The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2007-05-31LD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-i 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007 -00787ISSUED: 0513112007 APPLIED: 0513112007 EXPIRES: 1113012007 VALUE: SITE ADDRESS: 1620 MOHAWK BLVD Springfield TYPE OF WORK: Electrical Work Only ASSESSOR'S PARCEL NO.: 1703253105900 TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Additional circuits for lamp replacement and pole lights. Owner: Address: Owner: Address: Owner: Address: Contractor Type Electrical UNITED STATES NATIONAL LAKEOO12 28OO EAST LAKE ST MINNEAPOLIS MN 55406 UNITED STATES BANK NA #8685 50 S 6TH ST STE 1280 MINNEAPOLIS MN 55402 BANK OF OREGON LAKEOO12 28OO EAST LAKE ST MINNEAPOLIS MN 55406 Contractor JOHNSEN ELECTRIC INC License 38497 Expiration Date 0ur0/2008 Phone 541-461-0291 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: PUBLIC IMPROVEMENTS Notes: Pase I of2 $J,.$*i'N' \- t ult trtl\u rNruKlYrryJ \rt(iYrA I l(Jl\ | LD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2007 -00787ISSUED: 0513112007APPLIED: 0513112007EXPIRES: I113012007 YALUE: Description Type of Construction Fee Description + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Total Value of Project Date Paid 5t3U07 5t3u07 st3il07 st3u07 st3u07 Value Date Calculated Receipt Number 2200700000000000873 2200700000000000873 2200700000000000873 2200700000000000873 2200700000000000873 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $5.80 $2.90 $4.64 $43.00 $rs.00 $7r34 Plan Reviews To Request an inspection call the 24 hour recording at 726-3769, All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. nsnections By signature, I state and agree, that I have carefully examined the completed application 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 NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the properfy, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Pase 2 of 2 Date Valuation Description City of Springfield KN Lr,-irical Authorization To Begin Work E-mailed To: KELIASEN@ATT.NET Check on status of permit By Phone: (541)726-37 53 or Email : permitcenter@ci.sprin glield.or.us Receiot # ECsll979 513112007 1l:32:59 AM 0% Local Admin Fee; 5%ogy Supervising electrician's name: GARY E JOHNSEN Upon review and approval by your local rurisdictaon, your permlt wlll be e-mailed or faxod within one businese day, with instructions on how to schodulo your lnspection. NOTE: This Authorization To Begin Work expires within '180 days if a permit is not obtained. The local building department may determine that an Authorization To Bogin Work is null and void if it does not meet applicablo land use laws and local ordinances' f New construction lil Addition/alteratiorVreplacement fl t or 2 family dwelling l-l tvtulti-family fxl Commercial / lndustrial Job no.: US BANK Jobaddress: 1620 MOHAWKBLVD City/State/ZIP; SPRINGFIELD, OR 97 477 -3356 Suite/bldg./apt.no.: Project name: US BANK Cross strret/directions to job site: Subdivision Lot no,; Tax map/parcel no.: 1703253105900 Name: DAVID HAMMES LIGHTS & IO INSIDEONE FOR ONE LAMP FIXTTJRES. REPLACE BALLASTS, l'ax:Phone: (503) 275-5089 Email: CCB lic. no.: 38497El. lic. no.: 20-53C Business Name: JOHNSEN ELECTRIC INC Contact: KARIN ELIASEN Address: 2585 ROOSEVELT BLVD City/State/ZIP: EUGENE OR 97402-2500 Frx: (541X612340Phone: (541)4610291 Email: KELTASEN@ATT.NET City lic. no.:Metro lic. no.: Supervising electrician's lic. no.: 3485S Description Qty.Ea.Total 1,000 sq. ft. or less Ea. addl 500 sq. ft. or po(ion Limited energy, residential (with above so. ft.) - Limited energy, multifamily residential (with above sq. ft.) 200 amps or less 201 amps to 400 amps 401 amps to 599 amps 200 amps or less 201 amps to 400 amps 401 amps to 599 amps Brarch cirtuits - NtrW, alteratio ffi above service or feeder fee, each branch circuit. $43.00B. Fee for branch circuils without service or feeder fee, first branch circuit: $43.00 5 $3 00 $ I s.00each addl branch circuit Service reconnect only Each manufactured or modular dwelling, service and/or feeder Pump or inigation circle Sign or outline lighting not offered online at this jurisdictionSignal circui(s) or limited- energy panel, alteration, or extension. $s8.00Subtotal $4 64State Surcharge (8% ofpermit fee) $8.70City Of Springfield fees + TOTAL PERMIT FEE $7r 34 This Authorization To Begin Work must be posted at the job site until replaced by a Permit. TYPE OF WORK CATEGORY OF CONSTRUCTION JOB $ITE INFORUATION AND LOCATION DESCRIPT]ON OF WORK SITE CONTACT CONTRACTOR FEE SCHEDULE Residential SINGLtr- OR multi-fantily dwelling unit, Includes attached garage Services OR foeders installation, alteration, AND/OR relocetiotr TEMPORARY services OR feeders installation, alleration, AND/OR relocation I Misccllaneous ELECTRICAL PERMIT FEES 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Citr -of Springfield Official Receipt Dr. pment Services Department Public Works Department RECEIPT #: 2200700000000000873 Date: 0513112007 I1:44:3EAM Job/Journal Number coM2007-00787 coM2007-00787 coM2007-00787 coM2007-00787 coM2007-00787 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + l0%o Administrative Fee Amount Due 43.00 I 5.00 2.90 4.64 5.80 Item Total s7r34 Payments: Type ofPayment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid ONLINE CHGS ONLINE PERMIT CHGS ddk ONLINE Johnsen Electric Inc Online Payment Total: $71 .34 $71.34 cReceint I Page I of I 5t3l,12007 {ffimilrl} Building/Combination Permit Status Pending 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2005-01216 ISSUED: APPLIED: 09/06/2005 EXPIRES: VALUE: SITE ADDRESS: 1620 MOHAWK BLVD Springfield TYPE OF WORK: Curbcut ASSESSOR'S PARCEL NO.: 1703253105900 TYPE OF USE: Repair PROJECT DESCRIPTION: Driveway apron including sidewalk, repairing drywell got into d/w Commercial Owner: Address: C)wner: Address: Owner: Address: Contractor Type General BANK OF OREGON LAKEOO12 28OO EAST LAKE ST MINNEAPOLIS MN 55406 UNITED STATES BANK NA #8685 8OO NICOLLET MALL BC-MN-HIgU MINNEAPOLIS MN 55402 TJNITED STATES NATIONAL LAKEOOI2 28OO EAST LAKE ST MINNEAPOLIS MN 55406 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1 -800-332-2344). License Expiration Date PhoneContractor GALE ROBERTS IION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improyements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: )RMATION PUBLIC IMPROVEMENTS Notes: Pase I of2 LLl :U Tf Building/Combination Permit Status Pending - 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-01216 ISSUED: APPLIED: 09/0612005 EXPIRES: VALUE: Description Type of Construction Fee Description Total Amount Paid Total Value of Project Date Paid $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Receipt Number Date Calculated Amount Paid $0.00 tr'ees Paid Plan Reviews To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. By signature, I state and agree, that I have carefully examined the completed application 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 NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. ?