HomeMy WebLinkAboutPermit Building 1983-7-7 (3)
'"I INSPECTION LIIIE
726-3769
e
Legal Description
17032220. Dart of TL 2400
CiTY Ur SPRINGfIELD
COMBINATION APPLICATION/PERMIT
E!lERGY SOURCES:
Heat
Hater Heater
,
INFOR/IATlON liNt .,
726-3753
Sq. Ftg. '.Ia i n
~q. ~tg. Access.
Sq. Ftg. Other
Ilew Add A 1ter Pep.
-Fence Demo Change/Use ~
Other- - ""
'"
'"
~
Job Address
1198 Gateway LOOD
Address 1198 Gatewav LOOD
SDrin~fie1d. Ore~on
Construction lender
Phone
Ranqe
ValuE of Hark:
38,440.00 I
BuilciinQ Pen11it Info: Describe Work(i'.e.,
Familv nesidence With Attached Garaae)
Build Single
Owner
3M Business Equipment Center
97477
726-7888
Remodel of existing office building
Address
Ut~lliN TtAr.'
{namel
Phone
{address}
(lies. no.)
(exoi res)
(ohone no.)
Primary Richard G. Williams (WEGROUP Architects) 863 E. 13th, Eugene
344-3249
Structural
Electrical Warner Engineering
Mechani ca I Rogers Engineering
CONTRACTORS Inamel
895 Country Club Road, Eugene
78A Centennial Lp, Eugene ,__
(address) l1ic~_ no.)Jo..- {plloirp<;.\
"bo.....r.'\-eJ s.. Mr In-h1rr.... ~S5D
484-0620
484-0227
(ohoop nn, \
r",n.~f4-J
General rl~"',Cc..~'''~' '!:~...... -... ~...._.:.......
Plumbina
Electrical
~'echanical
PLUllBIrIG
ELECTRICAL
MECHANICAL'
NO.
FFF
fHARr;F
"ll-
FFF
r"ARliE. ..lJQ.....'
I furnace/burner to
BTlII s
Floor furnace
and vent
CELl
Each single fixture
Residence of
SQ. FT.
Relocated building
(new fix. additional)
x
New circuits alts.
or extensions
, n.,.. mn.,..p
ISERVICES
I
1 ~ or
S.F. Residence
(1 hath'
Ouplex (1 bath) each
Additional bath
Recessed wall
-X-. ~n"'rp hp"'tp.. .....ri~_
6.00
Water service
ITemporary Construction
IChange in existing
rpc;idpnrp
Imuftff"amilY, COITITI. or
,Tndllc:tri<'ll -
1 App 1 i ance vent
5:~oaratp
I' Stationary evap.
cooler
I Vent fan with
sinol~ duct
I Vent system apart from I
heatino or A.C.
I Mechanical exhaust
hood "nd duct
I ~'Iood stove/heater
IModify Existing
IDuct Work
I
6.00
I
10f amps. I
ICOffi1./IND. FEEDERS I
IInstall/alter/relocate I 1 'I
rli~trih fpprlpr~
X 10f.2.U1' amps.1 115. O~ X
I I I
1 I I
1 I 1 ISSUANCE OF PFR!lIT 10.00
TOTAL CHARGES _0._ TOTAL CHARGES 30. orl TOTAL CHARGES 22.00
WHEnE STATE L\I/ REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this permit
shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division
I Sewer
Istorm Sewer
I HAVE CAREFUllY EXAMltlED 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 oerformed 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 OCCUPAf~CY 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 basis for exemption is noted hereon. and that
only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project.
llAlIE(Pl~ase print)\( 'D'ttv' {)l..::.....TvtV; SIf,tl^TUR~~Wr ~.AJ
FO~ OFFfCE USE OtlLY .
Sq. Ftg. r1ain
Sq. Ftg. Access
Sq. Ftg. Other REMODEL
DATE...k')-'- 7- 13
Zone CC
Fire Zone
Flood Plain
Tvpe/Const.
Bedrooms
Stod es
5-N
Uni ts
Occy Load
Occy Group
x
Value
Value
Value
38,440.00
x
1
B-2
x
TOTAL VALUATION
BUILOIllG PERI.IIT Plan Ck. Comm/Ind S~stems Development
Charges an~ ___l~4..,.9Q.____ 65%/Blrla Pj'r Fp. 100.10 PAID C arqe (1.5~) ,
Surcharges Plan Ck. Res
6.16 30%/Blda Per Fee Mav 31. 1983 Overpayment of 'lan Check
PLW1B I NG PERMIT I Fence I I fee- CREDIT OF 34.45
Charges and ------------
Surcha rges I Demo I I
ELECTRICAL PERI~IT 30.00 I Sidewal k I I
Charges and ------------ I A/C Paving
Surcharges 1.20 1 ITotal Comb. rermit
11ECHANICAL PERMIT 22.00 I Curb Cut I 1 I
Charges and ------------ I I TOTAL $179.79
Surcharges .88 I
I
e
..
~
-
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATIDN
1. Applicant to furnish
A. Job Address
B. Legal Description
1. examp.le- Tax Lot 100. Lane County Map Reference
II UJ 43
2. examole- lot 1. Block 3. 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. examele- heat/electrical ceilinq/or forced air OdS
Z. examole- waterheater/electrlcal/or solar
E. Square footage or valuation. etc. ------
1. examole- 1250 sq. foot house. 500 sq. foot garage
2. examp'le- 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. 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. DESIGN TEM4 AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design infonmation 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 Electr;cal 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
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
Whenever possible. the initial application will be us~d 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.
'7-1~83
1'75\
(j
'dJ
(
.,i
V. FOR OFFICE USE ONLY
Permit Clerk
~L
""
1
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
I
PLANS REVIEWED BY:
name
Lorne W. P1eger
signature4~ ~ ___da~e June 9, 1983