HomeMy WebLinkAboutPermit Demolition 2001-01-03crTY oF SPRINGFIELD, OREGON
SPllINGFIELD
Job# 01-00006-01
INDUSTRIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 155 S 00028th St Spr
AssessorsMap#: 17023100
Lot: Block: Addition:
Job Number: 01-00006-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot #: 03300
Subdivision:
Owner: Willamette lndustries Phone Number: 541-926-7771
Address: 419 South 28th Street City/State/Zip: Sprinfield, OR97477
Scope Of Work: Miscellaneous Demolish Value: $0
demolish existing warehouse
This building is on a separate tax lot purchased by Willamette lndustries, and is being
demolished as a condilion of nermit.loh # 00-00980-01
Contractor Type Contractor Registration # Expiration Date Phone
General Contr Larry Jensen 99310 1211012001 541-942-9292
1590 Harvey Ln., Cottage Grove, OR
97424
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
i
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
Building I
r.sr(,PlluIle
,Notification
'J441.Demolition
-Capped*ithinfi#ndcappedwithanapprovedmaterialasrequiredbSanitary Sewer Cap
Construction Types:
Occupancy Groups
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq. Feet)
Main:
# Of Stories:
Current Units:
Census Code: Does not a
Height (feet):
Proposed Units:
pply
IRE,FruEWOBK
ISPEHI\4ITISNOT
.,DONEDFOB
Accessory:Total:
I
Job# 01-00006-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Building
Demolition
State Surcharge For Building Permit
Building Administrative Fee
Tota! Building
01103t2001
0110312001
01t03t2001
41 60
41 60
41 60
1 $18.00
$1.26
$.s+
$19.80
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Miscellaneous Plumbing
Administrative Fee - Plumbing
Total Plumbing
Plumbinq
0110312001
0110312001
01103t2001
01t03t2001
41 60
41 60
41 60
41 60
15
$.00
$1.05
$15.00
$.4s
$16.50
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 allwork
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. I also agree to call for the required
inspections as noted above (726-3769) at the appropriate times. I also state that I was provided with
Lane Regional Air Pollutions phone number and asbestos removal information. I further agree that
the project address will be readable from the street, and the permit card is located at the front of the
pro duri e procesi.s
sig re Date
$36.30
74- 3, zDO[