- ob-c or Signature Paee? of2 Date S Valuation Description Keourred lnsDectrons 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt elopment Services Department Public Works Department RECEIPT #: 2200500000000001223 Date: 0910612005 2:04:55PM Job/Journal Number coM200s-012r6 Description Curbcut Permit Amount Due 80.00 Item Total:$80.00 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Cash NATHAN KRUGER CAS In Person Payment Total: $80.00 -58-o"o-d' 9t6/2005 Page I of 1 .DIIIOI.1,D OF Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-36768ax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00947ISSUED: 0810212004APPLIED: 07/3012004 EXPIRESz 0210212005 VALUE: SITE ADDRESS: 1620 MOHAWKBLYI) ASSESSOR'S PARCEL NO.: 1703253105900 PROJECT DESCRIPTION: Springfield TYPE OF WORJ(: Plumbing Only TYPE OF USE: Alteration Commercial Replace 135' of storm line and attach to 2 existing catch basins. Add filters to existing catch basins. Owner: Address: UNITED STATES BANK NA #8685 % ERNST & YOUNG LLP NATIONAL PROPERTY TAX COMPLIAN D TX 75222-3723 follow r Those ruies are set fonn 0 through OAR 952-001- Contractor VOS PLUMBING INC 0090 calling # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled PEB/ # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: obtain Phone 541-485-0551 Contractor Type # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: r.( Sn t, OD BANI)0N 'twlr L s NOE0 F0 is 1-800-332-2A44). Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: nla Occupant Load: IF rHE W0,rft,reumrD PARKINGB rrB Total: Sidewalk Type: Downspouts/Drains Handicapped Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Page I of2 Value Date Calculated Valuation Descriotion I I'UILI-'INU II\ I IJI(IYIA T TUN I Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00947ISSUED: 0810212004APPLIEDz 0713012004 EXPIRESz 0210212005 VALUE: Fee Description + l0oh Administrative Fee + 7o/o State Surcharge Encroachment Permit Fixture Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100' Total Amount Paid Amount Paid $8.70 $6.09 $120.00 $28.00 $4s.00 $14.00 $22r.79 Total Value of Project Date Paid 8t2t04 8t2t04 8t2t04 8t2t04 8t2t04 8t2t04 Receipt Number 2200400000000000996 2200400000000000996 2200400000000000996 2200400000000000996 2200400000000000996 2200400000000000996 tr'ees Paid Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Plumbing: Prior to cover and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. nsnections By signature,I state and agree, that I have carefully examined the completed application 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 NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times construction. 7- z- 07 Owner or Contractors Pase2 ol2 Date -T 225Fiffh Street Springfield, Oregon 97 477 541-726-3759 Phone Citv of Springfield Official Receipt :lopment Services Department Public Works Department RECEIPT #: 2200400000000000996 Date: 0810212004 9:13:53AM Job/Journal Number coM2004-00947 coM2004-00947 coM2004-00947 coM2004-00947 coM2004-00947 coM2004-00947 Description Fixture Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100' + 7o/o State Surcharge + l0% Administrative Fee Encroachment Permit Amount Due 28.00 45.00 14.00 6.09 8.70 120.00 Item Total:$221.79 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check VOS PLUMBING swb 26192 In Person Payment Total: $22r.79 - 8/2/2004 Page I of I 5a __l SPRINGFIELD Job# 00-00252-01 COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 Job Number: 00-00252-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 05900 Subdivision: TRANST:01-00010?9 DATE:JUN 06 1000 Al{T RE[D:2 $ 16.50 IHANEE: CASHIER:061 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1620 Mohawk Blvd Spr AssessorsMap#: 17032531 Lot: Block: Addition ctTY oF SPRfiNGFfiELq OREGOAT Owner: US Bank Address: 1620 Mohawk Blvd Scope Of Work: Lease Space Phone Number: Gity/State/Zip: Alteration Springfield, OR97477 Value: $60,844 remodel US Bank building to create lease tenant space. Contractor Type GeneralContr ElectricalContr Mechanical Contr Contractor Quadrus lnc. 4647 SW Huber Street, Portland, OR 97219 Scofield Electric Co Po Box 2765, Eugene, OR 97402-0307 Fresh Air Co lnc 8462 Sw Umatilla St, Tualatin, OR 97062-6329 Registration # 88404 Expiration Date 1t20t01 Phone 503-293-8931 541-686-8612 503-692-1234 38702 661 55 12t21199 4l25lOO Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: Utilit!Quad Area: # Of Units: Constr. Type: Water Heater:ca To request an inspection callthe 24 hour recording at726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required !nspections Buitding Framing Walllnsulation Dryrvall Ceiling Grid Final Fire FinalBuilding -Prior to cover. -Priorto Cover NOTICE: -Prior to taping.- THIS PERIVIITSHALL EXPIRE IFTHEWORK -When all Fire Department requirements have bgArtTtlffi|ZED UNDER THIS PERMIT lS NOT - when all req u i red inspections have been apprqgffi Cffffi{trlg iffiffq6$1tft D FOH Rough Electrical -Prior to cover Electrical ANY 180 DAY PERIOD. .-,,; i&sc ;sqUiig$ yOU tr , Page 2 of 2 Required lnsPections Electrical Final Electrical Rough Plumbing Final Plumbing Construction TYPes: Occupancy GrouPs: # Of Buildings: # Of Bedrooms: Handicap Access? [ Area (Sq. Main: -When all electricalwork is complete' r- -Prior to cover -When all plumbing work is complete' # Of Stories: Height (feet): Current Units: ProPosed Units: Census Code: Does not aPPIY Accessory:Total: Fee Paid On Receipt# Value/Quantity Fee Amount Buildi Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 05/15/2000 05t15t2000 05/1 5/2000 0001 738 0001 738 0001 738 60,844 $316.00 $22.12 $9.48 $347.60 Branch Circuits WO Feeder or Service State Surcharge For Electrical Permit Electric Administrative Fee Total Electrical Electrical 02t1112000 02t11t2000 02t11t2000 567 567 567 16 $65.00 $4.55 $1.95 $71.50 Plumbing Minimum Plumbing Permit Fee Number of Fixtures State Surcharge For Plumbing Permit Plumbing Administrative Fee Total Plumbing 06/06/2000 06/06/2000 06/06/2000 06/06/2000 2029 2029 2029 2029 $5.00 $10.00 $1.05 $.45 $16.s0 Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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 Springfleld and the Laws of the State of Oregon. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that the project addresi is readable from the street, that the permit card is located at the front of the ', and the approved set of plans will remain on the site at all times d co $435.60 Signature Date I 1 Job# 00-00252-0'l COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 ot 2 SPRINGFIELD TRANS$:01-0001?38 DATE:HAY 15 TOOO Al{T REID:Z $ 419.10 CHANET:$ ?1.50 IASHIER: OO4 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1620 Mohawk Blvd Spr AssessorsMap#: 17032531 Lot: Block: Addition: Job Number: 00-00252-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 05900 Subdivision: ctrY oF SPRfiNGFIELq OREGON Owner: US Bank Address: 1620 Mohawk Blvd Scope Of Work: Lease Space Phone Number: City/State/Zip: Alteration Springfield, OR97477 Value: $60,844 remodel US Bank building to create lease tenant space Contractor Type GeneralContr Electrical Contr Mechanical Contr Contractor Quadrus lnc. 4647 SW Huber Street, Portland, OR 97219 Scofield Electric Co Po Box 2765, Eugene, OR 97402-0307 Fresh Air Co lnc 8462 Sw Umatilla St, Tualatin, OR 97062-6329 Registration # 88404 Expiration Date 1120101 Phone 503-293-8931 541-686-8612 503-692-1234 38702 661 