HomeMy WebLinkAboutPermit Building 1982-11-3 (2)
-~!!!!?"
.
.
/
Job Address
1186 GATEWAY LOOP
CITY UF SPRIIIGFIELD
COIIBlIlATlOfl APPLICATlOfl/PERMIT
E!lERGY SOURCES:
Heat Heat Pumo
!'Jater Hea ter
Ranqe
INFDRIIATlON LINt
726-3753 ,/
Sq. Ftq. r.lain
~q. Ftg. Access.
50. Ftg. Other
Ilew AddX Alter Rep.
--Fence Demo Change/Use
Other - -
co
N
N
o
co
'"
llrlSPECTIOII LIIlE.
726-3769
Legal
De5Cription 17-03-22-20
Lot 2411 Blk. 019-00
Gate Post Subd.
Address
Suite 250
8383 N.E. Sandy
Oregon 97220
Valu, Of '.Iork: ,...,.
.'Jc:,).....::lr......-"c...
.,si'!\! OrH).flO
Ph 257 05' 5Bullc;inQ Permit Into: Describe 14ork(Le..
one - . Family nesidence With Attached Garaoe)
Build Single
Owner
~nrin{1'f;pl(1 Tnut:>c~rn-c
Portland,
Alteration of Existing
Commercial Building
Construction Lender First Northwest Investment Co.
Address
DESIGN fEArI
(name)
Phone
(address)
(lics. no.)
lexniresl
(ohane no.
Primary
George Mayer
1065 High Street
Eugene
345-3711
Structural
Electrical Platt Electric
Mechanical Beymer
CONTRACTORS Inamel
Abe Wilson
(address) flies. no.l
fexoires)
345-5445
6RR-~O(l4
(nhonp nn.'
Genera 1
8383 N.E. Sandy Blvd. Portland
257-0595
Plumbina
Electrical Platt Elect
~1echanical Beymer
345-5445
hRR_~004
PLUIIBIIIG EXISTING
f10.1
-----lEach single fixture
jRelocated building
(new fix. additional)
Is.F. Residence
11 bath)
IDuPlex (1 bath) each
IAdditional bath
I ~Iater service
I Sewer
IStorm Sewer
FEE
CHARGE
ELECTRICAL
Ij(1
Residence of
SQ. FT.
New circuits alts.
2 or extensions
SERVICES
MECHANICAL'
<.EL J:llARlli. NO.
FFF
rH'lRG..l
,/
furnace/burner to
BTU. s
15.00
Floor furnace
and vent
Recessed wall
~n~rp hp~tpr ~nrl ~pnt
Temporary Construction
Change in existing
rpc;.idenr:p,
Imultifamily, COrml. or
Tndllc;.tri~l
IOf amps.1
Ico~1./IND. FEEDERS I
Ilnstall/alter/relocate I
di~trib. fppdprs
.11 Of 04'0-
I
I
amps.
10..00
Appliance vent
spoar~tp
Sta'tionary evap.
cooler
Vent fan with
sinale duct
Vent system apart from I
heatino or A.C.
I Mechanical exhaust
hood ~nd rlurt.
I Hood stove/heater
8 ISuoolv Air
3 I Return Air
I
6.0e
TOTAL CHARGES TOTAL CHARGES
WHERE STATE L'U REQUIRES that the Electrical work be done by an 'Electrical
shall not be valiJ until the label has been signed by an Electrical Supervisor
ISSUANCE OF PER/lIT
t5.00 TOTAL CHARGES
10.OC
l6.0e
Contractor, the electrical portion of this permit
and returned to the Building Division
I HAVE CAREFULLY EXN11NED 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 NO OCCUPArKY 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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project.
11A/-lE(please print) A j <e. I~ f's ~ 1'1 51r,11ATURE a-l",,-- ~-P~
O~,TE
dh/li"-L
FO~ OFF I CE USE OIiL Y
Zone CC Tvpe/Canst. 5-N Units N.A. Sq. Ftg. riain
Fire Zone N.A. Bedrooms N.A. Occy load Sq. Ftg. Access
Flood Plain NO Stories 2 Occy Group B-2 Sq. Etg. Other Interior
x Value
x Value
Remodel Va' ue -s.18:-000~'OO
TOTAL VALUATION $18-;000-.-00
",::/,:cP_~'"'"O.a.. -...
BU I LO !fIG PERfil T
Charges an~
Surcharges
r(4~OO:' ~~~~B~~~
------r3=36-:--PTan Ck.
-:: _""_ 30%/Bl do
,,-"w._"
Comm/Ind
Ppr Fpp
Res
Per F~p
1$51.20 paid Systems Development
-1f\-?1-R? ~QRR? CharQe (1.5~)
I 7?:=V/,,-=,>",> ? <... Fc;E
I r:e~ .~/O
~/Q~Ir.-;?e~T
I
5"~ g-
5",/, -;:;:0
:z.~C
PLW1BlflG PERMIT
Charges and
Surcharges
Fence
ELECTR I CPoL PERI:IT
Charges and
Surcharges
D~mo
!5.00 I'Sidewalk
------'E1~--1 A/e Paving
16.00 I Curb Cut
---n--~64---1
ITotal Comb. rermit
/ <7. 9~
13c. S<
-$l-30-;-QO
J
I1ECHAN I CAL PERMIT
Charges and
Surcharges
I
I TOTAL
.
-
..
.
COMBINATION APPLlCATION/PERfIlT (CAP)
PERMIT VALIDATION
I. Applicant to furnish
A. Job Address
B. legal Description
I. examDle- Tax Lot 100, Lane County Map Reference
i/ 03 43
2. example- Lot I. Block 3, 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. examole- heat/electrical ceilinq/or forced air qas
2. examoJe- waterheater/electrlcal/or solar
E. 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 permit information:
1. example. construct single family house with an
attached garage
2. examole - remodel existing garage into family room
3. examOle - 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 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 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. ---
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 perm.it.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.
.~
~ (-\,,:>0
~~
.
"
~:
I
;
I ~ -
.
V. FOR OFFICE USE ONLY
Permit Clerk
C~
I
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
See Job # 800019 for Original Plans and Permit Record
Permit applicant-exempt from registration with the Builder's Board because:
Additional Project Information:
.
~.~~,tnlO~ \
11 72 A /J '" )'
Signat~PJt7#-iIU.- 1/1.gUL/ date 10-25-82
_...::..- ...:..:.=-_..::::::__-:.::::. ..:u.:....::::~... -:::.::.'':':::..: ..~>::~'::':.~ _.:;:. ~::I-':::,.'::'-"::: l(;:::..;.;..:..-..:.:. ":'::' ~".:;::::.-:..:-.-:..:_..:=~..:~.....:::-...:-"
:"'~-''''-'''='::_:':;l...''''---_._-.=-:-:S.~.
PLANS REVIEWED BY:
name
Lorne P1eQer