HomeMy WebLinkAboutPermit Building 1988-3-29
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CITY Uf SPRINGFIELD
COMBIilATlON APPLICATION/PERMIT
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IINSPECTTON'LINE
726-3769
Job Address ?-';17J5 Gateway St.
Legal De<cription See attached
j..J>'7" ")/ S"'~N ~.J?r<d)"u,!:;;:<'fc:./A-c:.1;bA.K.
Owner Chevron U.S.A.
Address 1301 5th Ave.. Room 2900
Seattle. WA 98101
Phone
Construction lender
Address
DESIGN I EAt4
(name}
Phone
(address)
EilERG'LSOURCEs..c A
Heat Elec. F. .
I~ater Heater F.l """.
Range
ValUE of Hork:
$500,000
BU11dinQ Permit Info: Describe Work{;,e" Build Single
Familv Residence With Attached Garaae)
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INfORltATlDN LINE
726-3753
Sq, Ftg, I'lain 968
~q. Ftg. Access.lon
Sq. Ftg. Other
X Ilew Add A Iter Rep.
--Fence Demo Change/Use
-Other- -
~
~
~
~
Construct a new autorrobile fuel j no
facilitv with a convenience store
(l ics. no.)
Structural
Primary Billy Ray Strite, Architect P.A. 2660 Grover Court
Boise, ID 83705
1983
. Electrical
Mechanical
CONTRACTORS
, fnmel
r~7~/,gu/?1
(adnrpss)
I!.-o r</S?"Z'vc r ~
General
Plumbina
Electrical
~1echanical
PlUIIBING
NO'I
I j Each single fixture
Relocated building
(new fix. additional)
I FFF t r.HARGF
Nn I
Residence of
, 7.~clnSo
New circuits alts.
or extensions
S. F. Residel1a!
{J bathl
Duplex (l bath)
IAdditional bath
;?;e1 Water service
SERVICES
each
(exnires)
lohonp nn .-1
6-30-88
(208-336-8370
1,-,,---;\
_(lir~. no.) (pxoirpc;\
r> V ,,'-D;< -.J Vir", -
8EN~ l'eE:
1"\'"1 . <:5"'3 00
ELECTRICAL
I ~n. I r~AD(.:~
SQ. FT.
/ ITempOrary Construction
IChange in existing
rpc; i dpnr:p
ImuftffamilY~Or
Induc;tri<ll
I IOf l/t::'C>
ICOMfI./IND. FEEDERS
I Install/alter/relocate
di<;.trih. fppdpr<;.
I IOf
II
75.....
7'~"'"
, q'~Storm Sewer ~-
I /7i?'J/UA-T/o<<'A/ ~ ">7=. 7.5c
/ 8AC......~'o~('/c"'.Z.,&
2::'c Sewer
-;2.'2~
/?S
1/5-
I
I '~
~.~
I
I
1:57-95'
F<~~
amps.
amps.
(ohone no )
...95- J'i'f? ~~
Ii
MECHANICAL
NO. I
I ~,::~
I r~.ll.Q(.:~
(
furnace/burner to
"'4,= BTU's
,
~.--
Floor furnace
and vent
Recessed wall
SO<lr:p hp~tpr ~nrl vpnt
App 1 i ance vent I
c;poar<itl'l
Stationary evap. I
cooler
Vent fan wi th I'" Z ..;z.
sinole rlllr:t ? I'~. ~
Vent system apart from I I
heatinq or A.C.
Mechanical exhaust I I
hood <Inn rlurf:
I I
,$,R O/.J'7CF75, I f-z..r6
I I
I I
.
Wood stove/heater
ISSUANCf OF PFRIIIT
TOTAL CHARGES ? 5'7. 5 C TOTAL CHARGES /:27- 501 TOTAL CHARGES ;Z6 .50
, WHERE STATE Ul~ REQUIRES that tile Electrical work be done by an-'Electrical Contractor, the electrical portion of this permit
shall not be vali1 until the label has been signed by an Electrical Supervisor and returned-to the Building Division
I HAVE CAREFUlLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true
and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that UO OCCUPAfKY will 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 ba is for exemption is noted hereon. and that
only subcontractors and employees who are in comoliance with ORS 7nl.055 will be d on thi~~. .
NAIIE(pleaseprint) WItVAJE. lOA)G SIGNATURE, _ n.c--- DATE 3-Z?-'j}'
FO~ OFFICE US~Y / / I I
Sq. Ftg. rla; n ~/L.P/~y Va 1 ue ::z ;S"'~. cOD,,", d ..
Sq. Ft9. Access ~ Value
Sq. Ftg, Other2/ ~ /,..,..~V&'_ Value ..<:">,-,..,,.,.,.,." <:>
TOTAL VALUATION -6"~_ CZ:><f)_' -
\.- -.-{?-8? Systems Development
~41<;"It-'.t)?-;;::Charqe (1.5%) ~,,71>t:::J<t'.""'"
~O"n ~,..
Zone C c:.
~~.N
Uni ts
Type/Const.
Bedrooms
Occy Load /7'
Occy Group ~-?
Fire Zone
Flood Plain
/
Stories
BUILDING PERflIT
Charges and """\
Surcharges t::J-...
2 --?/l"--~ Plan Ck. Conm/lnd
___ LL::::,!-q-':__~/BldQ P_er Fpp
c<" Plan Ck. Res
'3B. .?::3> 30%/Bldq Per Fee
PLU'4BING PERMIT
Charges and r-
Surcharges ~
1?:?lF.Pff FoR I ~N A"'~ Y/"E"C.
IFEZ ctJl/"l9T?#7: - ~ 5'. ~ 3
I
____2??S9 Fence
I b.,~.81 De_o
1'27_.5~ I Sidewalk 'Tn Ii 7/-80
-n_--G~38-1 AIC Paving <ill 77tJ. ~C>
-, " 1"'>'5'" I Yob.ts
<'", 5" P Curb Cut /-h/" 11.. - 1"7'./,"
------/~~3- -/ .J..CJO
ELECTRICAL PERI~IT
Charges and
Surcharges ~. .
MECHANICAL PERMIT
Charges and I
Surcharges ~
ITota1 Comb. Permit
I
I TOTAL
'2203. 3'2..
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9?"37. ~?
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COMBINATION APPLICATION/PERMIT (CAP)
I, Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100. Lane County Map Reference
II uj 43
2. examp'le- Lot 1. Block 3, 2nd Addition to
spr,ngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. examole. heat/electrical ceilinq/or forced air Qas
2. examole- waterheater/electrlcal/or solar
Eo Square footage or valuation, etc. -
1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check-new - if addition,
check add, etc.
F. Building pennit information:
1. example - construct single family house with an
attaChed garage
2. examele - remodel existing garage into family room
3. exa~le - 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, DESIGN 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, & 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. ---
III. 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
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
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PERMIT VALIDATION
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Permit clerk~t7 ~
PROJECT CONDITIONS TO BE SATISFIED BEFORE -oCGUPANCY':/;5~~dcc--
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.#-6/?Ec?/"7?~/77 /"":;. ,.?fECE/'VCC2>. 0.<' NS.S8
Permit applicant exempt from registration with the Builder's Board because:
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Additional Projec;t Inf.qnnation:
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PLANS REVIEWED BY:
; - name~R....,r<;= ~..cz;<!"'R';igna't,ure,4~~~~,....a.,-date //~/~-2>?
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