55 12121199 4125100 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required Inspections Buildi Framing Drytuall Ceiling Grid Final Fire Final Building Rough Electrical Final Electrical - Prior to cover. -Prior to taping -When all Fire Department requirements have been met. -when all required inspections have been approved and the building is complete. Electrical I -Prior to cover. -When all electrical work is complete. Job# 00-00252-01 # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Page 2 of 2 Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main:Accessory:Tota!: Fee Paid On Receipt# Value/Quantity Fee Amount Buildi Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 05/1 5/2000 0s/1 5/2000 05/1 5/2000 60,844 $316.00 $22.12 $9.48 $347.60 Branch Circuits WO Feeder or Service State Surcharge For Electrical Permit Electric Admin istrative Fee Total Electrical Electrical 02t1112000 02t11t2000 02t11t2000 567 567 567 16 $65.00 $4.55 $1.95 $71.50 Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that the project address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times Signature Date $419.10 5-/5 -oo 0001 738 0001 738 0001 738 Job# 00-00252-01 Page 1 ot2 TRANSS:01-000056? DATE:FEE 11 TOOO Al{T RECD:? $ 71.5C IHANGE: IAEHiER:059 SPTIINGFIELD €n COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1620 Mohawk Blvd Spr Assessors Map#: 17032531 Lot: Block: Addition Job Number: 00-00252-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 05900 Subdivision: ctTY oF SPRrNGFIELD, OREGOTV Owner: US Bank Address: 1620 Mohawk Blvd Scope Of Work: Electrical Only Phone Number: City/State/Zip: Alteration Springfield, OR97477 Value: $0 Contractor Type ElectricalContr Contractor Scofield Electric Co Po Box 2765, Eugene, OR 97402-0307 Registration # 38702 Expiration Date 12t21t1999 Phone 541-686-8612 Quad Area: # Of Units: Constr. Type: Water Heater: Office [J5s - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-3769. All inspections requested before 7:00 a.m. vriill be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required lnspections Rough Electrical Final Electrical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? (sq.F Main: Electrical -Prior to cover. -\A/hen all electrical work is complete Accessory # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total Fee Paid On Receipt# Value/Quantity Fee Amount Electrical Branch Circuits WO Feeder or Service 02111t2000 567 16 $65.00 Job# 00-00252-01 Page2 ot 2 Fee Paid On Receipt# Value/Quantity Fee Amount State Surcharge For Electrical Permit Electric Administrative Fee Total Electrical 02t11t2000 02t11t2000 567 567 $4.55 $1.95 $71.50 Grand Total Signature $71.50 2-//-q Date C'TY OF li. s Bqa,,tlo INSPECaI0N REQUBSIz 726-3759 zonrns 0BFICE: 72{3759 Date 1 rccsrroN 0P A JOB DESCRTETTON !'tttN(3I'lEL-Et Job Hr.raber COHPL TE FgE SCEEDTII.B BEI.OS a. 225 YTFIE SIBEEr SPBJNGEEEIJ)OREGON, The following Proiect AS submitted has the lollowing zoning and does not 9T47?Plovar require specific land usl?l PCII(ICAr-PERI{IT AIPTTCATTON 0 CC 0t L- 2. COIIIBACTOR INSTAIJATION OI{II B. EIECtTiCAI CONtTACIOT SCOF'IELD ELECTRTC Address po Box 2765 Ci ty_ruclr{n, oR Phone GBG-BG1 2 Supervisor License Ndmber 508-S Expiration Date 10/01 /2001 Constr Contr. Number 38702 Expiration Date 12/21 /ee Sigaat of Electrlcian 0vners Nane Address C citv ht-L Phone L OSNER INSTAIIAEON .l *eirc*ilt Permits are non-transferable and expire 1f vork is not started uithin 180 daysof issuance or if vork is suspended for 180 days. The installation is being made on property f om vhich is not intended for sa1e, lease or rent omers Signature3 DATE:. A. Nev Residentlal-Single or Hulti-Fanily per drelling unit. Service fncluded: Iteos Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Eaeh Hanuf'd Home or Hodular Dvelling Service or Feeder $ 8s.oo $ 15.00 $ 40.00 Services or Feeders Insta1lation, Alterations or Relocation: A) s $ $ s s 40.00 C. Temporary Services or Feeders fnstallation, Alteration or Relocation rl c 200 amps or less 201 amps to 400 amps 401 amps to 500 amps 601 amps to 1000 amps Over 1000 amps./vo1ts Reconnect 0n1y gg ilBl| Sum above 50. 00 60.00 100.00 130.00 300.00 200 amps or less $ 201 amps to 400 aurps - $ Over 401 to 600 amps _ $ Over 600 amps or 1000 volts s 40. 00 55.00 80.00 D. Branch Circuits Nev, Alteratlon or Extension Per Panel One Ci.rcui t Each Additional Hiscellaneous (Service/feeder -Each installation' Pump or irrigation S Sign/outline Lightirrs- S - Limited Energy/Res S Limited Energy/Cona S 5. SIJETOTAL OP ABOVE '7 -1{state surc.harge 32 Cicy TOTAL I s3s.oo LP not included) 40.00 40. oo 20. oo @ Circuit or vith Service orFeederPermit tf S 2.00 7o-fr B. RECTEVED BI: 5to 1t .fo CITY OF OBEGO'V 225 FIFTE STREET SPRTNGFTELD, OREG0N 91477 INSPECTION REQUESTz 726-376 OFFICE: 726-3759 1.LOCAT TION . JOB ,{turrr PTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or-if vork is suspended for 180 days. 2. CONTRACTOR INSTALI..ATION ONLY Exoiration Date Signature of ising Electrician 4i Ovners Addr cir Phone OI]NER INSTALLATTON The installation is being made on property I ovn vhich is not intended for sale, fease or rent. Orners Signature: DATE: SPlrI]{GFIELE! MuIti-Family per dvelling unit. Service Included: I tems Cos t s 8s.00 Electrical Contractor Services or Feeders Installation, Alterations or Relocation: Address 200 amps or less 201 amps to 400 amps -40L amps to 600 amPS _ 601 amps to 1000 amPs- Over 1000 amps/volts Reconnect Only Ci ty Phone L Supervisor License Number LtSr Expiration Date ll- lttt c Constr Contr. Number .\\\)?L Temporary Services or Feeders Installation, Alteration or Relocation B L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder SUBTOTAL OF ABOVE 5Z State Surcharge 3% Administrative Fee TOTAL 200 amps or less 201 amps to 400 amps -Over 40L to 600 amPs Over 600 amps or 1000-ToT[s Sum $ 1s.00 s 40.00 60. 100. 130. 300. 40. .00 .00 ee rrB?r aEove S s s( D s 00 00 00 00 00 00 50. $ s $ S 40 55 BO 00 D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ Sign/Outline Lighting , $ Limi ted Energy/Res - $ Limited Energy/Comm $ 40.00 40. 00 20.00 36.00 4C (/u 5 RBCEIVED r Fl.nlhl- SPFlINGFIELO JOB dAERSIGN PERMIT APPLICATIOI\ 225 Fifth Str3e! Springlield OR 97 477 Zfr, lnspection Line: 7 26-3769 Olfice:726'3759 Bt86+OlfttDt)IDSITE ADDRESS: ASSESSORS MAP: OWT.JER DA 13 AN PHONE: N TAX LOT: PoTBDX StVzADDRESS: CITY:N OR 4t a BUSINESS NAME, FIRT./ TTC.:US OeSCatprtOru OF PBOPOSED SIGN(S): (please check a ANY 80 AVmgnlte information) IS NOT Roof _ Marquee - Wall X Freestanding Sinole Face Double Face Square Footage: 5', Pro jecting Billboard \./erticai Dimension of sign or enclosure:4 Dimension irclm Grade to bottom-of Sign Enclosure:l4'to"Electrical lnstallation: X V.. -- No VALUE (lf yes additional electrical permit is required) OF SIGN: Total Height above Grade Horizontal Width of sign or enclosure:o'7" )w- lt -\)Material Sign is const!'ucted of: List ALL existing signage and attach a photograph of oach slgn: (al Type (c) Type Sq. Ftg. Sq. Ftg. (b) Type (d) Type Sq. Ftg Sq. Ftg Z3 PHONE:Agr1b+b COI.JTRACTOR/IN STALLER: Lt"o OAK ATCH R.u. lE€ Ex-ts'(r? ADDRESS: I CITY:6 STATE:zlP'.4ol- CONSTRUCTION CONTRACTORS REGISTRATION NUMBER:ril ,7-bb EXPIRES: