HomeMy WebLinkAboutPermit Building 1989-6-22
I INSPECTION LINE
726-3769
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CITY OF SPRINGFIELD .
Cm1BI NATION APPLICATION/PERMIT
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INFORI1ATION LfNl
726-3753
Sq, F tg. r'1a i n
~q. Ftg, Access.
Sq. Ftg, Other
New Add Alter Rep.
--Fence Demo Change/Use
--Other -- --
Address
Oreqon
P. O.
Tax 'Lot 400
Cedar Products.
Box 280
EflERGY SOURCES:
Heat
('Iater Hea ter
Range __
ValuE o~Hork: \'O,O~ ~
Inc. $230,000.00.....J,..jlV\.:--
) B,\/ilc\inq Permit Info:. lOescr,be Hork(i,e.,
Ihone746-7!'O".4milY nesidence l'lith Itttached r,araqe)
Build Single
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Job Address 3700 CorMtercia1 Avenue
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Legal Description T 17S R2W SEC 31
Owner
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Springfield, Oregon
Construction Lender
97477
ERECT 320'LONG 40 TON 55'-6" SPAN
BRIDGE CRANE, CRANEWAY TO HANDLE
Address
DES I GN TEAI-I
: (name)
'.', Phone I LOGS.
(address)
(I ics. no.)
Structural
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(exnires) (Dhone no. )
12/31/89 (503)344-9116
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(exDires) (Dhone no, )
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(503)747-6638
Primary
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R. J. HILI/ ENGINEERING' 'CO.
R. J. HILt ENGINEERING CO.
44'80
Electrical
',11. . '.j
R. J. HILt ENGINEERING CO.
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r1echanical R.
CONTRACTORS
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ENGINEERING
CO.
(address)
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J. HILL
(name) '. ~
(I i cs, no.)
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Plumbinq
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Genera I OWNER
Electrical L. R. BRABHAM. 10 W. b STREET. SPRINGFIELD. OR
~1echani ca I
PLur1l3 I NG
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ELECTRICAL
MECHANICAL
NO,
FEE CHARGE NO.
I FFF r.HARr,F NO.
FFF r.HARr,F
Each single fixture
:, Res i dence of
SQ. FT,
furnace/burner to
BTlI's
Relocated building
(new fix, additional)
New circuits alts.
or extensions
Floor furnace
and vent
ITempOrary Construction
IChange in existing
residence
I multifamily , comm, or
Industrial
,IOf amps.1
., COI1f'1. II NO. FEEDERS I
!Install/alter/relocate I
distrib, ff'edf'rs
10f amp~1
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TOTAL CHARGES' ' I TOTAL CHARGES
WHERE STATE L'\~ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shall not be 'val H until the labe'l has been signed by an' Electri'cal Superv,isor and returned to the Build,ing Division
IS.F, Residence
(l bath)
IDuPlex (1 bath)
IAdditional bath
I Hater s,erv ice'
Sewer
,SERV ICES
Recessed wall
SDace heatf'r and vpnt
each
Storm Sewer
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Appliance vent
seDarate
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart from I
heating or A,C,
Mechanical exhaust
hood and duct
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Wood stove/heater
I SSUANCF OF PFRr1IT
TOTAL CHARGES
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I HAVE CAREFULLY EXNlINED the comflleted apfllication for permit, and do hereby cert.ify that all information hereon is true
and correct, and I further certify that any and all work performed shilll be done in accordance with the Ordinances of the City
of Spri~gfield 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 the:perrnission of the Building Division,., I further certify/that my -registration with the Builder's
1J0ard 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 \~ho are in compl iance wi th OP.S 701.055 \'Iill be used on this [Jroject.
"Ar-lE(pl"" pd"'} ROBERT J. HILL SI",^TU"E-W-.y,~__m___
FO~ OfFICE USE ONLY .
Sn, Ftn, r1ai~
Sq, Ft'J. Acce'J'T
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Sfj. Ftg. Other
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Zone
/,II
Type/Cons t..
lJedrooms,
Stories'
Units
Occy Load
Occy Group
x
DJl.TE ~~~
/3.COO,OO t
Fire Zone
x
Value
Value
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Flood Plain
x
Value
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BUILDING PWlIT , , Plan Ck. Comm/lnd ~'lloL\ .D~
____t<f~~~___
Charges and 65%/l3lrlo Per Fee
Surcharges. I Y::93 PI arlCk. Res I
, 30%JlJldQ Per Fee
PLWmlNG PERMIT I Fence I
Charges and - - -;'7!_.- - - - - - - - I D6m() I
Surcha rges ;"1
ELECTRICAL PERrm " I Side,~alk I
Charges and ,.
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J I A/C.:Pavi ng I
Surcharges " -: r- ~
/1ECHANICAL PERMIT, ;,4 I cur~i'cut I
Charges and " :
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Surcharges I I
I4Z00
'Systems Development' r/ ~
Chareje (1. 51,) /,Y",.. .
TOTAL VALUATION
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ITotal, Comb, Permit
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I TOTAL
I~"? ~ 3'
/~7~ 9'3
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'.,,,..... '~'.._"~I,.. ..,,,.'"....,..,.''' h ,_"u ".....11
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COMBINATION APPLICATION/PERMIT (CAP)
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I. Applicant to furnish
A, Job Address
B. Legal Description
1, example- Tax Lot 100, Lane County Map'Reference
17 03 43
2. example- Lot 1, Block 3, 2nd Addition to
Springfield Estates '
C, Name, etc. of owner and construction lender ,
O. Energy Sources
1. example- heat/electrical ceiling/or forced air gas
2. example- waterheater/electrical/or solar
E. Square footage or valuation, etc,
1, example-.I250 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. example - remodel existing garage into family room
3. example - convert single family residence into
res taurant (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
~ivision 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 ~ivision .:
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
O. As noted on the CAP, the labei must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contr~ctor is .not authorized
to sign the electrical label.
Applicant to sign and date '
Whenever possible, the initial application will be used'as
a'1worksheet 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. .
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~
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IV,
V, FOR OFFICE USE ONLY
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PERMIT VALIDATION
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Permit
Clerk IIA I J~
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
-./-.~..r77~h"'~ ~/r- ~___/-V.z7EL> ,~~ i!'2c:-~,...../~ ~.-_~vr'c:e--
2-_~ . ~~/~,-t;~/F ~ /~'"? '?'?.)?p-//" ~L .ZJEI/~P/?;~ "~~fi:k<~
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
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~LANS REVIEWED BY:
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. 'name' ~8#e ~.:. ...r~E,.,f>
signatur
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