HomeMy WebLinkAboutPermit Electrical 1990-4-27
,
.
IHFORlIATlOH LINt
726-3753
Sq. Ftq, I,tain
~q. Ftg, Access.
Sq. Ftg. Other
Ilew Add Alter Rep,
-Fence Demo Change/Use
Other- -
I INSPECTION LINE
726-3769
Job Address
4125 Main Street _ I
Description \ ~ (j'd r6'd-~ nC1\O.-J
I
Owner Little Plaza Market
Address 4125 Main Street
5" Buil(;;M Permit Info: Describe Work(Le.,
Phonc746_47 I 3Farnil " Residence Ilith Attached Garacel
Build Single
Ii
cc:
~
()
\)
cr-
Legal
(namel
Phone
(address)
Install circuit to walk-in cooler @
market.
Construction lender
Address
DESIGrl TENI
II ics. no.'
lexoiresl
J
(ohone no.
Primary
~
\~
~~
Structura 1
Electrical
Mechanical
CONTRACTORS
(name)
{address \
llies. no.'
(e~Diresl (~hnnp nn.l
Genera 1
Plumbino
Electrical L.R. Brabham. Inc.. 1~ "n" S.t
Sn~lrl. OR 97477 20-B7C lO/1/9~
747-663R
Ht>chanical
, ,
PLUllB IrIG
ELECTRICAL
MECHANICAL
Each single fixture
FEE CIIARGE NlL, ..r 'rH~ Nn
Residence of furnace/burner to
SQ. FT, BTU's
.r:r~ .rll~
NO,
Relocated building
(new fix. additional)
1
New circuits alts. 2? Sf
or extension'2 or morel:l: 23.6'
SERVICES
Floor furnace
and vent
S.F, Residence
(1 bathl
Duplex (1 bath) each
Additional bath
Recessed wall
~narp hpatp~ an~ vpnt
Storm Sewer
Of
amps.
Appliance vent
~@Da~at@
Stationary evap.
cool@r
Vent fan wi th
singl@ du<<;t
Vent system apart from
heatina or A.C_
Mechanical exhaust
hood and duct
Hood stove/heater
Sewer
Temporary Construction
Change in existing
r@sjde.nr~
multifamily, conm. or
Irtdustrial
Water service
COHfI,/IND, FEEDERS
Install/alter/relocate
rli~t~ih_ fppd~~~
Of
amps.
TOTAL CHARGES
WHERE STATE L~1l REQUIRES
shall not be vali~ until the
TOTAL CHARGES
I SSUANCF OF PFRllI T
23.63 TOTAL CHARGES
that the Electrical work. be done by an Electrical Contractor, the electrical portion of this permit
label has been signed by an Electrical Surervisor and returned to the Building Division
!
I HAVE CAREFULLY EXAMINED the completed application for permit. and do hereby certify that .11 information hereon is true
and correct, and I further certify that any and all work nerformed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Ore90n pertainin~ to the work described herein, and that 110 OCCUPAIICY will be made
of any structure without the permission of the Building Division. I further certify that my re~istration 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 subcontractors and employees who are in compliance with Or.S 701.055 will be used on this project.
Zone
Fire Zone
Flood Plain
Tvpe/Cons t,
Bedrooms
Stories
Units
Dccy Load
Occy Group
SJr.IIATURFL':i __ -:.:"
,FOr. OFFICE USE O~tY /'/'
Sq. Ftg. Hain
Sq. Ft!J. Access.
Sq. Ftg, Other
L ~.j/
DATE
4/27/90
IlAr'IE(please print)
Larry R. Brabham
,
Value
Value
Value
x
,
TOTAL VALUATlOI'
BUILDING PER/oIIT,
Charges and
Surcharges
Plan Ck. Comm/lnd
____________..2.5.l/Bldo p.pr Fpp
Plan Ck. Res
30t/Bldo Per Fee
Fence
Systems Development
Charce (1.5~)
PLUHBING PERMIT
Charges and
Surcharges
ELECTRICAL PERmT'
Cha rges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
I O/jlllO
NH. .':i)
I.f~
Sidewalk
A/C Paving
Total Comb. Permit
TOTAL
rr~,\3J I
Curb Cut
.
,
COMBINATION APPLlCATION/PERI,IIT (CAP)
I. Appl icant to furnish
A. Job Address
B, Legal Oescription
1. example- Tax lot 100. lane COLJllty ~ldp Reference
17 oj 43
2. exam~le' Lot I. Block 3, 2nd Addition to
Sprlngtield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. exal1!.Ple- heat/electrical ceil;n..9/or forced air Qas
2. examole- waterheater/elecmcallor solar
E. Square footage or valuation, etc. -
I. example- 1250 sq, foot house. 500 sq. foot garage
2. example- if new project. check-nfw - if addition,
chec~ add, etc.
F. Building pennit information:
1. exam~le - construct single family house with an
attached garage
2. example - remodel existing gar~ge 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. DESIGN TEM1 AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design infonnatiofl 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 fonn 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 OIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
O. 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.
111. Applicant to sign and date
Whenever possible, the initial application will b~ 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 char'gcs are due and
payable when the permit is issued.
#r (o~85
V. FOR OFFICE USE ONLY
P,mH Cl ,,' ~/()n _)
PROJECT CONDITIONS TO BE SATISFIED 8EFORE OCCUPANCY:
Permit applicant exempt from registration with the 8uilder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name
signature
date
.