L CITY BUSINESS LICENSE NUMBER:4r.o 'l-'PIRES:b 2 o qb OFFICE USE Sign District: Zoning: Sign Permit Fee:55 nd Use: Code Section: Approved By: o DATE a REOUIRED INSPECTIONS: _ Site to be made Prior to sign placement Footing prior to placement ol concrete \ Attachment Electrical after fasteners are prior to energizing Final completion of sign lnsta llatiorrinstalledipflorcoverI installation Additional Comments and/or Conditions: By signature, I state and agree, that I have care{ully examined the completed application and do hereby certify that all information hereir is true and correct, and I further certify that any and all work performed shall be done in accordance with the ordinances o' the citY o Springfield, and the Laws of the state ol oregon pertaining to the work described herein. lfurther certify that onlv contractors an enrployees who are in compliance with ORS 701.055 will be used on this prolect' I further agree to ensure that all required inspections are requested at the proper time, that proiect address is readable lrom the street' thi the permit caro is located at the Iront of the propeny, and the approved set of plans will remain on the site at all times during the installatio ol the sign(s) DateSignature Amount Received: L Date Paid:Validation: Receipt Number:Received By: Other ,/ hWNt^l.q3 COM M ERCIAL/IN DUSTRIAL PERMIT APPLICATION 225 Fiflh Street, Springfield, Oregon 97477 LOCATION OF PROPOSE RK SPIIINGFIELO o lL, afr, JOB NUMBER INSPECTION LINE: 726-3769 OFFICE: 726-3759 TAX LOTASSESSORS MAP D t -*tf,ft U, fullF-z1S-1ZtePHONE:E) o 5(o?- zte n-7 frl- ADDRESS OWNER lr"z-o STATE:CITY: , mfu, t E*r>rktl atE Ttlcttnt.F* tp eou9r- At^t,,otrat ADDITION DEMOLISH OTHER uoru.?-l@o. oo DESCRIPTION OF WORK *.* X FTEM.DEL ARCHITECT: MECHANICAL: - NAME ADDRESS PHONE 5 vd o AA4ENA Snto I .5t5 st ta- l-7+ 485-55+b CONTBACTOR'S NAME ELECTRICAL: EXPIRES lz-zo -13 PHONE #5'qi+u ADDRESS S3Nilo".o*, hwPuun lZro @fffc-1t GZ1o1GENERAL: PLUMBING PLUMBING NO.FEE CHARGE Single Fixture Relocated Bldg. (new f ix. addtl) Water Service ft. Sanitary Sewer ft. Storm Sewer ft Backf low Device TOTAL PERMIT MECHANICALNol FFF EHA RGF Furnace/burner & vent < 100,000 BTUs Furnace/burner & vent >100,000 BTUs Floor furnace and vent Suspended wall or f loor mounted unit heater Appliance Vent separate Stationary evap. cooler Vent Fan/Single duct Vent from System apart AC or htg. Mechanical exhaust hood and duct Permit lssuance $10.00 TOTAL PERMIT _ OFFICE USE - ZONING tll_c- HANDICAP ACCESS: FLOOD PLAIN: LIGHTING POWER BUDGET: WATER HEATER: CONSTR. TYPEr HEAT SOURCE: LAND USE: # OF UNITS OCCY GROUP: Y OF STORIES: QUAD AREA: Y OF BLDGS: SQ. FT.$/SQ. FT,VALUE TOTAL VALUE OF PROJ X X X SO. FTG MAIN SQ. FTG ACCESS SQ. FTG OTHER RCPT#PLAN CHECK FEE DATE BUILDING PERMIT u I =1.) PLUMBI NG DEMOLITION 5% State Su rcharoe . .69 570 State Surcharge MECHANICAL FENCE VALUE $ 5% State Su rcharqe SIDEWALK FT. SUBTOTAL PERMITS PAVI NG CURBCUT FT. SYSTEMS DEVELOPMENT TOTAL PERMIT FEES EXCLUDING ELECTRICAL AON\,J BY V V REQUIRED INSPECTIONS -1, It is the responsibility of the permit holderto see that all inspections are made at the proper time. To request an inspection, call 726.3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready for inspection. Requests received before 7:OO a.m. will be made the same working day, requests made after 7:00 a.m. will be made the following work day. SITE INSPECTION: To be ROUGH PLUMBING, PAVING: After gravel is in made after excavation, but ELECTRICAL & place but prior to placing prior to setup of forms. MECHANICAL: No work is to asphalt or concrete. be covered until these UNDERSLAB pLUMBING, inspections have been made SPECIAL INSPECTIONS: ln accordance ELECTRICAL & and approved' Section 306 0f the state specialty code MECHANICAL: To be made a special inspector shall be employed before any work is covered. ATTIC DRAFT STOPS & oy ine owneri Contractor during CURTAIN WALLS construction of the following work. A FOOTINGS & FOUNDATIONS: aAE. r copy of the special testing reports shall To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division. excavated and forms are facing materials and before erected, ail steel in place, but framing inspection' srRUcruRAL GoNCRETE: ln prior to placing concrete. FRAMING: To be made after excess of 2500 P'S.|. (306 a.1) coNcRErE SLAB: ro be f[J;:l; ilJ'3[XlHi,'],? ,, srRUcruRAL wELDS: made after all inslab building place aid all pipes,ihimneys Performed on the iob. (2722t) service equipment, conduit, and vents are complete and :i?[,?;""".',:;H:? ?i.i:'fJ *? H::li]igi:,1'i,i;[3:1: Bl?,:f],?E],?T[,??"'I]:". in place but before any tightening operations. (306 concrete is placed. TNSULATION & VApOR a.6) BARRIER: To be made after all UNDERGROUND: Plumbing, insulation and required vapor SPRAYED ON electrical, gas, sanitary sewer, barriers are in place but FIREPROOFING: U.BC. Storm sewer, water and before any lath or gypsum Standards 43-8. drainage lines. To be made board interior wall covering is prior to covering or filling applied. S'ECIAL GRAD'NG,trenches. ,NDERFL..R: p'umbins [l::,s*'i3*'J3[[i"' il;iJt'iiil#li.',5J:'j],"1 electrical, mechanical. To be according to plans' chapter 29) made prior to installation of floor insulation, decking or floor sheathing. POST & BEAM: To be made prior to installation of floor insulation, decking or floor sheathing. FLOOR INSULATION & VAPOR BARRIERS: To be made prior to installation of decking or floor sheathing. MASONRY: Steel location, bond beams grouting or verticals in accordance with uBc 2415. ROOF SHEATHING AND NAILING: Prior to installing any roof covering. LATH ANO/OR GYPSUM BOARD: To be made after all lathing and gypsum board, interior and exterior, is in place but before anY plastering is applied or before gypsum board joints and fasteners are taped and f inished. SIDEWALK & DRIVEWAY: Required for all concrete paving within street right of way, to be made after all excavating complete and form work and sub-base material in place. CURB AND APPROACH APRONS: After forms are erected but Prior to Placing concrete. GLU.LAM BEAMS: lnspection Certificate by an approved agency, furnished to the City's Building Division before beams are placed. (2501 U.B.C. srDS. 25-10,11). STRUCTURAL MASONRY: (306 a.7) 'ln addition to the inspec- tions specified, the Building Official may make or require other inspections of any construction work to ensure compliance with the Building, City or Development Code. I By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information herein 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 Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project' I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all / o' l+-17Signature'&Date times during construction t8"-yVALIDATI //-E2zAMOUNT RECEIVED RECEIPT Y: -4?-DATE PAID: _ RECEIVED BY: FINAL ELECTRICAL FINAL MECHANICAL FINAL FIRE DEPARTMENT ADDITIONAL COMMENTS: SITE PLAN REVIEW BOARD: Must be requested 2 days in advance of the date you wish inspection. AII project conditions such as landscaping, parking lot striping, etc. must be completed before requesting this i nspection. FINAL BUILDING: Requested after the final plumbing, electrical, mechanical and Fire Department inspections are made and approved. No occupancy of the premises can be made until a Certificate of Occupancy has been issued by the Building Division and posted on the Premises. I PLANS REVIEWED BY DATE FINAL PLUMBING - SIDTIINGFIELD 225 FTFTE STREET SPRINGFIELD, OREGON 97477 INSPECTI0N REQUBST. 