood stove/heater 157-9' 5' I~/R o/.m:F7Y. I ~-~ 1 I I 1 I I /::27.50 TOTAL CHARGES /Sl 1 1>?-:2 1 5'", l/il- I I f-z .)0 I I amps. ISSUANCE OF PFR!IIT , I HAVE CAREFULLY EXM1INEO the completed aprlication far permit. and do hereby certify that all information hereon is true and correct. and I further certify that any and all _wo~k De~formed shall be done in accordance with the Ordinances of the City of Spri ngfi el d and the laws of the Sta te of Or~(]on' pertai ni ng to the work descri bed herei n, and that UO OCCUPArKY wi 11 be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontr~ctors and employees who are in compliance with ORS 7nl.055 will be used on this project. IWIE(please print) Zone C,c; Tyoe/Const. ~~N Fire Zone Bedrooms Flood Plain Stories I \Jf,NATURE ___ ___ , DATE FOr. OfF I CE USE OIlL'Y , So, Ftg. Ilain ~/L.p/n>::;,..X) Value :2 S-ce:::>. <>D,,"_-'- Sq. Ft!J. Access x Value e:.. /' -'" Sq. Ft9. Other-",,/~ //?>'~V6'_ VaIue_":::~c..--."""""" TOTAL VALUATION ~~,~.o-~" Units Oeey Load / '7 Occ,V Group ~-? BUILDING PERHIT Charges and Surcharges . 2 --?/l c-o Plan Ck. Co","/lnd ___ Lc:::::-:-q-.:__ 65%/Rldo Pj'r Fpp c<" Plan Ck. Res ~~_ -' ~ 30t/BIdo p.., Fee ____'737S9 Fe, nee j ~_ ~.81 D~mo 1'27~5;::/ 1 S1dewalk 7'"/2. - --- - - G~3-8-1 AIC Paving ;;6, 5" p 1 Curb Cut j=rs;/ ------(~"jj-I PLUt~BING PERMIT Charges and Surcharges ELECTRICAL PERI~IT Cha rges and Surcharges MECHANICAL PERMIT Charges and Surcharges 'tPJ!l>-t?-a? lystems Development ~. 41<;" ir,LJ----;;: tharqe (1.51,) I,.::,;",~,,'/'~ J>,,", I"'" 1 7-s-" 6'""'. """" / :~~./;...~. /~'? .v,/,~.::-":':-_ ...... -~::: ./~ (" ? I 1 I 1- ":"!.",;.:;::~..y/-,r.:: I Irotal Comb. Permit I 72'03. 3'2. 7/-80 77". Sc> /6. /.Y l"9j.~ I I TOTAL " 93'37. (;,? - ,- .. ~,(",."" ':.":7~} "~'i:.\ . ,,;. tJ." , COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATION, I. Applicant to furnish A, Job Address . B, Legal Oescription 1. example- Tax lot 100. lane County Map Reference II oj 43 2. exam~le- Lot I. Block 3, 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. exa~le- heat/electrical ceilinqlor forced air Qas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - I. exam~le- 1250 sq. foot house, 500 sq. foot garage 2. examp.le- if new project, check new - if addition, . cnecK add, etc. F. Building permit information: 1. example - construct single family house with"an attached garage 2. example - 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 TEAM AND 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, & Electr;cal 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 DUT ALL FEES ANO CHARGES ON THE SCHEDULES D. 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. --- III. Applicant to sign and date . ~henever 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 signature. 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. ' V: FOR OFFICE USE ONLY I Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFOREOCCUPAtlCY': 1.55~-1"'d L c' 77?- '/0 T /~~C-"d.~ , '(?EVF(=.P//?{'~/7T --, / " ./"'" ,Yc~/r ,"-"~/5- T/<C ~,bP7" ~.--c- .-Y~d;.?7~;z:.o, ~6/?,~r..;~/?/r./77 /~ ;7/c-CE/V~?'_ OK i.iS-gfS Permit applicant exempt from registration with the Builder's Board because: , . . ~ . .... . ,I ,~ ..,Additional Project Information: /:" -. '., PLANS ,REVIEWED BY: :;name~R"",,~ .?2~~7? si'gna~ure4""",,,: -.;:?..........:~ ,-'"' date //../3-2$? '" /' '-- . v',;' .7' . ,-,~.;~- ~11. ~...;;;