HomeMy WebLinkAboutPermit Building 1992-9-15
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;, CITY OF SPRINGFIELD
; , .225 North 5th Street
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q::lllUILDING MOVING PERMIT/llUILDING DIVISION
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BUSINESS 726-3753
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INSPECTIONS
726-3769
OLD ADDRESS
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Legal Description., :
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NEW ADDRESS (Furnished by Building
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Div. )
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Legal
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Description
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Address
Phone
Exp.
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'!~~ .fe>t ,Ik :i~: tri.ROt- fi4T<</1/ ro 1::L,vr~~
"DescriPtion of 1l~~,ldin~:;1 . I,
,Square Footage :',1 ,Iii' , Moving Length -7:'-7 Moving Width 20 I Height On Dolly /I
~:Number Of secii'~:iisl'l! Beiri~1 Moved ; I !'Type Of, Construction ?:':J-r;C L VALUATION ,:':
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,;NOTIFICATIONOF,ilMOVE:, lThe"Building Division PLANS, FEES, AND CHARGES:, Prior to receiv-,
'will rou'te cdpi'~s~'Of tliisapplication',tci ;Iall ,ing a permit to move a building to property
l:a1.'propriate div~s'i:~ns', :l~~:partments andi Agen- ,within the 'City, the,applicant or his/her'
C1es. HOWEVER,,!llthe! app'l1cant must contact' 'authorized representative must:
:'p'roperty owner~'!:iflli:re,e,~s',! are imiol ~ed .'i~lthe 1. Submi t'2 copies of site or plot plan,
:proposed move!' _','IN ADDI,ToION,- the appl1cant ' ,for"new':site. "I,
::must secure th'e ,'approvdi.1 o'f all appropriate' 2. Sub~it: 2 copies of foundation pl~n for ,,'
,municipal, c'ount'Yiland':s'iate authorities: , the: relocated building. ,", ,:
: should the movel:'or:igiriit~ or terminate' 6ut-' , , 3; ObtaiTi a permit covering the new, founda-.
,side the City! of:,Springfie ld. :, , tion, as well as all plumbing/mechanical
II ',I <1":' I 'I '11"1' :. ' and ,electrical work relating to the re-"
! '. :;1:: II ':,~t:1 located building.
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, , 4. Pay Systems Development Charge if appli'- "I
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,SEWER CAP: Buildirgsi moved from within,the SEPTIC TANK REQUIRE~IENTS: Prior to moving"
Ci ty limits shal'll; have lthe sewer capped' 'at owner shall' have all sludge from the septic i
< the property ,lirie~'and inspected one working tank, seepage pit or cesspool removed by a ,.I I,'
"day prior to the:.inove. '!I;If the inspection, person holding a sewage dispoal service '1i- .
:iindicates that ,~~~: IS~\oI~Yi has, not. been prop- cense, and ,shall fill same with clean bar- ,; :'\
:,erly capped, thelmov1ngl,perffilt w1l1 be ,< ; run gravel or ,other material approved by th'e i ;
i,',\':ievoked. ,'" :ij'ii,"111 "I~1 .' ;';,' Director or his authoriz'ed representative. 'I ~'l'
ii, CERTIFY THA~i~he: jk~o~~'l informat~oh isitrue and corre~t;:tha~ ,all re,qui!.ed contacts Jlave . i t:
',been made and:autllonzatlons obtalned', that the move w111 begmat &.,'1') o'clock@pm ,1.'1
;:on'SAT. :::ff'f .I:/If!:, ::nl1 will be completed by '7'. ~C) o,'clock !!\IDJlpm on sA-T S6.n, (Cf ' '::'
::!'and that no change,s I in ;the route will be made without contacting the Building Division. I
,i~also certify thilt:!I havel been informed,'that NO PERMIT WILL. BE ISSUED BEFORE 5 WORKING . DAYS
"HAVE ELASPED. i II furth~r, certify that, my registration with the, Builder I s Board is in full
,)orce and effect, a's required by ORS 701.055 and 701.070~a d that if exempt the basis is
:inoted hzeon., :Bils:is f~f'llluilder's Board Exemption: (p , I
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WAME ;)t~/); ::~-CJ~ SIGNATURE v.'/I/ll';/'-..J DATEr/rl;C
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Application fee ,$18.00.~- Date Paid
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'<Permit fee $60; 00 !~- Date Paid
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,,'Number of Blocks over 61 @ . 60~
11 ,-,)'. , I I' I . 1 Jll. ~ ! ! I I ~ I
Sewer, Cap $10~ O;~:,:~ i ~%, ~~~ te Surcharge, ,u Date Paid
. c!L-P~,\i~e,:o.~p~Il;I~~~nt : !!!L- Wil~a~alane Park; and Recreation.,
tll:lw""F1T;el,,De~a~tm,e.n~11 ,,:Iill-~aClf1c NW!Bel~, .' ":,
!'::":yorthwest Ga'si'lll\'''' Lane Trans1 t D1stnct '
OTHER -- specify
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Type'of Construction
FOR OFFICE USE ONLY
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Occupancy Group
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Square Footage
VALUE
Receipt
Receipt
Amount
Number
Number
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___Rainbow Water /
. Group W Cable
---Lane County A & T
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BUILDING MOVIN~RMIT
I. Applicant to furnish (except as indicated)
A. Old address for building
B. Legal Description
C. New address for building
(Building Div. will furnish)
D. Legal Description
E. Name, etc. of building owner
F. Name, etc. of moving firm
G. A description of intended use
H. A description of proposed route
I. A description of the building
II. Applicant to contact property owners if trees
involved, and secure authorizations from
other jurisdictions as necessary.
III. A site or plot plan, and foundation plan must
be submitted for the new site (2 sets)
IV. Plans must also be submitted for any other'
work relating to the relocated building.
V. Fees & Charges:
A. Application fee due and payable at time
of application
B. Moving permit fees due and payable upon
permit issuance
C. FEES & CHARGES TO BE CALCULATED BY
BUILDING DIVISION STAFF
'VI. FOR OFFICE USE ONLY
A. Plan check data collected
B. Copies of application to appropriate
divisions, departments and agencies
4It PERMIT VALIDATION
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PERMIT CLERK ~V\JI.-' DA
BUILDING DIVISION REPORT:
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Date
TRAFFIC DIVISION REPORT:
B'J
Date
ENGINEERING DIVISION REPORT:
By
Date
, ADDITIONAL PROJECT INFORMATION:
By
Date