726-3769 OFFICE: 726-3759 r i.db PBRHIT APPLICATION 4=r I,Ci ty Job Number T.. LOCATION OT INSTALI.ATION ?4 JOB DESCRIPTION )D1 lal, oV&rt- A'( tn r4AcH tN Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days 2. CONTRACf,OR INSTALI,ATION ONLY EUqEP€ 9 qtr Electrical Contraclor P Av./)JtN1 Address LID H Ci ty euqApE ,ot-.Phone *9 q - €5 ?t Supervisor License Number O?- 515 9T Expiration Date o- | - n Constr Contr. Number b21o1 ExP iration Date I z- >o -13 Signature of Supervising Electrician o Owners Name \ )6 e{\\<- Address \tofD -a.r C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amPs - $ 55.09 0ver 401 to 600 amps $ 80.00 Over 600 amps or 1000lo1ts see I'Btr above D. Branch Circuits Nev, Alteration or Extension Per Panel rBE SCBEDUI.E BELOS Nev Residentlal-Single or MuIti-FamiIy per dvelling unit. Service Included: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular DveIling Service or Feeder $ 85.00 $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -401 amps to 600 amPs _ 601 amps to 1000 amps_ 0ver 1000 amps/volts 60. 100. 130. 300. 40. $ 3s.00 $ 2.00 Miscellaneous (Service/feeder not included) -Each installation P r rrl tion t ergy Limited Energy/Comm 4e gfro"t*tt A Sum B $ $ $ $ $ $ 50.00 00 00 00 00 00 L (l Ci ty Phone OIINER ALI.ATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners Signature: DATE: *: One Circuit Each Additional Circuit or vith Service or Feeder Permit STIBTOTAL OP ABOVE 5Z State Surcharge TOTAL E $ 40.00 s 40.00 s 20.00 $ 36.00 oo z. oo c[-TY-oF oRECOTU RECEIVED BY: 5 .oe Q.,* lus \I a-.tra In?.-;*kDL S{ri\H ,city of sPritrgfield 225 n.5tlr strect 1;f'ntr.rGFlELE! SIGN PERMTT APPLICATION lN Fo RMnTlol{ : 720-371i3 INSPECTIONS: 726.3769 LOCATTON Or SICN (ADDRIISS) LEC^L DESCRIPTIOI.I TA.1: LoT *oa OI.INER OR PROPERTY Ir (.-k PnoNE b?-7 *7RU q ADDRESS 7,r1' o1INEltorSIGI.I(I.FoTtIIiRTlt^lIPRoPliIrTYowNIiR) ADDRES S IONI: NA}IE O}' BUSINEI;S , FIR]'I , ETC.TYPri Or rlusrilEss B. rvrn or rloRK (-n,.r,,o A E E CTOR ERNCT RIiI-OCATIi oTltult VIiNDORS, s rcN l':Rri: }.DDIJCSS ,r,*,r._E# 3gz_2tY2 u 411 CITY LI CENSE IIIJ}IIJI]R l:::(l'. DATE ? slcN I'tAr'ruFACTUrrEIr (r!- OTI{ER Tll N EIlJiCTolt) ADDP.nSS Pll0ilIi DII,IETISIOI'IS, IIISTAI,LNTIOI'I [t CONSTRIJCTIO}I TOTAL IIEIGIIT ABOVIi GP.ADE VEP.TICAL DII'IEI.ISIOI.I OI.' STG}I HORIZO}MAL WIDTII OT SICN DII'INI.ISIOI.I ITROI,I GRADE TO BOTTOI.I OT SIGN TIIICKIIESS OR DEPTII DOES SIGN PROJECT BEYOND PROPERTY I.INN? IF YES, DII-IENSIO}J BEYOI'ID PROPI]RTY I,It.IE A4"44,' 12'.3" f(': YES NOTE: IF PITOJIICTIoII IS l{oRE TIIAN 12" 6-Vlill punt.rc I,RopEp.Ty rrn srGN EtEcroR I.IUS1' FILIi WITII TIIIi t}UII.DIt'IG D],VISIO}I COPIES OIT IIIS/IIIiR LIABILITY AI'ID PITOP. ERTY DA}TACE IIISUP"AIqCI' POLICIES. permic. NAIIE (PLF-ASE PRINT) f-. ' I IIAVE CARIIFIJLLY E:i^l'lINIID tha conrpl.erc(l flppl.i.carion for perntiU and do herel:y ccrtify chat all inl:ormation ls tr:tre an<l corrccc, and I ftritli.:r cerrify cirac all r.rnrl< performcd shalI bc done in accordance wirh rhe Springf ie1<t Sign Or:rlinarrr:c. ttra tliltform Siign Codc- as- adopred !y rt'te Cicy of SorinqfleLd ancl atl othcr-Orclinanccs of t:hc (lir:y of Iipri.nql.i-elrl attt! tlrc lirr.rs of che Scacc of Creg,rtri r:crtalni-ng Eo uitc vrorll <lcscr'.bcct he.urn. I furt!rcr corfLt'y tllatj l,lv 51g.n CorEracfor I-i- censc with Che Cify oJl SprinS',fieId is in [u]. I forcc an<l effcct as reorti.red by Spring.Ficld Codes 8-2-6(3) and 9-7-20(2). -I will rc(lucsc alI retprircd sign inspecE,ions Iistcd on che approved C' ,ro.ra'rrlt^I. TY'E oF srGN: l4AIrOtJl.:li uNDl.:R t{Al(oul':u OTI!EIT JLIIAI-L ROOF t'RIi[:lTA]lDT. ilC IRO.] T:CTI,I.IG . USE AI.ID CI}\IIACTER OF SIGII: _IDIlllTrTY _rNcrDEIITAL M oounr.n nncn-.t-- _sLNGr.E FACE !.!ULTr-FACE --P.EADEI{ BOARD BILLBOARD D EXI.STIIIIG !;lCNS ARE TIIERII A}IY };:(ISTI}IC SIC AI-L EXISTI}IC SI.CNS FO!l nt,srNIisS, IITC. nrroVrc\ uJ tst *'+- G ilo FTC -t+5() sq tBliP. rrsr )1vn.s SIZII IN S H' ,rr" srcN ,Avri ril'c'l'p.rc^L l,IrR,lc? IF YES, tJllICIl /1.Pl'LY? _ILLl.lltlNATl::D (II.ll)III': IiLECTIIICAL COIITP.ACTOR Pr:cNr :<8 2-2t8 Z Y€S{_ CTI-Y ADDRIS!; ELECTRICAL SIGII Lrcllr[D) Lrsc.Nur.,rlr:R q5(, l. DEscRTRE TypE oR r.hrERrALS srcN rs K.unrru oF srcN, 55r_2 CONSTIIUCTED OF. -tc\ tlr-trvr -,\tuoj-<^ SITE rllroFlu'rroll (LAND t,sE) -- EXISTTI'lc Usli oF EUil.DllrG OR LAND (oR I ST USE rr vAcANT) Ba.^h _ptn ooor,. DUS r NIis s _ou'rDoop. t,rERcttAN D I s I ltc fr:vv^rw otrci x 0 J PROI'OS U.sIi OF BUILDIT'IC 0R L.AND:- SICNATURE DA'IE 3z-zw)_ l("WLo[,r i,r )k Rl \/ cl, ?t4t1 I W{-br{ r)Se ar PLEAS E \D nA licat|on: A separlrCe appli.caLiorr ls requlrcd for cach scparaCc sign as defined I,nEe e. 2)Elcctrical Any pennit issued under tlris applicaLion will includc wiring lr] or on siSn scructurc, ,n, ioa cor.lrcction mtrsc be covbrc(l on an elcctrical liermiL. ElccLrical connecLion only by:r SLatc Liccrrsecl EIcctri.<:irl CorruracEor, Illtrminated signs (b-orh inrernally tt-in,,;t.o,,1or,, Lo Sccuions 9-7-tt (4) & (5) and 9-7-IB of thc Springficld Sign Or- EE-e sup-[Iy wi musE be made and exterrrall dinance . 3)plarrs Requircd: 1't1is applicauiorr is to Lrc srrbrnitLc<I r.rlth Lwo compleLe scts of plans showing.di- i* .igli;-of-!'i[ri; ua""rEi.sirrg rncssagc on si13n; IocaLion of sign or1 -propcrEl' wirh di- mensions to propcr;y 1i1of , structural ictnil..;'-oI supporc franring,, bracing and foocin[]s; narerials &";;;;;r;IuI..'i"i'"i[" ,r,a ri1;,', "Lructurc; elr:ctri;;1_ equiprneni and liglitinS; sizc and IocaEion of existing si1ils ou-[Iopo.:ry f8r tlre sarrrc busictss, all ;rs .iequircd.to dcLcrminq. comnllance wi-th ;h"-3-;;i;;?r"rE si;; b;JL"inte (nrri..tn z of une sl,ringfield Ciry Code). Also,. show che follow- i;; i;1;;afi;ri"" .""[,;-pi;; pi",.r 1pt,,,, snowing proi,,:rr] lincs aud locauion of signs): a) Show Che location of all exist:ing slgn(s) as well a:r proposed sigrr(s)' b) Show Che lengfh of the srrcct frontage L;rl<ctr rrp by uhc busiuess or btrllding. For wall signs, show -hc lcngrh of Lhe building front:48e. c) Show Che locaLion of entranccs opcll to Lltc publlc antl tlrivc1ays. llhen required, because of <Jesign,. siz:c, cfc., crrgi-nccred drawirrgs and-calculaEiolls musf be pre- pared by a licenseJ cnginco. oi slrall conilorrn Lo dcsiBIr sEandards on flle aE, thc Building Divi- sion Offlce. plans of lnsufficient clarity or dcLail will l,,c rcLurucd Eo Ehc applicant wirh no peroriE beitrg issued. Signs ntusE mr:ct corner visiol clcarance rcquircrnr:ttts au dcscribed in Figure 9 of uhe Springfield Cornprchensive Zotring Codc. lloTE: llo sisn may be crccted which ir; less Llian 12 fect horizonrally or vertically-from overhead affiiri.Ir-i3.a,,"1"i. i. o*"ors of 750 volLs, or lcr;s than 5 fccL in-any direcriotr frorr ovcrhcad electrical llncs whlclr are cncrgizcd aU lcss tiran 750 volEs. If a sign is noc irrsEallc<J wirhirr 60 <Jays afrcr Llrc daLe of issue of rhis permic, Eire pcrmir shall be void. . Inspec tioqs : a) Sice Inspecrion - to bc matlc bcfore tlre sign is placed. Usually, the lp-9$!ilnrLgtlion iff-€-ppTft;bTo- may bc rna<lc rru thc sarnc Lirnc as thc SiEc InspccEiotr. Thc loo[rng rnsPcc- ii"n 'ii fo be -i,adc'af cer holc (s) ls c.:ic.rv:rLuci, buL prior t-o tirc placctnenc of concrctc. b)Final Ins l)ccri.o r.o be madc u1:ou conrplcriolr of alL worl<. 