HomeMy WebLinkAboutPermit Building 1980-8-19 (2)
INFORlIATlON L1t1t
726-3753
Sq. F~~. ;";aln .1.0 ~CUU
~q. Ftg. Access.
Sq. Ftg. Other
-'~e\"_Add_Al ter ~qep.
__Fence__Demo__Change/Use
_Other
[
1
: 2 Temporary Construction 110. OJ20. 001
I Change in existing I
rps i dpnre
I multifamily, CQTlI!1. or 16
IndlJc;tr;<ll
I 1 Of , ?nn amps, 65. 001
I COI1I'I./lND. FEEDERS 'Z. ,t,. 9
I Install/alter/relocate I I I
dic;trih. fpprlprc;
I 5 Of 400, amps.125. OQ125. 0~8
I 2 600 AMP 50. Oq100. O~
I 1 225 AMP I 25.0~
,I 4 100 AMP 110.0q 40.0D ISSUANCE OF PFRllIT lV. Vl'
TOTAL CHARGES 150.001 TOTAL CHARGES j/';). UUI TOTAL CHARGES 76.01
WHERE STATEL:'\\~ 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
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I
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I Vent fan wi th I
,inole duct 3.00 18.0
I Vent system apart from I '
heatina or A.C.
I Mechanical exhaust
hood and dlJr:t
I ~'Iood stove/heater
I Heat Pumps
I
I
I HAVE CAREFULLY EXAmNED the completed apfllication for permit, and do hereby certify that all 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 Orel]on pertaining to the work described herein, and that NO OCCUPAIKY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
Board 1s in full force and effect as required by ons 701.055, that if exemot the basis for exemption ;s noted hereon, and that
only subcontractors and employees who are in compliance with OP.S 7(11.055 \-/ill be used on this project.
SIG;IAT~jiL:';'-~r11 j!fktdt;;~.~ DATE~..,-) ~ I
FOr. OFFICE USE allL //
Sn, Ftg. IIain x Value 483',848. 00
Sq. Ft9. Access x Value
Sq, Ftg, Other A.C. x Value 14,500.00
TOTAL VALUATION 4~tS, j4ts. UO
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INSPECTION LII/E
726-3769
Job Address 1077 Gateway Loop
Legal De,cription TL 2604
Map 17 03 22 02
Owner Associated Oregon Loggers
- _.
Address 1077 Gateway Loop
CITY OF SPRlflGFIELD
COtIBIIIATIOtI APPLICATION/PERMIT
ErIERGY ,SUURJ:.S: t
Heat HP tleC
!~ater Heater~l prt
Phone
Range
ValuE. of Hork:
498,348.00
Builiina Permit Info: Descrlbe Hork{i,e.,
Family t'!es;dence IHth JI..ttached Garaqe)
Office Buildinq
Construction Lender
Address
DES I GN HAIl
Phone
(address) (lies. no.'
200 South Mill Street
Primary
(name)
The Amundson Associates
(exn; res)
Structura 1
Electrical
f1echanical
CONTRA.cTORS
(name)
(acidress)
flies. nn. \
(t>mirp<;\
General Millhollen r;"n, r.ontr~dnr
133 Silver Lane Euqene 1801
8-81
Plumbina
ElectricaV-WaV El ectri c
4739 Main Street Sorinafield
~lecha n i ca 1
PLUlIBIIIG
ELECTRICAL
MECHANICAL
NO.1
~IEach single fixture
[Relocated building
(new fix. additional)
S.F. Residence
fl bathl
Duplex (1 bath) each
[Additional bath
1~later service
[Sewer
I Storm Sewer
FEE
r.HARGF
L~~~
I
I rlJARlif.. ...I1Q.....1
I [furnace/burner to
, BTlI's
Floor furnace
and ven~
NO.
Residence of
i. 00 150. 00
SQ, FT.
New circuits alts.
or extensions
SERVICES
Recessed wall
So~~P hp~t~r ~nrl vpnt
Appliance vent
s/O'(l!'lratp
Stationary evap.
cooler
IlAI-lE (p 1 ease pri nt)
RICHARD S. MILLHOLLEN
Zone
Fi re Zone
C-4
Units
V-I HR
Type/Canst.