4) 5) 6) 7) B) e) n c) Ulectrical - aIl electrical si.gns rnust bc lrrspecEecl for clecE.rical hook up afccr Ehe sign' fs erec-edil and before t-he sign is Eurtred orr. CALL rOR TllE REQUTRED IllspEcTrolls oN T|E 24 IIOUR rllsP[C'rrotl LINE AT 7?.6-3769 srGN DISTRICT u . zol',lli DrsrRlcr al TOTAL SQUARE FOOTAGE OT SIGN JOB # SICI.I PEIU,IIT FEE: DLIiCTRICAI, PER}IIT IEE: <. V7. strrru SURCIL\RGE: 7 REOUIRED INSPECTIONS: srrE/LOCATTON y'r-ootrlc or{ trrirrroD or ATTACilNni}tr -,/ -v/rlscrnrc1l y' nrtlnl OTHER SPECIAL CONDITIONS TO BE SATISTIED BETORE Ezu'CTION Ot; SICN: ADDITIONAL INFORMATION NI,IDED UETOIU' TEIiMIT I'IAY BIi I SSUI'D APPROVID BY: 'u,7{ TOTAL: DATE CLIiRK RECEIPT 3 \ DATE SECTION:SPRINGI:IELD SIGN OII.DINAI'ICE INSPECTION LINE 726-37 69 COMBI ICATI 7?6-3753 2-o k*Job Address v EI.IERGY SOURCES Hea t tlater Heater Ranq Ftg n Sq. Ftg. Access."-- Sq. Ftg. other__ _l'lew_AddJl ter_P.ep. _Fe nc e_Demo_C ha n g e/ U s e 0ther ffi l-ega1 Description Value of l,lork, -e 5&.ooOwnera.S Baile_ Address Sa.rnp-Phone Bui I tii r Fami l y ng Pernrit Info: Describe Work( lles i dence l,,li th Attached Ga raqe ..e ., guita Single Ztu^ou. ovi" l)n a. 1? " Y 5ln Construction Lender - ,tSLzn--' reDlde a. Y)'J-r- -2L1"f/q' Address Phone DESIGN TEAI.1 name address exoi res phone no Pri ma ry Structura I E i ectri ca l l'4ec ha n i ca I ACTORS name addres s I ics- no-exDI res ohone no- Genera I P l umbi nq ElectricaI (arL*rn aia'^G. ?-o.Rorr 5lA &-^d .oL q-^L rclqo 772-Z&LUq11dq l.tec ha n i ca I PLUI.lB I NG EL ECTR I CAL MECHAN I CAL N0.FEE CI]ARGE N0_FFF CHARGF NO FFF CHARGF Each single fixture Residence of SQ FT furnace/burner to BTLI' s Relocated building (new fix. additional) New ci rcui ts ai ts or extensions FIoor furnace and vent S. F. Residence ( I bat-h )SERV I CES Recessed wa l I Snacp hpatpr and vpnt Duplex (l bath) each Additional bath Temporary Construct i on Apol iance vent seDa ra t-e hlater service Chan rps i ge in existing dpncp Stationar.v evap. coo I er Sewer multifamily, conrn, or Indrrstrial Vent fan with sinole duct Storm Sewer 0f s.Vent system apart from heatinq or A.C C()MII./IND. FEEDERS Mechanical exhaust hood and duct I n sta I I /a I ter/ rel oca te di s,tri h- fepdprs [,lood stove/heater 0f s. ISSUANCF OF PFRIlIT TOTAL CHARGIS TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl,l REQUIRES that the Electricai workshall not be valil unt'il the label has been signed by be done by an Electrical Contractor, the electrical portion of this permit an Electrical Supervisor and returned to the Building Division I HAVE CAREFULLY EXAI{INED the completed application for permit, and do hereb.y certify that all information hereon is true and correct, and I further certify that any and all work rrerformed shall be done in accoidance with the 0rdinances of the Cityof Springfield and the Laws of the State of Oregon oertaining to the work described herein, and that NO 0CCUPAI'ICY will be madeof any structure without the permission of the Building Diviiion. I further certify that m.y reqistration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the baiis for exemption is noted hereon, and thatonly subcontractors and employees who are in compliance with 0l?S 701.055 will be used on this pro.ject. l,lAtlE(please print IGNATURE DATE Zone TYPel Cons t ts Ftg. l4ain x Value. Fire Zone Bed rooms 0ccy Load Sq. Ftg. Access x Val ue FI ood Pl ai n_-__t Group x Val ue TOTAL VALUATION----- Stori es Ftg . 0ther BUILDING PERNIT Charges and Su rcharges Plan Ck. Conm/Ind 65%/B1dq Per Fee Svs Cha tems Deverqe (1.57 opment PIan Ck. Res 30%/Bldq Per Fee PLUi4BING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERI1IT Charges and Surcha rges Sidewal k A/C Paving Curb Cut Tota'l Comb. Permi t I,IECHANICAL PERMIT Charges and Surc harges TOTAL \S.\S lD,as.eq r& \=AtS PERMIT VALIDATION Perm'it Cl erk UL I /) I COMBINATION APPLICATION/PERMIT (CAP) L Applicant to furnish A. Job Address B. Legal DescriPtion l. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. examole- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sourcesl. examole- heat/electrical ceilinq/or forced air gas 2. example- waterheater/electrlca l/or solar E. Square footage or valuation' etc. l. example- 1250 sq. foot house, 500 sq..foot.garage 2. dampTer TT-new proiect, check new - if addition' check add, etc. F. Building permit information: 1. exampie - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. efimFlE - convert single family residence into restartrant (change of use) G. Value of work as defined'in Section 303 (a) of the Structural SPecia ltY 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 iob 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 adiacent to the appropriate item(s) to be installed B. FulI P'lumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated ?. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the 'labe] must be de] ivered to the electrical contractor for signature by his electrical supervisor. The general contractolis not authorized to sign the electrical label. III. Appl icant to sign and date I'lhenever 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 PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Perm-it appljcant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY date name natureS1g Dcr) tity .of springf ietd 225 n. 5th street SPFITNGFIELD ,,^r--.. ru Drve-J'tv lN FORMATTON: 726-37S: INSPECTtoNs: 726-376t ' 6f7- 7Y6-< A. E. SIGN PERMIT APPLICATION LOCATION OE SIGN (ADDRESS) LECAL DESCRIPTION O}INER OR PROPERTY ADDRESS OI.JNER OF SIGI{ CIF OTHNR THA}I PROPERTY O![NER)F ADDRESS NAME OF BUSII{ESS, FIRM, ETC.rYPE OF .BUSII:ESS D. TA,Y ror .I PHONE USE AIID CI4.RACTER OF SIGN: _IDENTII:r -l(rx.rou,nrar.DOUBLE FACE SINGLE FACE YI'LTI-FACE READER BOARD BILLBOARD VENDORS, SIGN ERECTOR CITY LICENSE }IIIMBER SIGN I.IANUFACTURER CIF OTHER THAN ERECTOR) . I HAVE CAREFULLY EXATINED Ehe complelnformation ls t rue and corre ct, andaccordancewith the S.pri I}IONE c?r'76e DA EXISTING SIGNS ARE THERE ANY D(ISTII]G SIG}IS?-}!tt -No 1 €, G. IN ELECTRI CAL COTITRACTOR ADDRESS LISC. NTJMBER ted apptLcaI further certtion forlfv 'pe tha rmic and doc all work , hereby certifyoerformed shalitheUniforrn S Code asfieand the 1 aws of tcertI f.t Ehat nv Cortractor .r-L-li-11:n.as reouired by Springfield Codes ALL EXISTING SIGNS FOR EUSINESS, ETC.7:g Vtn . IILL SIGN IIAVE ELECTP.ICAL I,IIRII{G? IF YES, WHICE APPLY?SIGN -ILLI,]MINATED LIGIITED) thar allbe done inSorinqfLe1 Cregon per cense with d and all othecalni ng Ehe Ci ngfield Sienr OrdinancEsto t:le worli cles cribe<f iter ern. 8-2-6(3)and 9-d is in full force and ei fec t Ordinance,of rhe CIE y of Sprinef further ign 1d adopced by the Cicyhe SEace of of 1 permi c. NAME (PLET\SE SIGNATURE insDeclionj tiste d on Ehe approved TYPE OF WORK: t,Y ERECT ALTER . RELOCATE OTHIiR B. STP.UCTURAL TYPE OF SIGN: -t ALL / r*r.oroNDrlrc ROOF PROJECTING HAROUEE . I'NDER I,{AROUEE OTHER c. DIT,TETISIONS, UISTALIiTION & CONSTP.UCTIO}I TOTAL HEIGHT ABOVE GRADE VEP.TICAL DI},IENSION OF SIGN HORIZOI'ITAL I"TIDTII OF SIGN DIMENSION TROM GRADE TOBOTTOM OF SIGN TIUCKNESS OR DEPTH 3f,5;'i+$-'l$3iu" ut'o*_"rs 1 tsr*o II_IFS, DrIlENsroN BEYoNDPROPERTY LINE E S/}IER LIABILiTi I}ISUP"ANCE POLIC FI PROJECTIOII I 5 IIORE l2TIIANNOTE 6vEE PUBLIC PROPERTY SIGNTEE ERECTORl.rusT FILE WI TI{THE BUILD ING DIVI ,ONSIIEScoPOFHIAI'ID PP.OP.ERTY DA}IAGE IES 3?" 34',q'/ K or l. DEScRTBE TypE ,OR YATERIATS SIGN IS ' VALUE OF SIGN: ,/_rNDooR BLIS rNESS/XLOUTDOOR PF.OPOSED USE OF BUILDING OR I,AND: I'ERCHANDISING J. EXISTING USEusE rP VACANT) ty of. Sprinpfie20(2). 'r wirr requesE all reguired sign DATE *t A I )a L'.ott /6' PLEASE N,rA-O 1) 2) 3) 4) separate Slsn Aoolication: A separace applicatlon ts requlred for each separate slgn as definedG-Ee sE;-eoZA: Electrical: Any permlt issued under thls applicatlon uill lnclude wiring in or on stgn sEruccure,the suPpry wires for connection must u" co"Llea-o,.-; "i"".ii".r-p=";ri;. Erecrrical connecEronmusc-be made only by a sEaEe Licensed sr"ctricaL-doil...co". rllirmi.nare.d sis.ns (borh incernarry:ljj:::'"ar1y) irust conform io-s".iio"" i:7:2.-?al-E-tsl ."i g:7-rii:.i-tr," springfield Sign or_ Plans Reouired: thts apprication is to be subrnitted wlth tlro courpleEe seEs of plans showing dl-mensrfiGtteight tf -;'iil;-;3i"tii"i"g t."""g"-o.-sign; I.ocarion of slgn on properry wirh di-uensions to ProPerEy rinei, structurar i"taiii-.e-""pp5.i rri.i"il ui."irre ancl foocinps; riaEertalsot consErucrion for sign and sign srrucEure; erecrritir-eq"i[r";E'.;a-ii;f;.i"g;-;i;;"8;; locarionof existinE.slgn:.on pioperty f6r Ehe-same 6";i;;;;;-ar1 as required Eo derertrine comnlrance wirhthe sprinsf ierd Sign. ordinante (Articre 7 "f -i[;--s;;rngriera-cicy-E.aJi. -'Air;:';nIi"'-if,l'rorror_ing lnform"cion on-che plot prari (plan sho.,i"t--lr;;;;;y ri.nes and locagton of signs): a) show the locarlon of all existlng slgn(s) as welr as proposed slgn(s).b) show the- length of the street fl?lq1g" caken up by rhe business or bulrding. For wallsigns, show che length of the building fronragl. ' c) Show che location of entrances open to the publlc and driveways. when required' because of design,-size, etc., engineered drawings and calculations EnrsE be pre-pared bv a ricensed engineer oi shall conform to"aesign srandarEs o"-fii.-"i-ai;- B"iiai,g oiri-sion Offlce. 5) Plans of lnsufficient clarity or detail will be returned to the applicant wtth no permit beingis sued. 6) Signs Eust Eeet corner vision clearance requirements as described in Figure g of the springfieldComprehensive Zoning Code. 7) N9TE: .No-sign.rray be erected which is less than 12 feet horizontally or vertically fron overheadeleccrlcal conducEors in excess of 750 vo1cs, or less ttr""-5-i"ut-irr'"ry airection'fioa overheadelectrical lines whlch are energized at less'than 750 volEs. 8) If a sign is not, installed within 60 days after the date of lssue of this peroit, the perruit shallbe void. 9) Inspections: a) SLte Insoection - to be mde before the slgn ls placed. Usually, the Footins Insoection - (if€jjG).TaYb-eoacieatthesametiieas.theSitern"p."lioition is.to be nade after hole(s) !s excavaleci, buE prior io-ti"-pii;.r;;; or-"""1...".b) Flnal rnspecrion,- to be made upon coryletion of all work. c) Electrical - qII electrical.signs mtrst be Lnspected for electstcal hook up after the sigrrls erecEEi[ and before the sign-is Eurned. or.-'-- CAIJ. FOR TIIE REQUIRED INSPECTIONS ON TIIE 24 HOI'R INSPECTION LINE AT 726.3769 srGN DrsrRrcTQ:m.a.rrr]c,( zoNE Drsri,rcT qq- TOTAL SQUARE FOOTAGE OT' SIGN REQUIBED INSPECTIONS: -js:rtt ttocATron _ELECTRTCAT TFOOTTNC 0R METHoD 0F ATTACHMENT y'wx, OTITER )-) . ') SPECIAL CONDITIONS TO 8E SATISFIED BEFORE ERECTION OF SIGN: ADDITIONAL INTORMATION NEEDED BEFORE PERMIT MAY BE ISSTIED: APPROVED BY:DATE ELECTRICAL PERMIT FEE: 47. STATE SURCHARGE: TOTAI.: DATE ?fl>fae, I CLERK SIGN PERMIT FEE JoB # oj SECTION:SPRINGFIELD .*-*d*.t ) C- .#T/r -=fl4 l7' city of springfield 225 n. sth street SPFITNGFIEI..E'INFORMATION: 726-3753 INSPECTIONST 726-3769 SIGN PERMTT APPLICATTON A E .LOCATION OF SIGN (ADDRESS) tl lt0 wtL Ll/ LECAL DESCRIPTION ; ." '-) :TAX LOT 7 ouNER oR pRopERry y E- firl .,ra PHONE ADDRESS lt,i)1\! otra*,, Buv n ztP qaLfi 1 ADDRESS PHONE I iNAME OF BUSII.IESS, FIRM, ETC. . VENDORS, CONTRACTORS: SIGNER.ECTOR ]',1 :; .TJDP.XSS OF .BUSII:ES5 i *.-iA-n ' i-'. i'.:. , D . USE AI{D CHARACTER OF SIGN: IDEMTIlY INCIDEIITAL t pouslr FACE -SINGLE FACE YLTLTI-TACE PJADER BOARD BILLBOARD zt? .8. rypu oF woRK: . RELOCATE OTH}|R A/]4 ATTERtLrnncr g nV. STP.UCTURAL TYPE OF SIGN: MAROUEN . I,NDER I,IAROUEE OTIIER "14-) e ,: f .-l-f n--t I'ALL t-€*u _ROOF f*t*ttro*o*r. PROJE,CTING DU.IErrSIoNS, IIISTALLATIOIT & CONSTRUCTTOII TOTAL HEIGHT ABOVE GRADE YEP.IICAL DI},IENSION OF SIGN ITORIZONIAL I.TIDTII OF SIGN DI}IEIISION FROM GRADE TO BOTTO!,1 OF SIGN TIIICzu{ESS OR DEPTT1 !'rorE: IF PROJECTIOII IS I{ORE THAN 12.' OVER PUBLIC ?ROPEPJY TI{E SIGN ERECTOR, I.ruST FILE WITI{ THE BUILDING DIVISION COPIES OF HIS/}IF:R LIABILITY AI,ID PP.OP-ERTY DAI.IAGE IIISUP"A}ICE POLICIES. N*o E YES i_) lb' DCES SIGN PROJECT BEYOND PROPERTY LINE? IF YES, DI}IENSION BEYOND PROPERIY LINE ' r[LL srcN HAvE ELEcrp.r,cAL rurnrncz YI -SIF YES, WTIICH APPLY? .C( TTECINTCAL SIGN -ILLTJ}'INATED (INDIPJCTE LIG}ITED) \! i n LISC. NUMBER H i :;,- ': ' i( -h'ELECTRI,CAT. CONTP.ACTOR DESCRIBE TYPE OR YATERIAIS SIGN IS CONSTRUCTED OF. t. La LFtEr . VALUE OF SIGN:lb.\a-K . SITE INFOF}IATIOTI (IA}JD USE) -- EXISTING USEoF BUILDII:G OR LAND (OR I3ST USE IF VACANT) _INDOOR BLTSINESS OUTDoO3, I4ERCHAI{DISIITG J q ut2R PR.OPOSED USE OF BUILDINC IOR LAND: " .-i,.-l-rl.z( CITI LICENSE SIGI{ I.IANI,'FACTURER CIF OTI{ER TI1AN ERECTOR) AhnDreC EXP DATE "( YEs uo FTG PHOIiE 3?)-)r G.EXISTING SIGNS ARE T}IERE ANY D(ISTING SIGTIS? I,'IJ}IBE9. ALL EXISTING SIGNS rOR. EUSINESS, ETC. OP"r.-rN Ya/-L compleEed application forct, and I further. cert ifv Uni permit and do hereby certifythat aI1 work oerformed shall u^fu" . I HAVE CAREFULLY EXA}IITIED IhElnformarion is Erue and correaccordance with the Springfield Sign Ordinance, theoEher 0rdinances of rhe Ciry of thar all be done in nv I15n Co'lcractor Ll-effect as re cuI Springfield Codesred byisced, form Sign Code- as adopced by Ehe Cicyinefield and the laws of che SEate of ofSoringfield and aIL sPrfurtCregon oercalni ng CiE Eo E:1e worl: <lescribetl i1e.ern. I her cert{.fv tharcense wiEh Ehe8-2-5(3) and 9-7-2 v o of Springfield is in full force and ccions I on Ehe aporovedpermic. NAME (PLEASE PRINT) SIGNATURE (2)I sill requesE all required si gn insoe TE i- }qY K Ai t,". PLEASE NE-AO 1)*W:Aseparaceapp1icac1on1srequiredforeachseparates1gn.asdef1nedln Ene Sign Code.----------- 2) Electrical: .Any P-ermit Lssued under thls application will tnclude wiring in or on sign rarrr"a,tr.".tne suppry wires for connection mrsc uu corEi"a-;-; "r."tii""r f,ernit. Electrlcal conneccionEIusc be made onry by a scate ir.censed Eleccricar conrractor. rllua"a "ii.ii"rryr-i""t;.;i;; io s..ii.""-i:i:i-t+i-a-i5i-;;i g-i--i[.li.:f,."lFli"[?i:to,liil"E]1,dlnance. 