Bedrooms
Occy Load
Occy Group
lJ-l:'
Flood Plain
NO
Stories
l:'
BUILDING PERI'1JT
Charges anG
Surcharges
884.00 ' Plan Ck. COI1'll1/lnd IPD
6s%lBldo Per FeoJ -.,Jr'E
------3S-:-36---PTan Ck, Res
30%/Bl do Per Fee
I Fence
I Demo
I Sidewalk 164' I
I A/C Paving 14,500.
~~____~g~__1 Curb Cut 34'
574.60
554.13
LC.:;]
Isyste~s Development
Charqe O.S~)
P _AN CHECK DUE
PLU!1BlNG PERI~IT
Charges and
Surcharges
_____l5b.OO
6,00
375,00
------ts.uu
ITotal
: TOTAL
ELECTRICA.L PERI~IT
\ Cha rges and
Surcharges
i!IECHANICAL PERMIT
~harges and
urcharges
\
.....J
16.40
72.00
13.40
Comb. rermit
CX>
o
o
'"
CX>
.....
Build Single
(ohone nt).
748-3231
(ohnl'1P nn.. )
689-3607
746-9743
1
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r>iARGE..J
I I
I I '
16. 00148. O~
I I
1 I
7.475.22
20.47
1,646.20
9,141.89
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COMBINATION APPLICATION/PERMIT (CAP)
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I. Appl icant to furnish
A. Job Address
B. Legal Description (
1. example~ Tax lot 100. lane County Map.Re
17 03 43
2. examole- lot 1. Block 3. 2nd Addition tc
Springfield Estates (
C. Name. etc. of owner and construction lender
D. Energy Sources
1. examole- heat/electrical ceilinq/or fore
2. exa~~le- waterheater/electr;cal/or solar (-
E. Square footage or valuation, etc. -
I. examole- 1250 sq. foot house, 500 sq. fo
2. examp.le- if new project. check-new - if
check. add, etc.
F. Building permit information:
1. example - construct single family house 1
a ttached garage
2. example - remodel existing garage into fi {t
3. examole - convert singie family residenc!
restaurant (change of use)
G. Value of work as defined in Section 303 (a) ,
Structural Specialty Code
H. DESIGN TEN1 ANO CONTRACTORS
To avoid design or construction delays. Buil{
Division Staff must be able to contact appror
persons regarding design information or job ~ ('
corrections, etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Sc
A. Except where blank spaces occur in-the descri
portion of the Mechanical and Electrical Sche ~s.,
the applicant need fill-in only the No. Boxes ~
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Sch
are available at the Building Division
1. To conserve space on the permit form the
have been abbreviated
2. If the item(s) to be installed are not co
the abbreviated schedules you should cons
full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEE:
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delive;
electrical contractor for signature by his ell
supervisor. The general contractor is _not au'
to sign the electrical label. ---
Applicant to sign and date
Whenever possible, the initial application will bE
a worksheet only. Where possible, Building Divisi
will prepare a type written copy and return it to
applicant at the time the actual permit is issued ,....
signature. <. .
Fees and Charges.
Plan check fees are due and payable at the time o~ne
application, and no plans will be processed until these
fees are paid. All other fees and charges are due and
payable when the penmit is issued.
I I 1.
IV.
V. FOR OFFICE USE ONLY
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PERMIT VALIDATION
CITY
OF
SPRINGFIELD
(
City Hall
Springfield. Oregon
Department of Public Works
OFFICIAL RECEIPT
(
S4350(
No. B
Dole ?J r Iq 19M
( Rec'd From ~((D}11tl.Q.(!V~INjl1c.
Address l33 ~I U )~r 1.-.. Vl - 'EL~
12_ P --C,):Q!\ 00 ~ - C
Received For: \~ ()7")T
~o;n ',~~. 3(0'(
ISO, ()O
1.0. 00
3ir:--). ru
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H P ( (r 00
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~wJCC /q.~O
(" --8.( C I?C'U) (YlO '1 -7 ,00
~hc... ' ) l~lS:2.~.
(: OLn(7,Lt::...CUI/1,/1 20,Q, (I,
I AmbunlRece,ved q~ (....t:: '
rD
- ,- AUTHOI'lIIEO SIG......TURE: (
5H[l10"-TU~"'Ull ....'..T[~. . ,[uGIE"I. O. .uo. ..,,,., ~'_
(
PO
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4O'-Jn
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Permit Clerk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
s ignature~~ L;aL"
name
DAN Sr1ITH
da te 8-19-80
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