3) Prans Reouired:. Ttrts-applicatl'on ls to be submitted wlth two complete sers of plans showing dl-mfi;rons-ana-E'ei'gfii-oe-5lg.i-ii""tti"ir,g-.""i;;;-." sign; rocatioir or slgn on properEy wirh di-uensi'ons co propircv linei, strucEurar deraits""f;";;3;i ;;;;i;;; bracing anct'foorings; naEeriarsot consEruction for sign and sign structure; electricar-equipme"i "na-ri!f,ci"g;-Iir" ".,a rocalionof existing signs-on pioperty f{r th;-;;;;-6o"i.rr.", all is i"q,rirua Eo dererains comnltance wirhthe Springfierd sign brdinante (etticre-7-.i-i[;"i;i,i.Iiiilia'El.'i^coa.l. Also,.iho, the fotlow_tng lnformari.on on-the prot prati (pran-"rioori"t--proierr! rrnes ani rocaEion of signs): a) show the rocarion of arl exisring stgn(s) as well as proposed slgn(s)b) show the length of the stleet frontage taken up by the buslness or butlding. For wallsigns, show the lengch of the buildiig iio"i.g.. ' er usrrsr*g' ro c) Show the locacion of entrances open to the publtc and drlveways.4) when required, because of design,-size' etc., engineered drawings and calculations Erust be pre-pared bv a licensed engine.r oi shall 6onro# io'a."ig., "r""a"iE" on file "t ii"--srrirding Divi-sion Offlce. 5) Plans of lnsufficient clarity or detail will be returned to the applLcant with no permit beinglssued. 6) Signs must EeeE corner vision clearance requirements a9 described in Figure g of the springfieldComprehensive. Zoning Code. 7) NorE: No sign-nay be erected which is less than 12 feet horizontalry or vertically froo overheadereccrlcal conductors in excess of 750lroii", o. r."" tha;-a-i;;t-ir,.rry direc.ion froo overheadelecErical lines which are energized .t i"""'thin 750 "ori".B) 15 i.iii t", 1o. lnstalIed within 60 days afrer the date of lssue of this perair, rhe permir sharl 9) Insoections: a) Site rnsoection - to be uade before the sign ls placed. usually, the Footinq rnsoectionTEaPeEca5Ia-""yu","a""tthesametif,easthesit.Inspect1on.@.tion is to be uade-after hole(s) ts excavai"a,-a"i-p=i;; ;;-'d; praceaenr of concreEe.b) Flnal rnspection:- to be uade upon coryretion of all work.c) Electrical - all electrical.slgns uust be lnspected for electrical hook up after rhe signis erecEEE and before the sign"i" E"..a-o"l- OIIJ. FOR TIIE REQUIRND INSPECTIONS ON TIIE 24 HOI,'R INSPECTION LINE AT 726.3769 SIGN DISTRICT '1 i '.i -. ..T.ZONE DISTRICT TOIAL SQUARE FOOTAGE OF SrcN REqUIRED INSPECTIONS: _SIE/LoCATION _FOOTING OR METIIOD OF ATTACHMENT '/rtgc:ntcr-r. FrNAL -OTIIER TO BE SATISTIED BEFORE ERECTION OF SIGN: .-):------C SPECIAL CONDITIONS \ ADDITIONAL INFORI'ATION NEEDED BEFORE PERMIT MAY BE ISSI]ED: L) t*-r.) €1/E *?WNsl) -g Lt (VTt7L'-Lcr\J TIZ 4 c- "r1) e'S .U Lct=zUs f+G APPROVED BY:DATE -f, ELECTRICAI PERMII FEE: 47. STATE SURCHARGE: ,i;t^ TOTAI.: 1 JOB SICN PER}fiT FEE: C{. (-r DATE CLERR SECTION NGr:IELD SICN'ORDINANCE.-. w'l * ON LINE CITY OF SPRINGFIELD COHBI NATI ON APPL ICATION/PER}I IT Job Address I Legal Oescription I at -o Range EIIERGY SOURCES: l{ater Heater ryValue ofn5)Owner Sg. Ftc. llain_ Sq. Ftg. Access._ So. Fto. 0ther ilew Add AIEffiE;- --Fence-Oem-Chan-gelUse-other- Bui li Fami' ..e., Build SingleAddressPhonef\ahaw c 1tb) Construction Lender Address Phone + o $ P name addre s s exDt res ohone no- Pri Structura I El ectri ca I Hechani ca I )1.,-tqq't R d I E oo I PLUl{BING ELECTRICAL T.IECHANICAL Each single fixture Residence of sQ. rr furnace/burner to - BTU' s Relocated Uui laino (new fix. additioiat)New circuits alts. or extensions FIoor furnace and vent 5.F. Residence(l bath)SERVICES Recessed wall Soace heater end vcnt Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent sepa ratellater service Change in existing residence Stationar.v evap. coo l er Sewer mul ti fami ly, corm. or Industria l Vent fan with sinole duct Storm Sewer 0f amDs.Vent systern apart from heatinq or A.C. COMI.I./IND. FEEDERS Mechanical exhaust hood and duct I nsta 1 I /a I ter/ rel ocatedistrib. feeders llood stove/heater 0f .amps ISSUANCE OF PFRI'IIT L.II,J REQUil untii done by El ectri TOTAL CHARGES TOT,AL CHARGES ALTOT HARGEc s sI.,lHERE TA TE RESI ttha Ethe ectri'I ac w0I berk E'Ian triec 'Ica torCon trachas'|the Ie caectri IIbenot ofva'|porti on sthi tperniIabe lthe has stbeen abygned Ica 1 sorSuperv and returned to Buithe dI I Di tv Is 0nng l,l/U.lE(please print S IGNATURE Ftg Ftg Ftg t,ta s rge an xI val Group So Flood Plain Shries -0ccy Fi re J Iue its lue 9_5 any of Ci ty made rining to Divisionof any Board rt the permi and effect f exempt .055 wiI Icomp cat tapp doand certihereb.y ttha '|a 'IIandfy 0ntiatcorrec s trueIndfurthercert1hattaIIrkwoandfyrfonnedDEhasIIbedonenIeaccordancthwlofOrdithe'Ie d ofnances theri ngfi and theSp Laws theof teSta perta0regon the work descri hebed nrel and that NO OCCUPAHCYstructu wl 'l berethouWIIssofonButheI'I di furtherI cert 1 thatI str,asn'I .Ifu I fy my regi t o'I wln thforce the IBui derASredI n9 70Lrequ0Rsby that I0s5 forsslbathe on'Ionexempt s'I noted'ly subcontrac hereon a thand ttorsandIempoyeesarewho1n'Ilcomp wlance th 0Rs 707 I onused 1th s proj ect.be opment Fence Domo 1n Accesr 0ther BUILDING PERI.IIT Charges and Surcharges PLUI,IEING PERT,IIT Charges and Surcha rges ToTAL VALUATIoI__ . Const. Un Sldewal k ELECTRICAL PERIIIT Charges and Surcharges A/C Paving Total Comb. Fermit Curb Cut HECHANICAL PERMIT Charges and Surcharges TOTAL )?.vg fuq \ ilechanical FFg FFF au8 0/:q itn FFF 1.HIDNE PIan Ck. Corm/tnZ- 65%/Bldo Ppr Fpc COMBINATION APPLICATION/PERI.IIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Descript'ion1. example- Tax Lot 100, Lane County Map Reference 17 0r 432. example- Lot l. Block 3, 2nd Addition to SbFrTo-q-fi e I d E s ta tesC. Name, etc. of owner and construction lenderD. Energy Sourcesl. example- heat/electrical ceiling/or forced air qas2. exami-l e- wa te r6-eiEil/TTETiJEa-t / o r so-I;F-E. Square footage or valuation, etC.l. example-- 1250 sq. foot house, 500 sq. foot garage?. erdTe- JT-new project,.cheik-new.- if additio;, check add, etc.F. Building permit information:l. example - construct single family house with an attached garage2, example - remodel existing garage into family room3. examole - convert single family residence into resfaurant (change of use)G. Value of work as defined in Section 303 (a) of the Structural Specialty CodeH. 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 SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedu'les, the app'licant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installed8. Full Plumbing, Mechanical, and E'lectrical Schedules' are avai'lable at the Building Divisionl. To conserve space on the permit form the schedr.iles have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult theful'l schedu lesC. BUILDING DIVISION STAFF I,IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. 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 tlhenever possible, the initial application wi'l'l be used as a worksheet only. Where possible, Building Division Staffrill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his si gnature.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- PERI'IIT VALIDATION UF 7v (=-q-zu V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: permit applicant exempt from registration with the Builder's Board because: Additional Proiect Information: PLANS REVIEWED BY: name si gna ture date